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3 1 6
 Malariology Epidemiology
Mobile migrants in Dak Lak province making their way into a forest.
Report on results of the survey of malaria prevalence and mapping of mobilised population in Dak Nong and Dak Lak province in 2016 (Part III)

6.6. Some characteristics of mobile migrants

Table 6: The living time of the mobile populations in new settlement

Province

Dak Nong

Dak Lak

Total

District

Tuy Duc

Dak R'Lap

Buon Don

Ea Sup

Commune

Dak Buk So

Quang Truc

Dak Sin

Dak Ru

Ea Huar

Krong Na

Cu M'Lan

Cu K'Bang

n

202

202

200

200

200

200

200

200

1604

MeanSD

4,78 2,95

5,15

2,71

5,39 3,22

7,15

1,95

5,32 3,18

7,25

2,53

5,95

2,43

6,20 2,03

5,90

2,73

Min - max

0 -10

0 -10

0 -10

0 -10

0 -10

0 -9

0 -10

0 -10

0 -10

Comments: The mobilised people have been in the comunnes where research points were set up for an average period of 5.9 years, with the shortest time of about 1 month and the longest time of 10 years. Dak Buk So was the commune where mobilised people have resided in for the shortest period of 4.78 years and the longest period of 7.15 years belonged to Dak Ru commune.

Table 7: The main reasons for the people's migration

Province

Dak Nong

Dak Lak

Total

District

Tuy Duc

Dak R'Lap

Buon Don

Ea Sup

Commune

Dak Buk So

Quang Truc

Dak Sin

Dak Ru

Ea Huar

Krong Na

Cu M'Lan

Cu K'Bang

n

202

202

200

200

200

200

200

200

1604

Finding land for farming

123

60,89%

187

92,57%

142

70,50%

175

87,50%

157

78,50%

151

75,50%

182

91,00%

171

85,50%

1288

80,30%

Accompanying family

30

14,85%

7

3,47%

17

8,50%

22

11,00%

34

17,00%

48

24,00%

16

8,00%

29

14,50%

203

12,66%

Trading

12

5,94%

6

2,97%

24

12,00%

3

1,50%

3

1,50%

0

0%

1

0,50%

0

0%

49

3,05%

Hired labour

13

6,44%

0

0%

6

3,00%

0

0%

4

2,00%

0

0%

0

0%

0

0%

23

1,43%

Exploiting forest products

2

0,99%

0

0%

0

0%

0

0%

1

0,5%

0

0%

0

0%

0

0%

3

0,19%

Others

22

10,89%

2

0,99%

11

5,50%

0

0%

1

0,50%

1

0,5%

1

0,50%

0

0%

38

2,37%

Comments: The survey results showed that the people's movements was mainly due to searching land for agriculture (80.30%). Migration along with family members accounted for 12.66%; trading 3.05% and working as hired labour o­nly 1.43%. The proportion of migration for working as hired labour was very low because migrants have come to these study points to live and do business in a short time, agricultural production has not grown, leading to less demand for hiring seasonal workers like other localities in the West Highlands provinces.

 

