Addressing Malaria Amongst Migrants, Mobile Populations and Mobility Impacted Communities in Cambodia, Lao PDR and Myanmar

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1 Addressing Malaria Amongst Migrants, Mobile Populations and Mobility Impacted Communities in Cambodia, Lao PDR and Myanmar TA-8959 REG: Mobile and Migrant Populations Dr. Montira Inkochasan International Organization for Migration Regional Office for Asia and the Pacific

2 MMP MALARIA PROJECT OVERVIEW Objectives: To strengthen access to care for vulnerable populations that are not reached by the current health systems. TA focuses on: - Increasing access to malaria prevention, testing, and treatment for MMPs, and - Strengthening regional coordination on malaria and communicable disease control (GMS).

PROJECT IN CAMBODIA: Oddor Meanchey Province Anlong Veng District Cover 81 villages; 5 health centers igh malaria cases * igh number MMPs (mainly local, Thai

villages; 10 health centers Low malaria cases* igh number of MMPs, mainly from other districts, provinces, and local MMPs Shares borders with Chong Kal and

3 PROJECT IN CAMBODIA: Oddor Meanchey Province Anlong Veng District Cover 81 villages; 5 health centers igh malaria cases * igh number MMPs (mainly local, Thai and Vietnamese) Shares borders with Samraong and Chhong Kal Districts, Siem Reap Province and Sisaket Province of Thailand Banteay Ampil District Cover 97 villages; 10 health centers Low malaria cases* igh number of MMPs, mainly from other districts, provinces, and local MMPs Shares borders with Chong Kal and Samraong Districts, Banteay Meanchey Province and Buriram Province of Thailand = Vector control = IEC/BCC eavily forested area Flat area 5 military camps 5 military camps

PROJECT IN LAO PDR: Champasak and Attapeu Provinces Khong District, Champasak Province Cover 22 villages of Nafang health zone and Nakasang

Cover 6 villages of Viengxai health zone and Phoukeua health zone igh number of MMPs Lao migrants and cross border migrants (Vietnamese)

4 PROJECT IN LAO PDR: Champasak and Attapeu Provinces Khong District, Champasak Province Cover 22 villages of Nafang health zone and Nakasang health zone igh number of MMPs Lao migrants and cross border migrants (Vietnamese, Cambodian, Chinese) Phouvong District, Attapeu Province Cover 6 villages of Viengxai health zone and Phoukeua health zone igh number of MMPs Lao migrants and cross border migrants (Vietnamese) International border check point with Cambodia Nongnokkhiene International Border Checkpoint Military camp with staff that take turns on duty along the border and forests. Lao Loum ethnicity (the main host community) International border check point with Viet Nam Phoukeua International Border Checkpoint Military camp with staff that take turns on duty along the border and forests. Khamu ethic minority (the main host community)

PROJECT IN MYANMAR: Mon State and Sagaing Region Bilin, Kyaiktyo Townships, Mon State igh number of MMPs internal migrants and source

moving into pre-elimination phase Multiple malaria partners but working in villages, not worksites Private Sector willing to be engaged Non

production (6 sites), Gold mine (3 sites), other plantation (2 sites) kamti Township, Sagaing Region igh number s of MMPs (10-25% of

2016 Lack of supporting partners working on malaria.

5 PROJECT IN MYANMAR: Mon State and Sagaing Region Bilin, Kyaiktyo Townships, Mon State igh number of MMPs internal migrants and source communities for international migrants to Thailand Rubber Plantations, small scale gold mines, road construction Medium malaria burden, but moving into pre-elimination phase Multiple malaria partners but working in villages, not worksites Private Sector willing to be engaged Non State Actor areas Identification of worksites: Bilin identified 4 sites Kyaikto identified 22 sites Rubber plantation (15 sites), Stone production (6 sites), Gold mine (3 sites), other plantation (2 sites) kamti Township, Sagaing Region igh number s of MMPs (10-25% of population) internal migrants to work in mining operations Mining is prominent industry Jade, Amber, Gold igh malaria burden, 3 deaths in 2016 Lack of supporting partners working on malaria. Private sector requires significant engagement Access challenges with seasonal flooding Identification of worksites: kamti identified 26 sites; Jade mines (13 sites in Nan Si Pon area, 3 sites in Nat Maw area), Amber mines (4 sites), Road construction (6 sites)

