The needs and opportunities for housing improvement for malaria control in southern Tanzania

Bofu, R. M. et al. (2023) The needs and opportunities for housing improvement for malaria control in southern Tanzania. Malaria Journal, 22, 69. (doi: 10.1186/s12936-023-04499-1) (PMID:36849883) (PMCID:PMC9972788)

Abstract

Background: Malaria disproportionately affects low-income households in rural communities where poor housing is common. Despite evidence that well-constructed and mosquito-proofed houses can reduce malaria risk, housing improvement is rarely included in malaria control toolboxes. This study assessed the need, magnitude, and opportunities for housing improvement to control malaria in rural Tanzania. Methods: A mixed-methods study was conducted in 19 villages across four district councils in southern Tanzania. A structured survey was administered to 1292 community members to assess need, perceptions, and opportunities for housing improvement for malaria control. Direct observations of 802 houses and surrounding environments were done to identify the actual needs and opportunities, and to validate the survey findings. A market survey was done to assess availability and cost of resources and services necessary for mosquito-proofing homes. Focus group discussions were conducted with key stakeholders to explore insights on the potential and challenges of housing improvement as a malaria intervention. Results: Compared to other methods for malaria control, housing improvement was among the best understood and most preferred by community members. Of the 735 survey respondents who needed housing improvements, a majority needed window screening (91.1%), repairs of holes in walls (79.4%), door covers (41.6%), closing of eave spaces (31.2%) and better roofs (19.0%). Community members invested significant efforts to improve their own homes against malaria and other dangers, but these efforts were often slow and delayed due to high costs and limited household incomes. Study participants suggested several mechanisms of support to improve their homes, including government loans and subsidies. Conclusion: Addressing the need for housing improvement is a critical component of malaria control efforts in southern Tanzania. In this study, a majority of the community members surveyed needed modest modifications and had plans to work on those modifications. Without additional support, their efforts were however generally slow; households would take years to sufficiently mosquito-proof their houses. It is, therefore, crucial to bring together the key players across sectors to reduce barriers in malaria-proofing housing in endemic settings. These may include government subsidies or partnerships with businesses to make housing improvement more accessible and affordable to residents.

• Item Type: Articles
• Additional Information: This work was supported by a grant from the British Academy, ‘Knowledge Frontier’s scheme (Grant Number: KF3/100047) and the Kings College London ESRC Impact Accelerator Award, both awarded to Ifakara Health Institute. MFF was also supported by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Carnegie Corporation of New York (Grant No. G-19-57145), Sida (Grant No: 54100113), Uppsala Monitoring Center, Norwegian Agency for Development Cooperation (Norad), and by the Wellcome Trust [Reference no. 107768/Z/15/Z] and the UK Foreign, Commonwealth & Development Office, with support from the Developing Excellence in Leadership, Training and Science in Africa (DELTAS Africa) programme. RMB was also supported by Ifakara Health Institute as part of the M.Sc studentship award (Ref.# IHI/TC/BAG/2020/108).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Okumu, Professor Fredros and Kahamba, Ms Najat
• Authors: Bofu, R. M., Santos, E. M., Msugupakulya, B. J., Kahamba, N. F., Swilla, J. D., Njalambaha, R., Kelly, A. H., Lezaun, J., Christofides, N., Okumu, F. O., and Finda, M. F.
• College/School: College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine
• Journal Name: Malaria Journal
• Publisher: BioMed Central
• ISSN: 1475-2875
• ISSN (Online): 1475-2875
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Malaria Journal 22: 69
• Publisher Policy: Reproduced under a Creative Commons License