title: Microfinance against malaria: impact of Freedom from Hunger's malaria education when delivered by rural banks in Ghana.
abstract: A community randomized pre-test/post-test design was used to compare the knowledge and behaviors of microfinance clients receiving malaria education (n=213) to those receiving diarrhea education (n=223) and to non-client controls (n=268). Comparisons assessed differences at follow-up as well as within-group changes over time. At follow-up, malaria clients had significantly better malaria knowledge than comparison groups: 48.4% of malaria clients were able to identify groups most vulnerable to malaria compared with 39.2% of diarrhea clients (P=0.044) and 37.7% of non-clients (P=0.024). Malaria clients were more likely than diarrhea clients (P=0.024) (P<0.001) and non-clients (P=0.028) (P=0.004) to report that insecticide-treated nets (ITNs) provide the best protection against malaria, and to agree that pregnant women should use ITNs, respectively. Between baseline and follow-up, malaria clients were most likely to: improve in knowledge of malaria complications during pregnancy; to own at least one bed net; and to report at least one child or woman of reproductive age sleeping under a bed net. Malaria clients also experienced the greatest increases in ITN ownership/use (9% vs. 2.9% and 6.7% among diarrhea clients and non-clients). Results indicate that, although significant barriers to malaria control remain, a malaria education program provided by microfinance institutions can effectively contribute to community and national malaria initiatives.
authors.affiliation: Department of Health Behavior, University of Alabama at Birmingham School of Public Health, 227 RPHB, 1665 University Blvd, Birmingham, AL 35294, USA.
authors.forename: Natalie
authors.initials: N
authors.lastname: De La Cruz
authors.forename: Benjamin
authors.initials: B
authors.lastname: Crookston
authors.forename: Bobbi
authors.initials: B
authors.lastname: Gray
authors.forename: Steve
authors.initials: S
authors.lastname: Alder
authors.forename: Kirk
authors.initials: K
authors.lastname: Dearden
mesh_terms: D000293:Adolescent; D000328:Adult; D003695:Delivery of Health Care / Q000458:organization & administration*; D057217:Economic Development; D005260:Female; D005869:Ghana / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008288:Malaria / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control / Q000379:methods*; D011247:Pregnancy; D012423:Rural Health / Q000592:standards*; D055815:Young Adult