Conclusion: Lessons Learned
The results of this study offer promise for a social, behavioral, and
environmental approach to malaria control:
- Malaria control and other development efforts in which communities
are participating fully hold the greatest potential for being sustained.
Participation by communities throughout the project cycle is essential.
Also critical are an understanding of social, economic, and cultural
factors influencing communities and incorporation of these factors into
- African expertise already exists throughout the continent and across
disciplines. African institutions and other entities conducting malaria
and development-related work present a compelling case for targeted
- Cross-sectoral approaches are being used in Africa. These initiatives
should be further studied to determine how they can best be strengthened
and in what situations they can most appropriately be replicated. A
cross-sectoral approach will successfully coordinate the:
- integration of "bottom-up" and "top-down" approaches
- cooperation among the participants in international development,
working together to achieve the goal of reducing the impact of development
efforts on malaria
- utilization of maximum resources available from all relevant sectors
to reduce their impact on malaria transmission
To provide the undergirding for this approach:
- Malaria control must be a high priority, along with a commitment to
implementation, for all active participants in international development.
At the same time there are specific activities most appropriate for
implementation by communities, local or national governments, donors,
- Strategies can and must be tailored to the social and physical environment
in which they are to be executed. A long-term mechanism for developing
strategies appropriate to the environmentally, culturally, and socially
similar regions, districts, or smaller divisions exists in the creation
and maintenance of training and resource centers within Africa.
This report discusses several existing and proposed cross-sectoral, capacity-building,
and other innovative initiatives targeted to different levels as appropriate.
A foundation has thus been established for future efforts through an evaluation
of these and other promising approaches in terms of their capacity for
reducing the impact of development on malaria. Such an assessment should
identify program achievements and constraints to success. In this evaluation
it is essential to examine African enterprises in order to determine their
potential for improvement and for replication in order to enhance the
effectiveness of malaria control in Africa.