Malaria is a parasitic infectious disease commonly spread by mosquitos that causes fever, chills, and flu-like illnesses that can also result in coma, or death. Documentation of the disease extends back to more than 4000 years ago in ancient civilizations where the disease was rampant, especially in areas with standing water. Today, Nigeria is one of the most vulnerable countries to malaria in the world. This is largely associated with poverty in the country, which is one of the most influential factors in the incidence of the disease. Despite large economic growth in Nigeria, poverty is still rising and income disparities are growing. This is especially problematic for rural populations where infrastructure is lacking and unable to effectively manage malaria prevention. Thankfully, there are large scale efforts to prevent malaria from the CDC collaborating with ministries of health to provide technical expertise, and as of 2005, the President’s Malaria Initiative. This initiative works to relieve the burden of malaria in 19 African countries through interventions (mosquito nets, indoor spraying with insecticides, preventative treatment for pregnant women, etc).
In H. Kristian Heggenhougen’s work, “The behavioral and social aspects of malaria and its control”, poverty and inequality are quickly recognized as factors that contribute to the prevalence of malaria in Africa, but Heggenhougen’s focus is placed on bringing attention to the sociocultural environment. Consideration of behavioral and social aspects of malaria control is generally a given in public health, however, Heggenhougen argues that it is only receives “superficial attention”. Acceptance of Western technology and practices by locals limits the effectiveness of interventions as their health-seeking behavior is vastly different from ours. For example, pregnant women in danger of contracting malaria would refuse preventative chloroquine tablets for fear of miscarriage (a possible side effect with excessive use) even though the malaria alone could cause fetal death. Heggenhougen truly advocates for an approach that emphasizes cultural context. Instead of simply providing insecticide treated nets, an initiative needs to consider local factors that will affect usefulness.
Heggenhougen, H. Kristian, Veronica Hackethal, and Pramila Vivek. “The behavioural and social aspects of malaria and its control.” 2003. http://www.who.int/tdr/publications/documents/seb_malaria.pdf.