Interpersonal Communication Can Work in Child Survival Programmes

This research brief describing the effectiveness of interpersonal communication (IPC) approaches in child survival programmes was prepared by The Health Communication Capacity Collaborative (HC3) at Johns Hopkins Bloomberg School of Public Health Center for Communication Programs in collaboration with Management Sciences for Health, NetHope, Population Services International, Ogilvy PR, and Internews.

The article reviews and evaluates IPC strategies (also known as face-to-face interaction) between health promoters, educators, communicators, service providers, and clients, calling it one of the oldest forms of health intervention. The article suggests that the advantage of IPC approaches, which can occur in multiple settings, is that they can tailor information to a client's needs and be simulated through many different channels, "including media campaigns or other forms of technology such as the delivery of personalised SMS [text messaging]."

• Client-Provider Interaction and Counselling - This includes educational counselling, which is "less participatory, less engaging and less effective" but can be enhanced by motivational interviewing. Hospital/clinic-based counselling can reach women at key moments (e.g., during pregnancy) and can be continued later in home visits.
• Frontline Health Workers - Also known as community health workers (CHWs), their services can be strengthened if the CHWs themselves are trained and have packages of services (e.g. birth kits, newborn care kits). The CHW model provides opportunities for diagnosis, counselling, and referrals. 
• Home Visits work best when the programme is intensive with repetition over time from well-trained CHWs. CHWs from the community can often better deal with local social or cultural issues.
• Peer Education is used mostly in reproductive and neonatal health situations. Peer educators can understand and relate to the audience. Research suggests that older, more knowledgeable and experienced people can be considered more trustworthy. Mother-to-mother support groups have a good track record and have been helpful with both exclusive breastfeeding and prevention of mother-to-child transmission (PMTCT) uptake. 
• A review of an article on the effect of training heads of household on malaria and anaemia prevention indicates that training on the proper use of long-lasting insecticide-treated nets (LLITN) can be effective in reducing malaria: a) demonstration of using training of trainers technique; b) monthly visits to ensure proper use of an observation checklist; c) community network system with monthly meetings/discussions on proper follow up and to address challenges (LLITN shortage, anti-malarial drugs).

This study included a control group - households given two LLITN with no training or community network system. The results indicated that during high transmission season, the children in the intervention group were less likely to have malaria than those in the control group. Some of the limitations that can be addressed in the future:

• The importance of building rapport and personalisation and of the message delivery personnel being trained and skilled communicators are emphasised;
• Sustainable is more likely when new educators are trained seamlessly and efficiently; and
• More research is needed to see how content dealing with "stigma, discrimination, and gender issues" affect social behaviour change (SBC).

This brief was informed by an article reviewing the "effect of household heads training on the burden of malaria and anaemia in under-5 children in Ethiopia."