Knowledge, Perception and Participation of Women in Aquatic Vegetation Removal for Schistosomiasis Prevention and Control in Ndaiga Subcounty, Kagadi District Anyango Caroline Olyet

Abstract

Background: Schistosomiasis remains a major public health concern estimated to affect 250 million people globally, particularly in sub-Saharan Africa, where marginalized communities face high infection risks due to dependence on contaminated water sources. Women, who engage in domestic and water-related activities, are disproportionately exposed. Aquatic vegetation, such as water hyacinth and hippo grass, provides habitats for schistosome-carrying snails, and its removal has been proposed as a complementary control strategy. Aim: This study assessed women’s knowledge, perceptions, and participation in aquatic vegetation removal for schistosomiasis prevention and control in Ndaiga Sub County, Kagadi District, Uganda. Methods: A cross-sectional convergent triangulation design was employed. Quantitative data were collected from 323 adult women using structured questionnaires, while qualitative data were obtained through four focus group discussions and six key informant interviews. Quantitative analysis included descriptive statistics, bivariate, and multivariate logistic regression, while qualitative data were analyzed thematically using a hybrid coding approach. Results: The response rate was 97.2% (n=314). Actual participation in vegetation removal was low (18.4%), although 94% of women recognized its importance for disease control and were willing to engage. Knowledge of aquatic vegetation as a risk factor was high, but awareness of reuse opportunities was limited. Multivariate analysis revealed that age, occupation, proximity to health facilities, cultural beliefs, and perceived benefits beyond disease control significantly influenced participation. Key barriers included lack of tools, technical skills, labor demands, and seasonal constraints. Conclusion: Women in Ndaiga Sub County are knowledgeable and supportive of aquatic vegetation removal, yet actual engagement remains limited due to structural, social, and ecological barriers. Sustainable schistosomiasis control requires enabling environments that address logistical, cultural, and livelihood challenges to translate willingness into effective community action. Keywords: Knowledge, Perception, Participation, Women, Aquatic Vegetation Removal, Schistosomiasis, Prevention, Control, Ndaiga Subcounty, and Kagadi District