Draft Communication Strategy for Home-Based Management of Fever/Malaria in Children And Control of Malaria in Pregnancy in Uganda: 2001 - 2005

Document excerpt:

This document describes the communication strategies that support the Ministry of Health Strategy for Home-Based Management of Fever/Malaria in Uganda. The strategy is presented in two parts: the first describes the communication strategy for improving home management of fever/malaria in under-fives; and the second describes the communication strategy for controlling malaria more effectively during pregnancy.

Though the communication strategies for home-based management of malaria among children and for malaria in pregnancy are presented as two separate sections in this document, there are points of overlap and integration that will allow the Ministry of Health (MOH) to link the two.

• Underlying problems. Many of the challenges facing home-based care and malaria-in pregnancy are similar. Women are unable to access the resources they need to take action. Service providers and clients are unaware of treatment guidelines. Communication between clients and providers can be improved. By understanding that both programmes face similar challenges, programme managers can craft training, supervision, and communication materials that address both malaria in pregnancy and malaria in under-fives simultaneously.
• Audiences. There are three audiences common to both strategies: men and opinion leaders, young and expectant mothers, and service providers. Men and community opinion leaders must understand that their families and constituencies need resources to protect pregnant women and children with fever. Young and expectant mothers need to understand how to take care of themselves during pregnancy, how to care for their young children, and how to advocate for the resources they need Service providers need to have a better understanding of counselling and treatment guidelines both for children with fever and for pregnant women.
• Media and mobilisation. Several of the media and mobilisation strategies called for by both programmes are similar. Both strategies call for: a logo to identify sources of quality malaria information and services; use of newsletters to improve provider compliance; radio programmes; information sheets; posters summarising treatment guidelines; meetings with in-charges and orientations to improve support supervision. Wherever possible, these materials and activities will be combined to encompass messages about malaria in pregnancy as well as management of fever/malaria in under-fives.

This malaria communication strategy was developed over a six-month period in 2001 through a three-step process:

• A literature review was conducted on malaria in under-fives and pregnant women. The review examined recognition of malaria, decision-making, treatment practices, treatment sources, compliance with treatment, caretakers’ sources of information, preventive measures, community perception about formal health services, and relevant MOH policies.
• Program managers examined that literature review to identify gaps in knowledge. Qualitative research was then conducted to fill in those gaps. This research took the form of focus group discussions with mothers with children under five, fathers of children under five, women aged 35 and above, and young women currently or recently pregnant; and key informant interviews with community drug vendors, traditional birth attendants, and qualified health workers.
• A group of communication and technical experts then gathered in a workshop between October 1-5 2001. They reviewed the literature and formative research findings, and developed communication strategy outlines based on those findings. The strategy presented here is a record and refinement of the results of that workshop.

The assumption underlying this strategy is that the service delivery, policy, management, logistics, and supply interventions that are necessary complements to any successful communication strategy will be put in place. No malaria communication program can succeed if well-articulated national protocols and service delivery guidelines are not adequately disseminated and understood, if the right drugs are not available at the right time, and if service providers are not adequately trained.



Recognizing the crucial importance of these complementary service delivery issues, the managers of this communication program must closely coordinate with their service delivery counterparts. Advocacy-related communication will be crucial to ensuring that the necessary services are in place. Communication programs should be synchronized with services; for example, when SP is fully is available and health workers trained in a certain district, appropriate communication interventions should accompany or follow close behind.