KENYA MALARIA COMMUNICATION STRATEGY 2016-2021 - Revised 2016 - The ...

 
KENYA MALARIA COMMUNICATION STRATEGY 2016-2021 - Revised 2016 - The ...
Malaria Communication Strategy National Malaria Control ProgrammeREPUBLIC
                                                                  2016 - 2021OF KENYA

                                                        MINISTRY OF HEALTH

KENYA MALARIA
COMMUNICATION
STRATEGY
2016-2021

                                                                                        Revised 2016
                    National Malaria
                   Control Programme                                                              1
KENYA MALARIA COMMUNICATION STRATEGY 2016-2021 - Revised 2016 - The ...
Malaria Communication Strategy National Malaria Control Programme 2016 - 2021

             This publication is a Ministry of Health document.
                Any part of this document may be freely reviewed, quoted, reproduced
                and translated in full or in part, provided the source is acknowledged.
                    It may not be sold or used for commercial purposes or profit.

                     The Kenya Malaria Communication Strategy
                                    2016–2021

                                                     National Malaria Control Programme
                                                              Ministry of Health
                                                             PO Box 19982, KNH
                                                             Nairobi 00202, Kenya
                                                     Email: head.domc@domckenya.or.ke
                                                           http://www.nmcp.or.ke

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                                           Table of Content
Table of content                                                                              ii
List of figures and tables                                                                    iii
Foreword                                                                                      1
Acknowledgements                                                                              1
Abbreviations                                                                                 1
Executive Summary                                                                             1

CHAPTER 1: Review of the Malaria Communication Strategy 2010-2014                             1
1.1 Background                                                                                1
1.2 Process                                                                                   2
1.3 Literature Review findings and implications                                               3
1.4 Evaluation of Malaria Communication Strategy (2010-2014)                                  6
1.5 Potential Challenges and Implications for Malaria Communication Strategy Implementation   8
1.6 Problem statement                                                                         10

CHAPTER 2: Malaria Communication strategy                                                     11
2.1 Goal of the communication strategy                                                        11
2.2 Approaches to implementing the communication strategy                                     11
2.3 Strategic objective                                                                       12
2.4 Specific objectives                                                                       12

CHAPTER 3: Key strategic interventions                                                        13
3.1 Strengthen structures for the delivery of ACSM interventions at all levels                13
3.2 Strengthen program communication for increased use of all malaria interventions           14
3.3 Increase inter-sector advocacy and collaboration for malaria ACSM interventions           18
3.4 Strengthening community-based social and behavior change
    communication activities for all malaria interventions                                    20

CHAPTER 4: Implementation Plan 2016–2021                                                      24

CHAPTER 5: Monitoring and Evaluation Plan 2016 –2021                                          27
Annex 1: Terms of Reference for ACSM TWG                                                      30
Annex 2: Contributors                                                                         31
Annex 3: References                                                                           32

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                                                  List of Tables
          Table 1. Potential Challenges and Implications                              9
          Table 2. Key audiences, messages and channels                               17

                                            List of Figures
          Figure 1. Guidance on implementing interpersonal communication activities   22
          Figure 2: Implementation and coordination arrangements of Malaria ACSM      23

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                                                         Foreword
          The Kenya Malaria Communication Strategy 2016 – 2021 is a product of the review of the Malaria
          Communication Strategy 2010-2014. This strategy is aligned to the Kenya Malaria Strategy (2009 -2018),
          the Global Technical Strategy for Malaria (2016 -2030), the Roll Back Malaria Partnership’s Action and
          Investment plan to defeat Malaria (2016- 2030), The Strategic Framework for Malaria Communication at
          the Country Level 2012- 2017 and the Roll Back Malaria Partnership’s BCC Indicators reference guide.

          This document spells out the operational framework for advocacy, communication and social mobilization
          (ACSM) interventions in Kenya and has taken into account the achievements and gaps in the implementation
          of the MCS 2010-2014 and the changes of governance in the health sector. This strategy has maintained
          the vision, mission and goal of the KMS 2009-2018 by moving forward the spirit of objective 5 that is
          linked to malaria ACSM of increasing utilization of malaria control interventions by communities in Kenya
          to at least 80 percent by 2021. The revised strategy includes new stakeholders, articulates their roles and
          responsibilities and coordination mechanism.

          We are confident that the strategy will play a key role in increasing uptake of malaria control interventions
          through the engagement and collaboration of multi-sector partners at both national and county levels.
          I urge all our partners to put their efforts into the implementation of this strategy as we move forward
          towards pre-elimination of malaria.

          “Komesha Malaria Okoa Maisha”

          Dr. Cleopa Mailu
          Cabinet Secretary
          Ministry of Health

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                                       Acknowledgement
          The Malaria Communication Strategy has been developed through a series of consultative meetings
          involving development and implementing partners; CSO representatives and county health teams. The
          stewardship provided by Principal Secretary Dr. Nicholas Muraguri, the Head Department of Preventive
          and Promotive Health, Dr. Jackson Kioko, supported by the Head of Division of National Strategic Public
          Health Programmes, Dr. Joseph Sitinei and Head of National Malaria Control Program, Dr Waqo Ejersa is
          highly appreciated.

          The members of the ACSM TWG who have participated in the discussions and giving feedback that have
          enriched the final product. Of special mention are our technical partners; WHO, PMI, PS Kenya, UNICEF,
          Malaria No More, ICF, PIMA, AMREF, CHAI, KEMRI and KeNAAM. We appreciate the participation of
          the Ministry of Health divisions, units and agencies including Health Promotion and Community Health.
          Appreciations, also go to Terry Muchoki (Independent Consultant) for coordinating and compiling the
          document as per all the stakeholders’ inputs.

          Financial support for the strategic review and drafting was provided by PMI/USAID through PS Kenya.

          PS Kenya.
          Dr. Nicholas Muraguri
          Principal Secretary
          Ministry of Health

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                                                Abbreviations
            ACSM               Advocacy, communication and social mobilization
            ACT                Artemisinin-based combination therapy
            AL                 Artemether Lumefantrine
            ANC                Antenatal care
            CHV                Community health volunteer
            EMA                Essential Malaria Action Guide
            FBO                Faith-based organization
            GoK                Government of Kenya
            HH                 Household
            HPAC               Health Promotion Advisory Committee
            HPU                Health Promotion Unit
            IEC                Information, Education and Communication
            IPC                Interpersonal communication
            IPTp               Intermittent Preventive Treatment in Pregnancy
            IRS                Indoor residual spraying
            KHSSP              Kenya Health Sector Strategic Plan
            KMIS               Kenya Malaria Indicator Survey
            KMS                Kenya Malaria Strategy
            LLIN               Long-lasting insecticidal nets
            LSM                Larval Source Management
            M&E                Monitoring and evaluation
            MOH                Ministry of Health
            NMCP               National Malaria Control Program
            RDT                Rapid diagnostic test
            SBCC               Social behavior change communication
            SP                 Sulphadoxine-pyrimethamine
            TWG                Technical working group
            WHO                World Health Organization

