Background: In 2015, malaria infected over 212 million people and killed over 429,000 individuals, mostly children under 5 years of age, with 90% of malaria cases occurring in sub-Saharan Africa. The aim was to develop an age and culturally appropriate song for Tshivenda-speaking children under 5 years of age to decrease the risk of malaria in Limpopo Province, South Africa.
Methods: Document review was used to identify appropriate disease determinants to decrease risk in children < 5 years old in the study area. These were used to develop lyrics and music for a song about malaria in line with the principles of participatory risk analysis. The age and cultural appropriateness of the song as well as disease determinants chosen were reviewed using a modified Delphi technique, by 10 purposively selected experts in malaria (4), Vhavenda music (3) and early childhood education (3). Thereafter, the song was translated into Tshivenda and reviewed by two focus groups living in the study area, one including female caregivers and pre-school teachers (n = 7) and a second comprising of male community based malaria control personnel (n = 5).
Results: The experts surveyed and both focus groups strongly supported the inclusion of knowledge about the link between mosquitoes and malaria and that children should know the signs of malaria to facilitate early diagnosis. Although the expert group felt that bed nets should not be mentioned, both focus groups suggested the inclusion of bed nets and it was observed that community members were purchasing their own nets. Focus group members also felt that young children should not be involved in internal residual spraying initiatives.
Conclusions: It was concluded that although risk communication on malaria prevention and treatment in young children should be aimed at caregivers, an age and culture appropriate song about malaria could be developed to help young children protect themselves. This song focused on understanding the link between mosquitoes and malaria, preventing exposure and recognising signs of disease.
Keywords: Malaria prevention; Participatory action research; Participatory risk analysis; Preschool children; Risk communication; Songs; Tshivenda music.