Effectiveness of Health Education Interventions for Malaria Prevention in Adults

This research study examines the effectiveness of health education interventions for preventing malaria in adults. It explores key international strategies, risk factors, and health promotion theories. The study provides findings and recommendations for improving malaria prevention.

Contents
ABSTRACT.......................................................................................3
INTRODUCTION...............................................................................5
BACKGROUND................................................................................5
LITERATURE REVIEW........................................................................7
THEME: 1 MALARIA AS AN IMPORTANT PUBLIC HEALTH ISSUE.......7
THEME: 2 KEY INTERNATIONAL STRATEGY OR PLANNING FOR
CONTROLLING MALARIA..................................................................8
THEME: 3 KEY RISK FACTORS FOR MALARIA....................................9
THEME: 4 KEY HEALTH PROMOTION THEORIES...............................9
METHODOLOGY............................................................................11
SEARCH STRATEGY.........................................................................11
DEFINE PICO FRAMEWORK............................................................12
PATIENT, PROBLEM OR POPULATION, INTERVENTION,
COMPARISON, CONTROL OR COMPARATOR, OUTCOME(S) (PICO)
FRAMEWORK.................................................................................12
ETHICAL CONSIDERATIONS............................................................13
CRITICAL APPRAISAL.................................................................14
DISCUSSION AND RECOMMENDATIONS...............................20
1
EFFEC
TIVEN
ESS
OF
HEALT
H
EDUCA
TION
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DISCUSSION...........................................................................................................................................20
RECOMMENDATIONS............................................................................................................................25
CONCLUSION........................................................................................................................................27
APPENDIX..............................................................................................................................................28
REFERENCES........................................................................................................................................34
ABSTRACT
Malaria has been a major disease for a large part of the world in the past few years. It
caused 405,000 deaths worldwide in the year 2018 one of the main factors which relate
to the widespread of Malaria in specific is shortage of skilled health professionals and
lack of access to information (Chourasia et al. 2014).
The research study has been summarized about the effectiveness of education
interventions for adults as prevention strategy for reducing Malaria globally. It has been
included different kinds of secondary sources such as articles and websites are used to
extract useful information for this research process. This will help for gathering relevant
information about the Malaria and gained more knowledge about the better intervention.
In this study, it has been explaining the brief overview about the significance
possibilities across the Malaria prevention strategies.
As per finding, it has been identified the one major reason for the widespread of
Malaria is misinformation or lack of sufficient information (Chourasia et al. 2014).These
factors must be taken in consideration in order to attain an improvised set treatment
2
VENTI

provisions for Malaria eradication programs. Although the primary reason for Malaria is
from biting of anopheles mosquito (Chourasia et al. 2014). Other hand, there is a
lacking information effects on the entire case study.
3

