Seasonal malaria chemoprevention: acceptance through the gender lens
Malaria control interventions are intrinsically community-based and demand active involvement from the entire community to be successful. As an intervention targeting children under five, this is especially true for seasonal malaria chemoprevention (SMC). Understanding gender differences in the determinants and consequences of malaria, and gender relations within the household and community, are key to ensuring the successful implementation of SMC at the community level.
A qualitative and quantitative study using a mixed methodological approach was developed to explore the main determinants for acceptance of SMC and to identify information sources that influenced the decision-making process within families. This study revealed over 80 percent of respondents knew about the benefits of SMC for their children, and 97 percent confirmed their intent of participating in future campaigns.
When it concerns a child’s health, without appearing central, women play a decisive role. Their role as the primary caregiver infers women first identify signs of illness and believe to know when it is appropriate to treat at home or contact a health worker, while fathers play a key role in covering costs. In every society, men and women play different roles and face different constraints. Whereas men engage in activities that put them at greater risk for malaria, it is actually women who bear more burden because of issues related to health care access and control of resources, among others. Some of the factors facilitating the acceptance of SMC by caregivers were it being administered door-to-door and being free of charge.
To maximize community acceptance, intervention strategies should be context-specific and address multiple factors in the wider social systems. While it is crucial for high-impact malaria control interventions like SMC to consider the pivotal role mothers play within the decision-making process, support is required from both male and female caregivers for SMC to reach its full potential of reducing malaria morbidity and mortality by 75 percent. If the ultimate decision to seek care lies with the father, mothers should be empowered to adopt positive behaviors and be used as advocates within families for heads of households to sanction those behaviors.