An assessment of gender and intersectionality in disease exposure, care seeking behaviour and treatment pathways in malaria prevention and control in Kenya and Malawi: a case of Migori county and Chikwawa district
Abstract
Type of study
This project will adopt a longitudinal study design with embedded mixed methods to allow for
translational research and long-term in-depth exploration. This study design will be a
multidisciplinary integration among basic, clinical, practice, population, and policy-based
research enabled by a multidisciplinary team of clinical and social scientists.
Problem
The burden of malaria persists despite the ongoing prevention and control interventions over the
last two decades with the different malaria endemic and epidemic zones being strategically
targeted with a view to eradicate this infectious disease. In Kenya and Malawi, malaria remains a
major cause of morbidity and mortality with more than 70 percent of the population at risk of the
disease. Kenya has four main malaria epidemiological zones with diversity in risk and
intervention determined largely by altitude, rainfall patterns, and temperature, as well as the
prevalence of malaria. Further, access to and uptake of health services for prevention and
treatment knowledge of malaria and health outcomes experienced throughout the life course are
influenced by the foregoing life stratifiers often overlooked in intervention programmes and
policies.
Objectives
Main objective
The aim of the study is to assess the gender and intersectionality of exposure to mosquito bites,
care seeking and treatment pathways for Malaria in Migori County, Kenya when compared to
Chikwawa district in southern Malawi
Specific objectives
1. To assess the intersection between the risk of exposure to mosquito bites with gender
and other social determinants (sex, age, occupation, level of education/class, place of
residence (urban/rural), and religion) of Malaria.
2. To describe how gender power relations, the prevailing gendered social inequalities, and
the culturally dominant constructions of masculinity and femininity intersect with each
other in shaping people’s understanding of ill-health and influence Malaria health seeking
behaviours.
3. To audit Malaria programme delivery and Malaria control interventions including research
and access to Malaria and disease management services using the intersectional gender
lens.
4. To identify the gender dimensions in Malaria programme delivery and control
interventions in the emerging COVID-19 pandemic context.
13-The study will be conducted in Migori County, Kenya and Chikwawa district in Malawi to target
health facilities and community members to explore gender and intersectionality of malaria
etiology, health and health seeking and treatment pathways and inform the specific study
objectives. The research will employ participatory , qualitative and quantitative methods to
explore gender and intersectionality of malaria etiology, health seeking and treatment pathways.
This study will be carried out in two phases: Phase one - the formative phase and will entail
mainly the document reviews and piloting of the study tools and; Phase Two - mixed methods
studies, the longitudinal comparative approach will include quantitative and qualitative studies to
assess malaria etiology, health and health seeking and treatment pathways through a gender
and intersectionality lens.
Expected findings and dissemination
The research protocol will be published after all ethical approvals have been received. Findings
from the study will be presented through community engagement mechanisms such as
community engagement meetings and science cafe’s. Advocacy work through various
mechanisms at county and national level based on the findings of the study will be conducted.
Results will be shared with the wider scientific community through presentations at national and
international conferences, and through open-access peer-reviewed journal publications. In
addition, we can submit the report of our findings to COMRE and national open data platform.