Jhpiego Corporation The Johns Hopkins University A Training Program on Community Directed Intervention CDI to Improve Access to Essential Health Services Module 19 Objectives By the end of this module learners will ID: 680607
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CDI Module 19:Behavior Change Communication
©Jhpiego Corporation
The Johns Hopkins University
A Training Program on Community- Directed Intervention (CDI) to Improve Access to Essential Health ServicesSlide2
Module 19 Objectives
By the end of this module, learners will
Define Behavior Change Communication (BCC)
Differentiate between BCC and Information, Education and Communication (IEC)Identify reasons why people change or do not change behavior easilyDiscuss basic issues and concepts in BCCState key BCC-centered messages to promote acceptance of integrated community case management (iCMM) by policymakers, frontline health care providers and community membersIdentify basic methods of communicating BCC-centered messages to the target audience
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Basic Issues
Basic Concepts and Messages for iCCM
Basic BCC Methods for iCCM
3Slide4
Basic Concepts
4Slide5
Introduction to Behavior Change
How can people avoid getting malaria?
[
Post these as flip chart pages
]
Are people behaving in these ways? No!
B
ut WHY?
5
Learners BrainstormSlide6
Why Do People NOT Change Behavior?
People may not
Understand
the messageSee themselves as vulnerableTrust the bearers of the messagePeople mayThink the short-term benefits
of current behaviors outweigh the long-term risks
Some “healthy choices” are
costly
Recommended behavior may
conflict with beliefs
After all, people believe that malaria is a common disease and is
not so serious
Can you name more reasons?
6Slide7
Information, Education and Communication (IEC)IEC is a process of working with individuals, communities and societies to develop communication strategies
These strategies support positive behaviors that
Promote health
Are appropriate to their settings 7Slide8
Behavior Change Communication (BCC)
BCC
Develops communication strategies
To promote positive behaviors that are appropriate to their settings
AND
Provides a
supportive environment
that
Will enable people to initiate and sustain positive behaviors
8Slide9
What Makes an Environment Supportive?
What can
Families do?
Local organizations do?Community leaders do?Health workers and managers do?Policymakers do?
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Who else can contribute to a supportive environment
?Slide10
Therefore, BCC Is …
…a process of promoting and sustaining healthy changes in behavior in individuals and communities
This process calls for participatory development of appropriately tailored health messages and approaches
These messages and approaches are conveyed through a variety of communication channels
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Using BCC to Promote Malaria Action
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BCC and Malaria
Before individuals can reduce their risk/change behaviors they need to
Understand basic facts about malaria
Develop favorable attitudes toward preventive interventionsLong-lasting insecticide-treated nets (LLINs)Intermittent preventive treatment in pregnancy (IPTp)Indoor residual spraying (IRS)Learn a set of skills to implement interventionsHave access to appropriate commodities and servicesPerceive their social, economic and political environment to be supportive of practicing malaria prevention behaviors
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What Can BCC Do?
Increase knowledge about malaria
Stimulate community dialog to stop malaria
Promote essential attitude change toward malaria preventionReduce stigma and discrimination against poor people who suffer frequently from malaria
Create
demand
for information and
malaria servicesAdvocate for more malaria resources
Promote services for prevention, care and
support
Improve skills and sense of
self-efficacy in using malaria interventions
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Can you name more?Slide14
Before We Communicate about and Manage Common Illnesses, We Need to Know Their Local Names
Medical Name
Local Name(s)
How Differs from Malaria
Malaria
Pneumonia
Diarrhea
Catarrh/Cold
Cough
Rashes
Measles
Others?
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Prevention ChallengesWhat if people believe that malaria is caused by hard work under the hot sun, and only herbal concoctions can prevent it?
What if people think nets are hot and uncomfortable?
What
can BCC do?
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More Prevention Challenges
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What can BCC do?
