Malaria BCC Indicator Reference Guide

1

Malaria Behavior Change Communication (BCC) Indicator Reference Guide

February 2014

Malaria BCC Indicator Reference Guide

2

Copyright 2014 Roll Back Malaria Partnership

The Roll Back Malaria Partnership (RBM) is the global frame-work for coordinated action against malaria. Founded in 1998 by UNICEF, WHO, UNDP, and the World Bank and strengthened by the expertise, resources, and commitment of more than 500 partner organizations, RBM is a public-private partnership that facilitates the incubation of new ideas, lends support to innovative approaches, promotes high-level political commit-ment, and keeps malaria high on the global agenda by en-abling, harmonizing, and amplifying partner-driven advocacy initiatives. RBM provides policy guidance and secures financial and technical support for control efforts in countries and monitors progress towards universal goals. The RBM Secre-tariat is hosted by the World Health Organization in Geneva, Switzerland.

The geographical designations employed in this publication do not represent or imply any opinion or judgment on the part of the Roll Back Malaria Partnership on the legal status of any country, territory, city or area, on its governmental or state authorities, or on the delimitation of its frontiers. The mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by the Roll Back Malaria Partnership in preference to others of a similar nature that are not mentioned or represented.This document may be freely reviewed, quoted, reproduced and translated, in part or in full, provided that the source is acknowledged.

The authors are grateful to all of the organizations and individ-ual photographers who granted permission for their photos to be used in this publication. Photo credits are on the inside back cover. Permission to reproduce any of these photos can only be granted by the original owners.

Cover explanation:

In the top picture, a data collector is conducting a household malaria survey. The bottom pictures represent various types of behavior change communication activities for malaria (L to R): a health worker counseling a pregnant woman and her husband on malaria in pregnancy in Uganda, a malaria educa-tion radio show in Cambodia and a home visit by a community health worker in Senegal.

Cover photo credits:

Top picture Sarah Hoibak/Mentor Initiative, Uganda

Left Stop Malaria Project, Uganda

Center - Moeun Chhean Nariddh/Containment, http://malaria-containment.wordpress.com/page/2/

Bottom: Diana Mrazikova/NetWorks Project, Courtesy of Pho-toshare. Senegal

Malaria BCC Indicator Reference Guide

3

Table of ContentsAcronyms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Rationale for Measuring these Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

How to Use this Document . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

General Notes on Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

Data sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Gender implications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Sample size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Core Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Targeted Behaviors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

1. Proportion of people who practice the recommended behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Reach/Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

2. Proportion of people who recall hearing or seeing any malaria message within the last 6 months . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Knowledge and Awareness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

3. Proportion of people who name mosquitoes as the cause of malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 4. Proportion of people who know the main symptom of malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 5. Proportion of people who know the treatment for malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 6. Proportion of people who know preventive measures for malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Risk and Efficacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

7. Proportion of people who perceive they are at risk from malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 8. Proportion of people who feel that consequences of malaria are serious . . . . . . . . . . . . . . . . . . . . . . . . . 29 9. Proportion of people who believe that the recommended practice or product will reduce their risk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 10. Proportion of people who are confident in their ability to perform a specific malaria-related behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Supplemental Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Norms and Attitudes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

11. Proportion of people with a favorable attitude toward the product, practice or service . . . . . . . . . . . 36 12. Proportion of people who believe the majority of their friends and community members currently practice the behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

Malaria BCC Indicator Reference Guide

4

Experimental Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

13. Proportion of people who have encouraged friends or relatives to adopt the specific practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 14. Bed net care and repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 48 15. Non-adoption (subjective/objective) of recommended malaria interventions . . . . . . . . . . . . . . . . . . . . 53 16. Proportion of members of the household who sleep outside the house, by month . . . . . . . . . . . . . . . 57

Upcoming Activities Requiring Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

1. Seasonal Malaria Chemoprevention (SMC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 2. Larviciding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 3. Intermittent Screening and Treatment (IST) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61