Challenges in implementing uncomplicated malaria treatment in children: a health facility survey in rural Malawi

Kabaghe, Alinune N.; Phiri, Mphatso Dennis; Phiri, Kamija S.; Vugt, Michèle van

doi:10.1186/s12936-017-2066-7

Cited by 19 publications

(20 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite these prospects for increasing the demand for, and uptake of, interventions by the community, the provision of health services in the targeted areas remains a challenge, with inadequate personnel, frequent stock-outs of anti-malaria commodities, and inconsistent case recording [ 48 ]. Consequently, systematic strengthening of the rural health services deserves urgent attention.…”

Section: Discussionmentioning

confidence: 99%

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

Berg

Vugt

Kabaghe

et al. 2018

Malar J

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

Berg

Vugt

Kabaghe

et al. 2018

Malar J

Self Cite

View full text Add to dashboard Cite

show abstract

“…When there is community buy-in, with behaviour change taking place, the challenge may be unavailability of adequate interventions. There have been shortages in supply ITNs, malaria test kits and antimalarial drugs in the study area [ 29 ]. Lack of access to ITNs has been shown to limit the uptake of ITN in other studies [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Malaria control in rural Malawi: implementing peer health education for behaviour change

et al. 2017

Self Cite

View full text Add to dashboard Cite

BackgroundInterventions to reduce malaria burden are effective if communities use them appropriately and consistently. Several tools have been suggested to promote uptake and use of malaria control interventions. Community workshops on malaria, using the ‘Health Animator’ approach, are a potential behaviour change strategy for malaria control. The strategy aims to influence a change in mind-set of vulnerable populations to encourage self-reliance, using community volunteers known as Health Animators. The aim of the paper is to describe the process of implementing community workshops on malaria by Health Animators to improve uptake and use of malaria control interventions in rural Malawi.MethodsThis is a descriptive study reporting feasibility, acceptability, appropriateness and fidelity of using Health Animator-led community workshops for malaria control. Quantitative data were collected from self-reporting and researcher evaluation forms. Qualitative assessments were done with Health Animators, using three focus groups (October–December 2015) and seven in-depth interviews (October 2016–February 2017).ResultsSeventy seven health Animators were trained from 62 villages. A total of 2704 workshops were conducted, with consistent attendance from January 2015 to June 2017, representing 10–17% of the population. Attendance was affected by social responsibilities and activities, relationship of the village leaders and their community and involvement of Community Health Workers. Active discussion and participation were reported as main strengths of the workshops. Health Animators personally benefited from the mind-set change and were proactive peer influencers in the community. Although the information was comprehended and accepted, availability of adequate health services was a challenge for maintenance of behaviour change.ConclusionCommunity workshops on malaria are a potential tool for influencing a positive change in behaviour towards malaria, and applicable for other health problems in rural African communities. Social structures of influence and power dynamics affect community response. There is need for systematic monitoring of community workshops to ensure implementation fidelity and strengthening health systems to ensure sustainability of health behaviour change.

show abstract

“…The study was done under the umbrella of the Majete Malaria Project (MMP). The study area has been previously described [ 8 , 18 ]. MWR perimeter is a rural area situated in Chikhwawa District in southern Malawi and lies within the Rift Valley between 60–500 m above sea level.…”

Section: Methodsmentioning

confidence: 99%

Fine-scale spatial and temporal variation of clinical malaria incidence and associated factors in children in rural Malawi: a longitudinal study

et al. 2018

Self Cite

View full text Add to dashboard Cite

Background: Spatio-temporal variations in malaria burden are currently complex and costly to measure, but are important for decision-making. We measured the spatio-temporal variation of clinical malaria incidence at a fine scale in a cohort of children under five in an endemic area in rural Chikhwawa, Malawi, determined associated factors, and monitored adult mosquito abundance. Methods: We followed-up 285 children aged 6-48 months with recorded geolocations, who were sampled in a rolling malaria indicator survey, for one year (2015)(2016). Guardians were requested to take the children to a nearby health facility whenever ill, where health facility personnel were trained to record malaria test results and temperature on the child's sick-visit card; artemisinin-based combination therapy was provided if indicated. The cards were collected and replaced 2-monthly. Adult mosquitoes were collected from 2-monthly household surveys using a Suna trap. The head/thorax of adult Anopheles females were tested for presence of Plasmodium DNA. Binomial logistic regression and geospatial modelling were performed to determine predictors of and to spatially predict clinical malaria incidence, respectively.

show abstract

Challenges in implementing uncomplicated malaria treatment in children: a health facility survey in rural Malawi

Cited by 19 publications

References 37 publications

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

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

Malaria control in rural Malawi: implementing peer health education for behaviour change

Fine-scale spatial and temporal variation of clinical malaria incidence and associated factors in children in rural Malawi: a longitudinal study

Contact Info

Product

Resources

About