A Collaborative Approach to Community-based Malaria Prevention in Benin
In Benin, limited human resources are a key constraint in improving the health of the population. Thus, it is essential for community members to play the intermediary role of raising public awareness and educating other community members about Malaria. More specifically, what it is and how it’s transmitted, the symptoms, preventative measures that can be taken, and how one should seek medical treatment if they or a member of their family may have contracted the disease.
Although malaria is largely preventable through the regular use of long-lasting insecticide-treated bed nets, or LLINs, only 34 percent of children under the age of 5 and 36 percent of mothers were using them.
To address this issue, Plan applied the improvement collaborative approach to a community-based malaria prevention project from 2007 to 2009.
Funded by USAID and overseen by the University Research Co., LLC, the project aimed to reduce child and maternal mortality rates by improving the behaviors associated with the prevention and treatment of malaria. The approach was implemented in 50 villages in the communes of Aplahoué and Djakotomey in the Couffo department of Benin.
Specifically, the project aimed to:
- Increase the use of insecticide-treated beds from 34 to 60 percent
- Promote appropriate management of malaria in households and communities
- Increase timely care seeking for complicated malaria among children under the age of 5 and pregnant women by 40 percent, and
- Strengthen collaboration between health structures and communities through house-to-house visits and community support groups
Results of the Project
A final evaluation using Lot Quality Assurance Sampling (LQAS) methodology was conducted in 19 of the project’s pilot villages in March and April of 2009. The main findings of the evaluation are detailed below.
Increased Usage of Long-Lasting Insecticide-Treated Bed Nets
The percentage of mothers and their children under the age of 5 found to sleep under a long-lasting insecticide-treated bed net in the 24 hours following the survey more than doubled over the duration of the project, increasing from 34 percent at the beginning of the project, to 70 percent at its conclusion. For mothers and infants from the age of 0 to 11 months, the percentage of long-lasting insecticide-treated bed nets used at the end of the project was even higher at 80 percent. Moreover, 90 percent of mothers of infants aged 0 to 11 months consistently slept under long-lasting insecticide-treated bed nets during their last pregnancy.
Receiving Appropriate Home-Based Care and Treatment
Over the course of the project, the percentage of children under the age of five who suffered from fever in the two weeks preceding the survey and who received appropriate home-based care and treatment for malaria within 24 hours increased from 25 percent to 55 percent. This number has surpassed the initial target of 40 percent.
An Increase in the Number of Early Referral Cases
One of the effects achieved through the project’s awareness-raising activities was an increase of knowledge in recognizing the symptoms of serious malaria cases and a consequent increase in the number of referrals of these cases to health facilities. From a baseline level of just 19 percent, the project has enabled 95 percent of mothers with children under 5 to identify at least one sign of serious malaria. As a result, the number of children under five in the project villages who were treated in health centers for serious cases of malaria increased from only 92 in 2006 to more than 200 in 2008.