An empowerment program to enhance women's ability to prevent and control malaria in the community, Chiang Mai Province, Thailand.

ABSTRACT

Paulo Freire's theory was modified to empower a women's group in Chiang Mai Province, Thailand, to prevent and control malaria. This study conducted an intervention in Mueang Na Wan Village, Mueang Na Sub-district, Chiang Dao District, Chiang Mai Province, where 45 women were systematically recruited into the study cohort. Navail Village was selected as a control village because it resembled the intervention village. The empowerment program emphasized enhancement of malaria preventive levels, using insecticide-treated bed nets, self-esteem, and self confidence expectation to prevent and control malaria. Intensive training was conducted and activities performed among the women's group, with 10 participatory meetings in all. Data collection was conducted for the pre-test in month 1, and post-intervention in months 3, 6, 9, and 12. The qualitative methods used were focus-group discussions, non-participant observations, and in-depth interviews with housewives, their husbands, and youths at risk for malaria. The results showed that, post-intervention, there were significantly increased levels for malaria preventive behaviors, behaviors of using insecticide-treated nets, self-esteem, and self confidence expectations, in the intervention village compared with the control village. Insecticide-treated net usage and insecticide-treated net usage behaviors increased in the intervention village more than before and more than that in the control village. The women's group in the intervention village created the following plans, which were crucial to malaria prevention (1) a family protection plan, (2) providing malaria education to community members, (3) a mosquito-control campaign, (4) scaling-up insecticide-impregnated bed nets, and (5) malaria control among foreign laborers. Finally, the empowered women's group performed sustainable activities. Between malaria-prevention activities, they conducted a joint program to raise income for their families.