Historically, family planning has been constrained by the risk of contracting malaria. While malaria impacts people globally, women and children in endemic regions suffer disproportionately, particularly girls and women of childbearing age. Although the disease knows no boundaries, gender-specific factors lead to differing and more severe effects on these groups, necessitating targeted preventative approaches. This article explains the gendered perspectives on malaria prevention to highlight how gender-specific approaches can better assist women and children.
Understanding the Gender Dimensions of Malaria
Malaria is a disease transmitted to humans by the bite of infected female Anopheles mosquitoes carrying complicated cycles of four species of Plasmodium parasites. Socio-economic conditions and poor health infrastructures in the high-burden areas of the world – sub-Saharan Africa, Southeast Asia, and parts of Latin America – often contribute to its disproportionate impact in these areas.
Women and Children as Vulnerable Groups
- Pregnant Women: Pregnant women and their newborn babies are at an increased risk of developing severe malaria, malaria-related anemia, and low birth weight, leading to maternal and infant mortality. At the same time, pregnant women are particularly vulnerable to malaria and the consequences for their unborn fetuses, which can include stillbirth, premature birth, or miscarriage.
- Children under Five: Children under five years of age are most vulnerable to malaria due to their immune systems that have not fully developed yet. Malaria causes severe disease, one of which is cerebral malaria, and is the main cause of morbidity and mortality among children in the endemic regions.
Gender-Specific Challenges
- Barriers to the use of health services: Cultural constraints, lack of mobility, and economic obstacles might delay the time for diagnosis and treatment, often worsening the potential consequences of malaria on women and children.
- Pregnancy and Malaria: Among pregnant women, the desire to avoid the known side effects of drugs and facilities on a fetus, coupled with the socio-cultural perception that pregnancy makes a woman’s constitution cold and weak, means fewer women will seek care promptly.
- Household chores: Women, who are often primary caregivers, may be less likely to find time for healthcare tasks due to their often overburdened household chores.
Gender-Specific Approaches to Malaria Prevention
Overcoming these problems requires that researchers be creative in having gender-specific approaches to malaria control, on the assumption that women and children are at different risks and that interventions need to be designed to further protect them.
1. Targeted Health Education and Communication
Effective malaria prevention strategies must include targeted health education that considers gender dynamics:
- Pregnant women should receive ante-natal health education programs that explain their increased susceptibility to malaria during pregnancy and the protective benefits of intermittent preventive treatment in pregnancy (IPTp) and insecticide-treated nets (ITNs). Counseling should also address concerns about the safety of antimalarial drugs during pregnancy.
- Mothers and Caregivers: Educating the mothers and other caretakers about malaria symptoms, prevention techniques, and early medical attention can help reduce the number of children diagnosed with severe malaria. The community outreach and house-visit type of education program can ease the understanding of the malaria problem and thereby improve the level of compliance with the malaria preventive measures.
2. Access to Prevention and Treatment Services
Improving access to malaria prevention and treatment services for women and children involves:
- Increasing ITNs and IPTp Coverage: Pregnant women should receive supplies of ITNs and IPTp in sufficient quantities. Antenatal clinics and community health workers should actively reach pregnant women.
- Mobile clinics and community health workers can provide diagnostic testing, treatment, and essential malaria services to women and children, especially in remote or underserved areas. These services should be community-based, involve women, address specific needs and barriers to access, and align with existing service delivery systems.
3. Integrating Malaria Prevention into Maternal and Child Health Services
Combining malaria prevention with other mother and child health services is also an important focus:
- Integrating Antenatal Care: Integrate malaria prevention measures, like IPTp administration and ITN distribution, into routine antenatal care services. Include regular screening and monitoring for malaria as essential components of prenatal care.
- Enhancing Child Health Clinics: Incorporate malaria prevention and treatment into child health services, ensuring early diagnosis and prompt treatment of malaria in children. Health clinics should educate caregivers and provide the necessary support.
4. Addressing Socio-Cultural Barriers
Addressing socio-cultural barriers is essential for effective malaria prevention:
- Communities: Sometimes public perception is skewed and superstitious, so it is important to engage with community members about how to prevent and effectively treat malaria. Community health workers and advocates can help to catalyze this process. Community influencers like community leaders can also play a valuable role in encouraging the use of preventive measures.
- Gender sensitivity – Gender-sensitive considerations, focused on key roles and responsibilities of women, particularly issues of mobility, economic constraints, and norms and obligations in the design of health programs.
5. Empowering Women and Strengthening Gender Equality
Empowering women and promoting gender equality can significantly impact malaria prevention efforts:
- Economic empowerment: Women’s health can benefit from economic empowerment. Programs to boost women’s economic standing increase access to healthcare and preventive services. One such measure might be microfinance and vocational training that promote women’s economic independence and resource access.
- Education and Leadership: Investing in women’s and girls’ education and leadership in health programs can lead to better health outcomes as educated women are more likely to make use of healthcare and have a better record of practicing preventive measures for their families.
Case Studies and Success Stories
Several programs and initiatives have successfully implemented gender-specific approaches to malaria prevention:
- The Malaria Elimination Initiative (MEI): MEI has designed programs in India and other countries that target pregnant women and children. MEI tries to integrate malaria control into maternal and child health services and uses community health workers to reach hard-to-access populations.
- The World Health Organization and its initiative the Roll Back Malaria Partnership: Provided support to improve access to ITNs and IPTp for pregnant women living in malaria-endemic regions, in particular through community-based distribution and education programmes specifically designed to meet the needs of these women.
- Community-Based Interventions in Kenya: community-based interventions designed to educate and empower women in Kenya succeeded in reducing the incidence of malaria by training female community health workers to spur malaria prevention in their communities.
The Path Forward
These achievements should serve as a model for the next phase – to enhance malaria prevention in women and children through research targeting:
- Reinforcing gender-specific policies: Governments and organizations should develop and implement policies that are tailored to the needs of women and children in malaria-endemic areas.
- Increased financial support and more infrastructure: Without sufficient funding, we cannot implement gender-sensitive interventions, especially education programs, ITN distribution, and access to healthcare services.
- Encouraging Further Research and Data-Collection: Research into gendered aspects of the disease and the effects of gender-specific interventions needs to continue to refine strategies and maximize impact.
- The first recommendation centers on Collaboration: Bringing together health sectors, other service sectors, and community groups to collaborate in addressing the multisectoral factors that contribute to and affect the uptake and effectiveness of malaria prevention is needed.
Because women and children are at higher risk of the disease, gender-tailored interventions are necessary to improve the efficacy of malaria prevention strategies. Improved access to services can significantly reduce morbidity and mortality for women and children. Moreover, taking socio-cultural determinants and concerns into account can further help mitigate the impact of the disease. In particular, gender-tailored malaria control strategies can effectively reduce the burden of the disease.
Notably, it was the human stories of pregnant women and children like the Ngeneke girl that made the victimization from malaria all the more vivid. By adopting a gender-sensitive view of malaria control, we are likely to make better decisions. Furthermore, by advancing women’s agency, increasing access to health care, modernizing healthcare services, and integrating malaria prevention into maternal and child health care, we can achieve stronger and more sustainable progress in reducing morbidity and mortality.
