The effectiveness of the Competence Approach in the struggle against Malaria

Global Fund support for action agains malaria has led to the large scale distribution of insecticide treated bednets, the treatment of the inside of many houses with insecticide and the use of more effective treatment against simple malaria.

But wherever we went we were struck by the personal commitment of the President of the Republic of the Gambia who has made the struggle against malaria a national priority and its eradication a national amibtion.

But it was Mr Malang Fofana, the Manager of the National Malaria Control Program at the Department of State for Health who remarked to us that, "It is one thing to distribute bed nets. It is another thing to get people to use them.

And his collaborator, Dr Adana Jagne Sanko added, "Control programmes on their own will never lead to the eradication of malaria in The Gambia. The involvement of communities is the key issue.

In Essau, Baba Njie, the Regional Director of Health of the North Bank West Region told us, "We kept on designing programmes to inform people about malaria, but we kept on getting more cases of malaria."

For Baba Njie, that all changed 2 years ago with the arrival of a team from the Nova Scotia Gambia Association.

This Canadian NGO works closely with the National Malaria Control Programme. In one week, they introduced the Regional Health Team to the Competence approach and to the use of the Self Assessment tool.

Reflecting on this experience withthe competence approach, Baba Njie reflected, "Whenever we use this approach with communities, we have seen them take ownership of the problem of malaria, we have seen them take ownership of the information that they need. And then they have designed their own plan of action to deal with malaria."

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