Mobile migrants in Dak Lak province making their way into a forest.

6.6. Some characteristics of mobile migrants

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

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

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

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

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

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

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

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

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

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

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

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

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.

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