The potential impact of irrigated agriculture on water-related vector-borne diseases has been an increasing source of concern for researchers from the bio-medical sector. While most research on the potential impacts of irrigation on the health of local populations focuses on vector densities, levels of exposures, health services and technologies (prophylaxis, mosquito nets), we argue that it is essential to enlarge the scope of investigation and consider the complex mechanisms by which factors such as agriculture-generated changes in ecosystems, gender repositioning in the family organization as a result of access to new crops, and production activities combine together in increasing disease risks and producing new scenarios in the management of disease. This paper presents the results of an investigation of how transformations induced on the local society by the intensification of inland valley irrigated rice cultivation influence malaria health care systems and modulate risks to the health of local populations, within well-defined geographical boundaries in northern Côte d'Ivoire. Our results indicate that socio-economic transformations and gender repositioning induced, or facilitated, by the intensification of inland valley irrigated rice cultivation lead to a reduction of the capacity of women to manage disease episodes, contributing therefore to increase malaria incidence among farming populations.
Malaria is one of the most serious public health problems in the world. For the last few decades, numerous studies have focused on the potential links between environmental transformations (such as the expansion of irrigation) and malaria occurrence. Most of these studies have been based on relatively simple models outlining the interactions of the host-vector-parasite triad. In this paper, we investigate the links between the intensification of irrigated rice cultivation and malaria. In an attempt to complement biomedical and entomological approaches we propose a model that recognises the influence of human-vector contacts on transmission processes, but stresses the importance of taking into consideration socio-economic and cultural factors in the management of disease episodes, and how these can be affected by transformations of natural resource management strategies. Using a case study in Northern Côte d'Ivoire, we investigated the complex mechanisms by which agriculture-generated changes in ecosystems and socio-economic organisation influence disease risks and produce new scenarios in the management of disease. Our results show that the socio-economic transformation and gender repositioning induced, or facilitated, by the intensification of lowland irrigated rice cultivation influence the health care system for malaria in the study area. They lead to a reduction of the capacity of women to manage malaria episodes among children and influence their vulnerability to the disease. We argue that these elements contribute to higher malaria prevalence in villages involved in double cropping of rice annually.
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