Table 8: Main occupation of mobilised people

Province

Dak Nong

Dak Lak

Total

District

Tuy Duc

Dak R'Lap

Buon Don

Ea Sup

Commune

Dak Buk So

Quang Truc

Dak Sin

Dak Ru

Ea Huar

Krong Na

Cu M'Lan

Cu K'Bang

n

202

202

200

200

200

200

200

200

1604

Farmer

125

61,88%

195

96,54%

150

75,00%

160

80,00%

170

85,00%

168

84,00%

198

99%

167

83,50%

1333

83,10%

Hired labour

13

6,44%

0

0%

3

1,50%

7

3,50%

6

3,00%

6

3,00%

0

0%

21

10,50%

56

3,49%

Horticulturist

7

3,47%

0

0%

1

0,50%

9

4,50%

1

0,50%

1

0,50%

0

0%

5

2,50%

24

1,50%

Forest exploiter

9

4,46%

0

0%

0

0%

0

0%

0

0%

0

0%

0

0%

1

0,50%

10

0,62%

Rubber worker

0

0%

1

0,50%

3

1,50%

3

1,50%

1

0,50%

0

0%

0

0%

0

0%

8

0,50%

Seasonal worker

1

0,50%

0

0%

0

0%

0

0%

0

0%

3

1,50%

0

0%

3

1,50%

7

0,44%

Animal raiser

2

0,99%

0

0%

0

0%

0

0%

0

0%

0

0%

0

0%

0

0%

2

0,12%

Others

45

22,28%

6

2,97%

43

21,50%

21

10,50%

22

11,00%

22

11,00%

2

1,00%

3

1,50%

164

10,22%

Comments: Farming is the primary occupation of mobilised population groups, accounting for 83.10%, other rackets have made lower proportion.

Table 9: Average number of members per household and average income

Province

Dak Nong

Dak Lak

Total

District

Tuy Duc

Dak R'Lap

Buon Don

Ea Sup

Commune

Dak Buk So

Quang Truc

Dak Sin

Dak Ru

Ea Huar

Krong Na

Cu M'Lan

Cu K'Bang

n

202

202

200

200

200

200

200

200

1604

Average number of members per household

Mean

4,43

4,41

4,18

4,19

3,85

3,85

5,14

5,47

4,44

Min-max

1-11

1-11

1-7

1-12

1-10

1-8

2-10

1-10

1-12

Average income (unit: thousand dong)

MeanSD

4855

2730

1132

840

2823

1636

2996

912

1975

1547

2260

1318

1525

911

2404

1153

2498

1838

Min-max

0-10000

0-4700

0-7000

0-5000

0-5000

0-6000

0-9000

0-5000

0-10000

Comment: The average number of members per household at the study points fluctuated from 3.85 to 5.47, averaging 4.44 persons per household; the lowest membership per household was 01 and the highest was 12. The general income per capita at the study points was 2.498 thousand dong per month. Quang Truc commune has had the lowest income per capita of 1.132 thousand dong per month; the highest of 4.855 thousand dong per month has belonged to Dak Buk So commune. Besides, a number of newly-emigrating people havenot had income yet.

6.7. Activities of forest walk and border exchange of mobilised populations

Table 10: Proportion of people with forest walks and cross-border exchanges

 

Province

Dak Nong

Dak Lak

Total

District

Tuy Duc

Dak R'Lap

Buon Don

Ea Sup

Commune

Dak Buk So

Quang Truc

Dak Sin

Dak Ru

Ea Huar

Krong Na

Cu M'Lan

Cu K'Bang

n

202

202

200

200

200

200

200

200

1604

Have they had forest walks and cross-border exchanges?

Yes

134

66,34%

196

97,03%

130

65%

73

36,50%

129

64,50%

100

50,00%

131

65,50%

99

49,50%

992

61,85%

No

68

33,66%

6

2,97%

70

30%

127

65,50%

71

35,50%

100

50,00%

69

34,50%

101

50,50%

612

38,15%

Comment: The average percentage of people going into the forest and crossing border at the study points was 61.85% with the highest of 97.03% in Quang Truc commune and the lowest of 36.50% in Dak Ru commune. The percentage of people without forest-related activities and border exchanges was 38.15%.

 

Table 11: The frequency of going into the forest/mountain field and average period of sleeping o­n the field-huts forest

