In Uganda, a Local Health Hero Ensures Her Community is Protected from Malaria

Evaline Nampima is a fierce advocate for her community. She is a district councilor, representing Muwayo town council, working as a bridge between her community and Bugiri District Council in Uganda. During the annual campaign to spray homes with a mosquito-killing insecticide to prevent malaria, Evaline became one of her town’s strongest supporters of the intervention.

Malaria is personal to Evaline. “I used to take my children almost weekly to the hospital. I would bring one home and another one would be down with malaria,” she shares. “As a leader, people used to come to my home nearly daily either asking for transport to the health center or money for treatment; I would help where I could, but it was overwhelming.”

This is why Evaline works so hard to ensure her community is protected from this disease. Evaline recalls that before homes were sprayed, “there used to be so many cases of malaria that when you’d go to the health center, it would be full.” Since the U.S. President’s Malaria Initiative (PMI) VectorLink Uganda Project’s spray campaign started in 2018, Evaline worked diligently as a campaign mobilizer in Bugiri district to educate her community on the benefits of indoor residual spraying for protection against malaria.

“During the campaign, I meet the spray team first before they go to the field to start their work,” shares Evaline. “I tell them how to approach a home and talk to the owners because home entry techniques and approach is very important in community acceptance of this malaria prevention method.” Evaline also participates in community dialogues—a participatory communication process where information is shared with groups of people to help solve problems such as increasing the number of households accepting spraying—when there is resistance to accepting the intervention.

Convincing community members to accept interventions that protect people from malaria is challenging. And that’s where Evaline comes in. With training from the Communication for Development Foundation Uganda (CDFU), she helped convince her community to accept having their homes sprayed.

PMI has worked with CDFU, a Ugandan nongovernmental organization that carries out social and behavior change, capacity strengthening, and community engagement programs, since 2015 to implement the necessary social and behavior change mobilization that supports spray campaigns. CDFU has trained Evaline and dozens of others as mobilizers to ensure Bugiri district was protected from malaria.

“Before the 2023 spray campaign began, we completed a five-day training where we were taken through communications skills, homeowner entry techniques, sexual violence prevention, and interpersonal communication,” explains Evaline. These skills help mobilizers communicate effectively with households and spray operators.

Interpersonal communication is particularly effective in encouraging community members to accept having their homes sprayed because it allows them an opportunity to express their concerns one-on-one. Some reasons people don’t want their homes sprayed include not liking the smell of the insecticide, thinking it leads to bed bug infestation, and that it can lead to infertility. “There are some issues in the community that people feel can’t be shared in public during community dialogues,” says Angom Dorcas Hope, project assistant for CDFU. Interpersonal communication enables community members to privately share their concerns.

Evaline’s community mobilization efforts have paid off. In Bugiri, spray operators have covered 92.6% of homes, protecting close to 80,000 people, including over 17,000 pregnant women and 110,000 children under five in 2023.

After the spray campaign finishes, Evaline talks to communities about the importance of sleeping under a mosquito bed net and getting rid of stagnant water around homes as malaria-carrying mosquitoes can breed there. When she gets a chance to talk with women’s groups, she encourages women to take their children to the health center if they have fevers and pregnant women to go early for antenatal care.

Evaline says, “if we continue to inform our community about spray benefits, but also embrace other preventive measures—seeking early testing and treatment and supporting health workers—we shall see a malaria-free Bugiri.”