Satisfaction of Malaria Patients with Care by Community Health Workers Trained in Microscopy: A Mixed-Methods Study in Palawan, the Philippines

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  • 1 Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan;
  • 2 Department of Parasitology, College of Public Health, University of the Philippines Manila, Manila, The Philippines;
  • 3 Pilipinas Shell Foundation, Inc., Puerto Princesa, The Philippines;
  • 4 Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

Palawan is the malaria-endemic province with the highest prevalence of malaria in the Philippines, and microscopists (community health workers) have been allowed to deliver early diagnosis and prompt treatment of malaria throughout the province since 1999. To improve the quality of care, the present mixed-methods study attempted to identify the factors associated with satisfaction of patients in Palawan with their microscopists by analyzing the patients’ perspectives. First, a quantitative cross-sectional study was conducted among 48 ex-patients and their nine microscopists. Ex-patients were asked about their satisfaction with care, and microscopists were asked about their job satisfaction and ability. Structural equation modeling was conducted for data analysis. Second, a qualitative cross-sectional study was performed using narrative interviews. Data were analyzed using the NVivo 10 software program. As a result, both studies revealed high patient satisfaction with microscopists. The quantitative study showed that ex-patients’ satisfaction with their microscopists was independently enhanced by two factors: high ability in malaria microscopic observation and low household wealth of the patients. Particularly, specific subpopulations (those with lower household wealth, relatively old people, and ethnic minorities) were more satisfied with the microscopists’ care. The qualitative study strengthens this finding by showing that their microscopists offered prompt and precise diagnosis and effective treatment for free. In conclusion, microscopists were shown to have an important role in narrowing the disparities in malaria care in Palawan. It is important to maintain/enhance the ability of microscopists in malaria microscopy to satisfy their patients.

Author Notes

Address correspondence to Masamine Jimba, Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan, E-mail: mjimba@m.u-tokyo.ac.jp or Shigeyuki Kano, Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan. E-mail: kano@ri.ncgm.go.jp.

Financial support: The present study was supported by grants from the National Center for Global Health and Medicine (25A2 and 30A4).

Authors’ addresses: Emilie Louise Akiko Matsumoto-Takahashi and Shigeyuki Kano, Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan, E-mails: emilie@ri.ncgm.go.jp and kano@ri.ncgm.go.jp. Pilarita Tongol-Rivera and Elena Andino Villacorte, Department of Parasitology, College of Public Health, University of the Philippines Manila, Ermita Manila, The Philippines, E-mails: ptongolrivera@yahoo.com and eavillacorte@yahoo.com. Ray Uyaan Angluben, Pilipinas Shell Foundation, Inc., Puerto Princesa City, The Philippines, E-mail: rayangluben@yahoo.com. Masamine Jimba, Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, E-mail: mjimba@m.u-tokyo.ac.jp.

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