Province

Dak Nong

Dak Lak

Total

District

Tuy Duc

Dak R'Lap

Buon Don

Ea Sup

Commune

Dak Buk So

Quang Truc

Dak Sin

Dak Ru

Ea Huar

Krong Na

Cu M'Lan

Cu K'Bang

Frequency of going into the forest/mountain field (unit: day per time)

n

134

196

131

73

129

100

131

99

993

MeanSE

3,38

0,87

5,10

0,94

3,74

3,55

2,61

0,09

6,46

1,02

2,01

0,30

2,04

0,10

2,46

0,33

3,70

0,27

Min-max

0-60

1-60

1-60

1-5

1-60

1-30

1-7

1-30

0-60

Average period of sleeping o­n the field-huts forest

n

134

196

131

73

129

100

131

99

993

MeanSE

1,40

0,42

1,41

0,23

1,63

0,23

1,58

0,08

1,83

0,24

0,87

0,15

0,94

0,09

0,86

0,81

1,33

0,09

Min-max

0-30

0-15

0-20

0-4

0-20

0-11

0-6

0-5

0-30

Comment: The general frequency of people's forest walks or the average period after that people went into the forest/mountain fields again at all study point was 3.70 days per time. The lowest frequency was 0, i.e. going into the forest/mountain fields daily and not staying overnight o­n the field-huts. The highest frequency was 60 days, i.e. people go into the forest/mountain fields 2 months per time. The average period people stayed overnight o­n the field-huts at the study pointswas 1.33 days. The lowest period is 0, i.e. people did not sleep o­n the field-huts; the highest period was 30 days, i.e. people going into the forest for agricultural work for o­ne month and then returning home.

Table 12: Proportion of bed-net usage in mobilised groups

Province

Dak Nong

Dak Lak

Total

District

Tuy Duc

Dak R'Lap

Buon Don

Ea Sup

Commune

Dak Buk So

Quang Truc

Dak Sin

Dak Ru

Ea Huar

Krong Na

Cu M'Lan

Cu K'Bang

n

202

202

200

200

200

200

200

200

1604

Level of coverage (how many people per net?)

Mean

1,75

2,15

1,50

1,14

1,73

1,55

1,68

1,68

1,65

Usage rate of bed-nets

Bed-net use

178

88,12%

177

87,62%

143

71,50%

135

67,50%

155

77,50%

146

73,00%

166

83,00%

140

70,00%

1240

77,31%

Non-use

24

11,88%

25

12,38%

57

28,50%

65

32,50%

45

22,50%

54

27,00%

34

17,00%

60

30,00%

364

22,69%

Are bed-nets taken with people as going into the forest?

Yes

24

17,91%

57

29,08%

90

69,23%

60

82,19%

114

88,37%

53

53,00%

70

53,44%

65

65,66%

533

53,73%

No

110

82.09%

139

70.92%

40

30.77%

13

17.81%

15

11.63%

47

47.00%

61

46.56%

34

34.34%

459

46.27%

Types of nets taken with people as going into the forest

Bed-net

24

100%

55

96,49%

78

85,71%

60

100%

107

93,04%

45

84,91%

66

94,29%

63

96,92%

498

93,08%

Hammock & hammock net

0

0%

0

0%

9

9,89%

0

0%

2

1,74%

8

15,09%

4

5,71%

2

3,08%

25

4,67%

Both

0

0%

2

3,51%

4

4,40%

0

0%

6

5,22%

0

0%

0

0%

0

0%

12

2,24%

Comment: The general level of bed-net coverage in the communes was 1.65 people per net. The highest coverage level of 1.14 people per net was of Dak Ru commune, the lowest of 2.15 people per net was of Quang Truc commune.

The general rate of bed-net usage at the study points was of 77.31%. The highest usage rate belonged to Dak Buk So commune (88.12%) and the lowest was of Dak Ru commune (67.50%).

Among the people having forest walks and cross-border exchanges, those taking their bed-nets for usage accounted for 53.73%, and the rest 46.27% without taking bed-nets. Among those bringging bed-nets to use when going into the forest and crossing border, 93.08% brought bed-nets, 4.67% brought hammocks and hammock nets, and 2.24% brought bed-nets and hammocks with attached hammock nets.

6.8. Several factors related to the malaria control of mobilised populations

Table 13: Awareness about the causes of malaria

Province

Dak Nong

Dak Lak

Total

District

Tuy Duc

Dak R'Lap

Buon Don

Ea Sup

Commune

Dak Buk So

Quang Truc

Dak Sin

Dak Ru

Ea Huar

Krong Na

Cu M'Lan

Cu K'Bang

n

202

202

200

200

200

200

200

200

1604

Have the people heard information about malaria control?

