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Table 6 Studies documenting both community engagement and population coverage (n = 11, in chronological order)

From: Community engagement and population coverage in mass anti-malarial administrations: a systematic literature review

Author, year, country Health education Incentives Community (health) structures Human resource mobilization Other relevant factors
Archibald 1960, Nigeria [45] NR NR Cooperation was sought with the village authorities (local native authority and the Emir in Council of 3 study village). The purpose of the study was explained to local councils and meetings were conducted with the family heads The drug administration was carried out by authorities in-charge and staff (medical officer, the superintendent of rural health and the health sister) at the local health care centre
The local drug distribution team consisted a team leader, a female community attendant, a native authority representative from each ward and the locally recruited labourer
The acceptance of the small tasteless tablet of pyrimethamine was far better than the chloroquine which was often vomited by toddlers. The bitter taste, big size and the number of chloroquine tablets all were disadvantage for the administration
Clyde 1962, Tanzania [46] Information dissemination through health education sessions and demonstration of the advantage of the project NR Cooperation of the public was achieved through involvement of community leaders. Community leaders were sought for any raised problems and various reasons for defaulters A medical worker paid visits for treatment on a personal basis to everyone in the study site. Persistent follow up of defaulters was carried out Authors attributed the success to correct approach to the villagers through the community leaders and promotion of awareness through health education and demonstration of the advantages of the project
Roberts 1964a, Kenya [40] NR NR A joint collaboration with Ministry of Health of Kenya, WHO and UNICEF. Malaria control was handed over to the district health office (medical officer). Propaganda was introduced about the study, meetings were held with the inhabitants such as at trading centers, dispensaries and schools. A concerted program was organized to inform all the population about the objective of the campaign The advisory capacity was provided from the medical headquarters and ministry of health. The daily operation of the project was carried out by the district health inspector
School masters and agricultural scouts were involved as monitors and guides. 100 men were selected, trained and recruited on the work
A joint collaboration and successfully devolved the responsibilities to host government and local structures
Garfield, 1983, Nicaragua [27] Literacy follow up classes, health promotion activities were conjoint work with other diseases too NR Malaria control program in Nicaragua was one of a series of national health campaign 70,000 anti-malaria volunteers trained to conduct a census, provide door to door education about malaria, promote community participation, package and distribute drugs and keep records. In addition, about 10% of the country’s total population was estimated to have taken part in promotional activities Apart from the coverage of 70% of the whole population, the other benefits were the value of national level census, the long term impact of modifications in malaria control strategies based on campaign results, and the impact of increased citizen awareness on case finding and malaria control efforts
Baukapur 1984, India [34] Health education was carried out at different levels. Community health volunteers played a major role in increasing the awareness in the community NR The local health structure and additional health personnel and resources from district headquarters were utilized in this program Trained microscopists, leave reserve staffs, community health volunteers, malaria staffs from the district headquarter to local structures were involved in the malaria control program The study utilized both local and district level health staffs in both technical and non-technical works (health education) related to the malaria control work
Pribadi 1986, Indonesia [31] A comprehensible learning module for the community was prepared to provide the health education. Health education to children were also provided by the village teachers (cadres) NR The regular monthly meetings of the cadres and the periodical meetings with the health centre officer was conducted concerning the cases of malaria. The health centre and the sub-health centre both were provided with a paramedic who was trained at blood slide preparation and treatment Nine key persons from the sub village, consisting of school-teachers, heads of the RT’s and active young people were selected (cadres/facilitators) who were chosen by villagers co-ordinated by village heads. The cadres were trained on malaria signs and symptoms and treatment. The volunteers/cadres were appointed to distribute the learning module to each house in the village Adverse events were reported from some villagers and discussions were held to counteract the misunderstandings and were treated at local health center
Doi 1989b, Indonesia [44] NR NR Malaria control was one of the activities among other community health activities. A local school teacher, health center staffs and village volunteers were involved in the implementation of the project Part of a national initiative. A health center staff was responsible for testing the blood samples, examination of spleen and similarly, two community health volunteers were responsible for recorders and guides The project operated under the national initiative and the size of the project within the national initiative was proportionately small
Kaneko 2000, Vanuatu [35] Aggressive health education were conducted and were attributed for the sustained compliance with the bed net programme.
Information dissemination on MDA medicine through meetings were conducted after the incidence of adverse events
NR The district malaria supervisor and the staff of the central malaria section directed the local malaria intervention activities. Several meetings with community were conducted to explain the purpose and the objective of the MDA. 12 village volunteers were selected and trained as MDA staff and were responsible for drug administration.
One village volunteer was selected by the local health committee for the training of malaria microscopy. Thus trained community microscopist and registered nurse cooperated to guard against the future introduction of malaria
The adverse event such as vomiting and the number of tablets decreased compliance. The meeting was held to answer their questions and additional information was provided to the villagers. In addition, Chloroquine was removed from the regimen after 4th round
Von Seidlein 2003, Gambia [42] NR NR Discussion and co-operation with national and district level, members of the government district health team was sought
Meetings were conducted in villages in the presence of national and district level government officials to explain the objective and methods of study and in addition, questions were answered during the meetings
Village elders were engaged in the meetings to discuss about participation at the MDA. The consent of participation was given by the village head
A translator and fieldworker was appointed for consent process with the participants during drug administration. Similarly, two health center staff recorded the visits of individuals living in the study village Because of likely human and mosquito movement between villages, apart from 9 each intervention and placebo-controlled villages, 24 other neighbouring villages were treated which were not included in the study
Shekalaghe 2011, Tanzania [12] NR NR Meetings were conducted in all villages and the study was explained to all village leaders and local ten-cell leaders (balozi). A stepwise consent process was applied. At first, the verbal approval was obtained from these local leaders. Verbal household consent was sought after explaining about the study at their household. Three health facilities in the study area were involved in passive case detection
The concept of asymptomatic malaria and the benefits of participation was discussed during community meetings
Seven study teams consisting of one medically trained individual (medical doctor or medical officer) and 1 or 2 field workers were responsible for consenting, screening participants for the safety and administering drugs
All balozis were involved in the monitoring of movement of people in the study area. The approach to give local leaders a central role in explaining the study purposes, drug administration and monitoring migration were considered to influence the community participation
Each household received a household ID card and were entitled to free health care at the local health centers
Number of tablets (24 tablets/3 days; 7/day for 2 days and 10 for 3rd day) were complained as burdensome by some participants
A symptom diary was provided to the parents for their children, where they were asked to record the daily occurrence of fever, headache and body pains
Lwin 2015, Thai-Myanmar border [25] NR NR The cross-sectional survey results were discussed with the communities and different containment strategies were discussed. Chemoprophylaxis was endorsed by the residents of the village. Community leaders and key workers were consulted about the project, and approval was obtained from the Tak Province Community Ethics Advisory Board (T-CAB). The T-CAB consists of representatives from both the local ethnic Karen and Burman border communities which has been the primary ethics review body for health care interventions along the border for past 6 years Village malaria workers were trained in detection and treatment Community participation was low mainly because of difficult access to the communities, which resulted from the terrain and political instability
  1. NR not reported, IRS indoor residual insecticide spraying, ITN insecticide treated bednet, DDT dichloro diphenyl tricholoroethane, ND not done