Table 5 Studies documenting community engagement activities only (n = 12, in chronological order)
Author, year, country | Community engagement | Other relevant factors | |||
|---|---|---|---|---|---|
Health education | Incentives | Community (health) structures | Human resource mobilization | ||
Butler 1943, South Pacific [36] | Bulletins, announcements, short talks and movies | NR | The medical officer provided direction and information dissemination | Local community members provided manual labor | Mild initial intolerance to the anti-malarial consisted mainly of nausea, vomiting and diarrhoea. Less than 1% of participants showed absolute intolerance, usually manifested by repeated vomiting |
Berberian 1948a, Lebanon [26] | NR | NR | Discussion with village head and elders were held and the study was started after their consensus | NR | Villagers were grateful and demanded for the anti-malarials to an extent that villagers in the control arm were also provided with the anti-malarials which reduced the people in control arm. The population was mobile. For instance, only 160 out of 200 were present in one of the village |
Chaudhuri 1950a, India [83] | NR | NR | Young men from the village established themselves to form an anti-malarial society and were affiliated to central anti-malarial society | A local man worked as a volunteer to visit door to door of the villagers. A filed assistant was appointed for drug distribution | Some villagers migrated out of the village because of the perennial fear of malaria. Within the village, some villagers were reluctant to swallow the tablets in front of the study staff and preferred to keep it to take later. Adverse events such as vomiting affected others from taking them. There were propaganda about the ill-effects of the medicine which was eventually resolved |
Edeson 1957, Malaysia [84] | NR | NR | In each valley, committees were formed to serve as channels through which villagers were informed about the blood surveys or house spraying and villagers could express their views to the committee as well | Village volunteer was responsible for drug distribution | Even though medicine were distributed by a volunteer, there was no actual supervision of participants taking antimalarial) |
Gabaldon 1959, Venezuela [39] | NR | Incentives (lottery tickets) were provided for those completing MDA. A bonus incentive was given to MDA distributors if their sector was found malaria free | Nurses at local dispensaries coordinated with the study in keeping the record of any cases of malaria and preparing the slides | Involvement of rural visitors as staff (two types: drug dispensers and blood slide makers/collectors) who were supervised by inspectors and sub-inspectors A local doctor was engaged in conversation with few villagers who were reluctant to take the medicine | There were relapses observed in the groups of 5–14 years and 15 years or more after the completion of MDA. These groups took less than designated 18 treatments. This was attributed to the greater mobility, consequently, it was difficult to find them at their houses |
Clyde 1961a, Tanzania [32] | Articles for general public were written in 2 local newspapers | NR | German Hospitals as health structures were already present | The medical facilities and treatment was initiated by German health workers and in the established hospitals by Germans | Government’s consensus was sought for the initiation of Malaria control program in Tanga (research site) |
Charles 1962, Ghana [33] | Weekly health education class was conducted. Residents were also prepared by preliminary educational propaganda | NR | The trial formed part of the pilot malaria eradication project supported by Ghana government, WHO and UNICEF | Anti-malarial distribution was delegated to the formed team consisting of 2 volunteers who were selected from representative clans of the community | The study town had successfully participated in previous community development projects and the community was deemed to be cooperative. However, reluctance to take the medicine was noticed particularly in children and some informed that the tablets were sold or shared with other villagers |
Sehgal 1968, India [37] | Health education through audio-visual aids and using local literature (language). Intimate and personal persuasion was applied for resisting tribal population | Incentives were paid as an advance for building houses | Central to community level health structures and social structures were utilized which included additional staffs recruitment at various positions | Augmentation of staffs were done in existing positions. In addition, lower qualified community members were recruited for the work | Geographical inaccessibility was a major barrier for the malaria control program. Reluctance of staffs to work and reluctance of tribal population to the intervention were major barriers which were subsequently resolved |
Omer 1978, Sudan [85] | NR | NR | Ministry of Health was involved in providing the technicians for the check-up of blood slides. Local health structure such as public health office, local school and youth organizations were directly involved | A school teacher was asked to supervise who was under resident public health officer supervising the operation. 2 or 3 people, generally from the youth organization, helped the night before and in the morning to encourage people to participate | The people in the village were cooperative and appreciated the medical services rendered to them during the previous survey. The purpose of the chemoprophylaxis was explained to them (but no details on how was it conducted) and they volunteered to cooperate |
MacCormack 1983, Tanzania [47] | Health education through meetings was delivered in tier approach to key community persons who in turn educated families | NR | Anti-malarial supplied by WHO, government committed to the Malaria control plan and health structures present at the rural site coordinated with the project | The direction and operation of the project was taken care by the medical director of the hospital in the study area. Officials and staffs at local hospital were involved | As many as 28% of children complained of vomiting and 56% complained of itching, and other unfavourable qualities of chloroquines were indicated for the reluctance to adhere to the medicine |
Dapeng 1996, China [38] | Before introducing the malaria control program in the community, health education through the primary health care system, by means of meetings, films, posters, and videos were conducted thus encouraging villagers to participate | NR | Malaria control program was carried out through the existing primary health care system already in place | Additional experts from the provincial and central level were involved in field research, guidance and evaluation. Village doctors were responsible for the chemoprophylaxis and the clinical care of the patients | The control program involving malaria treatment and chemoprophylaxis was less successful than the vector control. Bed net impregnation was more accepted in the community than DDT spraying as it killed flea, lice and bedbugs as well |
Song 2010, Cambodia [43] | Village leaders cooperated in educating the general (study) population | NR | Local health workers from the community and volunteers from the village were involved in the study | Village malaria workers were recruited to distribute drugs and monitor drug administration | The anti-malarial were redistributed in 4 of the study villages because of the lack of anticipated reduction in malaria. Improper distribution and inadequate training of VMWs were attributed for the lack of reduction and some VMWs were subsequently replaced |