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Published on: May 12, 2022
Nomadic Fulani communities manage malaria on the move.
O B Akogun1, A O Adesina, S Njobdi
1Common Heritage Foundation, Box 5124, Yola, Nigeria.
International Health
|September 14, 2013
Summary
Community-directed interventions empower nomadic populations to manage malaria effectively. This strategy significantly improved antimalarial usage and treatment for children under-5 among Fulani communities in Nigeria.
Area of Science:
- Global Health
- Tropical Medicine
- Public Health Interventions
Background:
- Nomadic populations are often underserved by public health initiatives, including malaria prevention and treatment.
- Insecticide-treated nets (ITNs) and prompt malaria treatment are key strategies, but their reach to mobile communities is limited.
- The community-directed intervention (CDI) strategy offers a potential framework for engaging hard-to-reach groups.
Purpose of the Study:
- To test the hypothesis that nomadic Fulani communities could implement the CDI strategy for managing fever and malaria in children under-5.
- To assess the effectiveness of a culturally adapted CDI approach in improving malaria control indicators among nomads.
- To compare intervention outcomes with existing practices in non-intervention nomadic communities.
Main Methods:
- A CDI strategy was adapted and implemented in 20 nomadic Fulani camps in northeastern Nigeria.
- Camp representatives were trained to distribute artemisinin-based combination therapy (ACTs) and ITNs.
- Malaria treatment and ITN coverage were monitored and compared to 20 control communities over 24 months.
Main Results:
- Antimalarial usage increased from baseline levels (<5%) to over 80% within 12 months in intervention camps.
- Appropriate malaria management in children under-5 reached 86.1% by 24 months, exceeding Roll Back Malaria targets.
- ITN possession increased significantly in intervention camps, though ITN usage remained suboptimal at 21.7% after two years.
- Control communities showed minimal change in antimalarial usage and ITN coverage.
Conclusions:
- Empowering nomadic communities through the CDI approach can lead to substantial improvements in malaria management and treatment adherence.
- The CDI strategy, when culturally adapted, is a viable and effective method for reaching nomadic populations with essential health interventions.
- While ACT uptake was high, further strategies are needed to improve consistent ITN usage among nomadic groups.
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