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                                     Executive Summary
        Malaria remains a public health problem in Kenya                        This Malaria communication strategy for Kenya
        with about 70 percent of the population at risk of                      2016–2021 (MCS) has been developed to provide a
        the disease. The Ministry of Health through the                         framework within which advocacy, communication
        National Malaria Control Program has adopted                            and social mobilization activities will be implemented
        the vision of achieving a malariafree Kenya. The                        to support the core strategies of the revised Kenya
        revised Kenya malaria strategy 2009–2018 (KMS),                         malaria strategy (2009–2018). It details in depth
        the National malaria policy (2010) and the Kenya                        how the four strategic interventions above will be
        malaria monitoring and evaluation plan (2009–                           achieved.
        2018) provide the guiding framework for malaria
        control in Kenya towards accelerating the reduction                     The MCS 2016–2021 advocates coordinated
        of the burden of malaria and achieving the vision of                    implementation at two distinct but connected
        a malaria-free Kenya.                                                   levels. At the national level, through a rejuvenated
                                                                                ACSM working group serving as the coordinating
        The KMS 2009–2018 is hinged on six strategic                            working group for all partners implementing
        objectives that lay out the key malaria control                         malaria ACSM at the national level as well providing
        interventions: vector control (universal coverage of                    technical guidance to county level coordination
        long lasting insecticidal nets in targeted areas; indoor                and implementation of activities. In the counties,
        residual spraying and larval source management;                         through health promotion advisory committees
        prevention of malaria in pregnancy), diagnosis and                      ensuring coordinated implementation, monitoring
        treatment, epidemic-preparedness and response                           of ACSM, advocacy for resource allocation and
        as well as surveillance, monitoring, evaluation and                     pooling of resources.
        operational research, advocacy, communication
        and social mobilization and program management.                         The goal of the strategy is to implement a
        The KMS recognizes strategic communication as                           coordinated and effective program over the next
        an integral component to achieve the vision of a                        five years, which will achieve change in behavior
        malaria-free Kenya as outlined in its fifth strategic                   at different levels: political, service delivery,
        objective that seeks to increase the utilization of                     community and individual. Chapter 1 of the strategy
        malaria interventions to 80 percent at household                        provides background into the review process
        level through malaria advocacy, communication                           and development of the communication strategy.
        and social mobilization (ACSM) activities by                            Chapters 2 and 3 outline the strategic directions,
        2021 through four strategic interventions:                              interventions and activities to address the key
                                                                                problems. Chapter 4 provides the implementation
            1. Strengthen structures for the delivery of ACSM                   plan and coordination framework between national
               interventions at all levels.                                     level ACSM and counties ACSM level while the
                                                                                Chapter 5 provides details of how ACSM activities
            2. Strengthen program communication for
                                                                                will be monitored and evaluated towards tracking
               increased utilization of all malaria interventions
                                                                                progress on the national target.
            3. Advocate for inter-sector collaboration for
               malaria advocacy, communication and social
               mobilization:
            4. Strengthen community based social and
               behavior change communication activities for
               all malaria interventions.

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        1 Review of the Malaria
          Communication Strategy
          2010-2014

        1.1 Background                                                          Objective 1: To have at least 80 percent of persons
        The review of the Malaria communication                                 in malaria risk areas using appropriate malaria
        strategy 2010–2014 (MCS) was informed by two                            preventive interventions by 2018.
        emerging issues: the mid-term review of the Kenya
        malaria strategy 2009–2017; and the change in                           Objective 2: To have all suspected malaria cases
        government structure that devolved power, roles                         that present to a health provider managed in
        and responsibilities — including the delivery of                        accord with National Malaria Treatment Guidelines
        health services—to counties.                                            by 2018.

        Mid-term review of the Kenya Malaria                                    Objective 3: To ensure that all sub counties in
        Strategy (2009–2018)                                                    malaria epidemic and seasonal transmission zones
                                                                                have the capacity to detect and respond in a timely
        Following a mid-term review in 2014, the National
                                                                                manner to malaria epidemics by 2018.
        malaria strategy for the period 2009–2017, has
        been revised into the current Kenya malaria                             Objective 4: To ensure that all malaria indicators
        strategy 2009–2018. This malaria strategy                               are routinely monitored, reported, and evaluated in
        has been developed to guide malaria control                             all counties by 2018.
        interventions in the country with the aim to reduce
        malaria morbidity and mortality. The revision of
        the previous strategy was informed by the Kenya                         Objective 5: To increase utilization of all malaria
        health sector strategic plan (2014 – 2018), the                         control interventions by communities to at least 80
        Kenya health policy (2012–2030), the new political                      percent by 2018.
        dispensation that has devolved health some health
        roles and responsibilities from the national to                         Objective 6: To improve capacity in coordination,
        county governments in line with the Constitution                        leadership, governance, and resource mobilization
        of Kenya (2010), the Global technical strategy for                      at all levels towards achievement of the malaria
        malaria (2016–2030) and the Roll Back Malaria                           program objectives by 2018. During the mid-term
        Partnership’s action and investment plan to defeat                      review of the Kenya malaria strategy in 2014,
        malaria (2016–2030).                                                    objective 5, which is linked to malaria advocacy,
                                                                                communication and social mobilization (ACSM),
        The Kenya malaria strategy lays out the strategic                       was reviewed and revised from
        framework for malaria control interventions, which
        hinge on six strategic Objectives:
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        addressing knowledge of malaria control                                 1.2 Process
        interventions (which had been achieved by over                          In May 2016, the National Malaria Control
        90%) to increasing the use of malaria control                           Program led the process of developing this malaria
        interventions by communities in Kenya to at least                       communication strategy that builds on the Malaria
        80 percent by 2018. This document builds on                             communication strategy (MCS) 2010–2014. The
        the strategic objective for ACSM in the Malaria                         process entailed a desk study of available literature,
        communication strategy (2010–2014), to align it                         in-depth interviews with key stakeholders and
        with the new strategic objective.                                       program implementers, as well as a stakeholder
                                                                                consultative workshop.
        Devolution of government
        The Constitution of Kenya (2010) mandates the                           Developing this communication strategywas
        devolution of power to 47 counties. Health service                      based on consensus among multiple stakeholders
        delivery was devolved to the counties, with limited                     to ensure wide ownership. The review has been
        functions remaining at the national level, making                       informed by the Kenya malaria strategy (2009–
        counties key actors in achievement of the vision                        2018), the Global technical strategy for malaria
        of a malaria-free Kenya and, consequently, in                           (2016–2030), the Roll Back Malaria Partnership’s
        achieving 80 percent utilization of malaria control                     action and investment plan to defeat malaria
        interventions by 2018, as laid out in the Malaria                       (2016– 2030), the Strategic framework for malaria
        communication strategy. These changes have also
        seen the Division of Malaria Control evolve into the
        Malaria Control Unit, and now the National Malaria
        Control Program.

