The social context of schistosomiasis and its control: an introduction and annotated bibliography
Birgitte Bruun, Jens Aagaard-Hansen
Foreword by Susan Watts
Schistosomiasis is widely recognized as a disease that is socially determined. An understanding of the social and behavioural factors linked to disease transmission and control should play a vital role in designing policies and strategies for schistosomiasis prevention and control. To this must be added the awareness that schistosomiasis is also a disease of poverty. It still survives in poverty-stricken, remote areas where there is little or no safe water or sanitation, and health care is scarce or non-existent. For a variety of complex reasons, many of which are addressed in this book, the disease is particularly prevalent in sub-Saharan Africa, and persists in certain areas of rural China. This concern for human behaviour in an environment of poverty echoes the concerns of the new research priority for “diseases of poverty” identified by TDR.
This book presents a micro as well as a macro view of schistosomiasis. It presents evidence for the complexity of the behaviour of people in endemic areas exposed to schistosomiasis, and of health personnel who provide schistosomiasis control services. This evidence, in turn, suggests ways in which preventive programmes can be updated and made relevant to real-life situations in remote rural areas by using the insights of social scientists – medical anthropologists, health geographers, sociologists and others – whose skills enable them to explore the social context of schistosomiasis transmission and control at the micro level, in the setting in which the infection is transmitted and where efforts are made to control it. From this perspective there is no “quick fix”, which highlights the importance of a schistosomiasis control policy that allows scope for local-level decision-making rather than depending on a “one-size-fits-all” strategy.