Social and Behaviour Change Communication for Malaria in Pregnancy: Strategy Development Guidance Implementation Kit (I-Kit)

This Implementation Kit (I-Kit) was developed to help social and behavior change communication (SBCC) and malaria in pregnancy (MiP) programme managers and stakeholders improve SBCC strategies and interventions for MiP, especially those interventions that target healthcare workers.

As stated in the I-Kit, “MiP is a significant public health issue with harmful consequences for not only pregnant women but also unborn and newborn children. Every year, MiP is responsible for the deaths of over 100,000 newborns and 10,000 pregnant women around the world. MiP is also associated with anemia, spontaneous abortion, stillbirth, prematurity, low birth weight and severe malaria.” The proven method of preventing the risk of malaria in pregnancy is to give pregnant women living in endemic areas preventive medicine (referred to as intermittent preventive treatment of malaria in pregnancy, or IPTp).  Unfortunately a growing body of evidence shows low use of this life-saving drug, even though the drug is cheap, safe, and effective. Research has shown that one of the reasons for low uptake lies with service providers. They often fail to procure adequate stores of IPTp, often fail to provide it to clients regularly, and in some instances mistreat their clients such that pregnant women do not return for their remaining scheduled appointments.

For this reason, this guidance focuses on developing national strategies that address drivers of behaviour for both service providers and communities. “Many of the issues to consider in this guidance are country-specific. Rather than give users a number of globally applicable silver bullets (which clearly do not exist), this guidance draws attention to time-honored SBCC processes with a new focus on service providers. While the reasons for low IPTp uptake are known and finite, the understanding of how to find out which apply to a specific country are not being followed. Country strategies are often generic, failing to seek or provide any detail about local perceptions, attitudes, beliefs, or motivations. Audiences are poorly segmented, integration between malaria and maternal and child health units is often unclear, and communication and behavior objectives are commonly confused. This new strategy guidance walks users through a standard process of inquiry, prioritization of behaviors, and strategic, evidence-based decision-making about how to most effectively influence behaviors that prevent malaria in pregnancy. The hope is that service delivery and SBCC practitioners alike will improve their approach to preventing malaria in pregnancy, and that more work will be done in collaboration.”  [from Mike Toso, HC3 Program Officer]

This guidance is divided into four sections:

• Conducting a Situation Analysis - Offers global guidance documents and consensus statements that should be considered when conducting a situation analysis. It also offers a list of service provider factors (such as social and demographic, and attitudinal factors) and community level factors (such as awareness, social support, and response efficacy) that have been shown to influence the use of MiP interventions.
• Audience Segmentation and Problem Statement - This section will help users make decisions on primary, secondary, and tertiary audience segmentation, and on prioritising and defining problems.
• Choosing Objecives - Once a number of problem statements have been written, it is important to prioritise them and decide which communication and behaviour objectives will bring about solutions to each.
• Drafting the MiP Strategy - Users are guided through each element of a MiP SBCC strategy with the help of a MiP SBCC Strategy Template.