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        communication at the country level (2012– 2017),                        • Semi-arid zone: this zone includes the arid
        and the Roll Back Malaria Partnership’s BCC                               and semi-arid areas of the northern and south-
        indicators reference guide.                                               eastern parts of the country that experience
                                                                                  short periods of intense malaria transmission
        Developing this communication strategy entailed:                          during rainy seasons.
          • Reviewing relevant malaria ACSM documents                           • Low risk zone: this zone covers the central
            and survey reports to understand existing                             highlands of Kenya including Nairobi.
            issues and challenges
          • Undertaking key informant interviews with                           Implication:       Malaria     interventions   are
            relevant stakeholders                                               implemented selectively in the different
                                                                                epidemiological zones. This communication
          • Conducting a consultative workshop in May
                                                                                strategy will support targeted ACSM interventions
            2016 at Naivasha with stakeholders drawn
                                                                                that can be applied to each epidemiological zone.
            from the National Malaria Control Program, the
            ACSM technical working group and partners
                                                                                Ownership and use of long lasting
          • Drafting and circulating a zero draft of the                        insecticidal nets (LLIN)
            communication strategy based on the literature
                                                                                Ownership of LLINs has over the years been higher
            review, key informant interviews and workshop
                                                                                than use. However, between 2010 and 2015 there
            report
                                                                                has been an increasing trend in LLIN use among
          • Convening an ACSM technical working group                           pregnant women and children under 5 years. KMIS
            meeting in June 2016 with relevant partners to                      (2015) showed that household LLIN ownership
            present the zero draft and receive comments                         stood at 63 percent with each household owning at
            for further review                                                  least 1 LLIN; 40 percent of these households had
          • Revising the zero draft and developing a first                      at least
            draft based on comments received
                                                                                one LLIN for every two people - an indicator of
          • Subjecting the first draft to external peer review
                                                                                universal coverage - who stayed in the house the
          • Presenting the second and third draft to
                                                                                previous night. In 2010, 39 percent of children
            stakeholders for validation
                                                                                under 5 slept under a LLIN the night before the
          • Presenting the 3rd draft to the Malaria                             survey compared to nearly more than half of the
            Interagency Committee                                               children in 2015. Among pregnant women, LLIN
                                                                                use has increased from 36 percent in 2010 to 58
        1.3 Literature Review Findings and
                                                                                percent in 2015. The overall usage of LLINs stood
            Implications
                                                                                at 48 percent, with 56 percent of children below 5
        The findings of the Kenya malaria indicator survey                      years and 58 percent pregnant women having slept
        (2015) were used to develop the communication                           under an LLIN the previous night. Ninety percent
        strategy. The main findings are highlighted below:                      of the respondents were confident of hanging up
                                                                                LLINs and knew the importance of sleeping under
        Malaria epidemiology
                                                                                a LLIN. Sixty percent of the LLINs were in good
        Kenya has four malaria epidemiological zones.                           condition.
        • Highland epidemic zone: this includes the
          western highlands of Kenya where malaria                              Implication: The strategy advocates consistent
          transmission is seasonal with considerable year-                      communication around use of treated nets to
          to-year variation; when climatic conditions are                       address barriers hindering use of LLINs.
          favorable malaria epidemics occur.
        • Endemic zone: this zone includes areas around
          around Lake Victoria in western Kenya and the
          coastal region where malaria transmission is
          stable.
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        communication at the country level (2012– 2017),                        • Semi-arid zone: this zone includes the arid
        and the Roll Back Malaria Partnership’s BCC                               and semi-arid areas of the northern and south-
        indicators reference guide.                                               eastern parts of the country that experience
                                                                                  short periods of intense malaria transmission
        Developing this communication strategy entailed:                          during rainy seasons.
          • Reviewing relevant malaria ACSM documents                           • Low risk zone: this zone covers the central
            and survey reports to understand existing                             highlands of Kenya including Nairobi.
            issues and challenges
          • Undertaking key informant interviews with                           Implication:       Malaria     interventions   are
            relevant stakeholders                                               implemented selectively in the different
                                                                                epidemiological zones. This communication
          • Conducting a consultative workshop in May
                                                                                strategy will support targeted ACSM interventions
            2016 at Naivasha with stakeholders drawn
                                                                                that can be applied to each epidemiological zone.
            from the National Malaria Control Program, the
            ACSM technical working group and partners
                                                                                Ownership and use of long lasting
          • Drafting and circulating a zero draft of the                        insecticidal nets (LLIN)
            communication strategy based on the literature
                                                                                Ownership of LLINs has over the years been higher
            review, key informant interviews and workshop
                                                                                than use. However, between 2010 and 2015 there
            report
                                                                                has been an increasing trend in LLIN use among
          • Convening an ACSM technical working group                           pregnant women and children under 5 years. KMIS
            meeting in June 2016 with relevant partners to                      (2015) showed that household LLIN ownership
            present the zero draft and receive comments                         stood at 63 percent with each household owning at
            for further review                                                  least 1 LLIN; 40 percent of these households had
          • Revising the zero draft and developing a first                      at least
            draft based on comments received
                                                                                one LLIN for every two people—an indicator of
          • Subjecting the first draft to external peer review
                                                                                universal coverage—who stayed in the house the
          • Presenting the second and third draft to
                                                                                previous night. In 2010, 39 percent of children
            stakeholders for validation
                                                                                under 5 slept under a LLIN the night before the
          • Presenting the 3rd draft to the Malaria                             survey compared to nearly more than half of the
            Interagency Committee                                               children in 2015. Among pregnant women, LLIN
                                                                                use has increased from 36 percent in 2010 to 58
        1.3 Literature Review Findings and
                                                                                percent in 2015. The overall usage of LLINs stood
            Implications
                                                                                at 48 percent, with 56 percent of children below 5
        The findings of the Kenya malaria indicator survey                      years and 58 percent pregnant women having slept
        (2015) were used to develop the communication                           under an LLIN the previous night. Ninety percent
        strategy. The main findings are highlighted below:                      of the respondents were confident of hanging up
                                                                                LLINs and knew the importance of sleeping under
        Malaria epidemiology
                                                                                a LLIN. Sixty percent of the LLINs were in good
        Kenya has four malaria epidemiological zones.                           condition.
        • Highland epidemic zone: this includes the
          western highlands of Kenya where malaria                              Implication: The strategy advocates consistent
          transmission is seasonal with considerable year-                      communication around use of treated nets to
          to-year variation; when climatic conditions are                       address barriers hindering use of LLINs.
          favorable malaria epidemics occur.
        • Endemic zone: this zone includes areas around
          around Lake Victoria in western Kenya and the
          coastal region where malaria transmission is
          stable.
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        Prevention of malaria in pregnancy                                      Malaria Case Management
        Prevention of malaria during pregnancy targets all                      KMIS (2015) showed that 72 percent of the
        pregnant women in 14 malaria endemic counties.                          respondents sought advice on treatment during the
        The women receive three doses of intermittent                           onset of fever with 75 percent of these respondents
        preventive treatment in pregnancy (IPTp) with                           visiting a public health facility while 18 percent
        Sulphadoxine-pyrimethamine (SP) during visits                           sought treatment from a faith-based facility. Thirty-
        to antenatal clinic. KMIS (2015) showed that 94                         nine percent of those who sought treatment had a
        percent of the respondents in the survey attended                       parasitology test carried out with 91 percent of the
        antenatal clinics during their last pregnancy; 56                       respondents reported having received artemisinin-
        percent of the respondents received at least two or                     based combination therapy, 60 percent received
        more doses of IPTp while 38 percent receiving three                     treatment on the same or the next day; 43 percent
        or more doses. The report on knowledge, attitude,                       of the respondents could recognize the nationally
        beliefs and practices on the 10 key child survival                      recommended artemisinin-based combination
        development and protective behaviour (KABP),                            therapy (ACT)/Artemether Lumefantrine (AL).
        2016 stressed the fact that ANC coverage is lower                       Knowledge of ACT/AL among women declined
        among women who need it the most: the poor, less                        slightly from 56 percent in 2010 to 53 percent
        educated, and those living in rural areas. There is a                   in 2015. The National Malaria Control Program is
        common belief that pregnancy is often perceived as                      undertaking projects aimed at increasing the use
        a natural process of life. This perception may make                     of rapid diagnostic tests in the private sector, and
        women, families and communities underestimate                           changing national policy to allow point-of-service
        the importance of ANC. Studies reviewed in this                         testing at registered pharmacies. Pilot projects
        report also suggested that the lack of knowledge                        are also ongoing in the coastal counties of Kilifi,
        about danger signs in pregnancy may make women                          Kwale and Mombasa with the objective to increase
        and families not know how to seek care when a                           access to use of rapid diagnostic tests through the
        complication occurs during pregnancy.                                   private sector.