6 PROJECT STAKEOLDERS Country ealth Sector Non-health Sector Private Sector Cambodia Lao PDR Myanmar MO CNM PD of Oddor Meanchey Province WO MO CMPE PD (Champasak and Attapeu) DO (Khong and Phouvong) WO MOS NMCP State ealth Department (Mon State, Sagaing Region) Township ealth Department Department (Kyaiktyo, Bilin, kamti) Department of Labour and Vocational Training (DoLVT) Department of Public-Works and Transport (DoPWT) Department of Water Resources and Meteorology Department of Woman Affairs Department of Planning Department of Rural Development Department of Mines & Energy Department of Agriculture Forestry and Fisheries Military Region 4th Ministry of Labour and Social Welfare Ministry of Agriculture and Forestry Ministry of Security (Immigration) Ministry of Natural Resources and Environment Lao Federation of Trade Union Military Camp Township Mining Offices Ministry of Immigration, Labour and Population Ministry of Natural Resources and Environment General Administration Department *** Project stakeholders have been involved in project planning, implementation and M&E through regular meetings, workshops and joint implementations of some activities. Rubber plantations Gold, charcoal mines Logging/timber cutting on land concession Vietnamese Agriculture Company Mobile and fixed venders: Lao and Vietnamese Restaurant and motorbike shop repair Dam construction company Private Sector Worksites Rubber Plantations Rubber Plantation Association Mining operations

7 DEFINITION: Mobile and Migrant Population IOM DEFINITION OF MIGRANT: Any person who is moving or has moved across an international border or within a State away from his/her habitual place of residence, regardless of (1) the person s legal status; (2) whether the movement is voluntary or involuntary; (3) what the causes for the movement are; or (4) what the length of the stay is. OPERATIONAL DEFINITION FOR MALARIA INTERVENTIONS Population Type Residing Time Movement Type Migrant Type Mobile < 6 months (CA, LA) Circulation Internal (CA, LA) Cross border (LA) Migrant 6 months to 1 year (CA) 6 months up (LA) Migration Internal (CA, LA) Cross border (LA)

8 MALARIA PROJECT SITE SYSTEM WORKFLOW training of VV, PE training of VV and PE on malaria, health education, RDT according to existing CMPE/CNM/NMCP guidelines practical orientation for RDT testing, treatment, awareness, education, reporting ealth education +awareness mobilisation of VV and PE for malaria awareness and education orientation on RDT provider and services arrangements for malaria awareness and education in communities and reporting LLIN and protective distribution procurement/mobilisation of LLIN stocks from CMPE/CNM/NMCP assessment and planning by project team, VV and PE distribution together with health education activities follow up and monitoring of usage malaria testing and treatment RDT providers equipped with RDT 24 hours availbillity of onsite QA process for RDT tests established referral to health facilities for treatment regular reporting to PC, DO monthly coordination meetings with DO/MO incorporation of data into DO/MO reporting data Follow up and supportive supervision regular visit by IOM project staff updates of any techincal changes link with DO/MO and data monitoring actions

ADVOCACY AND CONSULTATIVE MEETING/WORKSOP Consultative Workshop, 42 participants from participants from

based association, all checkpoint representatives and private sector.

participants from 7 potential partner ministries MO (DCDC, CMPE), MOPS, MOLSW, MOPI, MOAF, LFTU

