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Pages 257-278

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From page 257...
... 12 Social and Behavioral Aspects of Malaria WHERE WE WANT TO BE IN THE YEAR 2010 There is widespread recognition that understanding the human response to malaria and to control programs is crucial to the success of all malaria control strategies. Because of an improved understanding of the way people perceive malaria, many social and behavioral barriers to the acceptance and use of prevention measures will be addressed in the design of malaria control programs.
From page 258...
... parts of the world are finding that available control measures are either too expensive, not efficacious, or efficacious only under certain conditions. Obtaining high rates of acceptance and use of such interventions, especially those that are marginally efficacious, is crucial to the success of control efforts.
From page 259...
... Agricultural Development The link between farming and malaria has a long history. In West Africa some 2,000 years ago, the advent of iron tools and higher-yield crops made the rain forest worth exploiting for agriculture (Livingstone, 1958)
From page 260...
... Type I and Type II Farming Systems For the purpose of discussing the interaction between agriculture and malaria, farming systems can be divided into two primary types: type I systems, typically smallholder-subsistence or "minifundia" cash-crop businesses, in which land-use rights are held by the farmers working the land; and larger, type II systems, in which the land is not owned by the people who farm it and frequent use is made of migrant or wage laborers. This distinction is similar to that drawn by Bruce-Chwatt (1987)
From page 261...
... Type II farms are also distinguished by their large-scale use of water. Irrigation is common to almost all forms of type II farming systems.
From page 262...
... Housing, if available, is crowded, of poor quality, and often located adjacent to Anopheles breeding sites. Third, the type of work performed by migrants and the conditions under which they work often result in greater exposure to malaria-infected mosquitoes.
From page 263...
... Anopheles stephensi is the most important vector of urban malaria on the Indian subcontinent. Nowhere else in the world is there a malaria vector so well adapted to urban life.
From page 264...
... that contribute to the appearance of urban malaria are similar to those involved in producing malaria in rural populations and in migrants. The recently settled, low-income neighborhoods on the periphery of urban areas where malaria commonly occurs are usually populated by migrants from rural sites or refugees from war, famine, or changing patterns of land tenure.
From page 265...
... Although there is an awareness that the other cultural, behavioral, and operational factors may also be acting as barriers to adoption of interventions, they tend to receive less attention for several reasons. First, program planners seldom have the training in qualitative research techniques necessary to investigate these factors.
From page 266...
... said the disease could be caused by "germs" in contaminated water, and nearly 30 percent blamed the disease on "microorganisms" (Lariosa, 1986)
From page 267...
... the only cause of malaria is that people may feel that methods of treatment such as chloroquine do not work for all forms of malaria. In Malawi, Helitzer-Allen (1989)
From page 268...
... Finally, nosological fusion can make local treatments seem effective when they are not. For example, if a viral infection is diagnosed incorrectly as malaria and the patient takes a local remedy and becomes well, the patient may conclude that the treatment is efficacious against malaria when it is not; the viral infection has merely been resolved by the patient's own immune system.
From page 269...
... MacCormack and Lwihula (1983) show how a program aimed at controlling malaria in children through the use of prophylactic chloroquine failed because of a lack of sensitivity to a series of quite practical problems, including the exclusion of socially marginal families from the program and irregular drug supplies at the local level.
From page 270...
... and Panicker, 1984)
From page 271...
... group of the United Nations Development Program/World Bank/Word Health Organization/Special Program for Research and Training in Tropical Diseases/ Social and Economic Research. RESEARCH AGENDA The application of social and behavioral science research on malaria (excluding questions of economics and management, which are dealt with in other chapters)
From page 272...
... health care providers. Relevant data are obtained through free listing of illnesses, narratives of past malaria episodes, hypothetical case scenarios, paired comparisons, severity ratings, and sorting tasks.
From page 273...
... RESEARCH FOCUS: Adoption and evaluation of contemporary health communication techniques that use qualitative and quantitative research intensively to define the audiences, behaviors, strategies, channels, and messages for malaria control programs. RESEARCH FOCUS: Explorations of the applicability of contemporary learning models to bring about behavior change in population and evaluation at risk.
From page 274...
... RESEARCH FOCUS: Development and evaluation of novel ways of involving communities in the planning, implementation, and evaluation of malaria control programs. REFERENCES Allen, S
From page 275...
... Friedlander, J
From page 276...
... MacCormack, C
From page 277...
... Mexico. Unpublished document.

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