Stakeholder perspectives on a door-to-door intervention to increase community engagement for malaria elimination in Zanzibar
Abstract Background Malaria remains a major public health problem in sub-Saharan Africa. The 2021 World Health Organization (WHO) World Malaria Report indicates a slowing in the decline of malaria incidence since 2015. Malaria prevalence in Zanzibar has been maintained at less than 1% since 2010, ho...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-02-01
|
| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12936-023-04474-w |
| _version_ | 1811166043517747200 |
|---|---|
| author | Faiza Abbas April Monroe Samson Kiware Mwinyi Khamis Naomi Serbantez Abdul- Wahid Al- Mafazy Fauzia Mohamed Emmanuel Kigadye |
| author_facet | Faiza Abbas April Monroe Samson Kiware Mwinyi Khamis Naomi Serbantez Abdul- Wahid Al- Mafazy Fauzia Mohamed Emmanuel Kigadye |
| author_sort | Faiza Abbas |
| collection | DOAJ |
| description | Abstract Background Malaria remains a major public health problem in sub-Saharan Africa. The 2021 World Health Organization (WHO) World Malaria Report indicates a slowing in the decline of malaria incidence since 2015. Malaria prevalence in Zanzibar has been maintained at less than 1% since 2010, however from 2018 to 2021, the annual number of reported malaria cases has gradually increased from 4106 to 9290. Community engagement has been emphasized by the WHO for reducing malaria transmission. To better understand the potential for a door-to-door approach for malaria, a three-month pilot programme was carried out. This qualitative study aimed at understanding stakeholder experiences with the pilot programme and considerations for its implementation. Methods Through multistage sampling, four shehias (wards—the lowest administrative structure) with comparatively high (> 1.9 per 1000) and four with low (< 1 per 1000) incidence of local malaria cases were selected and involved in a door-to-door pilot intervention. The qualitative study was conducted after the pilot intervention and employed focus group discussions and in-depth interviews. All field notes were written on paper and audiotaped using digital audio-recorders. Summaries were developed by integrating field notes with reviews of recordings; themes were developed based on the topics identified a priori. Responses for each theme were summarized using an iterative process. Results Most community members reported high levels of acceptance of door-to-door interventions. Some factors that might affect implementation of door-to-door include, low risk perception of the disease, local beliefs and practice, lack of initiative from the programme level to involve communities, and political instability during the election period. All Community Health Volunteers (CHVs) recommended this approach for community engagement, however, ensuring adequate resources was identified as a key factor for ensuring its sustainability. Conclusion The door-to-door intervention was perceived as helpful for promoting community engagement. There are several factors to consider including ensuring that CHVs are provided with adequate education, regular supervision, and have access to essential resources. Community leaders should be fully involved in choosing CHVs that are acceptable to the community. To ensure sustainability, the government should allocate sufficient resources and improve coordination systems. |
| first_indexed | 2024-04-10T15:46:03Z |
| format | Article |
| id | doaj.art-17753a3ed4254edfaf4404d16ad3a1ff |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-04-10T15:46:03Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-17753a3ed4254edfaf4404d16ad3a1ff2023-02-12T12:05:07ZengBMCMalaria Journal1475-28752023-02-0122111010.1186/s12936-023-04474-wStakeholder perspectives on a door-to-door intervention to increase community engagement for malaria elimination in ZanzibarFaiza Abbas0April Monroe1Samson Kiware2Mwinyi Khamis3Naomi Serbantez4Abdul- Wahid Al- Mafazy5Fauzia Mohamed6Emmanuel Kigadye7Zanzibar Malaria Elimination ProgrammeJohns Hopkins Center for Communication ProgramsIfakara Health InstituteZanzibar Malaria Elimination ProgrammeU.S. President’s Malaria Initiative, U.S. Agency for International DevelopmentRTI InternationalOpen University of TanzaniaOpen University of TanzaniaAbstract Background Malaria remains a major public health problem in sub-Saharan Africa. The 2021 World Health Organization (WHO) World Malaria Report indicates a slowing in the decline of malaria incidence since 2015. Malaria prevalence in Zanzibar has been maintained at less than 1% since 2010, however from 2018 to 2021, the annual number of reported malaria cases has gradually increased from 4106 