Abstract:
BACKGROUND : The World Health Organization (WHO) recommends integrated vector management
(IVM) as a strategy to improve and sustain malaria vector control. However, this approach has not
been widely adopted.
OBJECTIVES : We comprehensively assessed experiences and findings on IVM in Kenya with a view
to sharing lessons that might promote its wider application.
METHODS : The assessment used information from a qualitative external evaluation of two malaria
IVM projects implemented between 2006 and 2011 and an analysis of their accumulated entomological
and malaria case data. The project sites were Malindi and Nyabondo, located in coastal and
western Kenya, respectively. The assessment focused on implementation of five key elements of IVM:
integration of vector control methods, evidence-based decision making, intersectoral collaboration,
advocacy and social mobilization, and capacity building.
RESULTS : IVM was more successfully implemented in Malindi than in Nyabondo owing to greater
community participation and multistakeholder
engagement. There was a significant decline in
the proportion of malaria cases among children admitted to Malindi Hospital, from 23.7% in
2006 to 10.47% in 2011 (p < 0.001). However, the projects’ operational research methodology
did not allow statistical attribution of the decline in malaria and malaria vectors to specific IVM
interventions or other factors.
CONCLUSIONS : Sustaining IVM is likely to require strong participation and support from multiple
actors, including community-based groups, non-governmental organizations, international and
national research institutes, and various government ministries. A cluster-randomized controlled
trial would be essential to quantify the effectiveness and impact of specific IVM interventions, alone
or in combination.
