Malaria is known to be endemic throughout Zambia and continues to be a major public health problem. Eighty three percent (83 %) of Zambian population is reported to be living in malaria high risk areas and the remaining 17 percent is reported living in malaria low risk areas. Zambia has a 16 percent malaria national prevalence. Malaria peak transmission periods are usually during the rainy season ? from November to April and the main transmitting vectors are anopheles species; funestus, gambiae and arabiensis. Plasmodium falciparum is the main transmitting parasite accounting for about 98 percent of all malaria infections in the country. Other species of plasmodium that can be found in Zambia are ovale and malariae. The main intervention measures used in the prevention and control of malaria in Zambia are; Indoor Residual spray (IRS), mass distribution of insecticide treated mosquito nets (ITNs) and Intermittent Prevention Treatment (IPT). The main aim of this thesis is to analyze the efficiency and effectiveness of the the current intervention measures used to prevent and control malaria in Zambia. I approached this issue from time the ?roll back malaria ? project was intiated in 1998 up to 2011. With help of the changes introduced to the health sector under the sector wide approach reforms in 1995, the public health approach in the fight against malaria was even much widened. The second aim of my thesis is to offer acceptable alternative interventions that can used in the prevention and control of malaria. In this qualitative type of research, I chose to use secondary analyzation of data as my research method. I obtained much of the information from studying health literature, journals, laws and other online publications, which I found to be relevant to the topic at hand. I also consulted with the Zambian ministry of health through provincial health offices as well as via district health offices. A series of three open research questions was used as a guide to obtaining the much needed data. However, the results revealed that the current intervention measures used in the prevention and control of malaria are efficient and effective. In 2009, Zambia recorded a 66 percent reduction in deaths due to malaria. This success recorded clearly surpasses the target set by the ?roll back malaria? 2006 which was aimed at reducing mortality due to malaria by 50 percent by year 2010. However, parasitemia results still show great variation in prevalence between urban areas and rural. This inequality is also evident in the access to health care as well. There is much need to scale up on intervention measures if a Zambia without malaria is to be achieved. This work can as used as a public health tool in the prevention of malaria in Zambia and also as a road map to future research concerning malaria and public health.

Malaria is a major public health problem in under developed countries especially countries undergoing war or conflict due to breakdown of health system and exposure of the vulnerable population through displacement. The knowledge, practice and attitude (KAP) of community members have direct influences on malaria preventive measures. A quantitative, explorative and descriptive study was conducted among rural communities of Mundri East County using interview schedules to ascertain malaria related knowledge, practices and attitude and the common factors hindering the malaria control measures at house hold level. Data were collected from 68 respondents from the randomly selected household through personal interviews using a pre-tested interview schedule which was analysed using the SPSS version 15 computer soft ware program. Most of the respondents demonstrated some understanding of malaria as a disease, its transmission, prevention and treatment, although there is a need to improve this through the preferable and acceptable community channels as well as the methods of accessing the modern and scientifically proved and acceptable methods. Given the relatively moderate acceptability of malaria control measures used by the participants in Mundri East County, there is need to conduct further research on the practical implemented measure including the local herbs used for preventive and treatment of malaria Understanding the factors that inhibits or promotes the malaria control measures at community level is necessary for better planning and implementation of malaria intervention programme, which keeps complex and sensitive matters such as educational background, religious and cultural beliefs, and political affiliations in mind. / Health Studies / M.A. (Public Health)

Malaria is a major public health problem in under developed countries especially countries undergoing war or conflict due to breakdown of health system and exposure of the vulnerable population through displacement. The knowledge, practice and attitude (KAP) of community members have direct influences on malaria preventive measures. A quantitative, explorative and descriptive study was conducted among rural communities of Mundri East County using interview schedules to ascertain malaria related knowledge, practices and attitude and the common factors hindering the malaria control measures at house hold level. Data were collected from 68 respondents from the randomly selected household through personal interviews using a pre-tested interview schedule which was analysed using the SPSS version 15 computer soft ware program. Most of the respondents demonstrated some understanding of malaria as a disease, its transmission, prevention and treatment, although there is a need to improve this through the preferable and acceptable community channels as well as the methods of accessing the modern and scientifically proved and acceptable methods. Given the relatively moderate acceptability of malaria control measures used by the participants in Mundri East County, there is need to conduct further research on the practical implemented measure including the local herbs used for preventive and treatment of malaria Understanding the factors that inhibits or promotes the malaria control measures at community level is necessary for better planning and implementation of malaria intervention programme, which keeps complex and sensitive matters such as educational background, religious and cultural beliefs, and political affiliations in mind. / Health Studies / M.A. (Public Health)

Les politiques de lutte contre les maladies plus généralement et celles relatives au paludisme singulièrement, mises en œuvre depuis 1948, ont connu des fortunes diverses dans leur application à l'échelle locale. L'exemple de la Côte d'Ivoire que cette recherche a mis en lumière en est la parfaite illustration. Ainsi, de la politique «d'éradication du paludisme» qui couvre la période 1955-1970, à laquelle succède celle du contrôle du paludisme depuis cette date, les directives de lutte, qui accompagnent les grands programmes de santé de l'institution internationale, ont été diversement appliquées, du moins en ce qui concerne le paludisme. Les raisons de ce décalage entre les indications normatives et les pratiques thérapeutiques sont à la fois exogènes et endogènes. Cette étude illustre ainsi les contradictions entre les politiques de santé décidées en amont, et leur application, en aval. Elle permet de saisir aussi, le rôle central de l'OMS dans la gouvernance de la santé mondiale. Mais, elle n'occulte pas pour autant les énormes difficultés encore pendantes des systèmes de santé des pays en voie de développement comme la Côte d'Ivoire, malgré tous les efforts entrepris par l'OMS pour y remédier. / The policies to fight diseases in general and malaria in particular since 1948 have met different forms in their implementation on a local scale. The example of the Côte d'Ivoire that this study has brought into light perfectly illustrates that point. From an "eradication of malaria" policy that ranges from 1955 to 1970 to a control of malaria since then, the fighting directives, which go along with the main health programs of international institution, have been variously implemented, at least as far as malaria is concerned. The reasons that account for this discrepancy between normative indications and therapeutical practices are both exogenous and endogenous. This study thus illustrates the contradictions between health policies decided upstream and their implementation downstream. It also helps to understand the major role of the World Health Organisation in its govemance in world health. But it does not ignore the huge and still remaining difficulties of health systems of developing countries such as the Côte d'Ivoire in spite of all the efforts undertaken by the WHO to deal with them.