Yes

178

88,12%

174

86,14%

143

71,50%

109

54,50%

174

87,00%

113

56,50%

114

57,00%

111

55,50%

1116

69,58%

No

24

11,88%

28

13,86%

57

28,50%

91

45,50%

26

13,00%

87

43,50%

86

43,00%

89

44,50%

488

30,42%

Have the people known the cause of malaria

Yes

172

85,15%

169

83,66%

127

63,50%

115

57,50%

135

67,50%

116

58,00%

152

76,00%

125

62,50%

1111

69,26%

No

30

14,85%

33

16,34%

73

36,50%

85

42,50%

65

32,50%

84

42,00%

48

24,00%

75

37,50%

493

30,74%

Comment: The general percentage of the people's access to malaria control information in the communes was 69.56%. The general proportion of people knowing the cause of malaria at the study points was 69.26% ,with the lowest 58.00% in Krong Na commune and the highest 85.15% in Dak Buk So commune. The general percentage of people having no knowledge about the cause of malaria was 30.74%.

Table 14: The people's behavior when they were suspicious of malaria infection

Province

Dak Nong

Dak Lak

Total

District

Tuy Duc

Dak R'Lap

Buon Don

Ea Sup

Commune

Dak Buk So

Quang Truc

Dak Sin

Dak Ru

Ea Huar

Krong Na

Cu M'Lan

Cu K'Bang

n

202

202

200

200

200

200

200

200

1604

Place to go for treatment as having doubt about malaria infection

Health facilities

189

93.56%

196

97.03%

137

68,50%

173

86,50%

159

79,50%

172

86,00%

168

84,00%

184

92,00%

1378

85,91%

Village health station

1

0.50%

3

1.49%

5

2,50%

21

10,50%

3

1,50%

7

3,50%

21

10,50%

25

12,50%

86

5,36%

Herbalist

0

0%

5

2.48%

2

1,00%

3

1,50%

1

0,50%

4

2,00%

5

2,50%

6

3,00%

26

1,62%

Private pharmacy

10

4.95%

27

13.37%

46

23,00%

39

19,50%

32

16,00%

29

14,50%

38

19,00%

36

18,00%

257

16,02%

Private clinic

1

0.50%

9

4.46%

2

1,00%

4

2,00%

6

3,00%

3

1,50%

0

0%

1

0,50%

26

1,62%

Reason for not going to health facilities as having doubt about malaria infection

n

13

6

63

27

41

28

32

16

226

Far away from home

10

76,92%

5

83.33%

44

69.84%

8

29.63%

22

53.66%

18

64.29%

11

34.38%

6

37.50%

124

54.87%

No money

3

23.08%

1

16.67%

19

30.16%

19

70.37%

19

46.34%

10

35.71%

21

65.63%

10

62.50%

102

45.13%

Comment: Most of the people (85.91%) chose to go to health services when they were suspicious of malaria infection. Among those who didnot choose to come to public health services as infected by suspected malaria, 54.87% pleaded difficult travel conditions, and 45.13% said they had no money, it's probably that these people have just emigrated there because they havenot known that they are tested for malaria freely and antimalarials are delivered free of charge.

