Opposing observations and the political-economy of malaria vulnerability: A community-based study in Bududa, Uganda

Abstract

Malaria is a parasitic infection that remains a leading threat to health and development in many communities, especially in Sub-Saharan Africa. In Bududa, Uganda, malaria represents a key threat to health and well-being. However, whether or not malaria rates are improving in the district over time represents a conundrum. By using structural fieldwork and drawing on multiple data sources that include more-and less-powerful actors, I uncover opposing observations: while community members perceive marked increases in malaria rates over time, official district-level data depict the opposite. World-systems analysis illuminates the reasons behind this discrepancy, along with the factors that community members use to explain the rise in malaria suffering, including environmental changes and decreased healthcare access. This research demonstrates how global economic policies and structures create unequal health impacts, placing those in Bududa at disproportionate and elevated vulnerability to malaria.