Social and behaviour change (SBC)

Operational guidance on planning for SBC in school-based ITN distribution, including advocacy, outreach, social mobilization, rumour management and promotion of ITN use and care.

Key SBD Considerations

Every country should have an evidence-based malaria SBC plan, which includes section(s) for ITN distribution across the country’s channel mix. Messages and materials should be harmonized across channels. The plan should be developed with members of the national malaria coordination structure, with inputs from partners and sub-national health units.

In line with national decisions on ITN distribution channels, ITN distribution SBC plans should also include channel-specific approaches. For ITN SBD SBC planning, objectives and approaches should align with the national malaria SBC plan and the RBM SBC Strategic Framework and Resources and include:

  • Integration of SBC plans for ITN distribution within existing malaria and ITN communication strategies and activities.
  • Development and production of SBC materials for ITN distribution.

As part of ITN SBD planning, it is important to outline planning for SBC as part of the overall PoA SBD strategy (Section 8f). In addition:

  • Young people can bring powerful voices to health behaviour change within the household and communities.
  • Teachers and school health educators are well placed to provide schoolchildren with clear information and priority messages to share with family and community members.
  • Participatory learning should be tailored to the unique needs and preferences of schoolchildren. This approach helps capture and maintain their attention while conveying clear and memorable information. It also fosters a lifelong interest in healthy behaviours and empowers children to shape their vision for a healthy future. By building self-efficacy, they can adopt and promote healthy behaviours for themselves, their families and their communities.
  • Schools often include malaria among the health issues in the standard curriculum. When SBD is planned, it is important to include related messages as part of this curriculum in class.
  • While ITNs are distributed to schoolchildren, it is important to reinforce that the ITN is for the household. Pilot programmes have shown that students may feel that the ITN belongs solely to them. SBC should include messages and approaches to reinforce that the ITN is for the family as a whole.
  • The SBD section of the national malaria SBC plan may include:
    • Sharing SBD organizational information with all eligible students and their caregivers regarding the purpose, timing, distribution activities and key messages
    • Messages to reinforce correct and consistent ITN use and care behaviours which promote ITN longevity

ITN SBC planning for SBD should include:

  • Advocacy at global and local levels to influence resource allocation for optimal distribution options to maintain ITN access and to ensure that the most effective ITNs are selected according to insecticide resistance profiles.
  • Outreach to build community awareness of the channel options available to access ITNs.
    • Interpersonal communication (IPC) as a main channel to disseminate key messages on ITN use, care and repair.
    • Alongside engaging school administrators/teachers to set strong examples and lead SBC, consider also including and receiving support from trusted local leaders or influencers to promote ITN use and importance as well as SBD programmes. Engage and empower caregivers/parents through information sessions or informational materials, parent-teacher, and child-to-family interactions.
    • Considerations for ITN repurposing and safe disposal of end-of-life nets.
    • Social mobilization to encourage ITN use and care behaviours which promote ITN longevity and to create healthy social norms.
    • Reinforcement of key malaria prevention messages to improve ITN user self-efficacy for hanging, washing practices, net repair, consistent use, promoting priority use by vulnerable populations and care.
  • Inclusion and consideration for socio-cultural factors that may act as barriers to ITN use including personal, religious or cultural beliefs, historical distrust of NGOs, government or health workers and interventions carried out by certain groups.
  • Planning for rumour management, e.g. for students in grades which do not receive ITNs; mitigating risks if schoolchildren inadvertently transmit incorrect information to their household members.
  • Planning for equitable distribution, e.g. reaching children who may not be attending school regularly.
    • Promotion of key messages, targeted at specific age-groups, through communication channels which are most frequently used and appreciated by priority populations. These may include, for example:
    • Mass media: radio and/or television
    • Social media
    • SMS or text messaging
    • Print media (e.g. flyers, class posters, visual materials, take-home pamphlets)
    • IPC
  • Promotion of education and awareness campaigns (e.g. school assemblies, classroom demonstrations) that include SBC on malaria health risks, benefits of ITN use and guidance on proper net use and care (i.e. how to hang an ITN properly, avoid tears, mend holes, use consistently every night):
    • This may require educational training for teachers, health educators, etc. or older students who can act as peer trainers
    • This can include malaria-related education integrated into the class curriculum such as in health classes or science classes focused on disease spread or the environment

Resources

  • AMP job aid for schoolteachers and school health educators EN | FR | PT
    This job aid was developed for ITN mass distribution and can be adapted for ITN SBD. It includes key messages and lesson plans for social mobilization and SBC for malaria prevention and ITN use and care which teachers can use and adapt for SBD SBC lessons and activities.