A community-based health education programme for bio-environmental control of malaria through folk theatre (Kalajatha) in rural India

In December 2001, the Kalajatha events were performed in the evening hours for two weeks in a malaria-affected district in Karnataka State, south India. Thirty local artists including ten governmental and non-governmental organizations actively participated. Impact of this programme was assessed after two months on exposed vs. non-exposed respondents.The exposed respondents had significant increase in knowledge and change in attitude about malaria and its control strategies, especially on bio-environmental measures (p < 0.001). They could easily associate clean water with anopheline breeding and the role of larvivorous fish in malaria control. In 2002, the local community actively co-operated and participated in releasing larvivorous fish, which subsequently resulted in a noteworthy reduction of malaria cases. Immediate behavioural changes, especially maintenance of general sanitation and hygiene did not improve as much as expected.This study was carried out under the primary health care system involving the local community and various potential partners. Kalajatha conveyed the important messages on malaria control and prevention to the rural community. Similar methods of communication in the health education programme should be intensified with suitable modifications to reach all sectors, if malaria needs to be controlled.Malaria is a major public health threat to the developing world, indirectly affecting the economic development. Nearly 40% of the world's population is at risk and 80% of the burden exists in sub-Saharan Africa. Almost all the remaining cases exist in tropical and subtropical Asia, Latin America and Melanesia [1]. In India, less than two million cases with few hundred deaths are recorded every year [2,3], but the estimated number is 15 million with about 19,500 deaths [4]. Karnataka state, south India contributes approximately 7–10% of India's annual malaria burden [5].Unlike HIV/AIDS, sufficient emphasis has not been given to health education in