Table 15: Channels of malaria control information

Province

Dak Nong

Dak Lak

Total

District

Tuy Duc

Dak R'Lap

Buon Don

Ea Sup

Commune

Dak Buk So

Quang Truc

Dak Sin

Dak Ru

Ea Huar

Krong Na

Cu M'Lan

Cu K'Bang

Information channels disseminating malaria control among the people

n

178

174

143

109

174

113

114

111

1116

Health workers

139

78,09%

135

77,59%

95

66,43%

101

92,66%

116

66,67%

83

73,45%

96

84,21%

99

89,19%

864

77,42%

Television

74

41,57%

36

20,69%

42

29,37%

16

14,68%

60

34,48%

25

22,12%

26

22,81%

9

8,11%

288

25,81%

Neighbour

98

55,06%

23

13,22%

41

28,67%

3

2,75%

51

29,31%

15

13,27%

17

14,91%

38

34,23%

268

24,01%

Relatives

10

5,62%

20

11,49%

27

18,88%

13

11,93%

40

22,99%

11

9,73%

25

21,93%

4

3,60%

150

13,44%

Radio

25

14,04%

14

8,05%

36

25,17%

1

0,92%

28

16,09%

10

8,85%

17

14,91%

12

10,81%

143

12,81%

Newspaper

10

5,62%

10

5,75%

23

16,08%

1

0,92%

24

13,79%

4

3,54%

8

7,02%

0

0%

80

7,17%

Pharmacist

0

0%

3

1,72%

10

6,99%

17

15,60%

54

31,03%

1

0,88%

25

21,93%

5

4,50%

64

5,73%

School

6

3,37%

15

8,62%

7

4,90%

0

0%

13

7,47%

13

11,50%

1

0,88%

3

2,70%

58

5,20%

Billboard/ posters/ leaflets

7

3,93%

2

1,15%

29

20,28%

0

0%

1

0,57%

12

10,62%

0

0%

6

5,41%

57

5,11%

Comment: Of those who have the access to malaria control information, 77.42% heard of that from medical staff, 25.81% from television, 24.01% from neighbours, 13.44% from relatives, 12.81% from radio. Information channels such as newspapers, pharmacists, schools, billboards/ posters/ leaflets accounted for lower proportion.

Table 16: Practice of malaria control measures

Province

Dak Nong

Dak Lak

Total

District

Tuy Duc

Dak R'Lap

Buon Don

Ea Sup

Commune

Dak Buk So

Quang Truc

Dak Sin

Dak Ru

Ea Huar

Krong Na

Cu M'Lan

Cu K'Bang

n

172

169

127

115

135

116

152

125

1111

Bed-net usage

178

88,12%

177

87,60%

143

71,50%

135

67,50%

155

77,50%

146

73,00%

166

83,00%

140

70,00%

1240

77,31%

Insecticide impregnation

35

20,35%

11

6,51%

29

22,83%

15

13,04%

13

9,63%

13

11,21%

26

17,11%

1

0,80%

143

12,87%

Others

26

15,12%

 

18

10,65%

9

7,09%

5

4,35%

10

7,41%

4

3,45%

13

8,55%

9

7,20%

94

8,46%

Comment: The interview results showed that people mostly chose two main antimalarial measures for themselves and their families including sleeping under bed-nets (77.31%) and spraying insecticides (12.87%). Other malaria control measures accounted for 8.46%.

Table 17: Construction of the people's housing

Province

Dak Nong

Dak Lak

Total

District

Tuy Duc

Dak R'Lap

Buon Don

Ea Sup

Commune

Dak Buk So

Quang Truc

Dak Sin

Dak Ru

Ea Huar

Krong Na

Cu M'Lan

Cu K'Bang

n

202

202

200

200

200

200

200

200

1604

Simple

140

69,31%

192

95,05%

158

79,00%

170

85,00%

166

83,00%

191

95,50%

186

93,00%

197

98,50%

1400

87,28%

Solid

62

30,69%

10

4,95%

42

21,00%

30

15,00%

34

17,00%

9

4,50%

14

7,00%

3

1,50%

204

12,72%

Comment: o­nly 12.72% of the respondents have lived in solidly-built houses and 87.28% of them in simple housing.

VII. General comments:

- The infection level of malaria parasites among mobile populations is now low with the general rate of malaria parasites infection of 0.25%; the general rate of gametocytes infection is 0.19%. Malaria parasite cases were all detected in Quang Truc commune, other research points didnot detect any case of malaria parasite infection. This is also reflected by the retrospective data of malaria patients at the study sites, which showed that malaria patientshad declined continuously and fallen sharply from 2013 to 2016, particularly in Quang Truc commune there were fluctuations in malaria patients in 2016 compared to 2015.

