Zanzibar co-creates mosquito-free hospital designs

In December 2024, the Mosquito-Borne Diseases (MBD) Free project team launched a series of co-creation workshops across four hospitals in Zanzibar. The initiative aims to explore ways to create hospital environments that are safe from mosquitoes.

“The risk of being infected with a mosquito-borne disease is very much real in many hospitals located in disease-endemic areas, such as Zanzibar,” says Karin Schiøler, principal investigator of MBD Free.

Poor waste and water management in the local environment often creates habitats for mosquitoes, while the open structure of tropical hospitals provides easy access for these blood-seeking insects. Patients, relatives, and staff are exposed to mosquitoes around the clock.

“We aim to deliver environmentally safe and sustainable mosquito control solutions to hospitals in Zanzibar, building on the knowledge and experience of those who spend much of their time within the hospital setting,” Schiøler explains.

To achieve this, PhD fellows Eliza Lupenza and Otis Sloan Wood have introduced innovative architectural models and intervention cards during the project's first co-creation workshops. These co-creation sessions brought together patients, medical staff, hospital maintenance personnel, management teams, health officers, and mosquito control agents to collaboratively develop viable solutions for the district hospitals of Zanzibar. The workshops followed a comprehensive co-creation training conducted in September 2024 by Postdoc fellow Danielle Agnello.

“We have been testing our mosquito intervention cards, developed for a series of co-creation workshops as part of the MBD-Free Project. Each card, in Swahili and English, describes simple ways to adapt the built and landscape environment to protect against mosquitoes without insecticides. Photo examples are provided on the back of each card. These methods were identified from a literature review of over 800 papers on mosquito control interventions,” explains Sloan Wood.

During the workshop, co-creators helped analyse existing interventions, identified those suitable for integration into Zanzibar's hospital structures, and explored broader applications in outdoor environments. "The workshops showcased the power of collaboration, with enthusiastic and inspired participants contributing valuable insights, and expressing genuine satisfaction in co-creating tailored mosquito control solutions for hospital settings," reflects MBD Free Co-PI Fatma Saleh.

In early 2025, these co-created solutions will be tested in patient wards, waiting areas, staff stations, and treatment units across four district hospitals.

“If successful, we aim to inform current and future hospital designs to permanently create mosquito-free hospital environments in Zanzibar and similar high-risk areas,” concludes Schiøler.

Launched in 2022, MBD Free is a Danida-funded project supported by a 12 million DKK grant.

Read more about MBD Free here.