The Importance of Building Community Trust for Sustained Malaria Elimination Interventions During Unforeseen Major Disruptive Events Such as COVID-19: A Cambodia Case Study

Abstract Background Impressive progress in reducing malaria trends combined with the 2018 report of no malaria related deaths for the first time, puts Cambodia well on track to reaching its malaria elimination goals. However, the novel coronavirus SARS-CoV-2 (COVID-19) pandemic presents a potential challenge to this goal. The path towards malaria elimination is dependent on sustained interventions to prevent rapid resurgence, which can quickly set back any gains achieved. Methods Mobile Malaria Workers (MMWs) need to have a strong understanding of the local geography and, most importantly, build and maintain trust among the communities they serve. To achieve this, Malaria Consortium uses a peer-to-peer approach for the MMWs and ensures the same level of trust operates between the MMWs and Malaria Consortium. Malaria Consortium’s policy during COVID-19 has been to follow national guidelines while continuing to support community-based malaria services via the MMWs / mobile malaria posts (MPs) with as minimal disruption as possible. A risk assessment was carried out by Malaria Consortium, with a mitigation plan quickly developed and implemented, to ensure MMWs were able to continue providing services without putting themselves or their patients at risk. Results Malaria Consortium ensured the MMW/ mobile MP program is built on trust, relevance to, and connection with the communities being served. An overall decline in malaria testing was reported from Health Centres and VMWs among all three provinces in March and April, not seen in previous years and possibly attributable to fear of COVID-19. However, Malaria Consortium supported MMWs have not reported any such decline in the utilization of their services and attribute this to the trust they have among the communities. Conclusion Malaria Consortium has effectively demonstrated care and solidarity with and among the MMWs and communities being served. This has ensured a high level of trust, and therefore willingness among the MMWs and communities to continue providing and utilising malaria services as usual despite the fear of COVID-19. Building trust among rural communities builds resilience and ensures uninterrupted and effective malaria elimination activities can continue even during a potential extraneous disruptive force, such as the Covid-19 pandemic.