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Ethiopia

Malaria Prevention and Control 

C-Change has been working with the regional governments in Ethiopia to combat the devastating effects of malaria, with funding from the U.S. President’s Malaria Initiative (PMI), and leading the development of communication programming for PMI partners.

Based on C-Change's success with the development of Essential Malaria Actions (EMAs) and its core messages for malaria, C-Change is assisting other PMI partners to adapt materials for malaria prevention and control. 

C-Change Provides SBCC Support to RTI
RTI asked C-Change for  communication support to successfully implement a program that encourages families to carry out a series of actions that sustain indoor residual spraying (IRS). In the course of a campaign, RTI had identified a number of barriers to effective spraying and sought to expand on the core IRS message: Protect your Family against Malaria–Take the Following Actions to Cooperate for Indoor Residual Spraying. The result was five additional IRS core messages. Posters and a scorecard with illustrations to assist families in carrying out required actions to assist the spraying teams were developed and distributed. The scorecard is in the Oromia languague;  translations can be seen below:
 

  

                                                              PROTECT YOUR FAMILY AGAINST MALARIA

                       Take the Following Actions to Cooperate for Indoor Residual Spraying

 

Message 1: Cooperate with sprayers during IRS period.
 Message 2: Put all your clothes in a chest; take all food items and cooking utensils outside, covered with a cloth.

 Message 3: After spraying is complete, keep family members and domestic animals outside for two hours.

 

Message 4: After spraying, clean and dispose of the IRS residue by burying it.

 

Message 5: Do not re-plaster your homes for six months after spraying is complete.

The core messages are Incorporated into a scorecard for families, which provides the visual check and confirmation that helps keep track of actions families must carry out to ensure successful indoor spraying. Prior to a spraying campaign, RTI dispatched community volunteers to put up posters to alert communities and encourage them to support IRS. Community members and/or families are also given the scorecards. C-Change further supported the effort by providing SBCC training to RTI staff in Adama town to build their skills and knowledge around the communication elements of their program.


 

Malaria Prevention Activities Launched in July 2010

Young Ethiopian mother knows how to prevent malaria and displays the Malaria Prevention StickerC-Change assisted the Oromia Regional Health Bureau (ORHB) to carry out malaria prevention activities. Under the established ORHB Health Extension Program, zonal and local health workers are on the frontline of social and behavior change communication (SBCC) activities to prevent and control malaria, working under the Model Families Program.

In July 2010, C-Change launched the rapid scale-up of the Model Families Program with an SBCC training-of-trainers of district and zonal health professionals in West Arsi and South West Shoa districts. In turn, the health professionlas are cascading the training down and mentoring and coaching volunteer community health workers. See below for more detail. 

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 the specific actions that will prevent malaria. These specific actions grew out of community workshops conducted by C-Change in 2009. Eight essential malaria actions (EMAs) were modified into four doable actions that are visually represented on the scorecard maintained by each family. This scorecard is one of several tools that C-Change has developed as part of this malaria prevention activity.

Training Local Health Workers

Young Ethiopian woman in Oromia displays correctly-hung bednet to  prevent malariaC-Change also trained trainers on how to implement the Model Families Program on the Community Conversation Model used by CARE, a C-Change partner. The trainers were zonal health officials and health professionals in woredas, Ethiopian administrative units similar to a district.  The training was then cascaded to health extension workers (HEWs) and volunteer community health workers (vCHWs), and to personnel of community-based and faith-based organizations and local schools. Qualitative and quantitative studies carried out by C-Change indicated that community members consider HEWs and vCHWs as the most trusted and common sources of health information.

These communication activities were integrated into antenatal care and other health programs and supported through radio programs and anti-malaria clubs initiated by school directors.

Following training, the vCHWs and HEWs visit households, using the flipcharts, posters, and scorecards developed by C-Change as they provide information on malaria prevention, treatment, and control. The visits encourage families to carry out the four doable actions—1) sleep under a net and give priority to pregnant women and children under 5; 2) seek treatment at first sign of fever; 3) adhere to treatment and do not share medication with others; and 4) follow guidance on not plastering after indoor residual spraying.

Malaria Protection Stickers

Families earn malaria protection stickers and become model families when they successfully carry out the four doable actions. HEWs and vCHWs use the Malaria Protection Scorecard when they conduct house-to-house visits and community group meetings. The scorecard helps families chart their own progress and guides them step-by-step toward carrying out the four doable actions and earning the sticker.

As each doable action is carried out, the family member and a HEW or vCHW check the appropriate box and initial that the action has been carried out. When families have earned a malaria protection sticker, they are a model family. They affix the sticker to their front door where it announces to other families their status as a model family household. Model families are encouraged to mentor three other families. Mentoring is one of the benchmarks of the program—families and neighbors encouraging each other to succeed. The Model Families Program lasts 90 days in each woreda. 

The rapid scale-up aimed to expand the program to an additional 812 kebeles and reach an estimated 15 million people by the end of 2010 in Arsi, West Arsi, East Wollega, Southwest Shoa, and West Shoa zones.

Quick Glance

Map of Ethiopia from CIA World Factbook

Click map to enlarge

 

Population
90,879,739

Total fertility rate
5.3

HIV prevalence
1.4% (adult population 15-49)

Contraceptive prevalence
15% (married women 15-49)

Use of ITNs
3% (households with at least one)

Use of IPTs among pregnant women
4% (received two doses)

 

Sources: Ethiopia DHS 2005; PRB 2011; World Factbook