The effectiveness of the Competence Approach in the struggle against Malaria

The NSGA facilitators insisted on this point: if you want to work with a community, above all, you must be accepted by it. The first thing to do is to visit the head of the village and the representatives of the community. They must know who is coming, why, what they are proposing to do and how. Without their agreement, nothing can be done.

Then, you must devote as much time as you need to get to know the community and to be able to identify its particular rules and traditions. These will be different from one community to another in this country where different languages can be spoken in villages separated by a few tens of kilometers.

In one village, for example, it will be considered to be poor manner to broadcast music loudly. And in every village, one should not discredit maraboutism, because this is a major element of a living tradition.

And yet, a first step into Malaria Competence is the identification of malaria as a disease brought by mosquitoes and cured by medical care, and the recognition that is is not the result of a spell that a marabout can make disappear.

To reach this point, facilitators do not give instructions: do this, do not do that. But, through dramas, they bring to life situations that the community members have already witnessed, situations they can recognise. For example, a sick person taken to the marabout doesn’t recover. Their health gets worse. A sick person brought to the Health Centre does get better. In the Health Centre people receive explanations about malaria. The drama shows what is said, what is done. There is no message about maraboutism in general. The drama merely shows that he does not cure malaria and that the other possibility of going to the Health Centre is worth trying..

The Self Assessment tool will often be used, at least at first, with separate groups : men, women, young people. And if, as often happens, women find that they have a new right to speak in public, this change will come about through their own activities and not from the influence of an outside voice.

And finally, the NSGA facilitators pointed out that, even if they feel very welcome in such or such community, they must remain well aware that they are not community members, that they must behave as visitors and they must know how to behave properly.