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JOURNAL OF SCIENCE, Hue University, N0 61, 2010COMMUNITY ACTION TO SUPPORT MALARIA CONTROL IN.TRADITIONAL VILLAGES IN HUONG HOA DISTRICT, QUANG TRI.PROVINCE, VIETNAM.Ho Sy Quang.Medical Committee Netherlands-Vietnam.E. Pamela Wright.Hanoi, VietnamSUMMARY.The Vietnamese government has been implementing a national malaria control program.for many years. The program uses several effective strategies but the burden of malaria in poor.and remote communities has not yet reduced. The reasons include reluctance on the part of.some communities, especially ethnic minorities, to use bed nets and change their customary.routines. MCNV supported a community-managed health approach in Huong Hoa,Quang Tri, in.which the villagers themselves identified malaria as a health problem and undertook changes to.reduce their risk. In this report, the activities of villages in the program are compared with those.in villages not involved in the program. Methodology:This was a cross-sectional study in.combination of quantitative and qualitative methods. Four communes in Huong Hoa district,.two with and two without the community-managed health development (CMHD) intervention.program were involved in the study. Results: Significant differences between the CMHD and.non-CMHD communities were found in the levels of new activities undertaken, including.negotiation with authorities for additional bednets, the behavior change for reducing risk of.malaria, and people’s confidence for addressing the malaria problem. In all of these cases, the.CMHD communities were more active than the communities receiving only the NMCP.interventions. Conclusions: The CMHD intervention could empower to change the traditional.routines of the people in the mountainous area. CMHD using participatory planning could also.lead to an effective health promotion, and better functioning of the existing "vertical" programs.1. Introduction.Vietnam has been praised for its successful fight against malaria over the years,.reducing morbidity by 60% and mortality by 97% between the peak in 1991 and a.decade later. The good results have been maintained through the National Malaria.Control Program (NMCP) (Erhart, et al, 2004; Hung et al, 2002; Schuftan, 2000)However, in 2007 Vietnam still had more than almost 15,000 registered cases of malaria.and 20 fatalities (WHO Western Pacific Country Profile, 2009). According to the NMCP,.375.half of these cases, more than 90% of the severe cases and 95% of the deaths occur in.the Central Highlands. These areas have been economically attractive for migrants from.other endemic areas, thereby maintaining transmission and re-introduction (Erhart A et.al, 2005). Vietnam shares borders there with Laos and Cambodia, which are both highly.endemic for malariaThe NMCP is managed by the National Institute for Malariology, Parasitology.and Entomology in Hanoi, and operates through a wide network reaching to the villagesThe responsibility for the program is divided between the health services, which have to.provide good prevention, diagnostic and treatment services, and the community, which.has to use the bed nets provided and be actively involved in other prevention measuresOne obstacle to successful control in the Central Highland areas was reported to be that.villagers did not fully practice the interventions recommended by the NMCP. Another.approach was needed, and community-based approaches have proven to be successful in.other areas of the world in empowering the people and by that, raising their health statusIn the mountainous district of Huong Hoa in Quang Tri province, the Medical.Committee Netherlands-Vietnam (MCNV) introduced a program of communitymanaged health development (CMHD), aimed at empowering the village people to.improve their own health by changing their living conditions. Such a program could.supplement the national malaria control strategies for more effective malaria controlCMHD program is a dynamic bottom-up process aimed at i