Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jul 16;17(1):266.
doi: 10.1186/s12936-018-2415-1.

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

Affiliations

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

Henk van den Berg et al. Malar J. .

Abstract

Background: Increased 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.

Results: Community 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.

Conclusions: Three 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.

Keywords: Community participation; Community workshops; Health education; House improvement; Integrated vector management; Larval source management; Malaria transmission; Vector control.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Study site map, showing Majete Wildlife Reserve, surrounded by 19 groups of villages known as community-based organisations (CBO). Three focal areas (A, B and C), each with their individual villages, are indicated (Reprinted with modifications [23, 49])
Fig. 2
Fig. 2
A Community workshop on malaria by health animators; B field training of health animators on larval source management. Photographs by H. van den Berg, Malawi, 2015 and 2016
Fig. 3
Fig. 3
A House improvement pre-intervention; B closed gable; C screened ‘windows’; D former water body filled with soil; E drainage passage created to prevent standing water; F trained HI committee member applying Bacillus thuringiensis israelensis to remaining water bodies. Photographs by H. van den Berg, Malawi, 2015 and 2016
Fig. 4
Fig. 4
Guideline on the use of methods of larval source management

References

    1. Bhatt S, Weiss DJ, Cameron E, Bisanzio D, Mappin B, Dalrymple U, et al. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature. 2015;526:207–211. doi: 10.1038/nature15535. - DOI - PMC - PubMed
    1. Atkinson JA, Vallely A, Fitzgerald L, Whittaker M, Tanner M. The architecture and effect of participation: a systematic review of community participation for communicable disease control and elimination. Implications for malaria elimination. Malar J. 2011;10:225. doi: 10.1186/1475-2875-10-225. - DOI - PMC - PubMed
    1. Chilaka MA. Ascribing quantitative value to community participation: a case study of the Roll Back Malaria (RBM) initiative in five African countries. Public Health. 2005;119:987–994. doi: 10.1016/j.puhe.2005.08.010. - DOI - PubMed
    1. Whittaker M, Smith C. Reimagining malaria: five reasons to strengthen community engagement in the lead up to malaria elimination. Malar J. 2015;14:410. doi: 10.1186/s12936-015-0931-9. - DOI - PMC - PubMed
    1. Heggenhougen HK, Hackethal V, Vivek P. The behavioural and social aspects of malaria and its control: an introduction and annotated biliography. TDR/STR/SEB/VOL/03.1. Geneva: World Health Organization; 2003.