        Implication: The strategy aims to integrate                             Implication: Because most respondents (75
        messages that encourage pregnant women to                               percent) sought treatment from public health
        attend antenatal clinic as soon as they discover                        facilities, this communication strategy proposes
        they are pregnant to receive at least three or more                     the use of a two-pronged communication
        doses of IPTP, as well as continue to leverage                          approach targeting both health workers and
        on the partnership with the department of                               caregivers. Communication efforts for health
        reproductive health and other partners to increase                      workers as change agents will focus on ncreasing
        uptake of IPTp.                                                         acceptance and use of malaria testing before
                                                                                treatment. For caregivers communication efforts
                                                                                will focus on prompt seeking behavior on onset of
                                                                                fever and request for malaria test.

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        Malaria and Anemia                                                      Sources of Information
        The Kenya Population and Housing Census (2009)                          The KMIS 2015 shows that radio and television
        showed that 43 percent of the population is less                        ownership stood at 70 percent and 36 percent
        than 15 years of age while KMIS (2015) results                          respectively. An impressive 90 percent of
        found that malaria prevalence to be high among the                      the households interviewed owned a mobile
        5–9 year olds at 10 percent and the 10–14-years                         phone. According to a report released by the
        age bracket with 11 percent. Prevalence was also                        Communication Authority of Kenya in 2015, radio,
        found to be high in the rural areas while the lake                      mobile phones and television are the leading
        region had the highest prevalence at 27 percent                         sources of information in Kenya and will continue
        and the coastal region at 8 percent.                                    being so for communities in the coming years.
                                                                                In 2013 Kenya moved from analogue to digital
        Implication: Investing in communication in                              broadcasting. Digital broadcasting saw a sharp rise
        school health programs is critical in reducing high                     in the number of TV stations. The report estimates
        prevalence among the 5–14-years old school-                             there are 130 radio stations, 61 TV Stations on
        going children. The NMCP has made initial efforts                       digital platform, 34 newspapers, 36.1 million
        towards implementing school health programs in                          mobile phone subscribers, 27.7 million mobile
        some counties. Results from these interventions                         money subscriptions and 29.6 million internet
        will be critical in informing future school health                      users. Vernacular radio stations continue to shape
        interventions. More ACSM interventions will                             the radio landscape with approximately 23.7 million
        be concentrated in rural areas where malaria                            listeners daily. The vibrant and solid media and ICT
        prevalence remains high.                                                infrastructure in Kenya provide wide coverage for
                                                                                disseminating messages.

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        Implication: Radio and mobile telephony can be                          1.4 Evaluation of Malaria Communication
        widely explored and continuously tracked to deliver                         Strategy (2010–2014)
        the intended behavior change.                                           While developing this strategy, it was important
                                                                                to review the previous strategy in order to
        Literacy
                                                                                appreciate its achievements, challenges faced in
        The KMIS (2015) showed that 87 percent of the                           its implementation and the lessons learnt. This
        respondents were literate; however, literacy levels                     section aims to leverage on the gains and make
        varied across different regions and counties.                           recommendations on overcoming challenges of
                                                                                the previous strategic period. During the mid-term
        Implication: Communication efforts will consider
                                                                                review of the KMS in 2014, the ACSM objective was
        literacy levels in each region or county.
                                                                                changed from increasing knowledge about malaria
        Gender                                                                  control interventions to utilizing malaria control
                                                                                interventions. ACSM interventions by the National
        While children and pregnant women are biologically
                                                                                Malaria Control Program and partners in the period
        more susceptible to malaria, gender differences
                                                                                after the review (2014– 2016) focused on utilization
        are compounded due to sociocultural norms and
                                                                                of malaria control interventions within the four
        expectations that influence patterns of exposure,
                                                                                key strategic interventions of the Kenya malaria
        decision making, and economics. Neglecting
                                                                                strategy 2009–2018.
        the role that gender plays will undermine efforts
        to reach crucial milestones and improvements                            The ACSM objective in the National malaria strategy
        in the health of families and communities in                            (2009–2017) aimed at “strengthening advocacy,
        Kenya. Understanding how gendered patterns                              communication and social mobilization (ACSM)
        of behavior influence exposure to mosquitoes,                           capacities for malaria control to ensure that at
        treatment decisions, and access to care can help                        least 80 percent of people in malarious areas had
        in developing more effective recommendations for                        knowledge of prevention and treatment of malaria
        preventing malaria infection (WHO, 2007). KMIS                          by 2014,” and deployed three key strategies to
        2015 indicated that 36 percent of households are                        achieve this objective:
        headed by women. While this data is important
                                                                                 • Strengthening the capacity for ACSM
        in understanding decision making within the
        household, it does not explain the challenges                            • Developing appropriate advocacy
        female-headed homes face in accessing and using                          • for uptake of specific malaria
        malaria control interventions.                                           • interventions
                                                                                 • Conducting multi-sector IEC/BCC
        Implication: With 36 percent of households
        headed by females, this communication strategy
        recognizes the important role women play in
        increasing the use of malaria interventions at
        household level.

