Musoke David, Karani George, Morris Keith, Ndejjo Rawlance, Atusingwize Edwinah, Guwatudde David, Musoke Miph Boses
Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
Cardiff School of Health Sciences, Cardiff Metropolitan University, Wales, UK.
Afr Health Sci. 2018 Dec;18(4):1144-1156. doi: 10.4314/ahs.v18i4.35.
The integrated approach to malaria prevention, which advocates for the use of several malaria prevention methods at households, is being explored to complement other existing strategies. We implemented a pilot project that promoted the integrated approach to malaria prevention in two rural communities in Wakiso district, Uganda.
This paper presents the impact evaluation findings of the project carried out 2 years after implementation with a focus on changes in knowledge and practices on malaria prevention.
The project evaluation was cross-sectional in design and employed both quantitative and qualitative data collection methods. The quantitative survey was conducted among 540 households (household heads being participants) while the qualitative component involved 4 focus group discussions among community health workers (CHWs). Chi-square test was used to compare quantitative results from the evaluation with those of the baseline while thematic analysis was employed for qualitative data.
There was a statistically significant positive change in malaria prevention practices in the evaluation compared with the baseline regarding indoor residual spraying (χ2 = 7.9, p = 0.019), mosquito screening of windows and ventilators (χ2 = 62.3, p = 0.001), and closing windows of houses before 6:00 pm (χ2 = 60.2, p < 0.001). The CHWs trained during the project were found to be highly knowledgeable on the various malaria prevention methods in the integrated approach, and continued to promote their use in the community.
Findings of the impact evaluation give promise that utilisation of integrated malaria prevention can be enhanced if use of multiple methods is promoted in communities.
疟疾预防的综合方法提倡在家庭中使用多种疟疾预防方法,目前正在探索该方法以补充其他现有策略。我们在乌干达瓦基索区的两个农村社区实施了一个试点项目,推广疟疾预防的综合方法。
本文介绍了该项目实施两年后的影响评估结果,重点关注疟疾预防知识和实践的变化。
项目评估采用横断面设计,运用了定量和定性数据收集方法。对540户家庭(户主为参与者)进行了定量调查,而定性部分则涉及与社区卫生工作者(CHW)进行的4次焦点小组讨论。使用卡方检验将评估的定量结果与基线结果进行比较,而定性数据则采用主题分析。
与基线相比,评估中疟疾预防实践有统计学上显著的积极变化,涉及室内滞留喷洒(χ2 = 7.9,p = 0.019)、窗户和通风口的防蚊纱窗(χ2 = 62.3,p = 0.001)以及下午6点前关闭房屋窗户(χ2 = 60.2,p < 0.001)。在项目期间接受培训的社区卫生工作者被发现对综合方法中的各种疟疾预防方法非常了解,并继续在社区中推广使用这些方法。
影响评估结果表明,如果在社区中推广多种方法的使用,综合疟疾预防的利用率有望提高。