Discussion
malaria
MALARIA
Housing modifications are a promising new strategy against malaria. Studies suggest that screening windows, ceilings/eaves, and doors, and placing eave tubes and eave ribbons in houses is acceptable. There is, however, little discussion of the influence of the local context on participant experience and interpretation of the implementation of modifications in urban and rural settings. Knowing how the intervention intersects with different elements of society is useful and can provide a map or set of issues that should be considered when interventions are being scaled up.This qualitative study was carried out to provide a holistic account of local interpretations and experiences of the four housing modification types in Jinja. The findings suggest that forms of land and property ownership, poverty and difficulties completing house construction, and ideas about the spirit world, shaped experiences and interpretation of the interventions as they were introduced to study residents.Land and housing remain a major source of security and independence for the residents [As public health actors become more involved in housing [As in other parts of the country, house design was changing from traditional mud-walled houses to modern baked brick bungalows [The importance of engaging local leaders to enable the successful implementation of public health interventions is well documented [This study had several limitations. First, the qualitative assessment was carried out in only a few selected households in two villages. However, this approach provided an in-depth understanding of key contextual issues that need to be taken into consideration when implementing housing modification interventions in low resource settings. Extensive ethnographic observations enabled a better understanding of the housing context in the study area before and during the installations of interventions. Second, the qualitative team’s position as researchers and evaluators of the four housing modifications, and how the community members perceived the role of the study team, may have influenced what information household members and research participants were willing to share. Finally, in this article, the focus is on what is valued about housing and what housing represents in this setting to give insights on key factors that shape the acceptability of housing modifications to prevent malaria, rather than more broadly on overall health or other goals of housing construction.