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Badilisha Tabia, Tokomeza Malaria (Change Behaviour to Eradicate Malaria)


In the Simiyu and Shinyanga regions of Tanzania, some people don’t perceive malaria as a risk, even though it causes many deaths. Many do not take action to prevent the disease or seek treatment for malaria symptoms early enough.

T-MARC’s Badilisha Tabia, Tokomeza Malaria (Change Behaviour to Eradicate Malaria) project aimed to engage communities on malaria prevention and treatment towards positive health-seeking behaviours. This was done through a mix of Social Behaviour Change Communication (SBCC) activities targeting pregnant women, lactating mothers, and children under the age of 5 through their caretakers.

The project worked with community health workers to reach the target audience and their surrounding communities. One-to-one sessions, house visits, marketing such as posters, cultural theatre events were all used as methods to encourage people to access health services and promote preventative behaviours. The project also used radio programmes to convey important health messaging to reach the target audience.

T-MARC also engaged with the government at national, regional and district levels to support their malaria control initiatives. Biolarviciding is an important element of the government’s integrated vector control management strategy, and T-MARC’s support in the procurement of biolarvicides, spraying equipment and training of community health workers was highly appreciated by the government. The government planned to gather evidence from the T-MARC experience and advocate for biolarvicide funding with bi-lateral partners.

The successes of the project included an improvement from baseline on care seeking practices for children under 5 with febrile illness and adherence to treatment regimen. Also, the work done to improve the health workers’ interpersonal communication skills resulted in the project beneficiaries having positive perceptions on the healthcare services provided.

Key learnings

Health seeking behaviours are dynamic

Environmental factors such as poor transport infrastructure, the outbreak of an infectious disease (e.g. Covid) deterring people from traveling to seek help, and medicine stock-outs must be accounted for when strategising the delivery of SBCC messages.

Biolarviciding works, but not as a stand-alone vector control activity.

It needs to be integrated with other cost-effective options.

Key statistics

  • There was a significant increase in knowledge on net care and repair by pregnant women, lactating mothers and female caretakers of children under 5, going from 54% of baseline respondents to 91% of endline respondents.

  • There was an increase in the health seeking behaviours of caretakers for children under 5 from 81.2 % to 89% (1% shy of the target set).

  • The proportion of targeted audiences reporting ‘barriers’ to prompt (within 24 hrs) diagnostic testing for suspected malaria went down from 81.5% to 53% at endline.

  • The target for the proportion of wards reporting Community Health Workers (CHW) larviciding activities taking place as the result of project training was set at 50%. The endline result exceeded this, finishing at 77% of the wards.

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