A total of 102 household visits were conducted in this study in which composed of 65 migrant families in Bamauk and 37 in Shwegyin. Most of them were working age group and male predominant (Table 1). Very few migrants were living with family while most were living with other migrants together at the temporary camp. More than one-third of the migrants in Bamauk, malaria controlled areas, and nearly one-fifth of the migrants in Shwegyin, malaria (pre)elimination areas, had a known history of malaria within five years. More than half of them agreed they have a risk of malaria (Table 1).
Among the health facilities, the most popular included drug sellers, quacks, rural health centers, and private clinic while malaria volunteers were not mentioned although nearly all nearby villages have the volunteer for diagnosis and treatment of malaria (Table 2). Although almost all families had the bed net, less than one-third in Bamauk and about 40 percent in Shwegyin used it regularly. Interestingly, most of them were unable to mention the benefits on the use of LLINs (Figure 2). The reasons for not utilization of the bed net included too hot inside the net, dislike to use, and nature of the work. More than one-third of the families complained that their nets had holes or damage. Only half of them used the bed net last night before the household survey (Table 2). Moreover, more than 30 percent in Bamauk and 15 percent in Shwegyin lacked knowledge on the benefit of the LLINs (Figure 2). Only 57.9% of the migrant in Shwegyin and 68.3% in Bmanuk were using the Long-lasting Insecticidal treated bed nets (LLINs) regularly although utilization of any bed net is high (91.0% in Shwegyin vs 79.9% in Bamauk). More than 80% (85.4% in Bamauk and 88.9% in Shwegyin) said that they did not receive any health education session or activity for the prevention of malaria within the last two years.
During household visits, misuse of the distributed LLINs was assessed. The use of the LLINs for animal farms, plant covers, and fence of the housing were noted in 4 households in Bamauk and 5 households in Shwegyin (Figure 3).
Qualitative findings
One of the migrant workers in gold-mine said
"We know that malaria is caused by the bite of mosquitoes and it can be prevented by insecticidal bed net. But I got this message while I was staying in my native town, not here. In this migrant site, no health care person comes and gives information about malaria”
At the same time, one man (38 yr old) said that
"In my previous place, there are many posters and bill-board on the side of the road. Here, there is no bill-board nor poster. It would be better to have a similar board near-by gold mine or our place so that we can know the information"
One of the local health staff pointed out that
"There is no specific budget allocation for behavior change communication (BCC) in this area. We have a very old vinyl poster presented at the front of the hospital. We need specific support for information, education, and communication (IEC) materials to improve the BCC of the migrants"
One migrant woman complied on the distribution and ownership of the LLINs as follows,
"We got no insecticide-treated net from local health centers here, but we have the bed nets that were carried from our previous place"
Local community leader explained the challenges of the health-related activities in their places as
"Migrants peoples are moving one place to another place without prior notice. Moreover, some are working 48 hours continuously in the underground mine, followed by 48 hours rest. So, it is difficult to meet and give proper health education"
Moreover, one worker said that
"We have received the nets, but we don't know what is it exactly. So, we used it at night, and become a red rash appeared on face and hand. We were afraid to use the net. Then, we do not use until now"