INTRODUCTION
Malaria is the most prevalent parasitic endemic disease in Africa which is
treatable, curable and preventable. The main question which remains highlighted under
this subject is the fact that despite of its ability to be cured, how Malaria remains
occurring in some of developing countries, (Chourasia et al. 2014). Prominent reason
for this particular perspective is the lack of information availability among the individuals.
In today’s world, Malaria is the found throughout sub-tropical as well as tropical region
of global world. There are cause more than 300 to 600 million people illness and deaths
annually basis (Chourasia et al. 2014). As per approximation, 40% of world population
which is mostly living the poor countries whereas they will have high level of risk due to
Malaria. It is directly affects on the five times as many people those are suffering from
the immune deficiency syndrome, measles, leprosy and tuberculosis combined
(Chourasia et al. 2014). In recently, Malaria is the most important cause of disability and
high death rate among children’s (Chourasia et al. 2014). The ultimate aim of report is
to understand about the behavioral change and ensure that individuals, communities,
families and health worker which are taking preventive measure. There are many
reasons why country bears an overwhelming proportion of Malaria. The report will
describe that how Malaria as an important public health issue across the global world. It
will identify the key factors of Malaria which directly affects on the health condition of
adults. The documentation will describe health promotions theories which providing the
facilities of intervention and prevention against Malaria.
BACKGROUND
Malaria has been considered as a constantly increasing the dangerous threats and risks
for human being. As per report, it has been found that 216 million people in the global
population was at a severe risk of this parasitic endemic disease in 2016. ( Balami et al.
2019).Government has been initiative towards identifying the primary reason behind
increasing causes of malaria across global world.This kind of malaria disease will be
increasing threat of every people because many people have a lack of awareness
regarding positive intervention. (Cox et al. 2018).
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As per report, it has been identified that Malaria across the world depict lack of
efficient educational support within the cultures which ultimately leads to an unsecure
operational environment and a comparatively less specific conservation program.
Community education on Malaria has been a largely evident factor for controlling the
spread of Malaria and overcoming positive cases (Balami et al. 2019). An efficiently
operated community education program is capable of promoting the knowledge base
related to this disease and helps communities to counter it collectively.
In past decade, there are various kind of education program organized by other
committee. In order to control or manage the overall positive practices, knowledge and
attitudes usage to achieve a control on the spread of Malaria. In order to increase the
awareness possibilities across the population for achieving behavioral changes across
the communities (Tobgay et al. 2013). This initiative has been ideal across the South
African regions to increase the awareness about Malaria and its spread. The behavior
change communication under this particular Malaria prevention and elimination strategy
has been also quite useful across the South African regions in achieving better results
(Tobgay et al. 2013). MAP is an adult education program that is largely put in place for
controlling the initiation and spread of Malaria (Tobgay et al. 2013). This particular form
of awareness program is popular across South African states such as Limpopo and
Vhembe districts. The overall effectiveness of these programs is assessed based on the
participation ratio and the effectiveness across learning possibilities of the participants
(Ndira et al. 2014). This comparative analysis is largely helpful in acknowledging the
overall impacts which an educational process has over the desired objective of
eliminating Malaria (Cox et al. 2018). Behavioral changes are an important portion of
the relative Malaria prevention process and it is put in place for assessing a controlled
attribute.
Aim: To Investigate the Effectiveness of health education interventions for prevention
of Malaria in adults.
Objective
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 To analyze the key international strategy or planning for controlling Malaria
 To determine the health promotion theories for prevention of Malaria in adults
 To identify the key factors of Malaria
Research Questions
 What is the concept of public health issue such as Malaria?
 What are different key international strategies or planning for controlling Malaria
across the world?
 What are different health promotion theories for prevention of Malaria?
 What are key factors of Malaria?
LITERATURE REVIEW
THEME: 1 MALARIA AS AN IMPORTANT PUBLIC HEALTH ISSUE
Malaria exists as one of the most dangerous acute illness in the human history. It
has been a major player in causing large scale infections and ultimately deaths across
the world. As the main cause of this disease is related to parasitic infection, the chances
of elimination are directly proportional to the elimination of a particular parasite (Tobgay
et al. 2013). The intensity of this issue can be assessed from the fact that in the year
2016, approximately 212 million cases of Malaria were reported worldwide. The total
numbers of people died of this disease in that year were around 429,000 (Tobgay et al.
2013). However, majority of the developed countries have been able to control Malaria
and have developed sufficient measured the parameters. Malaria has been able to exist
in developing and underdeveloped countries across African and Asian regions at higher
(Chourasia et al. 2014) (Chourasia et al. 2014)rates (Tobgay et al. 2013). In the year
2015, the sub-Saharan African region accounted for 90% of the total cases of Malaria
and 92% of the total deaths caused by Malaria (Balami et al. 2019). These regions have
been largely affected by the impacts of Malaria and thus there has been a greater need
for preventive programs across these regions.
Malaria is one of the most public health problem across global world. It is
increasingly cause of morbidity and mortality in different nations. According to WHO, it
has identified that 350-500 clinical cause related the malaria across global world
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(Tobgay et al. 2013). Afterwards, it can be transmitted from widely areas and also
distributed into different countries such as South Africa, Middle East, South America
and Asia. However, it is the significantly understand the geographical variation in term
of morbidity as well as mortality that exits between regions, countries. On the other
hand, America contributed approximately 3% of different malaria causes across the
word. In between 1979 and 2002, large number of imported cases related malaria exists
in UK (Cox et al. 2018).
Topic is important as one of the main reasons behind the spread of Malaria is the
lack of knowledge across adults (Cox et al. 2018). Interactive and informative adult
health education for preventing Malaria can be highly useful to acknowledge the
importance and operability across its relative ideologies and thus attain a better coping
mechanism (Cox et al. 2018). For instance, factors such as Larval mosquito control is
propagated throughout the adult health education programs are helpful in controlling the
Malaria virus at its very early stage and thus improves the coping mechanism
effectively.
THEME: 2 KEY INTERNATIONAL STRATEGY OR PLANNING FOR CONTROLLING
MALARIA
There are a number of programs and strategies that are put in place to reduce Malaria
epidemic. These initiatives are processed and acknowledged by independent countries
as well as the World Health Organization (WHO) (Ndira et al. 2014). Some of the most
significant programs and activities on global as well as national levels are discussed
below.
WHO GLOBAL MALARIA PROGRAM
The WHO global Malaria program is an important program that is put in place for
facilitating a coordinated approach towards the elimination and control of Malaria. The
guidance and counselling facilities under this particular approach is incorporated under
the world health assembly. This program aims to reduce the global cases related to
Malaria by 90%) (Ndira et al. 2014) Elimination of Malaria in approximately 35 countries
by 2030) (Ndira et al. 2014). Lastly, providing preventive resurgence for Malaria across
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the Malaria free countries of world. So as required for understanding the current
scenario of prevention program which always supporting to protect against the
diseases.
GLOBAL TECHNICAL STRATEGY FOR MALARIA 2016-2030
Elimination and control of Malaria on global levels requires huge technical attributes
and support system for coping up with the spread of Malaria. This strategy is liable to
disseminate a global guidance and policy framework that can be useful for sustaining
the global Malaria control operations (Tobgay et al. 2013). Provide a supportive
mechanism for the participating countries in terms of adoption and implementation of
global guidelines from WHO in order to tackle Malaria (Tobgay et al. 2013). Provide
assistance to the partnering countries in making efficient national strategic planning for
preventing Malaria. These structures are also helpful in developing a robust surveillance
system to tackle Malaria.
THEME: 3 KEY RISK FACTORS FOR MALARIA
In addition to this, a number of social beliefs are also directly linked to initiate a
major impact over the Malaria prevention activities among individuals (Tobgay et al.
2013). These beliefs lay the foundations for delayed treatments and prevention
measures. The risk factor for Malaria is that when Plasmodium parasite is considered
as main cause of the infection, lifestyle factor, cultural or environmental factors. It
always play important role for contribution towards Malaria (Tobgay et al. 2013)
Lifestyle factor is the most common issue where it is directly infected the people
in certain geographical region with change the tropical climate. In this way, it has
chances to increase more mosquitos vector that carries more parasite. Living in the
different areas which has increased the Malaria substantially increase more risks
(Tobgay et al. 2013) in this way, it can be improved the understanding towards life style
factor which always influencing the people to aware about critical situation or condition.
At certain aspects, it has analysed the health related risk, threat due to climate change.
Environmental Factor: it has increased the exposure to Malaria which includes
lack of protective clothing. In order to expose the sleeping accommodation and other
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lack of immunization (Tobgay et al. 2013). It has been spreading especially when
people travelling from one place to another. In this way, it is the best ways to use
suitable precaution of maintain or control.
THEME: 4 KEY HEALTH PROMOTION THEORIES
There are several key health promotional theories that signify the availability of
strict standards that are better way to facilitate better cooperation attributes that are
linked to facilitate better results in context of controlling Malaria (Beauchamp, Crawford
and Jackson, 2019). These theories are put in place for effective orientation of
strategies and accomplishments that may be helpful eradicate Malaria. The available
theoretical framework is a key ingredient to influence the behavioral approach as well as
the medical interventions across the Africa (Beauchamp, Crawford and Jackson, 2019)).
The challenges and restrictions are originated with an insufficiency across the
knowledge factor. Thus, most of the applied theories are linked to assess the
behavioral. Some of the most suitable theories which have been or can be helpful in
managing the control factor across Malaria are listed below.
Social cognitive theory: it is based on the learning theory in 1960s by Albert bandura
(Beauchamp, Crawford and Jackson, 2019). This theory is identifying the behavior used
in the health promotion. The primary goal is to understand that how people always used
to regulate the behavior through reinforcement and control. In this way, it can easily
achieve the significant goal and objective in public health.
Protection motivation theory: this theory is mainly useful for proposing the action in
order to protect themselves. Sometimes, it is mainly considered the different factors
such as severity of threatening, probability of occurrence and other type of
vulnerabilities. By using this theory, it can easily identify the changing behavior of
people due to health issues (Ling, Kothe and Mullan, 2019). There are many medical
professional recommendation to prevent the behavior and perceived the self-efficiency
in proper manner.
 Health belief model: This type of model is to be considered as theoretical approach
which providing the better guidance of people while promoting the harmful affect due
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to Malaria. So as require to conduct the prevention program which help for predicting
the individual changes in health behavior (Beauchamp, Crawford and Jackson,
2019) In another way, it can be understand the use of model to examine current
situation or condition.
In additional theories such as Stress and coping theories.
METHODOLOGY
In this research project, Researcher has chosen Qualitative research
methodology for collecting or gathering large amount of information or data relevant to
the Malaria. Qualitative method with the acknowledgement of generalization as well as
abstraction (Kumar, 2019)
Define the Literature review and critical literature review, key types of literature
review are used in public health.
A Literature review seeks to determine, analyse and summaries the published
research related the concept of Malaria and what are different intervention or prevention
to reduce the affects among adults. LR has been assigned as course project which
mainly included the currently situation or condition. Afterwards, it can be evaluated the
strength on the basis of evidence for gaining more knowledge (Kumar, 2019). A review
of public health issue such as Malaria, identifying the implications in term of clinical
practice. Literature review is mainly defined the different area of topic that needed to
further expansion. By using LR, researcher is mainly focused on the research problem
in order to identify the possible solution. It might be included the research question to
find out their answer through analysis (Kumar, 2019) Furthermore, the identification of
various literature review method that help for analysing the public health issue such as
Malaria in adults. It is mainly include formulating the research questions, objective,
screening for inclusion, extract relevant data, assessing the quality of primary studies
(Kumar, 2019)
In this research study, investigator has chosen the research question which
mainly used in the literature review for analysing the better result or outcome. It is to be
considered as different way to handle the problem and issue during execution. Although
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public, social community will be assessing the information about the Malaria how it will
directly impact on the human health condition, the suitable key factors that consists of
various information that how increases public health issue or problem among people
(Kumar, 2019)
SEARCH STRATEGY
A search strategy is mainly introduced the main components of research project
such as Effectiveness of health education interventions for prevention of Malaria in
adults. The investigator has used the secondary resources such as journals, article and
books. The different sets of articles are assessed for managing the information
associated across the relative attribute and its design factor. In order to find out the
result or outcome. In this way, it help for researcher to use authenticate source on the
basis of journals, articles (Hayand, 2019).
In this way, researcher has been considered the journals, article as a search
strategy that provides the facilities to gather large amount of data and analyse them.
Through journal and article, it has randomised the sequence for generated by trained
staff members with hospital. They are directly coordinated with the social community,
individual people in order to increase awareness among them. The significance of
database libraries is that organises the collection of data or information for more
purpose (Hayand, 2019).
Inclusive and exclusive criteria
It is based on the characteristics that is mainly representing the prospective subjective.
On the other hand, exclusive criteria are m-ainly disqualifying the subjects from
inclusion.
In this case study, inclusion criteria related to the malaria which mainly occurred South
African regions population those people are not aware about the malaria.
Exclusion criteria is that when study might be limited awareness among people in term
of medical treatment.
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According to case study of six different studies, identifying the key gaps such as how
they can studies and using appropriate keywords.
 On the basis of study, it has been identified the current symptoms of Malaria such as
vomiting, cough, sneezing. So that it can be implemented a suitable intervention or
prevention. Through study, measuring and calculating the death rate in Africa
regions due to Malaria.
 Another studies representing the “Education intervention plan” for prevention and
also develop awareness among people.

