Communication for Behavioural Impact Strategic Plan for Afghanistan: 2008-2012

As detailed in this document from the National Malaria and Leishmaniasis Control Programme/General Directorate of Preventive Medicine and Primary Health Care, Ministry of Public Health, Afghanistan, the communication for behavioural impact (COMBI) strategy is a key component in the 4-year Afghanistan National Malaria Strategic Plan. The overall goal of the COMBI strategy is to contribute to the decrease in malaria mortality and morbidity burden in Afghanistan, where the World Health Organization (WHO) estimated 1.5 million cases per year in 2007. Behavioural objectives include: (i) to prompt 80% of all suspected malaria sufferers from each of the 14 high-risk provinces to seek early diagnosis and treatment; and (ii) to encourage 80% of all individuals from each of those high-risk provinces to own and sleep under a long-lasting insecticidal treated net (LLIN) every night from April 1 to November 30, especially those experiencing fevers, pregnant women, and children under five.

Communication actions will include:

1. Personal selling through Malaria Prevention and Treatment Assistants (MPTA), who will make household visits to raise awareness about the campaign and to explain the need for early diagnosis and treatment for all suspected malaria cases and the importance for every household member to sleep under an LLIN. MPTAs will make 3 household visits: at the beginning of the malaria season (Phase 1: March - May), before the peak of P.Vivax malaria (Phase 2: June - August), and before the onset of P.falciparum malaria (Phase 3: September - November).
2. Community mobilisation activities set out to gain community acceptance, support, and action for an intervention. The traditional decision-making mechanisms and modes of influence are taken into consideration in order to achieve the desired behavioural objective. Furthermore, the low literacy rates in Afghanistan demand a more interactive platform for communication through the following interpersonal channels: primary and secondary school promotional activities, local women's non-governmental organisation (NGO) meetings, community health workers, imams, traditional healers, and mobile theatre groups.
3. Administrative mobilisation/advocacy/public relations, whereby a high level of advocacy is conducted to raise support from all levels of political/governmental administrations, which is designed to ensure sustainable commitment and to create and maintain appropriate policies, regulations, and legislation. Advocacy will be carried out through various interpersonal (imams) and media channels (television and radio) to gain political and social leadership, acceptance, and commitment. Public relations activities will include newspaper articles, press releases, and public service announcements. This strategy will strive to inform, educate, and influence perceptions to change behaviour.
4. Sustained, massive advertising: An advertising campaign will be launched in a Massive, Repetitive, Intense, Persistent (MRIP) manner through provincial radio and television before and during the malaria transmission season.
5. Point of service: Flags bearing the campaign logo will be produced and distributed, along with inexpensive poles, to LLIN outlets and government-recognised private clinics. These flags emphasise easily accessible and readily available prevention and treatment methods.

Monitoring will follow the implementation of the COMBI strategy in order to assess the progress of the malaria campaign.