Abstract
BackgroundCommunity case management of malaria (CCMm) and seasonal malaria chemoprevention (SMC) are anti-malarial interventions that can lead to substantial reduction in malaria burden acting in synergy. However, little is known about the social acceptability of these interventions. A study was undertaken to assess whether combining the interventions would be an acceptable approach to malaria control for community health workers (CHWs).MethodsSixty-one interviews and six focus group discussions were conducted nested in a cluster-randomized trial assessing the impact of combining CCMm and SMC in a rural area of Senegal. Participants consisted of: (i) members of village associations, (ii) members of families who had access to the interventions as well as members of families who did not access the interventions, (iii) CHWs, and (iv) community leaders, e g, religious guides and village chiefs.ResultsThe interventions were acceptable to the local population and perceived as good strategy to make health care services available to community members and thus, to reduce the delays in access to anti-malarial treatment as well as expenses related to patients’ transfer to the health post. The use of malaria rapid diagnostic test (RDT) contributed to improving CHWs diagnostic capacity as well as malaria treatment practices. Study participants notified RDT and drugs stock-out as the major risk for sustainability of the intervention at community level.ConclusionCombining CCMm and SMC is a well accepted, community-based approach that can contribute to control malaria in areas where malaria transmission is seasonal.
Highlights
Community case management of malaria (CCMm) and seasonal malaria chemoprevention (SMC) are anti-malarial interventions that can lead to substantial reduction in malaria burden acting in synergy
Recently, the World Health Organization (WHO) advocated the scaling up of malaria control interventions in order to reduce malaria burden in areas where malaria is still a public health problem [1,2] and efforts are being made by sub-Saharan countries to reach that goal [3]
Seasonal malaria chemoprevention (SMC), previously referred to as intermittent preventive treatment in children (IPTc) [11] is a new strategy aiming at reducing malaria morbidity and mortality in children living in areas where malaria transmission is highly seasonal [11]
Summary
Community case management of malaria (CCMm) and seasonal malaria chemoprevention (SMC) are anti-malarial interventions that can lead to substantial reduction in malaria burden acting in synergy. A study was undertaken to assess whether combining the interventions would be an acceptable approach to malaria control for community health workers (CHWs). Community implication is central to controlling malaria It requires a good level of acceptability of anti-malarial interventions by community members and community health care providers. It is recognized that community health workers can play a major role in Malaria control in some areas will require a strategy using a combination of anti-malarial interventions [9]. Community case management of malaria (CCMm), defined as the provision of anti-malarial treatment at household level [10], is one approach to improving access to prompt treatment with effective anti-malarial drugs, such as ACT, at community level. Studies conducted in sub-Saharan Africa demonstrated that adding SMC to CCMm can significantly reduce malaria incidence [9,12,13]
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