Implementing a malaria curtains project in rural Malawi

This paper describes planning, implementation, monitoring and evaluation activities carried out in support of a malaria control project that used permethrin-impregnated curtains in eight villages in rural Malawi. Findings from formative evaluation and project monitoring aspects of the evaluation are presented. Permethrin-impregnated curtains were introduced to villagers who participated in household self-help projects. To implement the project, village health workers were trained and worked closely with existing project personnel as well as traditional headmen to assure village participation, facilitate health education and coordinate curtain-dipping (impregnation) meetings. A quasi-experimental evaluation design used surveys and observations to measure change in cognitive, behavioural and health outcome indicators. Village adoption rates averaged 50%, with variation between villages. Monitoring data showed a high degree of compliance with curtain re-impregnation initially and high perceived efficacy of curtains. Issues discussed include village readiness for change, trust, acceptability of the innovation, cost, sustainability and leadership.