Effectiveness of Strategy of Communication For BehavioralImpact (COMBI) in Increasing the Utilization of Insecticide

Abstract

A quasi - experimental community based study was conducted in Blue the Nile State with the aim of increasing utilization rate of ITNs to combat malaria. The study followed the quasi-experimental design. It consists of two groups experimental and control. For the purpose of pre- and post-intervention surveys a sample of 73 households from Alaardaiba village (Control) and sample of 75 households from Shin Tashrab village (experimental) have been chosen. The total sample size is 148 households, using random sampling (EPI INFO Program) according to formula: n = Z 2PQ D2 Structured questionnaire, observation, interviews and focus group discussion were used for data collection, Data analysis was conducted using SPSS computer software program. Base line data was collected from two villages to make a clear situation analysis so as to outline and determine the intervention components. A comprehensive health education and IEC campaigns were conducted in the experimental village according to the COMBI strategy on the bases of the situation analysis findings. Results of this study concluding in the following: • The acceptance and use of ITNs was increased significantly in the experimental group from 8% in base line data (BLD) preintervention to 48% in the post survey after COMBI intervention (OR= 4.8),while there is no significant change in control group. • Time of erecting and holding ITN changed from at night (28%) to before sunset from (78.7%) in the experimental group, while that in the control remained without change. • The provision of ITNs to be used by children under five years increased from (64%) to (85.3%) in experimental group. No significant change was observed in the control group. • There is a very high significant difference (P < 0.05) between households using ITNs all round the year and on daily bases the in experimental group, while, there is no significant difference (P > 0.05) in the control group. • The study indicated that a very high significant difference (P < 0.05) between households using their ITNs the night before the survey in experimental group, while, there is no significant difference (P > 0.05) in control group. • The prevalence of malaria decreased by (5%) after the intervention compared with that before the intervention (base line) data from 29.3% to 24.3%. The study concluded with three most important recommendations: • COMBI strategy should be sustained in the country to dispel any misconceptions related to ITNs and to ensure that ITNs are double size and can fit for two persons, specially children under five years and pregnant women. • Any new distribution of ITNs in the country should take into consideration the family size. • Replication of COMBI strategy in other states in Sudan to see if it brings the same results