Communication-for-Behavioural-Impact (COMBI) PowerPoint Presentation

This PowerPoint presentation on the strategy called communication-for-behavioural-impact (COMBI) emerges from a subgroup meeting of the Eastern Mediterranean Regional Advocacy, Communication and Social Mobilization (ACSM) planning workshop for tuberculosis (TB) control held in Mexico City, Mexico, from September 13-16 2005. COMBI is described here as a "carefully planned and monitored social mobilization directed at the task of mobilizing all societal and personal influences on an individual and family to prompt individual and family action with respect to specific healthy behaviours."

In the presentation, Dr. Everold Hosein notes that the World Health Organization (WHO) Mediterranean Centre for Vulnerability Reduction (WMC) international centre for social mobilisation, training, and operational research coordinates COMBI programmes in over 40 countries worldwide - addressing issues such as lymphatic filariasis, dengue fever, leprosy, TB, malaria, and HIV/AIDS.

Subsequent slides outline key COMBI planning principles, including doing nothing until one has: set out specific, precise behavioural goals or objectives; and carried out a situational "market" analysis in relation to preliminary behavioural goals/objectives. The HICDARM approach is outlined: Hear about the new behaviour; become Informed about it; become Convinced that it is worthwhile; make the Decision to do something about that conviction; take Action on the new behaviour; await Re-confirmation that the action was a good one; and, if all is well, Maintain the behaviour. Also, the "Four C's" are delineated: C = Consumer Need/Want/Desire; C = Cost; C = Convenience; and C = Communication.

Dr. Hosein stresses that capacity in social mobilisation should be built horizontally and vertically, which means: involving key personnel responsible for social mobilisation planning, implementation, and management; building on existing infrastructure; and promoting public-private sector partnerships.

One slide provides data from the partial implementation of a TB programme using COMBI in the state of Kerala, India: The government reported a 20% increase in the number of patients getting a sputum test.

Lessons learned from this and other programmes include:

• Well-researched behavioural goals focus efforts and result in clear, consistent messages.
• Strategic planning is a prerequisite to materials production and communication training.
• Recognise the implementation commitment; one may or may not need external personnel in implementation.
• Consider organisational restructuring.
• Explore possibilities for private sector partnership and support - for instance: Work with competent local advertising agencies.
• COMBI can foster 2-way dialogue between "communities" and services/organisations, which can improve community-organisation relationships.