Implementation of Indoor residual spraying for malaria vector control in Uganda: An exploration of community experiences

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Abstract Background Malaria vector control using indoor residual spraying (IRS) is a key intervention in the fight against malaria globally. However, IRS is faced with several challenges limiting wide scale deployment especially in sub-Saharan Africa. This study explored community experiences on implementation of IRS using clothianidin-deltamethrin, and pirimiphos-methyl insecticides in west Nile region of Uganda. Methods Using a phenomenological design were individuals involved in the implementation of IRS were purposively included in the study. In-depth interviews were conducted using an interview guide. The interviews were conducted in both the local language of the area (Aringa) and English whenever appropriate. All interviews were audio recorded and transcribed verbatim. The transcripts were then analyzed using thematic analysis using Nvivo ver 14.0 software. Results A total of 30 in-depth interviews were conducted. Majority, 60% (18/30) of the study participants were females. The themes that emerged included coverage of the household with the spray, practices of stakeholders, perceptions regarding insecticides, opportunities, and challenges facing implementation of IRS. Perception on effectiveness, involvement of different stakeholders including local leaders, religious leaders and training of spray teams helped enhance acceptance. While smearing or covering of sprayed walls, lack of transparency in recruitment and payment of spray operators, removal of house items, and shortage of spray supplies threaten scaling up of IRS implementation. Conclusion Communities were highly receptive towards IRS for malaria control with most study participants being positive on its effectiveness. Training of spray operators, involvement of different stakeholders, community compliance with local authorities, and involvement of social behavior change communication (SBCC) help enhance implementation of IRS. However, the deployment faced some challenges including inadequate supplies, removal of house items, and difficulty moving spray materials in the field. The Ministry of health and implementing partners should prioritize strengthening timely community engagement prior to IRS deployment.

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