Health education will be critical to the success of the Malaria Elimination Program for Ruhuha (MEPR) project in eastern Rwanda, if findings from a baseline study disseminated to stakeholders on May 28 -30 are anything to go by.

The Ruhuha Sector of Bugesera District remains Rwanda’s malaria hotbed as the country works towards pre elimination levels by 2018.

While community members rank malaria as the number one health problem in Ruhuha and are highly knowledgeable on malaria transmission, challenges abound on how to use some of the existing proven preventive measures.

One challenge for example is the association of bedbugs to bed net use, highly compromising ongoing efforts of minimizing malaria transmission. The community alleges that bed net usage comes with the multiplication of bedbugs in the households.

“All people were saying in the survey that they were using the bed nets but when it came to the focus group discussions we saw that almost all the participants said they have a high problem of bed bugs and the use of nets was really low,” said PhD student Ms Chantal Ingabire, also head of the behaviour sciences component of the MEPR study. “Some of the people were even saying that it was good to be bitten by a mosquito rather than bedbugs. This is really an issue if we have to maximize the preventive measures that we have.”

The findings also showed prevailing mis-information in that most survey respondents believed indoor residual spraying was no longer effective and therefore some community members were not allowing indoor residual spraying in their homesteads.

However, all hope is not lost according to Ms Ingabire who said that there were now signs that the community appreciates the need to tackle the problem.

“We have seen that this bottom - up approach of going to the community has made the locals empowered. It has enabled them to identify their local problems in terms of malaria and to suggest the solutions.  We believe that having the community as stakeholders will help inform the process of this program but also promote better participation for its success” Ms Ingabire noted.

Among the solutions suggested was the formation of community led sensitisation clubs and formation of partnerships with key stakeholders like religious leaders, non- governmental organisations, public and private healthcare providers, local leaders and schools.

“In our discussion with the communities, it was noted that the partnership of the various stakeholders was key in malaria elimination because no one can really eliminate malaria alone,” said Ms Ingabire. “There is need for a partnership with administrative, health, and other stakeholders.”

For more on community mobilisation efforts by the study team, the paper Community mobilization for malaria elimination: application of an open space methodology in Ruhuha sector, Rwanda offers invaluable reading!