Empowering the initiation of a prevention strategy to combat malaria in Papua New Guinea.

CONTEXT: Approximately 3 million people die each year from malaria, making it a significant public health issue worldwide. Malaria is endemic in Papua New Guinea (PNG) and is the second most prevalent cause of death. In addition to associated mortality there is a high degree of morbidity. In remote PNG the village population has low access to even rudimentary health care; however, the use of bed nets impregnated with insecticides has been established as a simple and effective strategy for malaria control. ISSUE: This project sought to explore if and how an empowerment approach to community development could affect changes in malaria prevalence among remote members of the Kewapi language group in PNG. The 'Batri Village Bed Net Initiative' began in 2004 as a development of the Erima Empowerment Research Health Promotion Project. Members of the Kewapi language group living in urban Port Moresby raised concerns that their extended families in the remote village of Batri could not acquire bed nets to prevent malaria. The project empowered members of the Kewapi language group to take responsibility for the acquisition, distribution and effective use of 400 WHO approved bed nets in the Batri village, demonstrating good governance and project acquittal. This empowerment approach to community development involved dialogue with a range of stakeholders including village Elders and the British High Commission in PNG. The project has led to a significant decrease in the incidence malaria-related mortality and morbidity in the village. LESSONS LEARNED: Participatory planning was a key aspect of the success of this initiative. Using an empowerment approach, opportunities exist to extend the development of language-group networks in the cause of effective health promotion and disease prevention in remote PNG.