Disease Prevention and Control / Communicable Diseases / Dengue
Planning Social Mobilization and Communication for Dengue Fever Prevention and Control: A Step-by-Step Guide
Will Parks and Linda Lloyd, in collaboration with the World Health Organization Mediterranean Centre for Vulnerability Reduction (WMC) and the UNICEF/UNDP/WORLD BANK/WHO Special Programme for Research and Training in Tropical Diseases (TDR)
Full Text (158 pp, PDF, 3.2 Mb, via WHO/TDR site)
The Behavioural Challenges of Dengue Prevention and Control
A major obstacle to effective implementation of selective, integrated mosquito control has been the inability of ministries of public health to mobilize and coordinate the resources needed to achieve and sustain behavioural impact among populations at risk of dengue fever and dengue hemorrhagic fever (DF/DHF). Knowledge is not enough. Regrettably, an informed and educated individual is not necessarily a behaviourally responsive individual. Many programmes continue to focus only on changing people's knowledge and on raising awareness, believing that behaviour will change; when it doesn't (and it usually doesn't), the standard response is to bombard people with even more entomological and epidemiological facts, often using sophisticated advertising techniques. But more information, fancy posters, colourful T-shirts, glossy pamphlets, and stylish TV features rarely, in themselves, lead to behavioural responses if they are not behaviourally focused. In addition, behavioural change must occur gradually. Most programmes usually manage to inform and convince but often fail to provide an effective and feasible new behaviour, or to prompt people to take the necessary steps towards adopting and maintaining the new behaviour. Achieving and sustaining behavioural results is still a major challenge.
An Enabling Environment: It may be that an individual cannot change his or her behaviour unless the setting in which he or she lives or works is also changed. The task is to discover how to make this setting an "enabling" environment, one that supports, for example, new behaviours, perhaps by providing more effective legislation, better housing construction techniques, improved services, or superior policies.
The Purpose of this Guide
A social mobilization and communication approach is called for that makes a seamless connection between knowledge and behaviour, addresses the costs and values of engaging in healthy behaviours, appreciates the gradual stages of behaviour change, and creates a supportive environment.
To date, social mobilization and communication strategies for dengue prevention and control and the research that informs these strategies, have been largely the pursuit of individual social scientists, university departments, and nongovernmental organizations (NGOs) implementing studies or field trials peripheral to national programme goals. Such strategies have tended to focus at the household and community level, with less emphasis being given to broader social changes needed in such domains as urban planning, municipal services such as water supplies, industry, and government institutions.
For the first time in relation to dengue, this guide offers a comprehensive and innovative managerial insight to planning social mobilization and communication for behavioural impact. The guide is intended for programme managers and individuals, NGOs, and other agencies with interests and/or expertise in integrating biological, chemical, environmental, and communication interventions to prevent and control DF/DHF. You may be an entomologist in charge of vector-borne disease control at national level. You may be an environmental health worker responsible for pest control, water supplies, and solid waste management within an urban authority. You may be a medical officer in charge of a district health service. This guide will help you learn about and ultimately apply the basic steps involved in developing a behaviourally focused social mobilization and communication plan that can help you achieve your public health objectives. Its style and extensive use of examples make the guide straightforward, easy to read, and enjoyable. While the topic is dengue, the planning process described can be applied to any other public health problem.
Some countries have produced or are currently producing national guidelines on community participation, behaviour change communication, and social mobilization for dengue prevention and control. It was felt that this WHO guide would contribute to the development and support of these local initiatives by demonstrating a breadth of international experiences. The guide is not a recipe book but a collection of examples and ideas, of group experiences and opinions. Its components should be challenged and adapted as occasion arises.
In this guide, we introduce COMBI (Communication for Behavioural Impact). In a structured and strategic manner, COMBI will help you to plan, implement, and monitor a variety of communication actions intended to engage individuals in considering recommended healthy behaviours and to encourage the adoption and maintenance of those behaviours. COMBI consists of three programmatic phases:
This guide concentrates on COMBI Planning. Although we illustrate how various projects and strategies have been implemented around the world, the exciting task of implementation is left up to you! We shall discuss evaluation but place greater emphasis on monitoring because we view social mobilization and communication as constantly evolving. There are also plenty of resources on evaluation to which you can refer (see Tool Number 1). COMBI Planning can be divided into 15 steps (see list to right).
COMBI's Five Integrated Actions
Following the 15 steps of COMBI Planning will accomplish three essential managerial tasks: