Table 2 Illustrative statements of the study participants during FGDs and IKIs

ASHAs

“During MEDP period, people called MEDP workers when they felt sick. However, we had never informed so that we lost our incentives and discouraged”

“These workers were most popular in the community due to their prompt availability and better quality of service delivery. Most of the time community preferred to contact MEDP workers for seeking treatment of fever which caused losses of incentive paid to us for our services towards malaria diagnosis and treatment”

“ASHAs are working for various health program delivery, and have overburden. MEDP workers helped in diagnosis and treatment of fever cases and pulse, polio, covid vaccination program. MEDP workers also helped in distribution of LLIN and monitoring of regular use of bednet and IRS work”

“MEDP has been provided printed literature in local language ‘Hindi’ and images related to malaria etiology, preventive measures, diagnostic methods, treatment dose chart according to the malaria species. MEDP also provided intensive training on malaria diagnosis and treatment to the ASHAs of the district”

Community members

 Female

“During MEDP period we got the treatment at our door step. Now when MEDP was closed we didn't get the facility inside the village and visiting Mandla which is about 35 km away as we have no other option and it not only expensive but also time consuming. Most of the time two or three visits are required for getting complete treatment”

“They always asked for our wellness even when they found us on the way. They are very much polite and respect to all the elders of the village”

“MEDP workers motivated the community for regular use of bednet, aware to clean surrounding, remove water to avoid mosquito breeding. Keep clean and covered the drinking water and change it regularly. I feel that now we felt sick very rarely particularly regarding episodes of febrile illness was very rare in the community”

 Male

“Earlier we spent money to seek treatment, went district government or private hospitals which was expensive and time consuming. These all effects badly to our economic condition mainly during crop season we lost lot of money and time. MEDP workers helped us a lot and provide prompt treatment at our door step”

“Few years ago, when MEDP not existed, almost every family suffered from fever with chills and rigor due to malaria. Now there is no malaria case in our knowledge”

“MEDP workers provided treatment only for malaria. This type of facility should be provided for all the common diseases in villages”

“MEDP staff repeatedly provided knowledge on mosquito and malaria, therefore, our community is now considerably awaked and taking care for their health and hygiene. The villagers now seek treatment as early as possible from ASHA or ANM or visiting PHC/CHC”

Sarpanch (elected community leader)

“Few years ago, almost every family experienced from malarial fever in the villages particularly during rainy season. Now we didn't see any malaria cases in our area”

“MEDP staff were worked very sincerely. Frequently visited each and every house to provide treatment of fever cases. They shared mobile number to contact them any time if we felt sick”

MEDP staff and ASHA, ICDS worker of the village, all together, occasionally visited households in the village

MEDP staff regularly organized health education campaign programme in the villages, weekly haat market, school and panchayat to motivate the villagers against malaria and other common health issues. They used various methods for awareness such as poster, slogan and song in local language, rally, road show etc

Block level healthcare providers*

“Malaria cases in district was already controlled before the MEDP and very less number of malaria cases was reported. However, recently almost zero cases reported in the district”

“MEDP contributed remarkable work for malaria elimination in the area. Staff were very sincere, hardworking and friendly. They test, treat and track each malaria cases, monitored all travelers to check the imported malaria cases in the area. I strongly believe that this type of intensified work is essentially needed for malaria elimination”

“The proper management and regular monitoring of the field activity in MEDP project was good”

“MEDP program objective was good and their work was also appreciable but the time when project was introduced was not correct as malaria situation was already under controlled. I think this was not required at that time in the district and it was total wastage of resources”

“Each MEDP village workers have to work in 4 to 5 villages and due to distance between villages usually their visit in village was delayed as when they reach village the villagers moved out from house for their livelihood and not able to contact. Also some of the areas were mostly ignored due to difficult terrain and hard to reach”

“MEDP field staff were work sincerely in coordination with state health staff and with their joint efforts we achieved the malaria elimination goal in the area.”

“Each positive cases were reported and shared with the group of state program personals including me to regular track the malaria cases which help in malaria control in the area”

“During the strike of state community health worker, MEDP staff help us to deliver health services in villages particularly in pulse polio vaccination programme”

“Mandla district is a tribal dominated district and rural community are less aware and poor health seeking practices which required the continuous efforts to educate and motivate for enhancing the health awareness. MEDP contributed very much in this regard”

“MEDP conducted IEC/BCC campaign in weekly market to aware community against malaria. Motivated community for regular use of bednet, aware to clean surrounding, remove water to avoid mosquito breeding. Also conducted meeting at village level and in school to aware the community against malaria”

“ASHAs and ANM are trained by state health program and time to time they get training at CHC during monthly meeting. However, MEDP also provided intensified training to ASHAs and ANM towards malaria diagnosis and treatment during the project period”

High school teachers

“MEDP staff behave very well and mixed with the community like a family member. They worked very sincerely for awareness enhancement towards malaria and other mosquito borne disease, symptoms, prevention, diagnosis and treatment. Students sprayed this information in their family and help in community awareness”

“Visits of MEDP staff in school was unscheduled and they visited without any pre-intimation which created inconvenience and disturbing to the scheduled teaching work. Occasionally, it also created conflict and unhealthy relation”

“MEDP staff were explained very well to children and also teachers regarding malaria disease, source of infection, preventive measures, symptoms, diagnosis and treatment. As a result of frequent awareness program people were using bednets regularly and very particular to use bednet during rainy season. Therefore malaria cases was controlled in our area”

District level other stakeholder**

“During the MEDP, all fever cases attended and treated at door step promptly by the MEDP staff, they were available at the village itself. But now we are visiting CHC for getting treatment when felt sick”

“They provided their services to aware against malaria to our ground level staff. They provided diagnosis and treatment for malaria on spot and immediately when we required their services”

“MEDP staff organized regular health awareness campaign to motivate the community and awareness enhancement towards malaria”