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DEFINE PICO FRAMEWORK
It is based on the mnemonic framework that mainly used to evidence on behalf of
practice. In order to identify the answer of clinical or health care related question. This
framework is developed the literature search strategies. For instance, it can be reviewed
the systematic approach (Mora, Deakin and Angelidou, 2019). As the PICO tool, it does
not currently accommodate term relating to the qualitative research methodology.
Furthermore, it can be identified the specific qualitative design which often modified in
the practices to “PICOS”. This framework is mainly focused on the population,
intervention, comparison and outcome of qualitative. It is commonly used for identifying
the component of clinical evidence for systematic reviews.
PATIENT, PROBLEM OR POPULATION, INTERVENTION, COMPARISON,
CONTROL OR COMPARATOR, OUTCOME(S) (PICO) FRAMEWORK
The PICO process under this particular research is based on real time evidences
from different population groups from country like Bhutan and continents like Africa and
Asia. The primary purpose of PICO framework is to make process easier. It plays
important part of well-built clinical question related Malaria prevention. It is helping for
formulating the search strategy by identifying the key concept (Mora, Deakin and
Angelidou, 2019). It is needed to be in use article information for identifying accurate
answer of research problem. The literature search strategies are an important part of
the process and are linked to justify the growth potential across Malaria prevention
programs that are put in place (Mora, Deakin and Angelidou, 2019). The keywords
developed with consideration to the PICO framework under this research account for
adult population and age group between 18-30 years. In order to use the educational
program or event which increasing the awareness among people. Afterwards, it will be
helping to generate answer while reducing effects on the Malaria in adults otherwise, it
is directly increasing the death rate across the global world (Mora, Deakin and
Angelidou, 2019)
Furthermore, it is considerations of database such as CINAHL and PubMed
which providing the relevant information related the research topic. Through research
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paper that can be to find out the conclusion. The journals, articles always support in the
real time where it can easily managing the process through informative assessment
obligations (Mora, Deakin and Angelidou, 2019). Thus, the databases are quite
supportive in facilitation of correct direction and guidance to the entire research process.
Article has shown the intervention activities, conducted the structural educational
program on the basis of course content. In order to adapt from the national Malaria
control program and relevant information obtained from the gap in knowledge identified
from the training. On the other hand, researcher should be considerations of different
Factors such as reliability, validity and generalizability for each of the selected articles
are assessed extensively to promote smooth transition across the process of research
(). The studies included were of different research designs.
ETHICAL CONSIDERATIONS
Ethics play an important role in justifying ness in research and thus it has been
largely taken in to account for this particular process. The process for storage, usage
and propagation of research information has been carried out extensively based on
available ethical standards (Mora, Deakin and Angelidou, 2019). This factor increases
the overall creditability factor that is associated across the region. It is also based on
managing the operational jurisdictions and achieves obligations across the ethical
considerations. There are different principles uses for maintain the ethical and moral
value of each participant during research study.
 Respect the dignity of other research participant during analyzing
 Protect and secure confidential information regarding research study
 Eliminate the misleading data or information.
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CRITICAL APPRAISAL
Critical appraisal is considered to be the process of evaluating systematically and
effectively the scientific literature to determine the relevance, value and trustworthiness
of a specific research. (Li et al., 2016). It has been created to provide assistance to the
people about that critical perspective and distinguish the quality of the research.
ARTICLE 1
Cox et al (2018) have conducted the study to evaluate the prospective
observational data with the help of the Malaria awareness program which was
structured as a quasi-experimental. The reason for conducting the program is that it will
act as an interactive initiative for educating about Malaria. The intervention took place
for approximately four weeks in the villages which had high risk of Malaria. The study is
conducted in the year 2018 in the district of Vhembe, Limpopo in South Africa. In
between the year, 2012 to 2016, the total number of individuals who participated in the
Malaria awareness program was 1330 (Cox et al 2018). The effectiveness of the
program was measured with the help of post and pre participation surveys through
which the knowledge of the individuals was evaluated regarding the treatment,
symptoms, prevention and transmission of Malaria. Primary analysis was conducted for
determining the knowledge of the individuals who participated in the Malaria awareness
program and who were not the participants of the Malaria awareness program. Total
number of participants was 499 total numbers of non-participants 399 (Cox et al 2018) .
The scores of the correct Malaria knowledge in comparison to the incorrect or partially
correct knowledge were 3.3.
It was construed that with the help of the assessment of sub analysis, the
knowledge of the individuals who participated in the program can be improved as they
participated in both pre and post interventions of Malaria awareness program. Around
21.4% more of the participants were able to correctly state the transmission methods of
Malaria and 10.5% proportionate increase was witnessed who correctly cited the
prevention method (Cox et al 2018). With the help of the research, the behavioral
changes of the people can be evaluated towards the treatment and prevention of
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Malaria through the intervention outcome and determine the effective changes in
African region.
ARTICLE 2
The use of insecticide treated net by the pregnant women have been optimal in
Nigeria. According to the previous studies, positive correlation has been found in
between the behavior, practice and knowledge of preventive measures of Malaria. The
study by Balami et al (2019) has the aim of developing, evaluating, and implementing
the impact of the health education interventions. It is on the basis of the model that
includes information motivation behavioral skills for the purpose of ITN use. The study
was conducted in Maiduguri in the North east in Nigeria. The location of the study was
antenatal care clinic in Maiduguri. The health center is considered to be the biggest
government secondary level in Borno State.
It included trial of randomised controlled parallel group in which the total
numbers of antenatal care attendees were 372 Balami et al (2019). The data was
collected with the help of the structured questionnaire. The group was provided with the
Malaria health education for four hours. It was followed by the IMB theory. The control
group was provided with the health education for four hours by the same facilitator on
breastfeeding. After two months, the following data was collected and after four months,
post intervention was done using the same set of questionnaires (Balami et al 2019). It
also included analysis of linear mixed models to ascertain the impact of within groups
and in between the group’s intervention. In addition to this, sensitive analysis was done
after the intention to treat analysis which was utilised for replacement of missing data.
The intervention was helpful in gaining the higher level of knowledge, behavioral skills,
and motivation. Using the sensitivity analysis, it was found that there was not much
difference in the sizes even when there was no replacement of the missing data. In
order to consider the positive intervention that always supports for identifying opinion or
view point of people with the help of questionnaire method. The data was collected with
the help of the structured questionnaire. It was provided with the Malaria health
education within four-five hours (Balami et al 2019). Sometimes, medical professional
use the IMB theory. In order to control the group which providing the better health
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education. The control group was provided with the health education for four hours by
the same facilitator on breastfeeding (Balami et al 2019)
ARTICLE 3
The study by Tobgay et al (2013) was conducted to illuminate the effectiveness
of the educational intervention for the prevention and control of Malaria in the endemic
areas of Bhutan in its district of Sarpang. According to the world Malaria report of 2011,
it was posited that in the year 2010, mortality rate reduced by 26% and morbidity
reduction was 17% (Tobgay et al 2013). Thus, the aim of the study is to further educate
individuals about the required measures for Malaria prevention and control.
The study has been designed using the quasi experiment in which both
quantitative and qualitative data has been used for data collection method. Also, it
included focus group discussions and in-depth interviews along with the survey in which
the questionnaires were structured. For the data collection, recruitment of non-formal
teachers was done. The interventions took place by the community action groups.
These were the groups who were given the training and they developed the action plans
for the intervention implementation within the communities. The community was facing
the common illness mainly as cold and cough along with eye problem, fever, cold and
diarrhea (Tobgay et al 2013). Some individuals in the community also mentioned
tuberculosis, Malaria, diabetes, blood pressure, typhoid. According to the health
workers the common illnesses faced by the community were diabetes and blood
pressure.
The reason for selecting Sarpang in Bhutan was that it had Malaria endemic
districts which were found to be the highest number of Malaria related cases. The
control group and intervention were selected so that the baseline can be provided in
respect to Malaria cases and restrict contamination. The sampling method used for the
household selection was systematic random sampling.
The study reflected significant improvement in the behavior and knowledge in
comparison to the post intervention survey. However, the practice score was high in
both pre interventions and the post intervention. The findings of the study concluded
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that the community directed interventions can be used as a mode of knowledge
improvement along with practices and attitudes towards prevention and control of
Malaria in the endemic areas of Bhutan (Tobgay et al 2013). There was requirement of
further studies for better impact and intervention sustainability.
ARTICLE 4
Ndira et al (2014) have conducted the study in Mifumi village which is in Uganda.
In between the year 2007 and 2010, US National Library of medicine and Makerere
University College of health science community-based education and service program
together conducted certain activities in order to prevent and control Malaria. The Mifumi
project is considered as an international aid agency which was initiated in the year 1989
(Ndira et al 2014). It has the objective to decrease the level of poverty by safeguarding
the basic human rights in the Uganda communities.
The group of people conducted the survey of the community in Uganda to
understand their knowledge regarding the prevention and treatment of Malaria. They
also implemented a health information intervention with the help of different media and
tutorials. It also observed use of insecticides treatment nets by the community through
the digital pen application. COBES conducted the baseline survey with the help of the
closed ended questionnaire while promoting the insecticides treated nets use.
Due to the concerted outreach and education, the residents of the villages were
found to have required understanding of Malaria prevention and the behavior towards
treatment. With the help of the information technology power and teamwork, the rural
community and the medical students were involved in the promotion and the health
education experience. It was observed at around 170 households in the Mifumi villages
were provided with mosquito nets and the medical students were provided with the
accessibility so that they can observe the bed nets use and its effectiveness Ndira et al
(2014). The preliminary observations reflected that the intervention regarding the health
information along with the group effort prevention and controlling of Malaria can help in
the protecting the health of the people in Uganda.
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ARTICLE 5
Owusu and Owusu (2014) have conducted the study to assess the health
education effectiveness to prevent and control Malaria in the community of sub-Saharan
Africa. In the study, systematic review has been conducted by using the unpublished in
published literature and using three websites and seven databases. It included center
for prevention and control of diseases, World Health Organization and Malaria journal.
In the study designs, it included non-randomised trials, quasi experiments, randomised
controlled trials, surveys and before and after studies. The extracted data was used for
narrative synthesis (Owusu and Owusu 2014). The review included the evidence for
policy and practice information and coordinating centers methods in order to conduct
the systematic review. Also, the review was conducted on the basis of the EPPI
approach. It permitted more variety of study designs along with narrative synthesis and
randomised control trials.
The review included 17 studies out of which the nine studies included health
education interventions on the bed nets which were treated by the insecticides ( Owusu
and Owusu 2014). In the three studies, health education was used for promotion of
intermittent presumptive Malaria. On the other hand, one of the studies concentrated on
the management of the environment for controlling Malaria. Moreover, the factors which
impact on the health education for conducting interventions for the purpose of
prevention and controlling Malaria involved participants education level, health
messages and also the community involvement level. It acts as a valuable tool in
interventions of control and prevention of Malaria based on community of sub Saharan
Africa. The study showed analysis that the impact of education intervention can help in
increasing the insight about Malaria and the manner of prevalence improvement in
pregnant women and children ( Owusu and Owusu 2014).
ARTICLE 6
The exposure of mass media has significant role to play in the health
communication and following a Healthy lifestyle. The study by Yaya et al (2018), the aim
is to determine the Malaria prevalence intervention and prevention among the adult
women in sub Saharan Africa. It also focuses on their behavior towards prevention of
19

