Treatment-seeking behaviour for malaria: a typology based on endemicity and gender.

A main component of current malaria control strategies to reduce malaria-related mortality and severe morbidity is early diagnosis and treatment at peripheral health services such as village health posts and dispensaries. This strategy has been promoted mainly by sensitising the population with regard to the available service offered and by providing classical biomedical descriptions of symptoms and signs of malaria. This strategy represents important challenges for successful implementation and maintenance. Early treatment depends upon prompt recognition of symptoms and signs of malaria in the household, i.e. mainly by women. Early treatment also requires that appropriate health services and medication are accessible and used. In this paper we argue that the success of malaria control depends upon an approach that is gender-sensitive and takes into account the level of endemicity in a given setting. The level of endemicity determines which group of the population is at highest risk for infection, morbidity and mortality, and is strongly related to gender considerations. The paper develops a typology that combines the key factors of gender variables with epidemiological features. It consequently outlines an approach to community-based, effective malaria control tailored to a given endemic setting. Finally, we suggest that the proposed framework could be validated for its potential application to the control of other communicable diseases.