Perceptions of tropical health risks in mponda, malawi: Attributions of cause, suggested means of risk reduction and preferred treatment

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Abstract
Malaria and schistosomiasis (bilharzia) comprise major health risks in much of sub-Saharan Africa. Technically preventable, improved understanding of local belief and behaviour regarding such diseases is crucial if public health programmes are to prove sustainable. This study examined attributions of cause, suggested means of risk reduction and preferred treatment for the two diseases in a sample of 50 respondents in Mponda, a marshy area within the Southern Region of Malawi, where both malaria and schistosomiasis are endemic. An earlier study in the area (Ager, 1992) had demonstrated that these diseases were considered as unpredictable and often uncontrollable health risks, although adherence to recommended control practices for the diseases was high. In the current study, belief in biomedical means of transmission and adherence to recommended control practices was evidenced by approximately two-thirds of respondents. There were no noted gender differences, but significant age effects in attributions of cause and means of risk reduction for malaria. Attribution of cause and suggested means of control did not predict preference for treatment, with a preference for medical treatment being widely held. Findings lend support to recent analyses which highlight individual capacity to in particular circumstances formulate health and disease processes with respect to alternative conceptual systems (e.g. biomedical or traditional). The implications for health promotion theory and practice in such settings are considered.

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