Social acceptance of antimalarial strategies in Uganda

Abstract: According to the World Health Organization(WHO) the most efficient and cost-effective strategies in the global fight of malaria are the Indoor Residual Spraying (IRS) and the Insecticide Treated Nets ITNs). However, since the strategies include the use of synthetic insecticides, WHO reports that they sometimes meet opposition in the society. In a Global Malaria Programme report from 20061, WHO describes that concerns in the community regarding the safety of the IRS hinder its effective implementation. WHO states that the social acceptability of ITNs2 has to increase. This study aims at investigating if and where in the Ugandan society the antimalarial strategies meet opposition. The study analyzes whether authorities, non-governmental organizations and caretakers in one region in Uganda reject the antimalarial strategies recommended by WHO. The aim is further to investigate where focus should be put in order to meet the opposition (if any) to current strategies and thus facilitate the implementation of the strategies. The methodology used is an empirical approach based on interviews with officials at authorities, representatives of non-governmental organizations (NGOs) and caretakers in the slum areas in Kawempe Division, which is an area highly exposed to malaria, in Uganda. The results show that the authorities and the NGOs in this study accept the current strategies but believe that they are not fully accepted by caretakers. Further, the authorities and the NGOs point out that current strategies, mainly IRS, meet great resistance among politicians and within the agricultural and environmental sector. Nevertheless, the majority of the caretakers in the interviews does accept the strategies and give other reasons for not having them implemented in their houses. Many of the households do not have the money neither to buy the ITNs nor to have the IRS implemented in their houses. Thus, this study implies that the opposition to the current strategies is not among authorities, NGOs or caretakers but in the political, environmental and agricultural sphere. In order to fight malaria in the study area, WHO and stakeholders have to work with the change of attitudes among politicians and stakeholders within the environmental and agricultural sector in Uganda. They also have to provide poor households with ITNs or IRS for free, since lack of money is the reason for the studied group of caretakers not having the recommended strategies implemented in their houses.