Disrupt Malaria: Netlife- working with and for Senegal to increase mosquito net usage

Malaria continues to cause significant morbidity and mortality in Africa.The people at greatest risk are children and those living in rural areas with less access to health care services.The most proven, cost-effective protection from malaria is the long-lasting insecticide treated mosquito net.These nets can prevent malaria transmission, but there are obstacles to using them regularly in the heat of the rainy season months.

Netlife is as a nonprofit that has worked in the rural areas of Bandafassi in Senegal since 2005.Our recent survey work and field observations found that during the hot months of the rainy season, many people socialize and fall asleep on outdoor structures while they wait for their homes to cool down. This survey also found the WHO estimate of nets needed per household is likely inadequate to cover the traditional beds and the outdoor sleeping spaces.The result is that outdoor sleeping spaces rarely have a net, leaving people without any protection from malaria for 25 to 33% of the vector transmission period.

In 2015, Netlife worked with the people of Bandafassi and several other neighboring villages to have a friendly competition. The goal of the competition was to find new ways to safely use mosquito nets outdoors. Eight teams competed and the winning teams took home awards for overall best design and best innovation. Among the winners was a women’s group, and a youth group. After the event, Bandafassi nurse Mactar Mansaly led a debriefing where teams discussed the obstacles of outdoor sleeping and the possible solutions. The community was starting to build the interventional foundations to mend this gap in malaria prevention.

Netlife is partnering with community groups to develop the next steps in this important public health work. We hope to meet with ministry of health representatives, health post staff and community groups in Bandafassi to plan interventions, implement a program and find appropriate ways to evaluate the created project.

The framework for the 2019 project will promote the ideas and innovations from the winners of the outdoor sleeping contest. 20 villages near Bandafassi have been selected for the intervention.The intervention will likely include the installation of demonstration outdoor sleeping spaces with safely and securely hung mosquito nets.If the outdoor nets show promise, we will work with community leaders to further pilot, promote and distribute nets for outdoor sleeping spaces.Education, general discussion and trouble-shooting will surround the demonstration outdoor nets.Additional efforts will be made to build sustainability by partnering with community members to write grant applications and develop village-level malaria report cards.

ADDITIONAL PROJECT DETAILS:

WHEN: January 24 - February 14.Netlife members will meet with local officials and group leaders in Kedougou and Bandafassi from January 25-29.Village by village interventions will occur from January 30th to February 12. Debriefing and sustainability plans will be finalized from February 12 to February 14.

WHERE:20 villages were chosen randomly for past research purposes (stratification and sampling design available upon request).These are:Niapouar, Patassy, Bandafassi Tanda, Landieny Peul, Boundoucondi, Afia Magasin, Bandafassi Peul, Asoni, Nenefecha, Ibel, Niangue Bassari, Habibiou, Nathia, Dongol (Nialby), Santanco, Lande Baityl, Iwol (Bandemba), Baya, Matacossi, Thiokoye Hamdalaye

Map of the 37 Villages served by the Bandafassi health post in southeast Senegal.Red diamonds were selected villages.Purple circles were unselected villages.Red + marks indicate a source of staffed health care access.(QGIS 2.4.0)

FUNDING: Netlife is a United States non-profit organization that raises its own funds from contributors interested in specifically helping the Bandafassi population.Your donations would go directly towards funding the participation costs of a vital team member, a third year Medical Student at the University of Rochester Susan Greenman and towards the purchase of any mosquito nets. Susan Greenman's role is as a local liaison as a former Peace Corps Volunteer in Western Africa, she will work to create a sustainable program to increase local utilization of mosquito nets.

Any additional funds will go towards the purchase of additional mosquito nets to distribute.

OBJECTIVES:

1. Increase awareness of outdoor sleeping problems
2. Engage community to find solutions to problems
3. Construct sustainability with plans for further funding and hiring of local people for ongoing work
4. Coordinating with health post to find ways to increase local knowledge of real time malaria statistics
5. Distribute needed outdoor mosquito nets
6. Education of safe outdoor mosquito net usage via a video production created by local youth and women’s groups
7. Engage community to find clear indicators to measure success

For example:

• People attending demonstrations and educational sessions
• Number or outdoor nets demonstrations
• Nets distributed for outdoor use
• Number of times that malaria rates are publically reported
• Malaria cases and malaria deaths

METHODS:

A significant need to improve outdoor sleeping was the result of qualitative and quantitative survey data correlated with community observations.Both the research and outreach aspects of this project function through community based participatory methods.

We define community-based participatory research as a partnership approach to research that equitably involves community members, organizational representatives, and academic researchers in all aspects of the research process. It enables all partners to contribute their expertise, with shared responsibility and ownership; it enhances the understanding of a given phenomenon; and, it integrates the knowledge gained with action to improve the health and well-being of community members, such as through interventions and policy change (Israel, Schulz, Parker, and Becker, 1998).

Local stakeholders will be incorporated into the Netlife outreach and research team.These community members will help with this project’s design, implementation, analysis and interpretation.

www.netlifeafrica.org