Stop Malaria in Your Community:
Communication Campaign Strategy
Background
 With a national average of six malaria episodes per person a year, malaria is the
leading cause of illness and death in Uganda, accounting for 25-40 percent of
outpatient attendance and 20 percent of in-patient admissions.
 Malaria is responsible for killing approximately 70,000 to 110,000 people
annually in Uganda and making half of the country’s disease burden.
 100 percent of the population is at risk of malaria, while 63% percent lives in
areas with high transmission levels and 25% percent are exposed to moderate
transmission.
 According to preliminary data from the 2009 UMIS:
Transmission
o 87% of respondents know that mosquitoes cause malaria, but myths
prevail around drinking unboiled water, cold/changing weather and eating
dirty food as causes of malaria.
Nets
o 83% report sleeping under a mosquito net as a way to prevent malaria.
o Only 46% of households own at least one LLIN.
o Only 32%of children under 5 and 43% of pregnant women slept under an
LLIN on the night preceding the survey.
o 58% of respondents report the net not being hung as the reason why they
did not sleep under a net the previous night.
IPTp
o Only 45% of pregnant women received at least one dose of IPTp to
prevent malaria during pregnancy, and only 32% received the
recommended two or more doses.
o 52% of women age 15-49 years do not know any medicines to avoid
malaria in pregnancy. 36% cite SP/Fansidar.
Diagnosis and treatment in children under 5
o Only 36% of children under 5 with fever in the two weeks preceding the
survey were given antimalarials on the same day or the day following the
onset of fever, as recommended.
o 23% of children under 5 with fever in the last 2 weeks received ACTs.
o 17% of children under 5 had blood taken for malaria testing.
Campaign Goal
To build individual, household, community and district competence (willingness and
ability) to stop malaria deaths and reduce malaria morbidity.
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Vision
By 2013, Ugandans will sleep under mosquito nets every night and seek appropriate
treatment for malaria within 24 hours of onset of symptoms. All pregnant women will go
for at least 4 ANC visits and take IPT twice during pregnancy. Communities will strive
for “malaria-safe” establishments, such as schools, religious institutions and
marketplaces.
Barriers to Change
 Malaria is not perceived as a dangerous sickness. It is accepted as a way of life.
 Men are the key decision-makers in the household, yet health in the family is
managed by the women.
 Myths and misconceptions prevail.
 High cost of nets and ACTs.
 Limited supply of ACTs.
 Low/late ANC attendance.
 Preference for lower cost malaria treatment such as herbs or Chloroquine, which
are not effective
Theoretical Framework: Social Ecological Model
The Social Ecological Model recognizes that multiple layers influence human behavior:
 Individual
o Knowledge and skills, beliefs and values, self-efficacy, perceived norms,
perceived risk
 Family and peer networks
o Parenting skills, positive peer influence, social support, supportive partner
relationships
 Community
o Leadership, collective efficacy, equal access to
resources/services/information, shared ownership, equal participation,
social capital
 Society
o Committed leadership, supportive policy, positive religious and cultural
values, equitable gender norms, supportive media
Using the Social Ecological as a theoretical framework, the campaign will seek to
position malaria as a pressing health issue that is everyone’s collective responsibility. It
will emphasize that families have the ability to increase their productivity if they prevent
malaria.
Phasing:
The campaign will take place over 12 months in 4 month intervals, with messaging
focusing on the following areas.
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Phase 1: The costs of malaria
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Phase 2: Preventing malaria: Nets and IPTp
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Phase 3: Diagnosis and treatment
Geographic Scope:
All of SMP’s 38 year 3 districts
Audiences
There are 4 primary audiences for this communication campaign.
Audience 1: Caretakers of Children Under 5
Profile
 Both fathers and mothers. Mothers typically care for the children, while decisions
about finances and treatment are made by the fathers. The campaign will
therefore emphasize male involvement.
 Peri-urban and rural
 18-40 years old
 Level of education: P3-P6 completed
 Low income earners
 Engage in community activities
Communication Objectives
Increase the proportion of caretakers of children under 5 that:
 Recognize the signs and symptoms of malaria
 Feel that malaria is a serious problem
 Feel that they are able to prevent, seek diagnosis and appropriately treat malaria
in their children under 5
 Feel that the prevention, diagnosis and treatment of malaria in children under 5 is
their responsibility
Desired Behaviors
 Ensure all children in their care under the age of 5 years sleep under a net every
night
 Seek appropriate diagnosis and treatment for malaria for children under 5 in their
care within 24 hours of onset of malaria symptoms
 Talk with family, friends and community members about the importance of
malaria prevention, diagnosis and treatment
Key Constraint
Do not feel malaria is a serious problem.
