Assessment of community-based resilience to malaria in two transmission settings in Western Burkina Faso

Malaria transmission in Burkina Faso is continuous throughout the year. Anthropogenic changes in the environment affect the risk of disease transmission and the ability of communities to respond. This study aimed to evaluate the resilience of two communities in different malaria transmission settings in Western Burkina Faso by examining their ability to absorb, adapt, and transform regarding malaria burden. Conducted in Western Burkina Faso, this study focused on two localities, Bana and VK5, representing two distinct malaria transmission settings: a natural savannah and a rice-growing environment. A mixed-methods approach was employed in this study. Quantitative data were collected through a census of compounds in the two localities: 75 compounds in VK5 and 104 in Bana, using the KoboToolbox platform. Qualitative data were gathered through semi-structured interviews with 13 individuals from both localities. Quantitative data were subjected to descriptive statistics, whereas qualitative data were processed manually. The results showed that both communities demonstrate resilience through preventive measures and socio-economic strategies. Universal bed net coverage was higher in VK5 (74.33%) than in Bana (61.39%), significantly reducing malaria cases (χ² = 6.60, p = 0.0102). Communities adopted diverse economic adaptations, with 71.29% of compound chiefs in Bana and 78.38% in VK5 improving financial conditions through trade, farming, and vegetable cultivation. While Bana relied heavily on financial aid (76.47%) during illness, VK5 exhibited stronger community organization for environmental sanitation and broader social support networks. The strategies used to address malaria-related absences, the scope of solidarity networks available to assist affected families, and the nature of collective assistance provided, demonstrate that VK5 shows greater flexibility and resilience than Bana. Overall, the findings emphasize communities' commitment to improve their health and socioeconomic conditions. This commitment could be a key element in a potential community health insurance scheme.