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Mategula, Donnie, Ibarz-Pavón, Ana, Sakala, Melody, Chawani, Marlen, Sambakunsi, Henry, Phiri, Mphatso, Ndeketa, Latif, Sambo, Mwiza, Shonga, Wisdom, Sambani, Clara, Divala, Titus, Vinkhumbo, Steve, Nkhoma, Dominic, Mataya, Robert, Nyangulugu, Wongani and Saleh, Sepeedeh (2024) '"Kuteteza": A community-engaged COVID-19 Prevention and Protection Initiative in Southern Malawi.'. Wellcome Open Research, Vol 9, p. 24.
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Abstract
Background
The COVID-19 epidemic in Malawi involved almost 90,000 recorded cases and 2,638 deaths. In response to early concerns about vulnerable older people in rural areas, we developed ‘Kuteteza’: a COVID-19 mitigation response project. Clinicians, public health professionals, and researchers collaborated with government and district-level staff in two Southern Malawi districts. Interventions included supported ‘shielding’ of older people – minimising social mixing whilst having their daily needs supported. Additional mitigation strategies included provision of masks, handwashing stations, and soap. Government partnerships allowed additional support for vulnerable groups. We present the findings of a realist project evaluation, assessing the feasibility of this approach.
Methods
We collated anonymised descriptive data on Kuteteza procedures and conducted qualitative structured observations in villages involved in the initiative. We carried out three focus groups involving community members, frontline health staff, and volunteers in each setting. These provided deeper insights into experiences of the pandemic and impacts of the intervention, including suggested opportunities during future outbreaks.
Results
The project involved 25 villages across two districts, with 1,087 people over the age of 60 voluntarily participating in ‘shielding’. Supplies of food, water, and cooking fuel were mostly arranged within the family. In Kuteteza villages, the handwashing stations and soap were widely used, and there was awareness and some observance of COVID-19 prevention measures. The project, including the provision of supplies, was greatly appreciated by communities, but wider contextual constraints – namely widespread economic insecurity – presented persisting challenges. Suggestions for improvement largely concerned project enhancements and extensions.
Conclusions
Through effective stakeholder engagement and contribution to national response strategy, the Kuteteza project helped raise COVID-19 awareness and supported populations at a critical time in the pandemic. Kuteteza approaches were welcomed locally and may be incorporated in future epidemic responses. Supported ‘shielding’ should be paired with government-led measures to mitigate economic hardship.
| Item Type: | Article |
|---|---|
| Subjects: | WA Public Health > Health Administration and Organization > WA 546 Local Health Administration. Community Health Services WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 506 COVID-19 |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.12688/wellcomeopenres.20789.2 |
| SWORD Depositor: | JISC Pubrouter |
| Depositing User: | JISC Pubrouter |
| Date Deposited: | 13 Nov 2024 15:39 |
| Last Modified: | 13 Nov 2024 15:39 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/25562 |
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