Community-based malaria control in southern Malawi: a description of experimental interventions of community workshops, house improvement and larval source management

Abstract

BackgroundIncreased engagement of communities has been emphasized in global plans for malaria control and elimination. Three interventions to reinforce and complement national malaria control recommendations were developed and applied within the context of a broad-based development initiative, targeting a rural population surrounding a wildlife reserve. The interventions, which were part of a 2-year research trial, and assigned to the village level, were implemented through trained local volunteers, or ‘health animators’, who educated the community and facilitated collective action.ResultsCommunity workshops on malaria were designed to increase uptake of national recommendations; a manual was developed, and training of health animators conducted, with educational content and analytical tools for a series of fortnightly community workshops in annual cycles at village level. The roll-back malaria principle of diagnosis, treatment and use of long-lasting insecticidal nets was a central component of the workshops. Structural house improvement to reduce entry of malaria vectors consisted of targeted activities in selected villages to mobilize the community into voluntarily closing the eaves and screening the windows of their houses; the project provided wire mesh for screening. Corrective measures were introduced to respond to field challenges. Committees were established at village level to coordinate the house improvement activities. Larval source management (LSM) in selected villages consisted of two parts: one on removal of standing water bodies by the community at large; and one on larviciding with bacterial insecticide Bacillus thuringiensis israelensis by trained village committees. Community workshops on malaria were implemented as ‘core intervention’ in all villages. House improvement and LSM were implemented in addition to community workshops on malaria in selected villages.ConclusionsThree novel interventions for community mobilization on malaria prevention and control were described. The interventions comprised local organizational structure, education and collective action, and incorporated elements of problem identification, planning and evaluation. These methods could be applicable to other countries and settings.Electronic supplementary materialThe online version of this article (10.1186/s12936-018-2415-1) contains supplementary material, which is available to authorized users.

Investigation of mosquito larval habitats and insecticide resistance in an area with a high incidence of mosquito-borne diseases in Jining, Shandong Province

“…Therefore, aquatic habitats are important for mosquito breeding. Larval source management (LSM) involves the management of water bodies that are potential larval habitats to prevent the development of immature mosquitoes into adults [18,19], and studies have shown that mosquito LSM has an important potential impact on mosquito-borne disease transmission both in urban and rural areas [20][21][22]. For example, in urban areas of Dar es Salaam, Tanzania, the use of larvicides reduced the risk of malaria infection in 5-year-old children [23].…”

A qualitative exploration of the experiences of community health animation on malaria control in rural Malawi

“…The Health Animation model is a community engagement approach used to promote positive health behaviour for disease control. This is supposed to be achieved by focusing on influencing a mindset of understanding the threat of disease and promoting positive health seeking behaviours [10,18]. This involves the provision of information through peer-led health education and communication of diseases [10].…”

“…This involves the provision of information through peer-led health education and communication of diseases [10]. The HA approach was pioneered and is promoted by the non-governmental organization, The Hunger Project (THP), for awareness and prevention of disease in developing countries [10,18]. This concept works within THP's larger framework of community development through collective accountability and action [18].…”

“…The HA approach was pioneered and is promoted by the non-governmental organization, The Hunger Project (THP), for awareness and prevention of disease in developing countries [10,18]. This concept works within THP's larger framework of community development through collective accountability and action [18]. The model makes use of a volunteer recruited from within the community, by the community, to train in leadership skills that help unite the community in working towards a common goal, good health and subsequently development [10,18].…”

“…This concept works within THP's larger framework of community development through collective accountability and action [18]. The model makes use of a volunteer recruited from within the community, by the community, to train in leadership skills that help unite the community in working towards a common goal, good health and subsequently development [10,18]. The HA is given leadership training for leading all communal development activities and is provided with training in a condensed version of the science behind illness and disease control.…”