9 ADVOCACY AND CONSULTATIVE MEETING/WORKSOP Consultative Workshop, 42 participants from participants from 33 potential partner provincial departments present including CNM, district governor, military faith based association, all checkpoint representatives and private sector. 9 participants from NGO ealth Partners, Siem Reap, Cambodia, 18/11/16 Consultative Workshop, 37 participants from 7 potential partner ministries MO (DCDC, CMPE), MOPS, MOLSW, MOPI, MOAF, LFTU represented national, provincial and district levels, Pakse, Lao PDR, 01-02/09/16 Advocacy Meeting with private sectors and government in kamti, Myanmar, 19/05/17

10 MALARIA VULNERABILITY ASSESSMENT AND MAPPING Distribution of health facilities and services in Banteay Ampil and Anglong Veng, 2017 OSPITAL EALT CENTER CONSULTATION ROOM VMW S OUSE MALARIA POST

TRAINING of Village ealth Volunteers & Peer Educators

training, and 12 in Phouvong, Lao PDR, July 2017 Training

Bilin trainings, and 26 in kamti, Myanmar, May 2017

context of malaria elimination among MMPs for conduct

11 TRAINING of Village ealth Volunteers & Peer Educators Training of VV and PE, 18 participants in Phouvong training, and 12 in Phouvong, Lao PDR, July 2017 Training of worksite volunteers, 26 participants in Kyaikto and Bilin trainings, and 26 in kamti, Myanmar, May 2017 Cambodia: o Updating the existing training curriculum in context of malaria elimination among MMPs for conduct training to Village Malaria Worker/Mobile Malaria Worker in project target areas.

12 EALT EDUCATION AND BCC ACTIVITIES Number of Migrants and Mobile population in Khong District, Champasak Province, Jan.-Sept Forest goer Mobile population Migrant Example of IEC materials: Posters

13 LLIN AND MOSQUITOES PROTECTIVE GEAR DISTRIBUTION Cambodia: IOM procured 3,000 LLINs with a good quality, they were delivered in Cambodia in late October LLINs distribution plan was made and agreed by both PD and IOM. LLINs will be distributed to MMPs hotspot and mobile population by OMC-PD with cooperation with IOM. Lao PDR: LLINs were disseminated by CMPE. IOM Project procured following protective gears for disseminating to MMPs and forest goers in Khong and Phouvong Districts. 950 hammock nets 6,000 mosquito coils 4,000 mosquito repellent-spray 4,000 mosquito repellent-patch Myanmar: Received donation of 6,000 LLINs from NMCP on 24/5/17 Conducted bed net survey in June Plan to distribute 4,200 in kamti and 1,800 in Kyaito and Bilin Already started distribution at worksites.

Malaria have been trained to VV as a part of

2500 2000 Myanmar: RDT and Treatment ADB

September 2017) by Township 2073 1500 1279

14 MALARIA TESTING AND TREATMENT Patient Assessment, Diagnosis and Treatment for Malaria have been trained to VV as a part of training for VV and PE Myanmar: RDT and Treatment ADB Malaria tested and treated cases (June to September 2017) by Township Bilin Kyeikto Khamti Total Total Tested Pf and Mix Pv

15 KEYS TO SUCCESS FOR WORKING ON MALARIA AND MMP STAKEOLDERS AND PARTNERS - Key stakeholders in implementing areas - Oddor Meanchey: Min. of National Defense and Military Region 4 - Khong and Phouvong: Military, community leaders, dam coordinator, mobile venders - Bilin, Kyaiktyo, kamti: Private sector/companies - MO and CNM/CMPE/NMCP - Non-health Sector - ost Communities RESOURCES AND SUPPLIES - Capacity of local government and malaria staff >> strengthen - Adequate and proper supplies - Vector control - ITC - IEC materials in migrant languages - DO NOT ASSUME! Basic knowledge on malaria and infrastructure is still needed in remote areas. - CONSIDER CULTURAL SENSITIVITY & LOCAL CONTEXTS Note that: - National legal framework may not support migrants to access to health services, especially cross border migrant. - MMP are not included (or limited included) in national health systems, i.e. surveillance, LLIN distribution, reporting system.

16 LONG TERM DEVELOPMENT

17 TANK YOU For more information please contact:

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