Malaria along with evaluating the impact of mass media exposure in effective behavior
adoption. Cross sectional data was collected for the study. The age of the women from
whom the data was collected was in between 15 to 49 years Yaya et al (2018).
There were total of 46822 women and the Malaria indicator surveys was
conducted in Uganda, Sierra Leone, Kenya, Mali, Ghana, Burkina Faso, and Malawi
Yaya et al (2018).
The result of variable reflected the behavior of the people towards prevention of
Malaria with the help of insecticides treated nets as well as antimalarial drugs during the
pregnancy phase.
The prevalence witnessed of sleeping under treated nets and using the
antimalarial drugs at the last phase of pregnancy was effective. On the other hand, the
prevalence also included disparities of insecticides treated nets usage and using the
antimalarial drugs in different countries. Through the multiple regression analysis, it was
found that the nets were used less due to lack of awareness about Malaria related
information and its prevention. People who received the knowledge from radio had
better knowledge than people who could not listen to the information on radio. Through
these findings, it can be stated that Malaria information has significant role to play in
spreading awareness about using the insecticides treated nets among women in the
region of sub-Saharan Africa Yaya et al (2018). However, there is requirement of further
awareness so that a greater number of people can start using the antimalarial drugs
and insecticides treated nets.
DISCUSSION AND RECOMMENDATIONS
DISCUSSION
Theme: 1 implementing the malaria awareness event or program to identify the result.
In this study, it has been summarized about the significant improvement in the
knowledge of Malaria. In order to prevent diseases at the early stage. It is important for
understanding the about the negative impact of Malaria in the human being. The article
Cox et al (2018) sometimes, it is to be considered the serious issue that requires
20

