Move against malaria.

In a community-based malaria control project covering a predominantly Muslim population in the United Republic of Tanzania, difficulty was encountered in motivating people to have their mosquito nets reimpregnated with insecticide at six-monthly intervals. Education on this subject was therefore provided in mosques during Friday noon prayers. People who attended these services considered them an appropriate forum for discussing health concerns and viewed them as a credible source of information.Insecticide-impregnated bednets help to control the spread of the malaria parasite Plasmodium falciparum. The Bagamoyo Bednet Project is a community-based scheme to develop a sustainable system for the distribution and promotion of such bednets among 21,000 people in a rural coastal area 60 km north of Dar es Salaam. While the 13 village committees have sold and distributed the bednets, they have been unable to motivate people to have their nets impregnated with insecticide every 6 months, key to thwarting the spread of malaria. Posters and meetings also had only a limited impact upon user motivation. The target population is mainly Muslim. The sheikh in each of 4 villages was therefore recruited to teach during Friday noon religious services, when attendance levels are relatively high, the merits of regular bednet impregnation. This approach was chosen because people expect to receive some form of teaching or instruction during the service, and the religious leaders who run it are respected and seen as reliable sources of information. There are also many health teachings in the Koran and Sunna. Although only a minority of villagers attended, a considerable proportion disseminated the information to family and friends. This approach seemed most effective in reaching men aged 30-50 years, and ineffective in reaching youth; fewer women attended prayers than men. The project achieved 52-98% regular bednet reimpregnation except in one village where the level reached only 25%.