Abstract:

This study evaluates the impact of gender-sensitive interventions on malaria prevention in Uganda, focusing on male involvement in household health decisions. Implemented in Hoima, Masaka, and Rwenzori, the ‘Zooming-In’ approach utilized interpersonal communication and follow-up visits to engage men in malaria prevention activities. The study employed a quasi-experimental design, selecting intervention and control groups based on malaria burden, geographic distribution, and socio-economic factors. Households were randomly assigned within these groups to minimize selection bias. A total of 2,400 households were included, equally divided between intervention and control groups. Data collection involved household surveys, key informant interviews, and focus group discussions. Quantitative analysis applied descriptive statistics and logistic regression, while qualitative data underwent thematic analysis. Findings show significant improvements in malaria prevention behaviors in intervention areas, including higher ITN usage (81.8% vs. 76.5%, p = 0.028, OR = 1.27, 95% CI: 1.08-1.49), increased early treatment-seeking within 24 hours of fever onset (81.6% vs. 64.4%, p < 0.001, OR = 2.32, 95% CI: 1.89-2.84), and greater IPTp uptake (78% vs. 58%, p = 0.022, OR = 1.94, 95% CI: 1.61-2.34). The intervention also reduced malaria test positivity rates by 9%. However, sustaining male engagement remains a challenge, particularly in communities with entrenched gender norms. The study highlights the need for culturally tailored strategies and the integration of gender-sensitive approaches into malaria prevention programs. Future research should explore cost-effective scaling strategies, such as digital follow-ups and leveraging community health worker networks.

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