Governance of Malaria Prevention

Georges and Bernard interviewing a mother and her child
Dwelling in Benin
Regisse (our collaborator) preparing an interview

Georges Danhoundo and Mary Wiktorowicz are leading research that addresses the governance of malaria prevention in the Republic of Benin, where malaria is the leading reason for medical consultations and hospitalizations. The research focused on lake areas known to be particularly favorable to the malaria transmission vector. In exploring the intersection of health policies concerning access and quality of health services, the research incorporated a social determinants of health perspective comprised of three parts.

The first part examined the governance of public policy development concerning malaria prevention in pregnancy by deconstructing the factors that affect women’s access to Intermittent Preventive Treatment and the obstacles therein. In applying the theory of ‘sensemaking’ (Weick, Sutcliffe, & Obstfield, 2005) the research involved interviews and focus groups with policy makers, health professionals, and women to shed light on their perspectives and clarify actors’ decision-making logics including their construction of the “story”. The research involved analyzing decision-makers’ perspectives and how they intersect with health professionals’ and women’s lived experience and current evidence, to reveal the manner in which policy makers’ assumptions shape public policies.

The second part used a social ecology lens to clarify the factors affecting the use and maintenance of bed nets among pregnant women and their households to generate evidence that will support successful bed net policy interventions in similar contexts.

The third part aimed to: 1) understand women’s experiences concerning their interactions with midwives during antenatal visits including prevention; 2) explore midwives’ logic and explanations regarding their practices or behaviors during antennal visits; 3) understand decision-makers’ perspectives on healthcare providers’ professionalism in healthcare facilities.

The research was supported by the York Incentive Fund, the Faculty of Health and Professor Jianhong Wu.

Key publications from the project

Danhoundo, G., Wiktorowicz, E.M., & Yaya, S. (2016). Governance of malaria prevention: How decision makers’ and pregnant women’s sensemaking contribute to unintended consequences. Health Care for Women International http://dx.doi.org/10.1080/07399332.2016.1234483.

Danhoundo, G., Premji, S., & Wiktorowicz, E.M. (2016). Effectiveness of bed net campaigns: A social ecology lens. Annals of Global Health (Submitted, June 2016).

Danhoundo, G., Pilkington, B., & Yaya, S. (2016). What Happens during Antenatal Visits? An Ethnographic Study of Pregnant Women's Experiences Concerning their Interactions with Midwives in Benin's Lake Areas. Midwifery (submitted, July 2016).

Danhoundo, G., & Yaya, S. (2016). «Les déterminants du recours aux soins de santé maternelle au Bénin». In S. Yaya (dir) Risquer la mort pour donner la vie. Politiques et programmes de santé maternelle et infantile en Afrique.