Key Promise
If you protect your children from malaria, you will increase your family’s productivity.
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Key Message Content
The Costs of Malaria
 Many people do not feel that malaria is a serious problem, but it is the number
one cause of death in children and illness in households in Uganda.
 The average person has malaria 6 times every year. This means high costs in
terms of resources spent on treatment, money and time spent on travel to and
from the clinic. It is about 18,000 just for the medicines every time you have to
treat malaria.
 Malaria also means lost productivity. You will probably have to miss work or
digging to care for your child. (N.B. The campaign will translate “productivity” into
what it means in day-to-day life for caretakers of different professions, e.g. bodaboda drivers, farmers, shop owners, lawyers, managers).
 Malaria can result in very high costs for a burial if someone in your family dies.
 You have the power to prevent malaria and save your family all of these costs.
 If you protect your children from malaria, you will save resources and have more
time to earn money.
 People get malaria when they are bitten by a certain type of mosquito. This
mosquito usually bites at night when you are sleeping.
 Although there are more mosquitoes around during rainy season, you can get
malaria any time of the year.
Prevention: Nets
 The best way to prevent malaria is to sleep under a net every night.
 Protect your children from malaria by having them sleep under a net every night.
 The best kind of nets are those that have been treated in a factory with small
amounts of chemicals that kill mosquitoes. These nets last up to 5 years and do
not need to be retreated.
 There are many brands of these long lasting nets in Uganda, including
PermaNet, Olyset, DuraNet, NetProtect, Interceptor, and DawaPlus.
 The long lasting nets are not dangerous for people, including babies or children.
Some nets contain small amounts of chemicals that kill mosquitoes, but the
amounts are not enough to harm humans. The chemicals have been specially
tested and approved by the Ministry of Health and the World Health
Organization.
 Nets can be bought in most shops and supermarkets. The long lasting nets cost
about 10,000-15,000 Ush.
 In some areas where malaria is high, the Ministry of Health is giving nets out free
to children under 5 years and pregnant women.
 It is better to sleep under any type of net than no net at all!
 It is not enough just to own a net. Be sure to hang your net and sleep under it
every night.
Diagnosis and Treatment
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Not every fever is malaria. Make sure you visit the clinic before you are treated.
A child can die of malaria if not treated early and with the proper drugs. It is
important to know the signs of malaria in children so that you can get them the
proper treatment before it is too late.
The signs of malaria in children are fever, restlessness, general weakness and
failure to breast feed or eat food.
If your child has any of these signs, they may have malaria. All cases of malaria
should be treated within 24 hours.
The proper treatment for malaria is Coartem, Coartem can be found at all health
facilities, and from trained community drug distributors.
Children are given different doses of Coartem depending on their age. Your
community medicine distributor, the pharmacist, or health worker will know the
correct dose.
Children under 4 months of age should not take Coartem. Take them to the
health centre immediately for medical care.
It is important that you help your child finish the full treatment as instructed, even
if he or she is feeling better. Your child is likely to become sick again if he or she
does not complete the dose or does not take it correctly, and the medicine may
no longer work.
Herbs, traditional medicines, and self-treatment with Chloroquine are not
effective for treating malaria.
Communication Channels and Approaches
 Radio
o 30 second malaria “moments” (tips/spots) that run at the same time daily,
with a new tip every week (e.g. every day at 8pm as one is getting ready
for bed)
o Interactive radio programs
 Outdoor:
o Community posters
o Billboards
 SMS (e.g. net distribution information)
Audience 2: Pregnant Women
Profile
 Peri-urban and rural
 18-35 years old
 Level of education: P3-P6 completed
 Mostly farmers, lower income
 May have other children
Communication Objectives
Increase the proportion of pregnant women that:
 Know the dangers of malaria in pregnancy
 Know how to prevent malaria in pregnancy
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Feel that malaria in pregnancy is dangerous
Desired Behaviors
 Go for at least 4 ANC visits during pregnancy
 Receive at least 2 doses of SP/Fansidar during ANC visits
 Sleep under a mosquito net every night
 Encourage other pregnant women to go for IPTp twice during pregnancy
Key Constraint
Lack of awareness about the importance of the Intermittent Presumptive Treatment
Key Promise
 Intermittent Presumptive Treatment for malaria during pregnancy is the gateway
to having a healthy child.
Key Message Content
 Pregnant women are more likely to get malaria than women who are not
pregnant. This is because pregnant women have weaker immune systems, and
cannot fight off illnesses as well.
 When a pregnant woman has malaria, it is very dangerous for both the woman
and her baby. It can cause serious complications and even death.
