title: Community mobilization for malaria elimination: application of an open space methodology in Ruhuha sector, Rwanda.
abstract: BACKGROUND
  Despite the significant reduction of malaria transmission in Rwanda, Ruhuha sector is still a highly endemic area for malaria. The objective of this activity was to explore and brainstorm the potential roles of various community stakeholders in malaria elimination.
  
  
  METHODS
  Horizontal participatory approaches such as 'open space' have been deployed to explore local priorities, stimulate community contribution to project planning, and to promote local capacity to manage programmes. Two open space meetings were conducted with 62 and 82 participants in years 1 and 2, respectively. Participants included purposively selected community and local organizations' representatives.
  
  
  RESULTS
  Malaria was perceived as a health concern by the respondents despite the reported reduction in prevalence from 60 to 20% for cases at the local health centre. Some misconceptions of the cause of malaria and misuse of preventive strategies were noted. Poverty was deemed to be a contributing factor to malaria transmission, with suggestions that improvement of living conditions for poor families might help malaria reduction. Participants expressed willingness to contribute to malaria elimination and underscored the need for constant education, sensitization and mobilization towards malaria control in general. Active diagnosis, preventative strategies and prompt treatment of malaria cases were all mentioned by participants as ways to reduce malaria. Participants suggested that partnership of stakeholders at various levels could speed up programme activities. A community rewards system was deemed important to motivate engaged participants, i.e., community health workers and households. Establishment of malaria clubs in schools settings was also suggested as crucial to speed up community awareness and increase skills towards further malaria reduction.
  
  
  CONCLUSIONS
  This bottom-up approach was found useful in engaging the local community, enabling them to explore issues related to malaria in the area and suggest solutions for sustainable malaria elimination gains.
authors.affiliation: Department of Health Promotion, Maastricht University, Maastricht, The Netherlands. cingabire7@gmail.com.
authors.forename: Chantal Marie
authors.initials: CM
authors.lastname: Ingabire
authors.forename: Jane
authors.initials: J
authors.lastname: Alaii
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Hakizimana
authors.forename: Fredrick
authors.initials: F
authors.lastname: Kateera
authors.forename: Daniel
authors.initials: D
authors.lastname: Muhimuzi
authors.forename: Ingmar
authors.initials: I
authors.lastname: Nieuwold
authors.forename: Karsten
authors.initials: K
authors.lastname: Bezooijen
authors.forename: Stephen
authors.initials: S
authors.lastname: Rulisa
authors.forename: Nadine
authors.initials: N
authors.lastname: Kaligirwa
authors.forename: Claude
authors.initials: C
authors.lastname: Muvunyi
authors.forename: Constantianus J M
authors.initials: CJ
authors.lastname: Koenraadt
authors.forename: Leon
authors.initials: L
authors.lastname: Mutesa
authors.forename: Michele
authors.initials: M
authors.lastname: Van Vugt
authors.forename: Bart
authors.initials: B
authors.lastname: Van Den Borne
mesh_terms: D000328:Adult; D000368:Aged; D002675:Child, Preschool; D003256:Community Participation; D060740:Disease Eradication / Q000458:organization & administration*; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D012432:Rwanda / Q000453:epidemiology