The needs and opportunities for housing improvement for malaria control in Southern Tanzania

Abstract

There is evidence that mosquito-proofed houses can reduce malaria risk. However, housing improvement is rarely included in malaria control toolboxes. This study assessed the need, magnitude, and opportunities for housing improvement to control malaria in Tanzania. The exploratory mixed-methods study was conducted in 19 villages across four councils in southern Tanzania. A structured survey was administered to 1292 community members to assess need, perceptions, and opportunities for housing improvement. Direct observations of 802 houses and surrounding environments were done to identify the needs, opportunities, and to validate the survey findings. A market survey was done to assess availability, cost of resources and services necessary for mosquito-proofing homes. Focus group discussions were conducted with key stakeholders to explore insights on the potential and challenges of housing improvement. Of the 735 respondents who needed housing improvements, a majority needed window screening (91.1%), repairs of holes in walls (79.4%), door covers (41.6%), closing eave spaces (31.2%) and bettering roofs (19.0%). Community members invested significant efforts to improve their homes against malaria and other dangers, but these efforts were delayed due to high costs and limited incomes. Study participants suggested several mechanisms of support to improve their homes, including loans and subsidies. Addressing the need for housing improvement is a critical component of malaria control. A majority of the community members needed modest modifications and had plans to work on it. Thus, it is crucial to bring together key players across sectors to reduce barriers and making housing improvement accessible and affordable to residents.