The Straw That Breaks the Camel's Back Redirecting Health‐Seeking Behavior Studies on Malaria and Vulnerability

Abstract

In the wake of the Millennium Development Goals, the focus on vulnerability and access to care has increasingly gained ground in the malaria social science literature. However, little emphasis has been given to the cumulative processes of vulnerability. In this article, we draw on ethnographic data, in particular on case studies, gathered in southeastern Tanzania in the 1990s and reexamine them in the context of vulnerability. We analyze the underpinnings of the cumulative dimension of vulnerability at three levels: (1) structural, that is, elements that determine access to material and social resources; (2) agent driven, that is, the consequences of coping strategies that enhance vulnerability; and (3) conjunctural, that is, periods characterized by the confluence of adverse circumstances. We argue that the analysis of cumulative processes of vulnerability paints a more comprehensive picture of people's struggle for health. This opens up a more systemic and dynamic perspective on access to care for disadvantaged populations.

Understanding Interpretations of and Responses to Childhood Fever in the Chikhwawa District of Malawi

“…Participants also expressed frustration with receiving repeated doses of LA and the lack of an alternative treatment. Such repeat visits place considerable economic burdens on households [41,42]. Re-treatment of children who return within 2 weeks of a previous treatment with first line antimalarials is common, but clearly needs to be considered urgently, both from a policy perspective and to improve phase 3 outcomes and support appropriate treatment-seeking.…”

A review of malaria transmission dynamics in forest ecosystems

“…Such communities are mostly illiterate, prone to superstitious beliefs, and poor at communicating with malaria control workers. Tribes inhabiting forests have conserved traditions and practices that have remarkable impacts on malaria transmission [17] thus these forest dwelling people are vulnerable to malaria [21]. Slash and burn is a functional element of forest area farming practices in many parts of the world [17,140] leading to deforestation and succession of halophilic vectors, hence changes in the malaria transmission pattern [17].…”

“…Certain practices like slash and burn cultivation, overnight stays within forests in order to collect forest produce, hunting, wide open household construction, and cattle ranching, increase vulnerability to malaria. It can be challenging to educate forest communities about malaria control, and without their cooperation it is difficult to control malaria [21]. Now, worldwide malaria communities are aiming at malaria eradication/elimination [22,23], a proposition, which is impractical without prevention of re-introduction/re-emergence from hidden foci/uncontrolled forest malaria [22,24].…”

“…It is difficult to develop infrastructure in forests due to their uneven land forms, presence of streams, and dense vegetation. Additionally, poor communication hinders malaria control activities particularly during the rainy season [21,45]. Furthermore, forests with hilly land forms are more malariogenic, as their slopes form small rapid streams that facilitate breeding of efficient malaria vectors [46].…”

A WebGIS tool for visualizing and exploring socioeconomic vulnerability to dengue fever in Cali, Colombia

“…Such activities are urgently needed to effectively reduce the burden of vector-borne diseases (VBDs), in particular with regard to those for which there are currently no vaccines, e.g. dengue fever and malaria (Ribera and Hausmann-Muela, 2011;Dickin et al, 2013).…”