What if people use their nets for other purposes?Slide17
Treatment Challenges
In cases of malaria, the fever comes
With chills and aches and
At the same time each day, often between late morning and eveningIn cases of pneumonia, the fever can comeWith a cough and fast or difficult breathing
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Several Diseases Have Hot Body (Fever)Slide18
Many Diseases Can Have Fever…
If we give the wrong medicine for the disease, the child will not get well
We can do a special malaria blood test called rapid diagnostic test (RDT)
We can do the RDT in the community
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So We Need
a
Way
to
TestSlide19
Using RDTs
Your community-directed distributor (CDD) has been trained to use the RDT correctly and safely
Only a few drops of blood are needed to find out if the malaria “germs” are in the blood
Most RDT results are ready in only 15 minutes
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Positive and Negative RDT Results
Lines in “T1” and “T2” and a line in ‘C’
means
the patient DOES have
falciparum malaria monoinfection or a mixed infection
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T1
T2
Pf or Mixed +
NO LINE in
“T1” or “T2”
but a line in
“C”
means
Negative
T1
T2
C
C
t
he
patient
DOES NOT have
either falciparum malaria or non-falciparum
malariaSlide21
Treatment
We only give malaria medicine when the RDT is positive
New malaria medicine should not be wasted when the person does not have malaria
If the test is negative, we look for another disease and treatment
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The Communication ChallengeWhat if the RDT says the person does not have malaria, but she believes she has it and demands malaria medicine?
What can we do?
How can we use BCC to solve this problem?
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Basic BCC Methods
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Different BCC MethodsAddress Different Challenges
Method
How Method Helps Change Behavior
Posters, counseling cards, brochures
Provide information
Radio, TV, songs
Remind
people about malaria action
Stories, dramas, plays
Present
role models for behavior change
Discussions
Provide opportunities to plan for solving problems
Peer groups
Provide encouragement
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Using Visual Aids
Visual aids help to enhance understanding
Visual aids include
PostersCounseling cardsFlip chartsVideos
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Community Counseling Card
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Use
artemisinin-based combination therapy
(ACT) when you have malaria fever
Give all pregnant women 3 SP tablets beginning from 4 months
(MUST be given after
baby
started
moving in
mother’s womb
)
Every member of your household (especially pregnant women and
children
under the age of five years) MUST sleep under
insecticide
-
treated nets
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Telling StoriesStories facilitate understanding and are used to pass down a society’s traditions, values and norms to future generations
Stories could include
Folktales relating to malaria disease, (e.g., how misunderstanding the cause of malaria led to the death of a child or pregnant woman)
Testimonials (e.g., how RDTs helped to confirm malaria and aided treatment to prevent death)Cartoon stories
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Composing SongsSongs reinforce knowledge and help to internalize understanding
Adapting or composing songs about RDT use can help villagers
Understand how they can benefit from using RDTs and accept use
Feel comfortable being tested with RDTsSongs composed in the local language convey ownership and make issues indigenous28Slide29
Role Play and DramaTheories about behavior change, for example, propose that people develop confidence and willingness to perform a new behavior when they can observe others in their community doing the same
Therefore, role play and drama can build
people’s confidence in performing a
new skill or practice29Slide30
Community Discussion and Planning
Communities need to be actively involved in solving their own malaria problems
Communities can plan how to distribute nets
Communities can select volunteers to treat malaria
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What else can your communities do
?Slide31
Reminder: Some Basic Information
Understanding the signs and symptoms of a disease may enhance its prevention and treatment
In cases of malaria, fever may come with chills and aches; malaria fever comes at the same time each day, often between late morning and evening
In cases of pneumonia, fever can come with a cough and fast or difficult breathingIf we give the wrong medicine for the disease, the child will not get wellThis is why we carry out a special malaria blood test, called RDT, at the facility and community levels
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Reminder: More Basic InformationThis test (the RDT) will help us to know the cause of fever so that we can give the appropriate medicine to your child
The test is safe, and your CDD has been trained to carry out the test correctly and safely
Be sure to complete the dosage of artemisinin-based combination therapy (ACT) given to you or your ward, even though the fever has stopped
This new medicine is safe for everyone32Slide33
Reminder: With BCC,Information Alone Is Not Enough
We can help create a supportive environment by
Holding community meetings to plan malaria control activities
Ensuring that the health services have adequate supplies of nets and medicinesAdvocating with decision-makers at district, regional and national levels to make funds available to control malariaMaking sure that malaria interventions do not cost more than people can afford
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Small Group ActivitiesDivide the learners into three groups that will focus on
Promoting use of insecticide-treated nets (ITNs)/LLINs
Seeking prompt diagnosis and correct malaria treatment
Getting IPTp as part of antenatal care (ANC)Ask each group to plan a BCC program on their topic using locally available materials and mediaGroups will report back by sharing their plan and showing examples of their BCC activities
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