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Malaria Communication Strategy National Malaria Control Programme 2016 - 2021

        Strategy 1:                                                             Strategy 2:
        Strengthening the capacity for ACSM                                     Developing appropriate advocacy for
                                                                                uptake of specific malaria interventions
        Achievements
        Working with partners, the National Malaria Control                     Achievements
        Program developed and disseminated the Malaria                          Advocacy activities heightened around the World
        communication strategy (2010– 2014), the Essential                      Malaria Day where stakeholders were rallied around
        malaria action (EMA) guidelines, the Community                          the day’s events. The office of the Malaria Goodwill
        educators manual on Malaria, and the Teachers                           Ambassador was established.
        and pupils guide on malaria. Various partners
        have used these documents to guide delivery of                          Gaps
        content during implementation of interventions.                          • In the absence of an advocacy strategy to
        Some partners made efforts to build the capacity                           guide collaboration and resource mobilization,
        of the ACSM unit and of health workers (both at the                        advocacy events have been limited and
        facility and in the community) through training in                         sporadic, and largely centered around World
        behavior change communication.                                             Malaria Day. This has denied the program the
                                                                                   advantages of sustained advocacy efforts and
        Gaps                                                                       therefore there has been no firm political will
          • Malaria is a socioeconomic burden and requires                         for malaria.
            sector wide participation. The engagement                            • The office of the Malaria Ambassador remained
            with the relevant non-health sectors was not                           vacant denying the country the benefits this
            optimally exploited.                                                   office could offer by lobbying for malaria action
          • Counties continue to rely on central funding,                          at the political level.
            with little resource mobilization being                              • Poor funding for the office of the Malaria
            undertaken at that level.                                              Goodwill Ambassador led to little or no
          • Where funding for ACSM activities exists, focus                        advocacy intervention within the political arena.
            has primarily been on endemic zones with little
            support given to seasonal and low risk zones.                       Strategy 3:
            The lack of a bare minimum ACSM package                             Conducting multi-sector IEC/BCC
            to ensure malaria infections in these seasonal
                                                                                Achievements
            and low risk areas remain low poses the risk of
            prevalence rising and hence, eroding the gains                      The National Malarial Control Program implemented
            achieved.                                                           community-based malaria SBCC programs in 12
                                                                                endemic and epidemic sub counties in western and
          • Weak coordination and reporting mechanism
                                                                                Nyanza regions. The results show that household
            between the National Malaria Control Program
                                                                                malaria indicators on use of interventions can be
            and the county teams responsible for malaria
                                                                                achieved by working through the community health
            control.
                                                                                strategy. NMCP through partners implemented
          • The role of the health promotion unit in                            branded behavior change communication
            the ACSM thematic working group needs                               campaigns on use of LLINs and prompt fever
            to be strengthened for malaria advocacy                             treatment— “Msimu wowote” and “Haraka Upesi”—
            communication and social mobilizations to be                        at the community level in malaria endemic sub
            sustainable in the country.                                         counties. These interventions were through radio
          • The roles, responsibilities and membership of                       and TV and interpersonal communication activities.
            the national ACSM thematic working group                            An evaluation of SBCC interventions indicated that
            have become blurred and erratic.                                    exposure to SBCC was strongly associated with net

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Malaria Communication Strategy National Malaria Control Programme 2016 - 2021

        use the previous night. Behaviour change                                Gaps
        interventions around indoor residual spraying and                        • Uptake of the community health strategy
        malaria in pregnancy were also undertaken. NMCP                            and interpersonal communication in malaria
        also conducted a pilot project to increase access                          ACSM was low; where they exist, reporting is
        to rapid diagnostic tests in the private sector.                           poor with partners using varied reporting tools
        Innovative research interventions around the                               and channels that have no link to the national
        malaria vaccine and rapid diagnostic tests are on                          reporting mechanism.
        going.
                                                                                 • Limited translation into vernacular of ACSM
                                                                                   messages to reach all target audiences.

        Strategy 3:                                                              • ACSM’s focus was largely on communities (and
        Conducting multi-sector IEC/BCC                                            largely women) with little or no effort or focus
                                                                                   directed to health workers despite the constant
        Achievements                                                               provider– patient interface.
        The National Malarial Control Program implemented                        • ACSM funding for malaria in pregnancy was
        community-based malaria SBCC programs in 12                                low. Low ACSM funding could lead to low
        endemic and epidemic sub counties in western and                           uptake of IPTp doses.
        Nyanza regions. The results show that household
        malaria indicators on use of interventions can be                       1.5 Potential Challenges and Implications
        achieved by working through the community health                            for Malaria Communication Strategy
        strategy. NMCP through partners implemented                                 Implementation
        branded behavior change communication                                   Table 1 provides a summary of potential challenges
        campaigns on use of LLINs and prompt fever                              (and implications) that could hinder implementation
        treatment— “Msimu wowote” and “Haraka Upesi”—                           and achievement of positive outcomes of the
        at the community level in malaria endemic sub                           revised Malaria communication strategy.
        counties. These interventions were through radio
        and TV and interpersonal communication activities.
        An evaluation of SBCC interventions indicated
        that exposure to SBCC was strongly associated
        with net use the previous night. Behaviour change
        interventions around indoor residual spraying
        and malaria in pregnancy were also undertaken.
        NMCP also conducted a pilot project to increase
        access to rapid diagnostic tests in the private
        sector. Innovative research interventions around
        the malaria vaccine and rapid diagnostic tests
        are on going.

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Malaria Communication Strategy National Malaria Control Programme 2016 - 2021

  Table 1. Potential Challenges and Implications

      Challenges                                       Implications

      Weak links between the national                   • Low funding and prioritization of malaria ACSM activities
      and county malaria programs
                                                        • Poor delivery of ACSM interventions in counties
                                                        • Poor allocation of limited resources for malaria at the community
      Inter-sector collaboration is weak                  level as a result of duplication of partner activities
      nationally
                                                        • Over-reliance by county governments on funding from the National
                                                          Malaria Control program for ACSM activities
                                                        • Uncertainty in the devolution process regarding roles and
                                                          responsibilities where malaria control might not be prioritized
                                                        • Poor integration of health and non-health sectors resulting in low
                                                          leverage of ACSM resources amongst partners that could potentially
                                                          increase mileage for ACSM

      The roles, responsibilities and                   • Declining inter-sectoral collaboration
      membership of the ACSM TWG
      have become blurred and erratic

      Low communication capacity                        • Delayed ACSM technical assistance to counties
      among ACSM staff at NMCP

      Absence of an active advocacy                     • Low funding and prioritization of malaria ACSM activities
      strategy
                                                        • Limited, inconsistent and sporadic advocacy events

      Low uptake of the community                       • Low behaviour change at the household level—cultural barriers such
      health strategy in delivery                         as taboos and misconceptions around malaria remain challenges to
      of malaria interventions at                         prevention and care seeking in rural communities
      household level as well as lack of
      understanding of interpersonal
      communication

      Partners have varied monitoring                   • Difficulty in showing attribution
      and reporting tools that have
      no link to the national reporting                 • Apathy in funding ACSM activities
      mechanism.                                        • Lessons learnt cannot easily be integrated into subsequent
      Low or no documentation of best                   • interventions
      practices.

