Perception of a schistosomiasis control project in rural Kenya by the beneficiaries.

ABSTRACT

A schistosomiasis control project was implemented in Mwea Rice Irrigation Scheme in Central Kenya between late 1983 and December 1988 by Kenya Medical Research Institute scientists in collaboration with the National Irrigation Board. The aim of the project was to control schistosomiasis through provision of alternative water sources, bath and laundry units, latrines, chemotherapy and health education. The community participated fully. Five years later in December 1988, 203 household heads were interviewed on their perception of the control project in terms of purpose, project ownership and management, benefits, continuity and their knowledge of schistosomiasis transmission cycle. 61% of the respondents were females and 39% males. 92% of them said that the purpose for the project was to treat, control and prevent bilharzia from spreading, and to promote good health. Slightly over 50% said that the project belonged to them but that they would have liked to be more involved in its management. 74% said that they are able to save time because the facilities are now nearer to them; whilst 79% felt that they were saving money because they did not have to buy drugs since they felt healthier. 99% said that they thought that bilharzia has been controlled, and 82% said that their children looked healthier. 95% said that they could see the project surviving for a long time period suggesting that it was self sustaining and they were willing to start a maintenance of facilities fund. Overall, the community appreciated the social, economic and health benefits derived from the control project.

ABSTRACT

PIP In December, 1988, a medical student and field workers interviewed 203 household heads (61% females and 39% males) in Thiba, a village in the Mwea Rice Irrigation Scheme in Kirinyaga District in central Kenya, as part of an evaluation of the schistosomiasis (bilharzia) control project implemented between late 1983 and December, 1988. Specifically, researchers wanted to know the perceptions of the people that the project served. The project consisted of health education and a water and health committee, which managed the construction of pit latrines, handpump shallow wells, and laundry and bath units. Most everyone (92% and 96%) understood that the project aimed to treat, control, and prevent bilharzia from spreading and to reduce bilharzia morbidity, respectively. Only 53% thought that the project belonged to the community. The remaining heads believed the project belonged to the Kenya Medical Research Institute, Ministry of Health, or a combination of the community, supervisor, and field workers. 74% reported that they saved time because the facilities were nearby. 80% believed that they were saving money because they did not need to buy drugs, since they felt healthier than they did before project implementation. 82% thought that their children appeared healthier, mainly due to the provision of potable water and bathrooms near the well sites. Almost everyone (99%) believed that the control project controlled schistosomiasis. 70% considered their workload to be easier because of the reduced distances to water sources and easy-to-operate pumps that their children could use. More than 90% thought that the project could survive in the long term, if the entire community were trained to maintain the facilities and provided spare parts. This suggested that the project was self sustaining. More than 90% knew the cause of bilharzia, how it is transmitted, its treatment, and how to prevent and control it. In conclusion, the community recognized the socioeconomic and health benefits of the control project.