Process Evaluation of a Community-Based Microbial Larviciding Intervention for Malaria Control in Rural Tanzania

Nina Berlin Rubin, Leonard E.G. Mboera, Adriane Lesser, Marie Lynn Miranda and Randall Kramer
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Nina Berlin Rubin: Department of Earth System Science, Stanford University, Stanford, CA 94305, USA
Leonard E.G. Mboera: SACIDS Foundation for One Health, Sokoine University of Agriculture, 3297 Morogoro, Tanzania
Adriane Lesser: Duke Global Health Institute, Duke University, Durham, NC 27710, USA
Marie Lynn Miranda: Department of Applied and Computational Mathematics and Statistics, University of Notre Dame, Notre Dame, IN 46556, USA

IJERPH, 2020, vol. 17, issue 19, 1-11

Abstract: Microbial larviciding can be an effective component of integrated vector management malaria control schemes, although it is not commonly implemented. Moreover, quality control and evaluation of intervention activities are essential to evaluate the potential of community-based larviciding interventions. We conducted a process evaluation of a larval source management intervention in rural Tanzania where local staff were employed to apply microbial larvicide to mosquito breeding habitats with the aim of long-term reductions in malaria transmission. We developed a logic model to guide the process evaluation and then established quantitative indicators to measure intervention success. Quantitative analysis of intervention reach, exposure, and fidelity was performed to assess larvicide application, and interviews with larviciding staff were reviewed to provide context to quantitative results. Results indicate that the intervention was successful in terms of reach, as staff applied microbial larvicide at 80% of identified mosquito breeding habitats. However, the dosage of larvicide applied was sufficient to ensure larval elimination at only 26% of sites, which does not meet the standard set for intervention fidelity. We propose that insufficient training and protocol adaptation, environment and resource issues, and human error contributed to low larvicide application rates. This demonstrates how several small, context-specific details in sum can result in meaningful differences between intervention blueprint and execution. These findings may serve the design of other larval source management interventions by demonstrating the value of additional training, supervision, and measurement and evaluation of protocol adherence.

Keywords: process evaluation; malaria; vector control; larval source management; implementation assessment; microbial larvicide; Tanzania (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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