Malaria Competence

The fundamental idea that sits behind the Malaria Competence approach is that communities have the capacity to respond to those issues that are of concern to them. In the case of malaria, what we observe is that communities will take action when they recognise that malaria is their problem. Communties do indeed need knowledge and they need commodities, but if the knowledge and the commodities are to be effective, there must be ownership by the community.

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But how does the community come to take ownership of the problem of malaria? A prerequisite for ownership by the community is discussion by the community. Unless a problem is discussed, then it does not exist. So one aim of the Malaria Competence process is to stimulate discussion within the community, in particular it seeks to give a voice to those whose voices are seldom heard in the normal community forums.

Kevin Hughes is the Programme Director of the Nova Scotia Gambia Association (NSGA). The NSGA has been deeply involved with applying the Competence approach to malaria in The Gambia. In his view, the Self Assessment framework 'is an ideal tool to get maximum participation from all quarters of the community, particularly women....Quite often the decision making in the villages is a male domain.' And again, 'The Self Assessment was extremely good at getting women involved in the key decisions. It allowed them to play a much more active role in decision making.' (See video clip below)

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But what we have seen is not simply that women are taking part in the conversation. Their voices are being heard and respected. Gladys Tay-Agboli works with the Togolese Red Cross where she supports 'The Clubs for Mothers' that you will find throughout the country. She has noticed that, "Now the women speak when they are with the men. Today when they attend a meeting, even with the chiefs, they raise their finger to talk about what they want. Before they were behind the men, and the men decided for them."(See video clip below)

Lamboni Kouami, President of the Red Cross in the Savannah Region of Togo has noticed the same thing. "Now the women are free to speak. Before, in a meeting, only the men would speak and the woman was scared to interrupt." And he goes on to say that, "There has been a change. The women have changed. But the men have changed too. They listen to the advice from their wives. And this means that the malaria prevention message can go through the wives."(See video clip below)

Yakuba Bojang, a coach with the NSGS who has implented the Malaria Comptence process throughout The Gambia has noticed that the change in the men has gone even further than just listening to their wives! "When a child is sick it is the role of the mother to take the child to the hospital. But with the help of the Self Assessment, there are so many Health Centres that we are visiting today that say that the men are also taking the responsibility to bring the child to the Health Centre when she is sick."(See video clip below)

And perhaps Gladys Tay-Agboli begins to explain why all of this is happening when she says, "With the Self Assessment, the women are free. They are able to discuss these things together. They feel concerned. They are now at the centre of the issue."