Community engagement and participation has played a critical role in successful disease control and elimination campaigns in many countries. Despite this, its benefits for malaria control and elimination are yet to be fully realized. This may be due to a limited understanding of the influences on participation in developing countries as well as inadequate investment in infrastructure and resources to support sustainable community participation. This paper reports the findings of an atypical systematic review of 60 years of literature in order to arrive at a more comprehensive awareness of the constructs of participation for communicable disease control and elimination and provide guidance for the current malaria elimination campaign.
In the 1990s, the experience of eliminating malaria from Aneityum Island, Vanuatu is often given as evidence for the potential to eliminate malaria in the south-west Pacific. This experience, however, cannot provide a blueprint for larger islands that represent more complex social and environmental contexts. Community support was a key contributor to success in Aneityum. In the context of disappearing disease, obtaining and maintaining community participation in strategies to eliminate malaria in the rest of Tafea Province, Vanuatu will be significantly more challenging.
In March 2008, the Solomon Islands and Vanuatu governments raised the goal of their National Malaria Programmes from control to elimination. Vector control measures, such as indoor residual spraying (IRS) and long-lasting insecticidal bed nets (LLINs) are key integral components of this programme. Compliance with these interventions is dependent on their acceptability and on the socio-cultural context of the local population. These factors need to be investigated locally prior to programme implementation.
The implications of smoking refusal for personal identity style were studied through conversations in six small focus groups or dyads of 13- and 14-year-old non-smokers from an urban New Zealand secondary school. The approach to analyzing their talk was informed by notions of `performativity' and `social space' to focus on the connections between identity and social relations. Smoking emerged as a key signifier of power and status. It was salient at both top and bottom ends of the social hierarchy depending upon the competence displayed in smoking as part of a larger ensemble of personal deportment and behavior. Being a non-smoker therefore inevitably carried connotations of being `average' or `in the middle', presenting non-smoking adolescents with the problem of accrediting themselves against superior `smoker cool' groups. A discourse analytic approach was used to examine the resources and strategies participants brought to bear on this `problem', which was then seen to be solved differently by boys and girls. Boys could establish alternatives to `smoker cool' through physical activity, girls had little recourse but to accept their inferior status. The implications of this for health education and promotion are discussed
Traditionally, school‐based sex education has provided information‐based programmes, with the assumption that young people make rational decisions with regard to the use of condoms. However, these programmes fail to take into account contextual issues and developing subjectivities. This paper presents the talk of 42 young people from a New Zealand secondary school who were questioned in‐depth about the sex education programme they had received. They discussed a programme that concentrated on the ‘dangers’ and ‘risks’ of sexual intercourse and that failed to enhance negotiation skills or take into account the contexts in which sex occurred for many young people. Although participants were well aware of the public health discourses of the importance of condom use, the implications of putting these discourses into practice held the potential for ‘risks’ of a greater magnitude in the reality of their everyday life. The ‘risk’ to reputation and subjectivity overrode any ‘risks’ that may have occurred through non‐use of condoms. This highlights the need for sex education programmes to put greater effort into developing skills of assertiveness, communication and empowerment.
In 2003, New Zealand decriminalised sex work through the enactment of the Prostitution Reform Act. Many opponents to this legislation predicted that there would be increasing numbers of people entering sex work, especially in the street-based sector. The debates within the New Zealand media following the legislation were predominantly moralistic and there were calls for the recriminalisation of the street-based sector. This study estimated the number of sex workers post-decriminalisation in five locations in New Zealand: the three main cities in which sex work takes place as well as two smaller cities. These estimations were compared to existing estimations prior to and at the time of decriminalisation. The research suggests that the Prostitution Reform Act has had little impact on the number of people working in the sex industry.