to 9290. Community engagement has been emphasized by the WHO for reducing malaria transmission. To better understand the potential for a door-to-door approach for malaria, a three-month pilot programme was carried out. This qualitative study aimed at understanding stakeholder experiences with the pilot programme and considerations for its implementation. Methods Through multistage sampling, four shehias (wards—the lowest administrative structure) with comparatively high (> 1.9 per 1000) and four with low (< 1 per 1000) incidence of local malaria cases were selected and involved in a door-to-door pilot intervention. The qualitative study was conducted after the pilot intervention and employed focus group discussions and in-depth interviews. All field notes were written on paper and audiotaped using digital audio-recorders. Summaries were developed by integrating field notes with reviews of recordings; themes were developed based on the topics identified a priori. Responses for each theme were summarized using an iterative process. Results Most community members reported high levels of acceptance of door-to-door interventions. Some factors that might affect implementation of door-to-door include, low risk perception of the disease, local beliefs and practice, lack of initiative from the programme level to involve communities, and political instability during the election period. All Community Health Volunteers (CHVs) recommended this approach for community engagement, however, ensuring adequate resources was identified as a key factor for ensuring its sustainability. Conclusion The door-to-door intervention was perceived as helpful for promoting community engagement. There are several factors to consider including ensuring that CHVs are provided with adequate education, regular supervision, and have access to essential resources. Community leaders should be fully involved in choosing CHVs that are acceptable to the community. To ensure sustainability, the government should allocate sufficient resources and improve coordination systems.https://doi.org/10.1186/s12936-023-04474-wDoor-to-door interventionCommunity engagementCommunity health volunteersLocal malaria transmissionMalaria incidenceZanzibar |
| spellingShingle | Faiza Abbas April Monroe Samson Kiware Mwinyi Khamis Naomi Serbantez Abdul- Wahid Al- Mafazy Fauzia Mohamed Emmanuel Kigadye Stakeholder perspectives on a door-to-door intervention to increase community engagement for malaria elimination in Zanzibar Malaria Journal Door-to-door intervention Community engagement Community health volunteers Local malaria transmission Malaria incidence Zanzibar |
| title | Stakeholder perspectives on a door-to-door intervention to increase community engagement for malaria elimination in Zanzibar |
| title_full | Stakeholder perspectives on a door-to-door intervention to increase community engagement for malaria elimination in Zanzibar |
| title_fullStr | Stakeholder perspectives on a door-to-door intervention to increase community engagement for malaria elimination in Zanzibar |
| title_full_unstemmed | Stakeholder perspectives on a door-to-door intervention to increase community engagement for malaria elimination in Zanzibar |
| title_short | Stakeholder perspectives on a door-to-door intervention to increase community engagement for malaria elimination in Zanzibar |
| title_sort | stakeholder perspectives on a door to door intervention to increase community engagement for malaria elimination in zanzibar |
| topic | Door-to-door intervention Community engagement Community health volunteers Local malaria transmission Malaria incidence Zanzibar |
| url | https://doi.org/10.1186/s12936-023-04474-w |
| work_keys_str_mv | AT faizaabbas stakeholderperspectivesonadoortodoorinterventiontoincreasecommunityengagementformalariaeliminationinzanzibar AT aprilmonroe stakeholderperspectivesonadoortodoorinterventiontoincreasecommunityengagementformalariaeliminationinzanzibar AT samsonkiware stakeholderperspectivesonadoortodoorinterventiontoincreasecommunityengagementformalariaeliminationinzanzibar AT mwinyikhamis stakeholderperspectivesonadoortodoorinterventiontoincreasecommunityengagementformalariaeliminationinzanzibar AT naomiserbantez stakeholderperspectivesonadoortodoorinterventiontoincreasecommunityengagementformalariaeliminationinzanzibar AT abdulwahidalmafazy stakeholderperspectivesonadoortodoorinterventiontoincreasecommunityengagementformalariaeliminationinzanzibar AT fauziamohamed stakeholderperspectivesonadoortodoorinterventiontoincreasecommunityengagementformalariaeliminationinzanzibar AT emmanuelkigadye stakeholderperspectivesonadoortodoorinterventiontoincreasecommunityengagementformalariaeliminationinzanzibar |