PERCEPTIONS OF TROPICAL HEALTH RISKS IN MPONDA, MALAWI - ATTRIBUTIONSOF CAUSE, SUGGESTED MEANS OF RISK REDUCTION AND PREFERRED TREATMENT

Malaria and schistosomiasis (bilharzia) comprise major health risks in much of sub-Saharan Africa. Technically preventable, improved underst anding of local belief and behaviour regarding such diseases is crucia l if public health programmes are to prove sustainable. This study exa mined attributions of cause, suggested means of risk reduction and pre ferred treatment for the two diseases in a sample of 50 respondents in Mponda, a marshy area within the Southern Region of Malawi, where bot h malaria and schistosomiasis are endemic. An earlier study in the are a (Ager, 1992) had demonstrated that these diseases were considered as unpredictable and often uncontrollable health risks, although adheren ce to recommended control practices for the diseases was high. In the current study, belief in biomedical means of transmission and adherenc e to recommended control practices was evidenced by approximately two- thirds of respondents, There were no noted gender differences, but sig nificant age effects in attributions of cause and means of risk reduct ion for malaria. Attribution of cause and suggested means of control d id nor predict preference for treatment, with a preference for medical treatment being widely held. Findings lend support to recent analyses which highlight individual capacity to - in particular circumstances - formulate health and disease processes with respect to alternative c onceptual systems (e.g. biomedical or traditional). The implications f or health promotion theory and practice in such settings are considere d.