      Low capacity and commitment of                    • Poor delivery at the point of contact in the health facilities and in
      health workers on ACSM                              homes

      Underutilized school health                       • Increasing prevalence among children age 5–14 years
      program where children can be
      used as change agents for malaria
      control

      Low funding for malaria in pregnancy              • Malaria in pregnancy ACSM outcomes may continue to lag
      ACSM activities

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Malaria Communication Strategy National Malaria Control Programme 2016 - 2021

        1.6 Problem Statement
        Based on the situation analysis and review of the                       prioritization of malaria interventions remain low
        communication gaps and needs assessment, the                            at community and household s due to suboptimal
        core problem for malaria ACSM in Kenya that this                        implementation of malaria ACSM activities as a
        malaria communication strategy seeks to address                         result of weak links administrative units between
        is captured in the statement below:                                     national and county levels coupled with inadequate
                                                                                capacity and skills in ACSM among program and
        Despite increased access to malaria control
                                                                                health workers, in addition to low funding of ACSM
        interventions by communities in Kenya, use and
                                                                                activities.

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Malaria Communication Strategy National Malaria Control Programme 2016 - 2021

      2 Malaria Communication
        Strategy

        2.1 Goal of the Communication Strategy                                  Communication Behavior change communication
        The goal of the communication strategy is to                            is a crucial component in changing social norms;
        implement a coordinated program that will achieve                       addressing myths and misconceptions; and
        behavioral change at political, service delivery,                       improving knowledge, attitudes and practices
        community and individual levels. Behaviour change                       around malaria control among various groups of
        will be achieved through providing guidance to                          people. Effective behavior change communication
        all stakeholders and partners implementing the                          and messages need to convey more than just the
        advocacy, communication and social mobilization                         medical facts because on their own these facts
        agenda within strategic objective 5 of the revised                      do not necessarily motivate people to action. The
        KMS 2009–2018 to ensure coordination of effort,                         messages should explore the reasons why people
        messages, activities and reporting during the                           do or do not take action on the information they
        implementation period. The strategy will also guide                     receive, then focus on changing the actual behavior
        counties and sub-counties in developing social                          by addressing the causes identified, e.g. social
        behavior change communication (SBCC) plans that                         norms or personal attitudes.
        address specific behavioral challenges within each                      Behavior change communication is a set of
        county context.                                                         organized communication interventions and
        Aspirational values that will guide the                                 processes aimed at influencing social and
        communication function for the NMCP include:                            community norms and promote individual behavioral
        relevance, accuracy, integrity, transparency,                           change or positive behavior maintenance for a
        currency, open communications (two way including                        better quality of life…it is based on proven theories
        feedback mechanisms), flexibility and adaptability.                     and models of behavior change.
                                                                                Communication for Social Change – engage
        2.2 Approaches to Implementing the                                      & empower communities/networks to influence/
            Communication Strategy                                              reinforce social norms: human resource & time
        The communication strategy will use three                               intensive
        approaches:                                                             Social Mobilization brings together community
        Advocacy to ensure that the national government,                        members and other stakeholders to strengthen
        policymakers, donors and media i) remain engaged,                       community participation for sustainability and self-
        ii) are strongly committed to improving laws and                        reliance. Social mobilization generates dialogue,
        policies for malaria control, iii) allocate funds for                   negotiation and consensus among players. At the
        malaria control and iv) malaria control remains in                      heart of social mobilization is the need to involve
        the public agenda.                                                      people who are most affected by malaria. Mobilizing

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Malaria Communication Strategy National Malaria Control Programme 2016 - 2021

        resources, building partnerships, networking and                          4. To harmonize malaria ACSM activities
        community participation are all key strategies for                           implemented by the different partners.
        social mobilization Specific activities include group
        and community meetings, partnership sessions,                           The malaria communication strategy complements
        school activities, traditional media, music, song                       the revised KMS 2009–2018. The strategy covers a
        and dance, road shows, community drama, soap                            5 year period 2016–2021 beyond the lifespan of the
        operas, puppet show, karaoke songs and contests.                        KMS 2009–2018. It is anticipated that the midterm
        Other activities unique to a particular county or                       review of this strategy will be in 2018 (which is the
        region may provide even better opportunities to                         anticipated end term review of the current KMS
        engage and motivate individuals. Communication
                                                                                2009–2018) with an end term review in 2021.
        programs generally produce the best results when
        they work across these multiple levels.
                                                                                Guiding Principles
        A single effort has less impact than collective                         The following principles will underpin the
        effort. Although distinct elements, advocacy,                           planning, implementation and monitoring of the
        communication and social mobilization are most                          communication strategy:
        effective when used together. ACSM activities
        should therefore be developed in parallel and not                       Epidemiology- based intervention: ACSM
        separately. Chapter 3 provides details of how the                       interventions will be implemented based on the
        National Malaria Control Program will i) engage                         different epidemiological zones as outlined in the
        with the national government, decision makers                           National malaria policy (2010).
        and media to provide an enabling environment
                                                                                Local context approach: the strategy will
        through supportive policies and legislation for
                                                                                recognize, appreciate and make use of local
        malaria control; and ii) work with its partners
                                                                                structures and knowledge to facilitate the desired
        such as county governments, community health
                                                                                change.
        services and health promotion unit to deliver key
        malaria interventions through community units                           Evidence based interventions: Communication
        and networks to deliver health service closer to                        planning will utilize accurate data and theory to
        households.                                                             inform and guide the activities.
        2.3 Strategic Communication Goal                                        Gender       considerations: gender-related
        To increase the use of malaria interventions at                         information is crucial in program planning, data
        household level to 80 percent by 2018 through                           collection, monitoring and evaluation to raise
        well-coordinated malaria ACSM activities.                               awareness of gender imbalances, advocate for
                                                                                change, address gender dimensions of health, and
        2.4 Specific Objectives
                                                                                demonstrate program progress and impact.
           1. To influence positive behavior change among
              target audiences with regard to malaria                           Ownership: clear and consistent interaction
              control behavior that will helps to reduce the                    with county government is critical for coordinated
              incidence of malaria in Kenya.                                    response.
           2. To galvanize action around malaria Through
              advocacy aimed at increasing funding for                          Public private partnerships: Engaging in
              malaria by county governments and to                              public private partnerships for malaria ACSM
              strengthen links between the national and                         will strengthen and accelerate efforts towards
              county governments.                                               increasing utilization of malaria interventions.
           3. To strengthen coordination and linkages of
                                                                                Sustainable      interventions: The strategy
              ACSM interventions and improve the flow
                                                                                envisages creating positive and sustainable
              (dissemination) of information to key target
                                                                                behavior change by utilizing a variety of approaches
              audiences at national, county, community
                                                                                that are cost effective, evidence based and
              and household levels through a planned and
                                                                                appropriate within the Kenyan context
              systematic series of activities and channels.
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Malaria Communication Strategy National Malaria Control Programme 2016 - 2021

