“Moving like birds”: A qualitative study of population mobility and health implications in the Bijagós Islands, Guinea Bissau

Abstract

Population movement is a major driver for infectious disease transmission and can impact the success of disease control and elimination strategies. The relationship between disease transmission and permanent migration is well documented, but fewer studies have considered how different types of population mobility affects disease transmission and control programmes. This qualitative study was conducted on two islands of the Bijagós archipelago, Guinea Bissau to understand spatial and temporal population movement, and reasons for these movements, within, between and away from the Bijagós islands. Data were collected on two islands using key informant interviews (n = 8), daily activity-location interviews (n = 30) and focus group discussions (n = 6). Data were analysed thematically using an adapted typology of mobility. Findings revealed that movement within and between islands, and from islands to the mainland, was a common feature of island life for men and women alike. It was usual for trips away from home to last for several months at a time. Five key reasons for travel were identified: subsistence activities; family events; income generating activities; cultural festivities and healthcare. These movements often occurred erratically all year round, with the exception of seasonal travel within and between islands for agricultural purposes. Our study characterised detailed patterns of human mobility in the Bijagós islands as a first step towards understanding the potential impact of different types of mobility on disease exposure, transmission and public health programmes. Short-term mobility may have a significant impact on the spread of infectious diseases with short incubation periods. Predictable movements, such as travel for seasonal agricultural work, should be taken into account for tailoring and increasing the reach of public health interventions. Further research is needed to understand the role of human behaviour and mobility in disease transmission and control across the archipelago.

Prevalence of and risk factors for curable sexually transmitted infections on Bubaque Island, Guinea Bissau

“…This is a widely recognised phenomenon 1 24 25 with a number of explanations. In other contexts, gender power imbalances prevent women from negotiating safe sex 24 but in a matriarchal society, where women can make decisions about relationships, 14 15 this is less likely to be a factor. On the other hand, having the power to change partner might increase the number of partners a woman has and therefore the risk of STI.…”

“…The population is highly mobile, has matriarchal elements to its structure and people continue to follow traditional religious practices. 14 15 These unusual cultural aspects mean that sexual behaviour, patterns of STI transmission and health-seeking behaviour, may not be typical. Furthermore, the Bijagos Islands have been a site for mass drug administration (MDA) with azithromycin for trachoma control.…”

Prevalence, risk factors and health consequences of soil-transmitted helminth infection on the Bijagos Islands, Guinea Bissau: A community-wide cross-sectional study

“…It is also notable that the lowest prevalence of STH infection was seen in the 18–30 age-group, and within this, females were more likely to be infected than males (OR 2.06, p = 0.19). This may be because in the Bijagos Islands, unlike many in Sub-saharan Africa, communities have a matriarchal structure, with women typically working in farming more than men, a known risk factor for hookworm infection [ 39 , 40 ]. The age-intensity profile of hookworm in this study was linearly positive, reflecting the rising infection intensity into and throughout adulthood.…”

The use of islands and cluster-randomized trials to investigate vector control interventions: a case study on the Bijagós archipelago, Guinea-Bissau

“…Previous studies of the archipelago have monitored human activity and surveyed mosquito populations [63,64]. Using indoor adult light traps and larval dipping at potential breeding sites, our group characterized vectors likely to be responsible for the majority of malaria transmission.…”