In many places around the world, malaria remains one of the biggest health challenges, particularly in sub-Saharan Africa, where it disproportionately affects children. Despite medical advances in both preventing and treating malaria, it continues to cause high levels of morbidity and mortality in children, particularly in these regions of endemicity. Better outcomes could come from culturally sensitive approaches to the education of malaria, and what they can tell us about the usefulness of adapting health interventions to different cultural contexts.
The Importance of Cultural Context in Health Education
Cultural context matters. Today, we live in a global world with a diverse range of cultures and traditions. Health messages, like those for preventing malaria, are received within a cultural context and viewed through a cultural lens. If people do not understand, accept, or appreciate the health messages delivered by healthcare providers, they are less likely to know and follow the recommended practices for preventing malaria.
Challenges in Malaria Prevention for Children
- Cultural Beliefs and Practices: Community-level beliefs, such as practices regarding the etiology (causes) of disease, treatment, and prevention, determine the success of malaria prevention strategies. In some cultures, people attribute malaria to supernatural or spiritual causes rather than biological vectors, which makes them reject conventional preventive measures like bed nets or insecticide sprays.
- Access and Use: Even when effective technologies, such as insecticide-treated nets (ITNs), are available, users must embrace and integrate them into their lifestyles. For example, if sleeping arrangements or family structures do not allow for individual nets, communities may need to explore collective approaches.
- Barriers to Education: Low literacy rates hinder the rapid spread of health knowledge. Language differences can act as barriers to reaching diverse communities. Making educational materials culturally relevant and accessible increases their effectiveness in these populations.
Culturally Tailored Approaches to Malaria Education
- Community Action: Programs should enlist local leaders who hold credibility within the community and can effectively communicate with residents of North Kiryandongo. Residents typically respond positively to these leaders.
- Respecting Traditional Interventions: Malaria prevention strategies gain acceptance when they align with existing cultural practices. For instance, if community members use herbal remedies or traditional medicines to treat fevers, these practices should complement the use of ITNs.
- Use Local Language and Symbols: Create materials in local languages that incorporate relevant symbols and imagery. This approach ensures that messages resonate with the community. Utilizing visual aids and storytelling, including local folklore and parables about malaria prevention, can enhance communication.
- Family and Community-Based Interventions: Many cultures depend on family and community units for health decisions. Interventions designed to include family members and community groups are more likely to achieve compliance. For example, parents educated about ITNs and proper fever treatment are more likely to use nets consistently.
- Tailor Your Message: This final strategy is crucial. Different cultural beliefs and practices inform people’s views on the causes and treatments of malaria. Therefore, develop messages that leverage these beliefs effectively. For instance, messages about obstructive sleep apnea that align with cultural beliefs about its causes may prove more effective in outreach efforts.
Successful Examples of Culturally Tailored Malaria Programs
- The Malaria Consortium’s ‘Cultural Sensitivity in Health Education’ Initiative in Uganda targeted the overall use of ITNs and other preventive measures by incorporating local beliefs and practices, including using local languages and symbols and engaging traditional healers to encourage wider community acceptance.
- The ‘Mosquitoes and Us’ Campaign in Nigeria: The ‘Mosquitoes and Us’ campaign featured local storytelling. Photo courtesy Grand Challenge Science ‘Mosquitoes and Us’ primarily consisted of local storytelling and community theatre with training and scripts adapted from rural settings in the Yoruba language to bring the ITNs and mosquito control messages into local family circles in a way that felt culturally appropriate.
- ‘Elders as Educators’ Approach in Kenya: Community elders were trained to deliver malaria prevention messages. The use of elders’ status and support mobilized the community’s engagement in behavior change.
Evaluating the Impact of Culturally Tailored Approaches
Given the disastrous consequences of malaria, culturally tailored malaria education and be evaluated regularly. Evaluation methods should take into account that:
- Community Feedback: soliciting feedback from members of the community on the relevance and effectiveness of educational materials and interventions; ongoing feedback can inform both the course content and the design of the intervention.
- Behavioral Indicators: Behavioural changes that inform us whether the program is improving ITN use or treatment-seeking practices for malaria.
- Health Outcomes: We can assess the impact of culturally tailored approaches on health outcomes by examining changes in malaria incidence and morbidity in children.
- Continuous Adaptation: Health programs must be developed with agility, allowing for ongoing adjustments and improvements.They must be able to adapt to changing cultural contexts and communities’ evolving feedback. Continuous engagement of local populations and program flexibility can help to maintain effectiveness over the long elementary, community- and culture-centered child malaria education and prevention programs can meet the multifaceted experience of malaria in any given cultural milieu Elementary schoolchildren in Kapiri Mposhi, Zambia learn about malaria control with a hands-on toy made from clay.
