Implementing a malaria curtains project in rural Malawi.

This paper describes planning, implementation, monitoring and evaluation activities carried out in support of a malaria control project that used permethrin-impregnated curtains in eight villages in rural Malawi. Findings from formative evaluation and project monitoring aspects of the evaluation are presented. Permethrin-impregnated curtains were introduced to villagers who participated in household self-help projects. To implement the project, village health workers were trained and worked closely with existing project personnel as well as traditional headmen to assure village participation, facilitate health education and coordinate curtain-dipping (impregnation) meetings. A quasi-experimental evaluation design used surveys and observations to measure change in cognitive, behavioural and health outcome indicators. Village adoption rates averaged 50%, with variation between villages. Monitoring data showed a high degree of compliance with curtain re-impregnation initially and high perceived efficacy of curtains. Issues discussed include village readiness for change, trust, acceptability of the innovation, cost, sustainability and leadership.

PIP: Many malaria prevention strategies in sub-Saharan Africa promote household preventive sanitation self-help activities. However, it has been shown to have limited effectiveness, as well as increased parasite resistance to anti-malarial drugs, or unacceptable levels of toxicity in environmental spraying. This paper reports on planning, implementation, monitoring of an impregnated curtain project in rural Malawi. In this intervention, permethrin-impregnated curtains were introduced to villagers who participated in household self-help projects. To implement the project, village health workers were trained and worked closely with existing project personnel, as well as traditional headmen to assure village participation, facilitate health education and coordinate curtain-dipping (impregnation) meetings. A quasi-experimental evaluation design used surveys and observations to measure change in cognitive, behavioral and health outcome indicators. Village adoption rates averaged 50%, with variation between villages. Monitoring data showed a high degree of compliance with curtain re-impregnation initially and high perceived efficacy of curtains. Other issues discussed include village readiness for change, trust, and acceptability of the innovation, cost, sustainability, and leadership.

Factors contributing to high neonatal mortality rate in Lilongwe District; 1988

Prematurity is among the major causes of neo-natal deaths with a risk 10-13 times greater than full term babies. Tetanus was another major cause and accounting for 28 percent of neo-natal deaths