# Experiences of Community Members and Health Workers Regarding Malaria Control Programmes in the Rural Ingwavuma Community, uMkhanyakude District Municipality, KwaZulu‐Natal Province, South Africa

## TL;DR

This study explores how a rural South African community and healthcare workers experience malaria control efforts, highlighting both successes and challenges.

## Contribution

The study provides insights into community and healthcare worker perspectives on malaria control in a rural South African setting.

## Key findings

- Community members generally support malaria control activities like health education and indoor residual spraying.
- Healthcare workers face challenges due to illegal cross-border movement and local protests disrupting spraying.
- Negative IRS experiences and the need for improved community engagement were identified.

## Abstract

Malaria remains a health challenge in South Africa, particularly in Limpopo, Mpumalanga and KwaZulu‐Natal, where elimination measures are ongoing. This study explored the experiences of community members and healthcare workers with malaria control programmes in Ingwavuma, a rural community in the uMkhanyakude district bordering Mozambique.

We used an exploratory qualitative design. Data were collected through eight in‐depth interviews (IDIs) with healthcare workers (a supervisor, a senior administrator and fieldworkers) involved in malaria control and eight focus group discussions (FGDs) with 88 community participants. IDIs were conducted at a local clinic, whereas the FGDs were held in six villages using pre‐tested discussion guides in isiZulu. All sessions were audio recorded, transcribed and translated from isiZulu to English. Data were analysed thematically.

Community members generally viewed malaria control activities positively, particularly health education, indoor residual spraying (IRS) and vector surveillance. Rapport between malaria control personnel and communities was strong, with respectful engagement that enhanced programme acceptance. However, healthcare workers highlighted challenges in malaria surveillance linked to illegal cross‐border movement between South Africa and Mozambique. Local social protests occasionally disrupted spraying activities, with a few communities blocking access to their homes. Some participants reported negative experiences with IRS.

Community‐based malaria control measures have been instrumental in preventing malaria. Our findings indicate a need for continuous community engagement with all stakeholders to maintain good rapport with communities. The adverse experiences attributed to IRS require further investigation.

Community and healthcare worker perspectives reveal strong acceptance of malaria control programmes in the rural settings of South Africa, though challenges persist with cross‐border movement, local protests and negative spraying experiences. Strengthening community engagement remains critical for sustaining malaria elimination efforts.