Table 1 Barriers to prevention and implementation strategies that participants suggested to address these
Reach | Efficacy | Adoption | Implementation | Maintenance | |
|---|---|---|---|---|---|
Malaria | Village shops have no nets. | Doubts about effectiveness of nets | Cost of nets | Groups (for discussion & practical action) | Net replacement & retreatment with insecticide |
Mass media does not reach rural areas. | Feeling too hot in bed | Advice in clinics | |||
Mosquito control harder in marshy areas | Reactions to chemicals | Churches | |||
Various control measures used but gaps in knowledge about reservoirs for breeding | Mass media | ||||
HIV/AIDS | Condom availability | Lack of confidence in condoms | Cost of condoms | Test and treat early | Reliable condom supply |
Limited knowledge | Limited experience of people improving with treatment | Moral views on abstinence | Publicise facts on transmission | ||
Lack of confidence in health services | Peer & family pressure | Empower people to discuss HIV risk, say no and defer intercourse until tested | |||
Self-control a challenge | How can we help people to be faithful? | ||||
Alcohol | |||||
Fear of positive results may discourage testing | |||||
Family Planning | Transport limited | Doubts about effectiveness | Cost | Facilitate opening the topic for discussion | If side effects, people tend to stop, rather than try alternatives. |
Not all methods available | Worry about side effects (infection, bleeding, sterility) | Train facilitators | Reliable programme of clinics | ||
Limited knowledge | Men & women may have different ideas on ideal family size | Use visual aids & drama | |||
Religious constraints |