Community-based house improvement for malaria control in southern Malawi: Stakeholder perceptions, experiences, and...

Area of Science:

• Public Health
• Environmental Health
• Malariology

Background:

• House improvement (HI) involves screening openings and installing ceilings to reduce indoor mosquito-human contact.
• HI is a supplementary intervention for malaria control, but its implementation and evaluation in Malawi are limited.
• Concerns regarding local evidence, durability, and cost hinder HI adoption in low-income countries.

Purpose of the Study:

• To assess community perceptions, experiences, and acceptability of community-led house improvement (HI) for malaria control in Chikwawa district, Malawi.

Main Methods:

• Qualitative study employing focus group discussions with community members, health animators, and HI committee members.
• In-depth interviews with community members and key informants (health surveillance assistants, chiefs).
• Thematic content analysis of transcribed data using NVivo 12 Plus software.

Main Results:

• Participants demonstrated a thorough understanding of HI and expressed high satisfaction.
• Enabling factors for HI acceptability included reduced malaria cases and perceived safety/effectiveness.
• Barriers identified were unavailability of materials, inaccessibility, and increased heat/darkness in improved houses.

Conclusions:

• High knowledge and acceptability of HI were observed in the study area.
• Addressing barriers through strategies like improved material access and ventilation is crucial for effectiveness.
• Continued health education and community engagement are vital for enhancing HI acceptability and sustainability.