Community-Based Interventions

Promotion and implementation of Community-Based Interventions (CBIs) in the Malaria Programme is the back bone of effective community participation which ensures responsiveness, ownership and sustainability of disease control interventions. CBIs include prevention, case management at home and at community level, community-based surveillance and community-self monitoring of the performance of different disease control interventions. Community members are involved in decision making, planning and programme implementation, monitoring and evaluation.

The CBI unit within the malaria programme is charged with developing guidelines for CBIs, supporting countries to plan, implement and evaluate CBIs programmes including documentation of best-practices.

Engagement of communities

Recent assessment of approaches to malaria prevention has indicated that many communities regard malaria as the status quo – something that has always existed and will never be changed. Hence, when health workers advise draining of swamps, spraying homes and use of ITNs, this advice may be ignored.

Work is now focusing on multisectoral malarial control – for instance, involving agricultural advisors whose advice is often taken more seriously by rural communities, such as was found in Kenya. Potential interventions include:

  • water-management-based interventions;
  • using a development-oriented focus such as advocacy for reducing the malaria burden to increase productivity and food security;
  • collaborating with agrochemical businesses to integrate better malaria control;
  • collaborating with farmers’ field schools for integrating malaria with pest management programmes;
  • using intermittent wet/dry irrigation;
  • increasing the distance between residential areas and crops/methods that increase malaria.

A variety of strategies have been used to raise community awareness of malaria prevention and control interventions. Integrated community case management (iCCM) is being promoted as a strategy for reducing morbidity and mortality in the population less than 5 years of age through the delivery of adequate services by volunteer community health workers. The focus of iCCM is training and equipping community volunteers to recognize, diagnose and treat malaria, diarrhoea and pneumonia – the three top childhood killers.