 Malaria during pregnancy can cause:
- Abortion
- Stillbirth (death of the unborn child)
- Premature delivery, where the baby is born before it is time
- Low birth weight babies, where the baby is smaller and weaker than other
babies
- Maternal and perinatal anemia
- Maternal death
 Fortunately, it is very easy to prevent malaria in pregnancy! All pregnant women
should:
o Go for at least 4 antenatal visits, starting early in pregnancy.
o Get at least two doses of Intermittent Presumptive Treatment
(SP/Fansidar) at ANC to prevent malaria during pregnancy.
o Sleep under a mosquito net every night. All nets are safe for the mother
and the unborn baby.
 Many people do not understand why pregnant women have to take drugs when
they are not sick. This is because many pregnant women who have malaria will
not show any signs, and not know that they have malaria. Therefore, it is very
important to prevent malaria before it is too late. There are drugs that prevent
malaria during pregnancy (SP/Fansidar). They are safe and effective for both
mother and baby.
 The first dose of three tablets of SP/Fansidar should be swallowed during the
second trimester, between the 4th and 6th month of pregnancy. This is done at a
health facility and is observed by a health professional.
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The second dose of three tablets should be swallowed during the third trimester,
between the 7th and 8th month of pregnancy. This is also done at a health facility
and is observed by a health professional.
Any pregnant woman that experiences signs or symptoms of malaria should see
a health worker immediately.
Fever during pregnancy is not normal. All pregnant women should get advice and
proper treatment from a qualified health worker if they have fever during
pregnancy.
Communication Channels and Approaches
 Radio
o 30 second malaria “moments” (tips/spots) that run at the same time daily,
with a new tip every week (e.g. every day at 8pm as one is getting ready
for bed)
o Testimonial radio spots
o Interactive radio programs
 Outdoor
o Community posters
o Billboards
 SMS (e.g. IPT reminders, Interactive platform with health workers, net distribution
information)
Audience 3: Health Workers
Communication Objectives
Increase the proportion of health workers who:
 Believe that it is important to properly diagnose fevers as malaria before
administering treatment
Desired Behaviors
 Properly diagnose fevers as malaria before administering treatment
Key Constraint
Were originally trained to treat all fevers as malaria
Key Promise
If you first determine whether or not a fever is malaria before treating someone with
ACTs, you will be a highly respected health worker in your community.
Key Message Content
 Not every fever is malaria.
 It is important that you first carry out the appropriate tests to determine whether
or not a patient has malaria before administering treatment.
 Treating non-malaria fevers as malaria wastes ACTs and results in drug
shortages.
 Treating non-malaria fevers as malaria may lead to resistance to ACTs.
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Communication Channels and Approaches
 Training
 CME sessions
 Support supervision
 Branded job aids
N.B. These will be taken on by other divisions of SMP, with guidance from the
communication team.
Audience 4: Teachers
Profile
 Teachers of nursery and primary school students
 Male and female
 25-55 years
Communication Objectives
Increase the proportion of teachers who:
 Have accurate knowledge of malaria
 Feel that they have an important role to play in the prevention, diagnosis and
treatment of malaria in their communities
Desired Behaviors
 Educate their students about malaria prevention and treatment.
 Encourage their students to share what they learned about malaria prevention
and treatment with their parents/caretakers
Key Constraint
Do not view malaria prevention and treatment as a priority in their work.
Key Promise
If you encourage your students to prevent and properly treat malaria, you will have
higher attendance in your classes.
Key Message Content
 People get malaria when they are bitten by a certain type of mosquito. This
mosquito usually bites at night when you are sleeping.
 Although there are more mosquitoes around during rainy season, you can get
malaria any time of the year.
 The best way to prevent malaria is to sleep under a net every night.
 It is especially important for pregnant women and children under 5 years of age
to sleep under a net, since they are more likely to get malaria.
 The most common sign of malaria is fever. Other signs are pain in your body or
joints, feeling weak or dizzy, losing your appetite, having a headache, feeling
nauseous or vomiting or having diarrhea.
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If anyone has these symptoms, it is important that they are taken to the clinic
within 24 hours.
Communication Channels and Approaches
 Orientations by Health Assistants
 Malaria community competence tool
 Fact sheet on malaria
 “Malaria moments” in the school
 “Stop Malaria in Your Community” newsletter
 SMP website
Tone:
Empowering
Other Creative Considerations:
The campaign should:
 Use humor and principles of entertainment-education
 Use the umbrella “Stop Malaria in Your Community”
 Be consistent with the SMP color scheme and branding (yellow and green)
 Translate well in local language
 Include USAID and MoH logos
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