Cultural domains pertaining to malaria: an approach to non-institutional knowledge

Malaria control policies have not fully achieved the expected results due to little consideration of cultural aspects, among other factors. To explore the cultural domains pertaining to this disease in an endemic Colombian population, in order to both design and implement effective action plans. A convenience sampling was conducted to select inhabitants from 12 villages in Tierralta, Córdoba. In order to generate free-lists, participants were asked about their communities' health problems, causes of malaria, control measures and those responsible for malaria control. Smith's indexes were calculated for each item answered. Between 30 and 38 individuals per village participated in the study (N=401). The mean age was 40.24 years (standard deviation (SD)=14.22) and women were 45.39% of the total. Participants recognized malaria and respiratory infections as the primary health problems in the community (median Smith's indexes: 0.83 and 0.63, respectively). A lack of environmental interventions was identified as the main determinant of malaria (median Smith's index: 0.65). Finally, the health care center (median Smith's index: 0.71) and health professionals (median Smith's index: 0.52) were identified as those most responsible for malaria control. The design of programs to reduce the impact of malaria requires developing interventions or initiatives that are adapted to the community's needs, demands and available resources. Free-listing is proposed as an effective tool to collect information about cultural domains related to health.