Purpose Environmental control and management continue to be a challenge in developing countries. This study examines the contributions of preventive maintenance on malaria incidence among university student residents in Ghana. Design/methodology/approach Using a cross-sectional design, data were gathered from 528 students through structured questionnaires and onsite housing inspections. The study assessed maintenance routines, housing features and environmental conditions. Negative binomial and logistic regression models were used to assess the relationships between preventive maintenance and reported malaria episodes. Findings Students living in housing that received quarterly maintenance were significantly less likely to report malaria. Functional drainage systems and intact window or door screens also played a protective role. Interestingly, these environmental and structural factors had more impact on malaria risk than traditional personal protective measures like insecticide-treated net usage. A combined approach, such as regular maintenance and sound housing features, offered the most protection. Practical implications The results suggest that universities and facilities managers should ensure quarterly checks that ensure functional drainage and an intact window screen, which can significantly reduce malaria risk among university students in Ghana. Malaria prevention policies must treat maintenance as a core public health strategy, not just a facilities issue. Originality/value By applying ecological systems theory, this study reframes malaria prevention to emphasize how built environments influence health. It challenges behaviour-centred models and introduces housing quality and routine upkeep as vital, yet underused, tools in malaria control.
Gyan et al. (2026) studied this question.