Community change agents - getting a deeper understanding of malaria prevention

The Communication and Malaria Initiative in Tanzania (COMMIT) works to change social norms and foster self-efficacy around malaria prevention and treatment among communities and individuals. The project includes over 1,200 Community Change Agents (CCAs) responsible for mobilizing and empowering communities. More than 8.8 million people have been reached directly with malaria messages through home visits, group talks, school-based activities, and community-initiated events led by these CCAs. A qualitative assessment examined the contribution of the CCA program in changing individual and community behaviors for malaria prevention and treatment. Focus group discussions were conducted with the CCAs, and in-depth interviews were conducted with members of the communities where CCAs work.

Results showed community members felt the CCAs provided detailed information on malaria prevention through their interpersonal communication (IPC), which then resulted in positive individual and community change. Improved understanding of malaria encouraged sleeping under nets every night to avoid night-biting mosquitos, and contributed to prompt treatment of fever at health centers, rather than traditional healers. Respondents understood their susceptibility to and severity of malaria, and were able to take appropriate prevention and treatment actions as advised by the CCAs. They saw the CCAs as “doctors” of malaria information. CCAs provided information in understandable terms and in line with their community culture. People reported they were not only able to change their behaviors, but in turn initiated community discussions with those not involved in outreach activities. This is a successful replicable model that can incorporate other health prevention and treatment topics.