preventing through various intervention techniques. It always supported the finding of
this study, as per study conducted, it has been identified the causes of Malaria and how
it is directly impact on the human being. In this way, it requires to implement the
intervention and prevention to increase awareness among people. The mosquito bite as
causes the Malaria which was found to be high as increased significantly after
intervention. According to study, it has identified that people knew about the causes of
Malaria so that they can use precautions. Other countries such as Ethiopian and
Nigeria revealed that less than people identified the mosquito’s bites and also cause
Malaria. Cox et al (2018) as per study, it has identified that level of misconception
related Malaria which being caused by eating unripe mangoes in order to increase
death rate. So as implementing the intervention and prevention technique that help for
improving the current situation or condition. As per conducting the study through many
journals and articles, it has identified that mosquito bite is to be considered main reason
for Malaria transmission. Cox et al (2018) Furthermore, there are various mechanisms
that have been designed to identify and analyse the critical situation of diseases.
Afterwards, how it will be helping to cope up with the Malaria. The intervention was
effective in enhancing the insight of the people about the disease and its prevention.
There was considerable enhancement in the knowledge of the adults to take prevention
from Malaria disease. It also conducted the awareness program that has been designed
solely to control spread of Malaria Cox et al (2018). Sometimes, it has been undertaken
the consideration which always focused on the motivation level reflected on the
intervention effectiveness as behavioral belief aspect was attached which was
considered to be a significant motivation construct. The World Health assembly
provides the counselling and guiding facilities using the specific approach strategically
Theme: 2 Impact of various health related interventions through statistical observation.
According to Kroeger et al (2018), using the WHO Global Malaria programs, the
cases of people suffering from Malaria can be reduced globally to a large extent. The
intervention was of a nature that children could not be taken into consideration for such
education according to Kroeger et al (2018). It is mainly focused on the effectiveness of
the educational intervention for the prevention and control of Malaria in the different
21