      3. Key Strategic Interventions

        This communication strategy has four strategic                            ACSM program staff at the NMCP through
        interventions that will be implemented in the                             training, coaching, mentoring and enhancing
        strategic period 2016 –2021. The strategy will                            ACSM skills. This strategy recommends
        support the achievement of objective five of the                          institutionalizing key skills and expertise
        KMS 2009–2018 through advocacy, behaviour                                 required in the unit and drawing up a capacity-
        and social change communication and social                                building plan for staff to ensure that they are
        mobilization approach. The four strategic areas are:                      well trained to offer technical support to county
                                                                                  governments. Capacity building at national and
            1. To strengthen structures for the delivery of                       county levels will be a key component to achieve
               ACSM interventions at all levels                                   the objectives laid out in this communication
            2. To strengthen program communication for                            strategy.
               increased utilization of malaria interventions
                                                                                • The national ACSM technical working group
               at household level
                                                                                  will provide leadership and guidance in
            3. To increase inter-sector advocacy and
                                                                                  the implementation of the communication
               collaboration for malaria intervention
                                                                                  strategy. Over the years, roles, responsibilities
            4. To strengthen community-based social and
                                                                                  and membership of the working group have
               behavior change communication activities for
                                                                                  become blurred and erratic and this calls for
               all malaria interventions
                                                                                  rejuvenation of membership. The strategy
        3.1 Strengthen structures for the delivery                                calls for expanding the scope of the group to
            of ACSM interventions at all levels.                                  include new partners in the various sectors
                                                                                  that influence malaria control. The group
        Four activities will be undertaken under this
                                                                                  will continue to meet every quarter to review
        strategic objective.
                                                                                  progress in implementation of the strategy
        Strengthen national level ACSM coordination                               and facilitate decision making through the
                                                                                  development of an integrated annual work
        The NMCP through the ACSM unit will be
                                                                                  plan that captures activities implemented by
        responsible for overseeing the implementation of
                                                                                  the national program and partners. The terms
        the MCS 2016–2021. NMCP’s role will be to build
                                                                                  of reference and membership of the ACSM
        capacity and provide mentorship and technical
                                                                                  technical working group is in Annex 1. The
        assistance to counties on ACSM, formulate
                                                                                  health promotion unit will continue to chair
        policy and guidelines, develop strategic plans and
                                                                                  the quarterly ACSM technical working group
        coordinate with all partners.
                                                                                  meetings.
          • The ACSM unit requires technical expertise on
            ACSM to successfully fulfill these functions.
            This calls for strengthening the capacity of

 22
Malaria Communication Strategy National Malaria Control Programme 2016 - 2021

        Strengthen county level Malaria ACSM                                    to the county malaria context as outlined in the
          • The national ACSM TWG and partners will work                        county malaria profiles. County SBCC plans will
            closely with the Health Promotion Unit through                      guide county-specific malaria interventions and will
            health promotion advocacy committees (HPACs)                        be a tool for mobilizing resources in the county.
            at the county to articulate and strengthen                          The NMCP ACSM unit will continuously provide
            delivery of malaria ACSM interventions. HPACs                       technical guidance and training to counties to
            are county ACSM technical working groups that                       ensure malaria remains a priority at the county and
            bring together actors and stakeholders across                       that new county ACSM staff are well trained on
            all health areas to discuss and determine the                       malaria ACSM.
            direction of the health promotion agenda.
                                                                                NMCP will also continue to support counties in
            HPACs also provide a platform for lobbying
                                                                                ACSM implementation of national policies and
            and pooling of ACSM resources. The national
                                                                                guidelines and in ACSM campaigns like mass
            ACSM technical working group will work
                                                                                distribution of nets and malaria vaccine, as and
            with county malaria teams to ensure that the
                                                                                when required.
            malaria agenda is well articulated and that
            there is adequate representation during HPAC                        3.2 Strengthen program communications
            meetings. Implementing partners will continue                           for increased use of all malaria
            to play a critical in the delivery of malaria ACSM                      interventions
            at the community levels; hence their areas of
                                                                                Behaviour and social change communication
            coverage need to be mapped out so that gaps
                                                                                is evidence based and is most effective when
            and areas of need are identified for support.
                                                                                combinations of approaches are used, weaving
        The national ACSM TWG will also liaise with the                         together mass media, interpersonal communication
        Community Health Services (CHS) to provide a                            and structural approaches to promote new or
        platform for delivering key malaria interventions                       modified behaviors. This multimedia approach is
        at the household level through the network                              therefore recommended in the implementation of
        of community health volunteers across the                               ACSM malaria control interventions. The following
        counties. This will include reviewing the content of                    activities will be undertaken to achieve this
        malaria training, defining the volunteers’ role in                      objective.
        supporting malaria control interventions at the
        community level, and ensuring that key malaria                          Review of existing malaria messaging and
        ACSM indicators captured by the district health                         branding and establishment of an online
        information system (DHIS).                                              repository
                                                                                The ACSM TWG will bring together the other TWGs—
        Support counties to develop malaria
                                                                                case management, vector control and malaria
        communication plans
                                                                                in pregnancy—to review messages and materials
        NMCP will scale up ACSM capacity of implementers                        to ensure they are up to date and relevant. The
        in counties and sub counties through training county                    following activities will be undertaken:
        health teams in SBCC. Trainers of trainers will be
        identified in each county to ensure sustainable and                     a) Review existing information education and
        effective programming over time.                                           communication (IEC) material and development
                                                                                   NMCP and partners will seek to collate, review
        NMCP has trained county health promotion teams                             and establish an inventory of all the IEC materials
        across 29 counties on ACSM and it is anticipated                           and messages both print and audio related to
        that all the 47 counties will be trained in ACSM and                       malaria to ensure their relevance and alignment
        county SBCC plans will be developed during the                             with the malaria communication strategy.
        training sessions. The SBCC plan will be adapted

