Introducing insecticide‐treated nets in the Kilombero Valley, Tanzania: the relevance of local knowledge and practice for an Information, Education and Communication (IEC) campaign

Abstract

SummarySince 1997 the WHO has been recommending an integrative strategy to combat malaria including new medicines, vaccines, improvements of health care systems and insecticide-treated nets (ITNs). After successful controlled trials with ITNs in the past decade, large-scale interventions and research now focus on operational issues of distribution and ®nancing. In developing a social marketing approach in the Kilombero Valley in south-east Tanzania in 1996, a combination of qualitative and quantitative methods was employed to investigate local knowledge and practice relating to malaria. The ®ndings show that the biomedical concept of malaria overlaps with several local illness concepts, one of which is called maleria and refers to mild malaria. Most respondents linked maleria to mosquitoes (76%) and already used mosquito nets (52%). But local understandings of severe malaria differed from the biomedical concept and were not linked to mosquitoes or malaria. A social marketing strategy to promote ITNs was developed on the basis of these ®ndings, which reinforced public health messages and linked them with nets and insecticide. Although we did not directly evaluate the impact of promotional activities, the sharp rise in ownership and use of ITNs by the population (from 10 to > 50%) suggests that they contributed signi®cantly to the success of the programme. Local knowledge and practice is highly relevant for social marketing strategies of ITNs.keywords Tanzania, malaria, disease perceptions, local knowledge, vector control, mosquito nets correspondence Dr Brigit Obrist,

Assessing the Effect of a Combined Malaria Prevention Education and Free Insecticide-Treated Bed Nets Program on Self-Reported Malaria Among Children in a Conflict-Affected Setting in Northern Uganda

“…Increased availability of ITNs, accompanied by concerted health promotion and education campaigns, does improve net usage (Dike, Onwujekwe, Ojukwu, Ikeme, Uzochukwu, & Shu, 2006;Rhee, Sissoko, Perry, McFarland, Parsonnet, & Doumbo, 2005;Lin, Aung, Lwin, Min, Aye, & Webber, 2003;Minja, Schellenberg, Mukasa, Nathan, Abdulla, Mponda, et al, 2001). However, few studies have looked at the effect of enhanced health education on bed net utilization and malaria disease burden in a highly endemic setting after controlling for availability of nets, especially among the most vulnerable children, those below 5 years of age.…”

Knowledge and practices on malaria and its control among pastoralists in Simanjiro District, northern Tanzania

“…Some villagers were less convinced of the effectiveness of ITN in protecting a sleeper from malaria and believed that although the disease can easily be treated it can not be prevented. Already some studies have reported the impact of lack of knowledge as well as negative perception on the uptake of interventions such as ITN (Makemba et al, 1996;Minja et al, 2001).…”

Systematic reviews and knowledge translation

“…35 Social marketing of ITNs has been operat t tionalized to include consumertoriented promotion of key messages using an appealing brand name and logo, and targeting of specific segments of society via parties, drama and leaflets. 36 With the Cochrane Collaboration we have registered a systematic review on KT interventions to increase the uptake of malariatprevention strategies, includt t ing social marketing and free distribut t tion of ITNs. This systematic review will assess equity coverage, costs and health outcomes.…”