The role of community leaders in the enhancement of malaria programmes: A case study of Kakooge Sub County, Nakasongola District.
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The study was a descriptive cross sectional study of the roles and responsibilities of community leaders in the promotion of malaria programmes in Kakooge Sub County, Nakasongola District. Leaders have a vital role in the success of many interventions including malaria health interventions in their respective areas of jurisdiction. The roles of community leaders in the enhancement of malaria programmes range from community mobilization, influencing communities to utilise Long Lasting Insecticide Treated Nets (LLITN), provide correct information and plan for malaria control and prevention interventions. Despite the collective efforts of Uganda’s Ministry of health and the health development partners to minimise malaria through various interventions there seems to be a silent leadership contribution in this cause. Malaria accounts for 87% of the Kakooge disease burden compared to 51% in Nakasongola District (Nakasongola District HMIS, 2011). Uganda’s National Ministry of Health (MoH), reported that malaria accounts for 47% of outpatient attendance (Presidents Malaria Initiative, Uganda, Malaria operational plan, 2013). Therefore the study sought to establish the roles and responsibility of community leaders in collectively supporting malaria related interventions in order to reduce the disease burden and identify the available opportunities to reduce the malaria burden. The study identified information and knowledge needed to enable leaders promote interventions in the prevention and control of malaria. The findings would guide policy makers and other development partners to find effective ways to adequately address and equip community leaders with knowledge on malaria. Lastly the study established that there was a need to strengthen the levels of participation of community leaders and members in the implementation of health interventions. Leaders were a main link to health programmes and were better positioned to positively influence decisions made in the community. However the roles and responsibilities of leaders were limited because of the negative attitudes of leaders towards health interventions. The negative attitudes and perceptions of leaders have affected effective relay of health messages to communities, limited their participation and integration of health programmes into other community development programmes. Corruption tendencies have tremendously hindered the community leaders from the drive towards the promotion of malaria programmes. Leaders have not exhaustively utilised and supported the existent knowledgeable community based structures to promote malaria preventive and control measures. However in spite of this, there were many available opportunities in the community that the community leaders could utilise to promote of malaria health programmes and these included; community acceptance of health programmes, existence of health development partners, Community Based Organisations (CBOs) and community based structures. The recommendations based on the study included education and orientation of community leaders on malaria programmes, provide access to adult literacy classes to improve communication, reading, writing skills that can support community leaders in the promotion of malaria programmes. Another recommendation was to encourage leaders to own community health programmes and not to associate such interventions to reward or monetary attachments. Corruption was identified as a major challenge that retarded malaria programmes although the community had the responsibility to report corrupt community leaders to the relevant authorities. The community was encouraged in the recommendations to vote into power leaders who had the will to represent community interests nobly and not leaders who abused their power. The development health partners were encouraged to limit monetary incentives to community leaders upon completion of tasks and expose leaders that wanted to take bribes in order to ensure participation in the promotion of malaria programmes. Lastly the researcher recommended that periodic studies should be conducted to establish the effectiveness and impact of leader participation and involvement in malaria health interventions.