- Mobilised populations had lived in all three regions nationwide including the North, Central and South with nearly 50 provinces and cities recorded before emigrating to the research points. Some northern provinces with high rate of migrants are Cao Bang, Thai Binh, Hai Duong. The Central region includes provinces such as Thanh Hoa, Nghe An, Binh Dinh. The South and Southeast region includes Binh Phuoc, Dong Nai. The West Highlands has often seen the movements of mobilised people back and forth between Dak Lak and Dak Nong and from some other areas in these provinces.

- The new residence locations of mobile populations were also very diverse. In some study points, the migrantshave gathered and lived close to each other, forming residential areas such as Cu M'Lan andCu K'Bang commune. Some other research points saw the migrants' scattered settlements across communal areas, or some peoplemigrated to forestal areas near Cambodian-Vietnamese border to settle, such as in Quang Truc commune.

- The ethnic group compositions ofmobilized populations were varied. However, the Kinh people made up a high percentage of more than 54.11%, and distributed over most of the study sites. Other ethnic minority groups accounted for lower rate and also equally distributed over the study sites, except thatthe two ethnic minorities groups of H'Mong and Dao have distributed mainly in Cu K'Bang commune (H'Mong) and Cu M'Lan commune (Dao), which have formed large residential clusters. The main purpose of the people's migration were to find land for agriculture, which accounted for 80.33% and their main jobs have mainly based o­n agriculture. Each of them has earned about 2.5 million Vietnam dong per month on average, but income is not equal among respondents, while some newcomers havenot had income because of having no cultivated land yet, the others who could afford o­ne or some pieces of land have had relatively stable income and some othershave had income thanks to trading and working as hired labour. Most of the people's housing is of simple contruction, accounting for 87.28%. The mobilized populations were nearly in all of the age groups and also in the fairly uniform distribution of gender.

- 80.33% of the people did farming as a main job, but 61.85% of them did activities relating to forest walks and cross-border exchanges, while the rest did cultivation at home. The frequency of sleeping o­n the field-huts was 3.7 days per time and the period of staying overnight there was 1.3 days. In particular, there were cases staying there for about o­ne month. When sleeping o­n the field-huts, 53.73% of the people used the nets which were mostly bed-nets, a 4.67% lower rate of them used hammocks with attached hammock nets and 2.24% used both bed nets and hammock nets.

- The practice of bed-net use among mobilized populations: the level of bed-net coverage in the community was 1.65 people per net, the proportion of bed-net using people was of 77.31. With the investment of the National Malaria Control and Elimination Programme and other projects of Global Fund, RAI, ADB the people were fully allocated bed-nets, so the bed-net coverage level in the population was fairly high; however, the proportion of bed-net usage, o­nly 77.31%, wasnot high. Otherwise, the rate of using bed-nets as staying overnight o­n the field-huts was relatively low, so in order to improve this ratio, it is very necessary to enhance the propaganda of bed-net usage for the people when they stay at home, especially as going into the forest and crossing border.

- A number of other factors related to the people's behavior of malaria control: 69.58% of people could get access to the anti-malarial information and up to 85.91% of these people received the information primarily through medical personnel and public health facilities where they went to for treatment as having suspected malaria.

Mobile migrants might be at high risk of contracting malaria due to their occupations, working,
for instance, forest walks and cross-border exchanges. Photo: a temporary migrant settlement
in a forest area of Dak Nong province.

VIII. Recommendations:

- To strengthen the health education and communication o­n malaria control for mobilised population groups, especially to raise their awareness about using bed-net while sleeping.

- To enhance investment and training in malaria control for communal health network so as to better serve the early diagnosis and treatment of malaria and the management of malaria patients at localities.

- To expand the investigation scope of mobilised populations to other areas in order to set up the most complete map of mobilised populations for highly effective control of malaria.

 

02/06/2017
Written by Dr. Ho Van Hoang
Translated by Huynh Thi An Khang
 

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