The Malaria Prevention Campaign, launched in the Oromia Region of Ethiopia by C-Change in 2009, focuses on small, doable actions that families carry out to protect themselves against malaria. The campaign runs the Model Families Program which uses scorecards to monitor actions and success, and stickers to publicly recognise families and communities for taking specific actions to combat malaria. Community volunteers energise and support their communities, families, and schools through community based activities, aided by materials and tools such as posters and stickers. The campaign is supported by the United States President’s Malaria Initiative (PMI), with joint communication activities with RTI International.
C-Change has been assisting the Oromia Regional Health Bureau (ORHB) to carry out malaria prevention activities in Ethiopia's Oromia region. Under the established ORHB Health Extension Program, zonal and local health workers are the frontline workers carrying out social and behaviour change communication (SBCC) activities to prevent and control malaria. They work with families in villages and communities under the Model Families Program.
The Model Families Program engages health workers who help families improve their knowledge about malaria prevention actions and assist them to carry out specific actions that will prevent malaria. These specific actions grew out of community workshops conducted by C-Change in 2009. Designated essential malaria actions (EMA), eight identified actions were modified into four doable actions. The four actions are visually represented on a scorecard that each family maintains as a record. Using the C-Change developed campaign tools (such as flipcharts, posters, and scorecards), health extension workers (HEWs) and volunteer community health workers (CHWs) provide information on malaria prevention, treatment, and control. They also assist families to carry out the four doable actions - sleep under a net and give priority to pregnant women and children under 5; seek treatment at first sign of fever; adhere to treatment and do not share medication with others; and follow guidance on not plastering after indoor residual spraying.
The scorecard helps families chart their own progress and guides them step-by-step toward carrying out the four doable actions and earning the Malaria Protection Sticker. As each doable action is carried out, the family member, and a HEW or CHW check the appropriate box and initial that the action has been carried out. Families earn Malaria Protection Stickers and become Model Families when they successfully carry out the four doable actions. When families have earned a Malaria Protection Sticker, they affix it to their front door, where it serves as a reminder to other families that this is a Model Families household. These families are encouraged to mentor three other families. Mentoring is one of the benchmarks of the Model Families Program - families and neighbours encouraging each other to succeed. The Model Families Program lasts 90 days in each woreda (Ethiopian administrative unit similar to a district).
C-Change is also carrying out a training of trainers for the zonal and woreda professionals on how to implement the Model Families Program as well as information on interpersonal communication and on partner CARE's “community conversation” model. Using a cascading training approach, the zonal and local health officials in turn train the HEWs and CHWs, as well as community-based and faith-based organisation staff and local school personnel.
These communication activities receive support through radio programmes and through integration into other health programmes such as antenatal care (ANC). In addition, school directors are initiating anti-malaria school club activities.
C-Change and RTI International also collaborated to implement a programme that encourages families to carry out a series of actions that sustain indoor residual spraying (IRS). Having already identified a number of barriers to effective spraying in the course of the spraying campaign, RTI expanded on the core IRS message of "Protect your Family against Malaria - Take the following actions to cooperate for Indoor Residual Spraying." The result was five additional IRS core messages:
- Cooperate with sprayers during IRS period.
- Put all your clothes in a chest; take all food items and cooking utensils outside, covered with a cloth.
- After spraying is complete, keep family members and domestic animals outside for two hours.
- After spraying, clean and dispose of the IRS residue by burying it.
- Do not re-plaster your homes for six months after spraying is complete.
Incorporated into the scorecard for families, the core messages provide the visual check and confirmation that helps families keep track of the actions they must carry out to ensure successful spraying against mosquitoes. Prior to a spraying campaign, RTI dispatched community volunteers who put up posters to alert communities and encourage their support to the spraying efforts. During this time, community members and or families are also given the scorecard, which helps to reinforce key actions to be carried out by the community. C-Change further supported the effort by providing training to RTI staff in Adama town on SBCC to build their skills and knowledge around the communication elements of their programme.
C-Change, implemented by FHI 360, is a United States Agency for International Development (USAID)-funded project to improve the effectiveness and sustainability of social and behaviour change communication (SBCC) as an integral part of development efforts. The project works in the major health areas, including family planning and reproductive health, HIV prevention, and malaria prevention. C-Change is also providing communication support to other sectors, including democracy and governance, civil society, and environment.
Qualitative and quantitative studies carried out by C-Change indicated that Ethiopian community members consider HEWs and CHWs as the most trusted and common sources of health information. According to the C-Change, a rapid scale-up of the Model Families programme was estimated to reach 15 million people by the end of 2010.
FHI 360, United States Agency for International Development (USAID), United States President’s Malaria Initiative (PMI), RTI International.
C-Change website on November 3 2011.