A social network analysis on immigrants and refugees access to services in the malaria elimination context

Abstract

BackgroundThere has been significant progress in eliminating malaria in Iran. The aim of this study is to investigate the structure of inter-organizational collaboration networks in the field of unauthorized immigrants and refugees access to services in order to eliminate malaria.MethodsThis study employed social network analysis, in which nodes represented stakeholders associated with providing access of immigrants and refugees to services in the field of malaria elimination, and ties indicated the level of collaboration. This study adopted socio-centric analysis and the whole network was studied. In this regard, 12 districts of the malaria-endemic area in Iran were selected. Participants included 360 individuals (30 representatives of the organization/group in each district). The data were gathered by interview, using the levels of collaboration scale. UCINET 6 was used for data analysis. The indices of density, centralization, reciprocity, and clustering were investigated for each twelve network and at each level of collaboration.ResultsThe average density of the networks was 0.22 (SD: 0.04). In districts with a high incidence of imported malaria, the values of network density and centralization were high and the networks comprised of a larger connected component (less isolated clusters). There were significant correlations between density of network (r = 0.66, P = 0.02), degree centralization (r = 0.65, P = 0.02), betweenness centralization (r = 0.76, P = 0.004), and imported malaria cases. In general, the degree centrality and betweenness centrality of the organizations of health, district governor, and foreign immigrants’ affairs were higher. In all networks, 60% of the relationships were bilateral. At a higher level of collaboration, the centralization declined and reciprocity increased. The average of betweenness centralization index was 22.76 (SD = 3.88).ConclusionsHigher values of network indices in border districts and districts with more cases of imported malaria, in terms of density and centralization measures, can propose the hypothesis that higher preparedness against the issue and centralization of power can enable a better top-down outbreak management, which needs further investigations. Higher centrality of governmental organizations indicates the need for involving private, non-governmental organizations and representatives of immigrant and refugee groups. Recognition of the existing network structure can help the authorities increase access to malaria prevention, diagnosis, and treatment services among immigrants and refugees.Electronic supplementary materialThe online version of this article (10.1186/s12936-018-2635-4) contains supplementary material, which is available to authorized users.

A twenty-eight-year laboratory-based retrospective trend analysis of malaria in Dakar, Senegal

“…Monitoring malaria can be challenging in Africa due to the lack of basic population and health data [14,15]. Here we reported the relevance of analyzing routinely collected malaria data from laboratory registers to understand the malaria situation with regard to its trend.…”

Variation of preventive practices and its association with malaria infection in eastern Indonesia: Findings from community-based survey

“…To control malaria, the Indonesian government delivered some elimination programs through an integrated approach, particularly in endemic areas [7,8]. This integrated approach includes continuous distribution of insecticide-treated bed nets every two years in highly endemic districts, the distribution of Artemisinin combination therapy (ACT), and Insecticide Residual Spray [4,9].…”

“…The previous research regarding malaria prevention documented varied factors associated with malaria prevalence existed at individual and community level. These factors include the characteristics of participants, lack of knowledge about the availability of healthcare services, and unimproved housing [7,17]. At household-level, malaria risk factors determined by the number of inhabitants, household condition, household economic condition (income), insecticide-treated nets (ITNs) ownerships, and the ability to access healthcare facilities [17][18][19][20].…”

“…These factors include the characteristics of participants, lack of knowledge about the availability of healthcare services, and unimproved housing [7,17]. At household-level, malaria risk factors determined by the number of inhabitants, household condition, household economic condition (income), insecticide-treated nets (ITNs) ownerships, and the ability to access healthcare facilities [17][18][19][20]. Some research also shows prevention efforts at the individual level include the use of repellent, mosquitoes coil, electric rackets, and electric mosquito repellent [21][22][23].…”

Health workers’ perception of malaria rapid diagnostic test and factors influencing compliance with test results in Ebonyi state, Nigeria

“…Although earlier in 2013 and 2014, a nationwide cross-sectional survey provided some information on provider and patient perception of mRDT in Enugu, a neighbouring state in southeast Nigeria, evidence shows that Nigerian states have peculiarities and differ markedly in uptake of interventions [19,29,30]. This is evidenced in a recent study that examined the uptake of another malaria intervention in Nigeria, thus buttressing the need for state-specific information for evidence-based decision making [31]. We therefore assessed health workers’ perception of mRDT and factors influencing ACT prescription to patients with negative test results in Ebonyi state Nigeria; in order to provide state-specific support for improved management of malaria and non-malaria febrile illnesses.…”