Community based malaria control in Zimbabwe

Five community based NGOs initiated a health programme in marginal districts of Zimbabwe, with support from Oxfam Canada. A baseline survey was done to define community health preferences and public health profiles, which prioritized malaria and diarrhoea. In all of the communities malaria was cited as the most problematic disease. The communities proposed spraying dwelling places to continue a programme that the ministry of health used to implement in all areas, but which was now restricted to very severe areas because of limited resources.

To implement this programme, sprayers who used to work in the ministry of health programme were identified by the villagers, two from each community. The communities insisted on having local sprayers as they alleged that outsiders would substitute water for the chemicals to make themselves some money. They were trained by personnel from the environmental health department of the ministry of health. Village community workers were included in the training so that they could act as 'warners' (people who move ahead of the spraying team), notifying the villagers of when the team would be spraying their huts and also educating them about the benefits and hazards of the chemical so that they knew how to handle themselves around sprayed premises. Spraying took place between late November and March.

Those areas where the programme was carried out witnessed a significant reduction of malaria cases at clinics when compared to areas where no spraying was done. The school registers also showed a decrease in children absent due to malaria. However, the incessant rains continued to feed water into open spaces and the warm temperatures provided an ideal environment for vector mosquito multiplication. The communities found the spraying effective as it killed mosquitoes and other parasites in their homes. The spraying activity and education raised the levels of awareness about malaria within the communities. The villagers are now willing to take on malaria control programmes as their responsibility. Community members suggested the establishment of disease control committees that would mobilize people for disease control and make contributions for the purchase of chemicals where they are required.
Source: Oxfam Canada et al., 1999