areas of Bhutan in its district of Sarpang Kini et al (2018), through this report, it has
identified that Malaria has rapidly increasing which directly affected on the human health
condition. As per analysis, it has identified that year 2010, the rate of mortality reduced
by 26% and morbidity reduction was 17% (Tobgay et al 2013). The research study is
mainly focused on the developing the awareness among people. It is helping to further
educate individuals about the required measures for Malaria prevention and control.
Afterwards, it also focused on the selecting the region such as Sarpang in
Bhutan was that it had Malaria endemic districts which were found to be the highest
number of Malaria related cases Kini et al (2018), In order to calculate the estimation
where how many adults suffered from Malaria. This will help for using an effective
policies and procedures. Afterwards, the control group and intervention were selected
so that the baseline can be provided in respect to Malaria cases and restrict
contamination Kini et al (2018). The sampling method used for the household selection
was systematic random sampling. This research study is mainly reflecting the
importance in terms of improvement in the behavior and knowledge in comparison to
the post intervention survey. However, the practice score was high in both pre
interventions and the post intervention. The findings of the study concluded that the
community directed interventions can be used as a mode of knowledge improvement
along with practices and attitudes towards prevention and control of Malaria in the
endemic areas of Bhutan. Kini et al (2018), there was requirement of further studies for
better impact and intervention sustainability.
Theme: 3 effectiveness of education intervention that support for preventing Malaria.
As per analysis, it has summarized that resolve in the issue while implementing
the intervention program. Furthermore, it is necessary to expect certain level of
improvement in personal motivation instead of social motivation as it led to being
dependent on others. This explains the comparatively lesser impact of intervention on
the scores of motivations in comparison to the knowledge scores Balami et al (2019).
The study inferred that the health education program was unable to provide
maximum result to increase the awareness for Malaria. Other study such as Balami et al
(2019) has showed the same result. Also, it is not necessary to provide five hours
22

consistent health education intervention program adding lectures and exercises as it will
not provide much change in the attitudes of people towards Malaria prevention. There is
a requirement of personal motivation so that they can take measures by themselves.
Motivation level reflected on a new trend which included both knowledge and various
patterns. However, this course in the intervention process was high throughout the
baseline which reflected effectiveness of the intervention Malenga et al (2017).
The discussion has been made after reading the appropriate conceptual
framework which providing the overall objective of the research has been to analyse
the effectiveness of Malaria awareness program and ascertain the extent to which
participation can support enhancing their knowledge about Malaria transmission,
prevention and surveys based on treatment. As per analysis, it has identified that data
of Malaria awareness program reflects the lack of knowledge in community about the
prevention and transmission of Malaria malenga et al (2017). Participating in the
workshops of Malaria awareness program can support in increasing the understanding
of the people about the disease and improvements can be seen thereafter. It has been
deduced that the participants of MAP are considered to be more knowledgeable than
the people who did not participate.
On the other hand, Yaya et al (2018), the community education programs can
play a significant role for providing the awareness and large number of people taking
control participation. This will help in fighting effectively to combat Malaria. This style is
related to Malaria education intervention has been implemented and identified
comparing with the Malaria awareness program. Considering the previous literature, it
has been construed that so many Malaria education programs have emphasized on
Malaria disease during the pregnancy and for children who are below the age group of
five of Malenga et al (2017). However, the awareness programs still have targeted a
large number of people. There is less risk of Malaria to children and women who are
pregnant in South Africa. The reason behind this is the migrant workers having Malaria
have more chances to spread to the individuals whose immune system is not so strong.
Theme: 4 intervention support the communities, society in term of malaria
23