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Malaria Communication Strategy National Malaria Control Programme 2016 - 2021

        b) NMCP will also review its malaria branding and                       Development and dissemination of tailored
           slogans used over time and adopt a national                          communication on surveillance and epidemic
           and unifying theme and slogan. The strategic                         preparedness for highland epidemic, semi-
           objective of branding aims at strengthening                          arid and low risk zones
           NMCP’s public standing. This role requires                           This strategy recommends development and
           NMCP to maintain a consistent corporate                              dissemination of focused malaria ACSM intervention
           image and identity in all its internal and external                  packages (targeted to health workers, community
           engagements. The key principles underpinning                         health volunteers and the community) for the four
           NMCP branding and corporate identity shall                           epidemiological zones, as outlined in the Kenya
           include:                                                             malaria policy 2009–2018. The ACSM package
                                                                                aims at providing impetus for county governments
                                                                                in highland epidemic, semi-arid and low zones
                                                                                to continuously lobby for prompt care seeking
                                                                                behavior, epidemic preparedness and surveillance
                                                                                interventions. The ACSM packages will close the
            i. NMCP will promote its logo and slogan
                                                                                gap identified in the previous strategy (where little
               (Komesha Malaria, Okoa Maisha) to all its
                                                                                ACSM attention was given to these areas, hence
               partners and stakeholders. The NMCP brand
                                                                                posing the risk of resurgence of malaria).County
               will be projected in all its documents e.g.
                                                                                governments supported by the NMCP will support
               correspondence,, PowerPoint presentations,
                                                                                the development and dissemination of messages.
               and advertisements and any other form of
                                                                                Counties will be encouraged to secure resources
               publicity.
                              REPUBLIC OF KENYA
                                                                                and print their own IEC materials based on national
                                                                                guidelines and templates.

                                                                                Scale up routine multi-media activities
                                                                                NMCP will, with support from partners, conduct
                         MINISTRY OF HEALTH                                     multi-media campaigns for interventions that cut
            ii. The MOH–GoK logos will also be promoted                         across all malaria epidemiological zones. Multi-
                ensuring the ministry’s name is mentioned at                    media activities will be targeted to various audiences
                all times as Ministry of Health, placed below                   addressing key malaria control challenges.
                the words Republic of Kenya, which also                         Multiple media platforms that will be used include:
                define the complete and proper use of the
                                                                                Mass media. Mass media channels can reach
                Coat of Arms of the Republic of Kenya.
                                                                                large numbers of beneficiaries at a low to moderate
            iii. The NMCP corporate colors derived from the                     cost, and are an excellent means of increasing
                 logo portrait are predominantly blue and red,                  awareness about the gravity of malaria.
                 as in the revised Kenya malaria strategy 2009–                 NMCP with support from partners will conduct mass
                 2018 and in this document. All publications,                   media campaigns for interventions that cut across
                 correspondence and promotional materials                       all malaria epidemiological zones on promotion
                 must be clearly identified with this image that                of effective malaria diagnosis and treatment and
                 will be placed prominently.                                    communicating risk preparedness as part of malaria
                                                                                surveillance. Focus will be on using regional media
            c) Establish an online repository The materials
                                                                                channels that offer interactive radio programs
               and messages will be maintained in an online
                                                                                where communities can dialogue with county, sub-
               repository on the NMCP website as per the
                                                                                county and local implementing partners. The shift
               relevant strategic interventions areas. This
                                                                                from analogue to digital broadcasting has seen a
               will ensure counties and partners easily
                                                                                rise in the number of television stations in Kenya.
               access the materials, and avoid duplication of
               messaging.

 24
Malaria Communication Strategy National Malaria Control Programme 2016 - 2021

        Talk shows and advertisement around malaria                             communities that can target health careworkers,
        control will spur family discussions and deliver                        women groups including pregnant mothers, and
        intended message through vision and sound. It                           distributing content online. It is recommended that
        is imperative though for partners to establish                          the roll out for social media be gradual, and proper
        television viewership rates of their target audiences                   surveillance be in place to ensure that issues that
        before ad placement and ensure they place adverts                       arise are picked up and addressed.
        where they will reap maximum impact.                                    Outdoor advertising: can serve the purpose of
                                                                                increasing awareness and recall. This could include
        Mobile phone and social media penetration
                                                                                billboards, wall branding, signages, bus branding.
        and use:
                                                                                Print materials: serve two purposes: advocacy
        Mobile ownership and social media platform
                                                                                and educational. Newspapers and brochures can
        have grown rapidly in Kenya. KMIS (2015) places
                                                                                serve as advocacy materials to attain political
        ownership of mobile phones at 90 percent, it is
                                                                                goodwill. Comic books, posters and magazines
        however unclear the level of social media penetration
                                                                                serve an educational purpose. Use of comic books
        and use amongst the malaria audiences especially
                                                                                for school health programs will go a long way in
        in the rural areas. The short messaging service
                                                                                creating an engaging platform for school going
        (SMS) provides opportunity for sending messages
                                                                                children to engage in issues around Malaria.
        to pregnant women reminding them of their next
        date for antenatal visit, as a way of increasing                        Table 2 provides a matrix that outlines key malaria
        uptake of IPTp. Social media platforms such as                          control interventions, target audiences, key
        Facebook and Twitter can explore innovative ways                        messages and channels.
        of engaging malaria audiences; building new online

    Table 2. Key audiences, messages and channels
       Intervention         Target audience                 Key messages                                  Channels
      LLIN use             Primary: Head of                Ensure LLINs are hung up properly             Mass media radio & TV
                           households and                  Ensure everyone, especially children          Mobile phone
                           school-going children           under 5 and pregnant women sleeps
                           (5–14 years)                                                                  Outdoor advertising
                                                           under an LLIN every night
                           Secondary:                                                                    IPC
                           Household members
      Case                 Primary:                        Take prompt action towards diagnosis          Mass media radio & TV
      management           Individual patient and          and treatment of malaria with                 Mobile phone
                           health worker                   recommended ACT/AL
                                                                                                         Out of home
                           Secondary:                      Caregivers should demand for a test
                           Caretaker of a                                                                IPC
                                                           Complete the malaria treatment
                           sick child                      prescribed
      Malaria in           Primary:                        Attend antenatal care services as soon        IPC–women’s group, health
      pregnancy            Pregnant women                  as she realizes she is pregnant early         talks and household visits
                           Secondary: Spouses              and regularly.                                Mobile messaging
                           and mothers-inlaw               Take at least 4 doses of SP                   Radio TV Posters
                                                           Sleep under an LLIN every night and
                                                                                                         Social Media
                                                           after delivery
      IRS                  Primary:                        Household heads accept IRS in                 Mass media: radio & TV
                           Household head                  the house                                     Mobile phone
                           Secondary:                      Household members adhere to key
                           All household                                                                 Outdoor advertising
                                                           actions that follow IRS in the house
                           members
                                                           Household head to accept to remove
                                                           belongings during spraying
                                                                                                                                       25
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