Community health workers' perceptions of barriers to utilisation of malaria interventions in Lilongwe, Malawi: A...

In line with increased advocacy for implementation of malaria interventions at community level, universal net coverage has become a prominent intervention in Lilongwe, Malawi. However, beliefs and perceptions about malaria interventions have greatly affected the implementation of interventions at community level. This study explored the perception of community health workers in Lilongwe on barriers to effective malaria control service delivery and utilisation at the community level.

Data on perceived beliefs and misconception about malaria interventions were collected through qualitative interviews. Qualitative data were analysed using the Framework Analysis approach.

The study identified a number of factors that health workers cited as barriers and challenges to effective implementation of malaria interventions in Lilongwe. These related to health workers' assimilation of community's beliefs and traditions; beliefs about causes of malaria contrary to known biomedical causes of malaria; beliefs about traditional methods of malaria prevention and treatment; beliefs about insecticide-treated nets (ITNs) as a cause of infertility among married couples; beliefs about alternative uses of ITNs; and lack of understanding about selective susceptibility to malaria infections.

This study demonstrated, in part, that beliefs and perceptions about malaria intervention evolved through ecological correlations and requires education that fully explains how such correlations arose other than simple disproof as myths. A participatory approach in designing and delivering malaria interventions at community level complemented with the inclusion of traditional interventions results in better collaboration and is more likely to be accepted by members of the community as it provides cultural synthesis.