According to the study Li et al (2016), it can be health information intervention
has supported the community in taking effective measures show that the health of the
people can be controlled in context to Malaria. Similarly, Kini et al (2018) provided the
knowledge standard and quality information about Malaria as well as treatment is linked
with enhancing the knowledge of Malaria disease and training people to fight it. It has
been found at (ITNs) used by so many household’s intervention as well as in the
baseline knowledge. Household found that the residence work cleaning places which
were more prone to Malaria disease especially in front of their houses
As per the opinion of Yaya et al (2018) this resulted in finding the trend of combat
rate of mortality and morbidity due to Malaria as the intervention program was highly
helpful. The observation is found to be common in so many other studies which have
reflected the Malaria control measures. Using this, significant improvement can be seen
in the rural areas. Hence, health education highly required for Malaria prevention as it
will provide the care givers with adequate knowledge. However, it is difficult to see
change in the behavioral attitude of people and it was a time-consuming task
According to the study Li et al (2016), a downward Trend was witnessed in
regard to Malaria mortality and morbidity on the basis of the Major Histocompatibility
Complex (MHC) records as it was witness of the engagement in community for taking
control measures in the health of the public. The intervention programs were prepared
to understand the effect of mortality and morbidity in context to the study. On the other
hand, initiating support programs could help in providing motivation and tools for
bringing change at the community level Cox et al (2018). The community was constantly
educated about the correct usage of mosquito nets. Moreover, it was necessary to
monitor the intervention sustainability which can help in defining the work approaches
and involving in treatment and prevention programs
Theme: 5 investigate the Malaria disease among rural and poor communities
According to the literature of Malenga et al (2017), the study took place in rural
setting where Malaria is considered to be endemic along with other diseases due to
vector. There were so many respondents who were farmers and lacked education.
Some of the respondents also did not have any transport facility. These things reflected
on the high poverty prevalence in the area. According to Lucas et al (2019), it has been
24

averred that Malaria impact highly on the rural and poor communities as it in the zone of
diseases and poverty. As per the opinion of Yaya et al (2018), it has been reported that
people who live in poor built houses which is constructed with wood are engage in
higher risk to fall into the risk of getting Malaria than people who are residing in the
houses made of Western style.
As per the opinion of Yaya et al (2018) The Long lasting insecticidal net (LLIN) is
the most effective method of preventing Malaria and controlling it. It has been regularly
distributed according to the size of the family with the goal of attaining complete
coverage to fight with the disease. The findings in this study are the same as the survey
of Malaria indicator. This reflects that the LLIN effective for minimum of three years in
our community setting. However, there is requirement to evaluate and determine
regularly the exact availability the households so that it can be distributed accordingly.
Moreover, there was absence of regular insight based on the net care.
The elements of the program have not been prepared according to the research
undertaking. The activities forming part of the report provided with the scope of
participation show that the behavior and beliefs of the individuals living in the village
setting could be understood during health information intervention of the patients. The
students for facing challenging environment as their clinical abilities was checked along
with the research skills and related education. However, the most significant challenge
that the individuals faced was lack of understand the local language (Li et al., 2016).
RECOMMENDATIONS
it is highlighting different areas where committees believe deserver the highest
priority for research project. It should be considered the Malaria control program. In
order to suggest the effective things that help for maintaining future action. Sometimes,
it can be represented in the different ways such as policy, research, training and
controlling (Owusu-Addo and Owusu-Addo, 2014). In this way, it can easily diverse the
background and variety of perspective on the problem or issue (Owusu-Addo and
Owusu-Addo, 2014).
 The event or program recommends that will increase the fund which made
available in the U.K research on the Malaria (Owusu-Addo and Owusu-Addo,
25

2014). It can be addressed in the research project which include laboratory, field
research on the biology of Malaria parasites. The committee always believed that
increases the investment return which devoted the Malaria research. In order to
control or maintain the overall concept of project. Within committee, participants
aware about the field activities, should be considered highest quality relevance to
reduce level of Malaria (Owusu-Addo and Owusu-Addo, 2014).
 The committee has recommended that decisions on the basis of Malaria funding
which help for identifying the scientific merits. It also collaborated with the world
health organisation to conduct the program of training (Owusu-Addo and Owusu-
Addo, 2014). Government always support for providing the brief data or
information relevant to Malaria. Afterwards, it will be implementing the short-term
intervention that expected to reduce the short-term result or outcome.
Committees always believe that short term intervention has justified the current
emergency situation. Furthermore, Long term intervention should be undertaken
when it is supporting the sustained Malaria control (Owusu-Addo and Owusu-
Addo, 2014).
 It has recommends that region be given support to the other surveillance always
from the large collecting and screening of blood slides towards analysis of
epidemiologically related the data. On the other hand, information should be
used to monitor current situation or condition on the basis of ongoing. This will
help for identifying high-risk group and also detecting the potential epidemics
early.
(Owusu-Addo and Owusu-Addo, 2014)
 It has recommends to develop the greater cooperation and consultation between
the health sectors. They are planning for implementing the suitable development
project to handle the projects and other type of Malaria activities. Sometimes, it
has proposed various Malaria control program that mainly analysed for potential
impact on the public health environment, economic and social welfare. Various
enterprise can be recruited the people those participants in the Malaria control
program. It also contributed the substantially to the local Malaria control efforts
(Owusu-Addo and Owusu-Addo, 2014).
26

 It has recommended that adapt the Larval mosquito control technique which is
mainly applied to limit the growth of mosquito larva across stagnate water
sources to limit the spread of Malaria. This process is highly effective in limiting
the development and propagation of the Malaria virus and thus is a majorly used
option to control this disease (Ndira et al. 2014). This process eliminates
mosquitos prior to their adulthood and thus controls the issue at its very early
stage. The community education programs for preventing Malaria are stuffed with
this method thoroughly. The education program or event help for providing the
better idea where people adopt in their life. Sometimes, it is important for
improving understanding towards causes of malaria so that they can easily
reduce or control diseases. Nowadays, it is the most common which exists
among different nations. On the other hand, recommendation to give better
counselling of people who will really want to eliminate this problem in their own
lives. (Owusu-Addo and Owusu-Addo, 2014) medical professionals are directly
coordinate with people for providing the better idea which help them to protect or
secure. The most important is that when people self-motivated towards the real
life problem which is an essential to find out the result otherwise, it is difficult for
handle condition or situation.
CONCLUSION
From above study, it has been summarized about the intervention program that
always support for prevention from malaria. In order to educate the individual for self-
examine the current situation or condition within region of Africa. The intervention was
helpful in term of improvement for generating effective result or outcome. By using
intervention program, it can be identified the lack of proper disease information as a key
factor for this pandemic (Owusu-Addo and Owusu-Addo, 2014).
On the other hand, Research study has summarized about the threat of Malaria
that can cause health condition. In order to increase the impact on the individuals.
However, it is possible to make further improvement. The impact of Malaria can be
controlled by effective research evaluation provisions. The entire nation as well as globe
has the requirement of taking effective and appropriate measures. In this way, it is
necessary take important step towards the malaria while reducing the issues that are
27

