The Contribution of Social Science Research to Malaria Prevention and Control. (Perspectives)
Williams, Holly Ann, Chisholm, Caroline, Alilio, Martin, Zimicki, Susan, Azevedo, Inez, Nyamongo, Isaac, Sommerfeld, Johannes, Meek, Sylvia, Diop, Samba, Bloland, Peter B., Greenwood, Brian, Bulletin of the World Health Organization
In recent years, malaria has received a dramatic increase in attention worldwide, as witnessed by the growing number of articles in scientific journals, the forging of international partnerships such as the Multilateral Initiative on Malaria and Roll Back Malaria, and a global call to action. These initiatives have recognized the role that human behaviour plays in malaria control and have affirmed that social science has an integral role in defining strategies against malaria. In spite of this, we believe that social science's potential contributions to the field of malaria have not been fully realized.
Numerous factors impede the integration of social science knowledge and practice into malaria research and programmes: many health personnel overlook the different, complementary disciplines of social science and their prospective interaction with their own fields of activity and they may, in addition, have only a superficial knowledge of the workings of social science research.
First of all, many malaria control personnel, physicians and epidemiologists do not fully appreciate that social science comprises many disciplines including, but not limited to, anthropology, sociology, economics, political science, demography, and communications. The disciplines share an emphasis on understanding how human behaviour is shaped and modified in the global context by a vast array of influences. Each discipline is, however, guided by its own theoretical orientation, which influences the essential questions it asks and the methodologies it employs to answer them. For example, medical anthropology offers a particular approach to the investigation of human experience and behaviour, including health and sickness. The essence of a medical anthropological perspective is an appreciation of the complexity of culture and the realization that specific aspects such as health beliefs and behaviours cannot be understood in isolation but need to be looked at in relation to their larger historical, economic, social, political and geographical contexts. Applied medical anthropological research strives to understand the often competing dynamics that shape the various contexts important to diseases such as malaria. This type of applied research can help foster an understanding between what a biomedical professional and a member of the local community might consider as appropriate interventions in the local situation.
An understanding of the differences among the various social science disciplines is essential to an appreciation of the relative contribution that each can make. For example, while anthropologists may be aware of culturally specific local knowledge that would be useful in identifying community needs, health communicators may be far better at producing effective messages to respond to them. The failure to recognize these differences can lead to the employment of social scientists with skills that are inappropriate for the required task.
A second factor contributing to the less than optimal contribution of social science research to malaria control is that, in many cases, those who carry out behavioural research for control programmes may have had some training in rapid assessment techniques, but limited or no training in social science theory and methodology. This situation has led to research insufficiently grounded in social theory, the use of incorrect methodology, and inappropriate analyses resulting in flawed or inaccurate conclusions; such poor-quality science can reinforce a perception that social science has little of value to offer. By contrast, experience has shown that commissioning a well-trained social scientist with field experience (i.e., with both an understanding of the theoretical and critical perspectives of the discipline and a practical appreciation of what can realistically be accomplished) can be extremely beneficial for informing malaria control programmatic decisions and the development of effective intervention programmes. …