Family malaria management in Africa

Despite significant progress since the 2000s, malaria remains in Africa a major health problem for families who, in the absence of medical coverage, have to manage all the health problems occurring among household members. For economic reasons, the practice of self-medication is important, facilitated by a very active informal drug market. Thus, understanding the malaria burden in sub-Saharan Africa requires a dual approach combining quantitative measures estimating the extent of observed phenomena, and a qualitative ethnographic approach to better understand households’ management of these health issues. This chapter describes fifteen years of interdisciplinary research incorporating medical anthropological and social epidemiological approaches to explore ways of managing malaria in families and access to medicines outside the control of medical facilities. This was a collaborative research project, first conducted in parallel and then jointly as part of a European programme concerning pharmaceutical markets and Artemisinin-based combination therapies. Analyses and findings presented in this chapter based on surveys in Senegal and Benin highlight the impact that such a combined approach may have in improving the adaptation of malaria control strategies to people’s life contexts.