CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY  

Malaria is an entrenched global health challenge and is a major public health concern in many countries including

Kenya (Nyarko and Cobblah 2014). It is endemic in over 100 countries, and almost half of the worldwide population is at risk of malaria, where approximately one million people die from malaria each year (World Health Organization, 2015). This life-threatening disease is transmitted in humans from one person to another indirectly via the bite of female mosquitoes of the genus Anopheles, which harbors one of five species of parasites belonging to the genus Plasmodium (Fana, Bunza, Anka, et al., 2015).

In 2015, malaria transmission had been noted in over 95 countries and territories, constituting approximately

214 million cases. However, approximately 80% of all deaths due to malaria were concentrated in just 15 countries, mainly in the African region (World Health Organization, 2015). Children and pregnant women are most vulnerable to morbidity and mortality associated with malaria. Globally, approximately 306,000 children under the age of 5 died that year due to malaria, and approximately two thirds of these deaths occurred in the African region (World Health Organization, 2013). According to the World Health Organization (WHO), it is estimated that 9 out of 10 deaths in children were caused by malaria in Africa. Transmission of malaria highly depends on the temperature, humidity, and rainfall (Olson JAP and SH, 2006).

High temperature and heavy rainfall in summer season leads the highest malaria transmission, especially in

Africa. Despite those climatic factors, malaria transmission is also determined by the socioeconomic conditions and knowledge of and access to malaria prevention tools as well as the healthcare services (Chitunhu, and Musenge, 2012). In Africa, malaria transformation is comparatively higher among the rural setting than urban areas which may be because of the higher vector density, lower housing quality, and the poor drainage systems in rural settings (Oladeinde, Omoregie, Olley, et al., 2012).

Over 40 % of the world’s population in malaria infested areas. Malaria not only causes ill health and death but also hampers development due to the fact that lots of resources are spent combating the disease. For instance, expenditure on treatment and prevention is very high and there is loss of household incomes through absenteeism from work. According to a United Nations (UN) study, Malaria costs Uganda $347 million annually (The New Vision newspaper, 2004).

An estimated one million people in Africa die from malaria each year and most of these are children under 5 years old (World Health Report, 2002). In Uganda, malaria remains the biggest cause of death for children under five and one of the most important threats to new born babies. These deaths occur primarily among the poorest people because they do not have access to the drugs and protective measures necessary for prevention or cure. The fact that malaria kills an African child every 30 seconds proclaims distinctly the need for more attention on the health of children (Bellamy, 2003).

Combating malaria in scientific terms needs a lot of financial resources. Scientific efforts towards finding a malaria vaccine have so far been futile. In the meantime however, other alternatives towards malaria control would be using information campaigns to educate people on early detection of malaria symptoms and preventative measures such as using treated mosquito nets and seeking effective treatment. In this sense, communication programmes designed to bring about behaviour change will play an essential role in guiding people towards adopting the right malaria interventions.

Approximately, 40% of the world’s population is at risk of contracting malaria (World Health Organization, 2007). It is estimated that more than 500 million people become severely ill with malaria annually with more than one million people mostly children and pregnant women and most of them in Africa dying from the disease (Joel, Martin, and Anne, 2004) . These groups are at high risk due to immature and weakened immunity respectively. More than 80% of world malaria cases occur in Sub-Saharan Africa3 and 90% of deaths due to malaria occur in Africa South of the Sahara. Malaria is major public health concern in Eritrea with more than two thirds of the population living in areas at risk.4 Women and children constitute more than half of this exposed population(Shililu et a., 2003). Plasmodium falciparum malaria is predominant in Eritrea and is mainly transmitted by Anopheles arabiensis.  Community health agents have triple roles in their community as educators, health providers, and agents of change. According to the data from National Malaria Control Program, in 2008, about 70% of the malaria cases were treated by community health agents.10 Environmental factors and behavioral patterns of vectors and human populations combine to provide favorable conditions for malaria transmission (Nieto, Mendez, and carrasquilla, 2004). While much is known about vector biology and behavior and the malaria parasites, the importance of human behavior in malaria transmission has been largely overlooked. Therefore, this study focuses on the impact of mass media on the knowledge, attitude and reduction of Malaria among people using a case study of Ifo Local government area.

1.2     STATEMENT OF THE PROBLEM

Most people do not adopt a healthy behavior and tis increase their vulnerability to diseases, lack of a proper sanitation exposes adults and children to various disease especially malaria. The causative agent of malaria grows more in a dirty environment like dustbins, stagnant water, etc. the adoption of a healthy behavior reduces the exposure to malaria in the society.

The mass media does not educate ignorant people on how to prevent the prevalence of malaria in their society. Most mass media do not air programmes that addresses the causes and effects of malaria on adults and children in the society.

The worsening situation has been attributed to a number of factors such as, climate changes which lead to epidemics; increasing resistance to anti-malarial drugs; weak health systems with poor access to health care facilities; and poor access to knowledge about appropriate health behaviour in the population which leads to delay in treatment or wrong treatment; inadequate knowledge on the disease and costly preventive interventions, among others (MCSP, 2001-5).

School-aged children (age 5–15) bear the most significant burden of malaria in terms of having the highest prevalence rate [10]. Although a number of studies have been conducted on malaria among children and young adults, most of them are clinical-, treatment-, and prevention-based studies. These process make it obvious that there is a need to carry out a study on the impact of mass media on the knowledge, attitude and reduction of Malaria among people using a case study of Ifo Local government area.

1.3     OBJECTIVES OF THE STUDY  

The general objective of this study is to examine the impact of mass media on the knowledge, attitude and reduction of Malaria among people using a case study of Ifo Local government area. The specific objectives are:

1.     To ascertain the prevalence of malaria among people in Ifo local government area.

2.     To find out the attitude of people in Ifo local government towards sanitation and maintaining a healthy environment.

3.     To investigate how the mass media help to reduce the prevalence of malaria among people in Ifo local government.

4.     To determine the impact of the mass media on the knowledge of people on the factors responsible for malaria.

5.     To know if the mass media organizes programmes on the health implication of malaria.

1.4     RESEARCH QUESTIONS

The relevant research question related to this study are:

1.     What is the prevalence of malaria among people in Ifo local government area?

2.     What is the attitude of people in Ifo local government towards sanitation and maintaining a healthy environment?