“My children and I will no longer suffer from malaria”: a qualitative study of the acceptance and rejection of indoor residual spraying to prevent malaria in Tanzania

• Published in: Malaria Journal
• Main Authors: Kaufman Michelle R, Rweyemamu Datius, Koenker Hannah, Macha Jacob
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2012
• Subjects: Indoor residual spraying; Tanzania; Insecticide; Maneno muhimu; Upuliziaji wa dawa ya kuua mbu majumbani; Dawa; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/1475-2875-11-220; https://doaj.org/article/7e350ee586c4473391cda1b2ee4cb246

Abstract Background The objective of this study was to identify attitudes and misconceptions related to acceptance or refusal of indoor residual spraying (IRS) in Tanzania for both the general population and among certain groups ( e.g. , farmers, fishermen, community leaders, and women). Methods This study was a series of qualitative, semi-structured, in-depth interviews and focus group discussions conducted from October 2010 to March 2011 on Mainland Tanzania and Zanzibar. Three groups of participants were targeted: acceptors of IRS (those who have already had their homes sprayed), refusers (those whose communities have been sprayed, but refused to have their individual home sprayed), and those whose houses were about to be sprayed as part of IRS scale-up. Interviews were also conducted with farmers, fishermen, women, community leaders and members of non-government organizations responsible for community mobilization around IRS. Results Results showed refusers are a very small percentage of the population. They tend to be more knowledgeable people such as teachers, drivers, extension workers, and other civil servants who do not simply follow the orders of the local government or the sprayers, but are skeptical about the process until they see true results. Refusal took three forms: 1) refusing partially until thorough explanation is provided; 2) accepting spray to be done in a few rooms only; and 3) refusing outright. In most of the refusal interviews, refusers justified why their houses were not sprayed, often without admitting that they had refused. Reasons for refusal included initial ignorance about the reasons for IRS, uncertainty about its effectiveness, increased prevalence of other insects, potential physical side effects, odour, rumours about the chemical affecting fertility, embarrassment about moving poor quality possessions out of the house, and belief that the spray was politically motivated. Conclusions To increase IRS acceptance, participants recommended more emphasis on providing thorough public ...