connected with the Malaria virus and control the death rates resulting from the Malaria
virus recommendations can be provided with the help of the study in which it is stated
that routine antenatal care programs if incorporated and adopted, the impact can be
reduced (Owusu-Addo and Owusu-Addo, 2014). In addition to this, providing healthcare
sessions to the public will also be helpful (Owusu-Addo and Owusu-Addo, 2014).
Once the first session is completed, after two-three months, the additional session can
also be provided for more effective result that can be served as enforcement. For
understanding the extraneous factors, qualitative studies can be conducted to bringing
positive enhancement in the result of the study (Owusu-Addo and Owusu-Addo, 2014).
This can result in providing the opportunity of new intervention development in the
nearby future. The adults can attend the education program in the respective languages
for better understanding, evaluation and effectiveness (Owusu-Addo and Owusu-Addo,
2014).
28

APPENDIX
Article Article 1 Article 2 Article 3 Article 4 Article
5
Article 6
Referenc
es
Cox et al, 2018,
Chourasia et al.
2014
Balami et al.,
2019
Tobgay et al.,
2013
Ndira et al.,
2014
(Owusu
and
Owusu
2014)
Yaya et al
(2018)
Study
aim
The aim of this
article is to
identify the
impact which
evaluating
through the
observational by
implementing
the malaria
awareness
event or
program.
The aim is to
determine the
impact of
various health
related
interventions.
In order to
understand
the
effectiveness
of various
education
intervention
that always
supports for
controlling
and
preventing
through
Malaria in
Bhutan.
The
primary
aim of this
article is to
find out the
certain
level of
poverty
through the
safeguardi
ng in order
to maintain
the equal
rights
To
analyse
d the
current
effective
ness in
term of
preventi
on and
also
controlli
ng the
malaria
among
society,
commun
ity in
Africa.
To identify
the
prevalence
intervention
against the
malaria
among the
adults
women’s.
Study
Design
Quasi-
experimental.
Survey,
correlational
Quasi-
experimental
Observatio
nal
Quasi-
experim
ental
Survey
Study
Particpa
nts.
399 out of 499 372 Antenatal
care attendant
- - - 46822
participant
women’s
29

Findings
/ Results
Through this
article, it can be
identified that
WHO support
for providing the
direction while
conducting an
effective
program or
event. In order
to reduce the
diseases of
malaria. It may
be supports in
technically
manner.
It has
concluded that
intervention
program help
for gaining
high level of
knowledge
and motivated
towards
improve the
health
condition from
malaria.
As per
identifying the
ongoing
impact of
positive
intervention
which always
support in the
sustainability.
This
article is
reflecting
the
different
interventio
n in
regards
for
collecting
or
gathering
informatio
n related
the
multiple
group of
people
which
providing
the better
prevention
and
controlling
of Malaria.
It is
reflecting
the
certain
impact of
education
interventi
on which
always
helping
for
increasin
g the
insight
about
Malaria.
It is
concluded
the findings
which mainly
representing
the significant
role by
improving the
awareness
related the
spread of
malaria in
community
such as
women in the
region of sub-
Saharan
Africa.
Strength
s and
limitatio
ns of the
studies
The strength of
article is to
evaluate the
brief idea in the
different
intervention
program, event
which always
supports for
gaining more
knowledge. It
would be
controlled in
proper.
The limitation is
that when it has
increased the
issues or
problem in data
management.
The strength
of this study is
to increase the
own
knowledge
while
implementing
the better
antenatal
health
education
schedule. It
help for
identifying the
behavioral
knowledge
towards
malaria.
The greatest
strength is
that when
author
interact with
the
community
and collecting
a lot of new
information
about the
interventions
and how
improve the
attitude
practice and
knowledge.
Limitation is
that when
missing the
suitable data.
It can
easily
evaluating
the
interventio
n of the
health
informatio
n. In
another
way, it is
also
making
collaborati
ve
communit
y effort to
prevent
Malaria
The
As
identified
the
informati
on
related
the
health
education
which
become
considere
d for
study.
The
limitation
that when
it cannot
perfectly
analyse
the
Strength is to
use the
efficient the
tools and
techniques
that supports
for identifying
the
educational
procedures.
In order to
manage or
control the
changes in
study.
The limitation
is that when
increasing
the time
intervals for
completing
30

limitation
of study is
that when
author not
achieve
that much
Controls
and
measures
where
identifying
the
capacity
for taking
self-care.
review
the
finding
and
control
the
preventio
n.
the task.
Recomm
endation
s
In this study, it
will be
recommendatio
n that can be
used the various
approaches for
gathering large
information
related the
prevention. In
order to support
for identifying
the current
beahviour
changes among
people due to
malaria.
In this study, it
has
recommendati
on to focus on
the various
theories which
providing the
brief idea
about the
concept. In
this way, it has
adopted by
author to find
out the result
or outcome.
Moreover, it
also consult
within medical
professional to
gain their own
knowledge in
project
expansion
recommendat
ions is that
when it will
be
implementing
the effective
strategies for
improving the
clinical
practices and
also supports
for gaining
more
information
about the
prevention
and control of
Malaria
It has
recommen
dation in
the study
when use
the health
informatio
n
Through
different
Media and
tutorials.
In this
way, it can
easily
identifies
the
Use of
insecticide
s
treatment
nets within
the
communit
y.
During
Article
analysis,
it has
recomme
ndation
that
consider
the most
appropria
te tool for
identifyin
g the
interventi
ons in
context of
control
and
preventio
n from
Malaria in
the
Saharan
Africa
communit
y.
It has
recommende
d that
consider the
appropriate
strategy
approach
which always
supports for
collecting the
information
Malaria. In
order to
provide the
training,
counselling
the people for
improving
awareness.
This will help
for reducing
the spread of
malaria
diseases
across the
different
regions.
31

32

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