Roll Back Malaria Progress & Impact Series: Focus on Mainland Tanzania

This 72-page evaluation report, published by the Roll Back malaria Partnership and the World Health Organisation, shares finding of an assessment of Tanzania's National Malaria Control Programme (NMCP). According to the report, the success of malaria control in Tanzania is due to many factors, including strong, continuous, and enthusiastic leadership from the government and from the NMCP; availability of the right resources in the right place at the right time; strong political support and involvement from government, donor, and technical assistance agencies working together as one team; a shared vision by stakeholders; and a public that is receptive to malaria interventions. Besides reporting on the impact of activities implemented around the distribution of insecticide-treated mosquito nets (ITNs), indoor residual spraying (IRS), and the use of Rapid diagnostic tests (RDTs) and artemisinin based combination therapies (ACTs), the document also looks at the impact of the main communication initiatives - Zinduka! Malaria Haikubaliki (Swahili for “Wake up! Malaria is Unacceptable”) and the Communication and Malaria Initiative in Tanzania (COMMIT) programme - which are the focus of this summary.

This country report from Tanzania forms part of the RBM Progress & Impact Series, which is a strategic effort to secure high levels of commitment to malaria control among donor countries, international health organisations, and governments of endemic and epidemic countries. By benchmarking progress this series seeks to ensure a level of support that would result in sustained, long-term commitment and success toward ultimately ridding the world of malaria. By aggregating, analysing, and sharing data from a variety of sources, the series is intended to show progress, document impact, and drive future investment and action. It also seeks to inform vigorous advocacy for sustained or increased malaria control resources and prioritisation at the global and national levels.

As stated in the report, the NMCP has used its National Malaria Communication Strategy 2008–2013 as a guide to addressing priority communications issues related to Tanzania's malaria interventions. The reports states that the Strategy has helped coordinate and harmonise the communications activities of Tanzania's many stakeholders and implementing partners, which has helped to mobilise community responses and behaviour change for malaria control.

Coordinated by the NMCP communication committee, a number of behaviour change communication interventions have been used in Tanzania. The overarching communications campaign for Tanzania is the the Zinduka! Malaria Haikubaliki (Wake Up! Malaria is not acceptable) campaign. The Zinduka campaign has employed a number of approaches, ranging from using local and international icons for radio, TV, and print media to providing youth with the knowledge and tools to inspire other youth to join "Generation Zinduka" at the district level. At the centre of the campaign's approach to motivate youth through youth is the Theatre in Education programme. Youth from the Tanzania House of Talent (THT), a multi-media and communications centre supported by Malaria No More, have held music, dance, and theatre performances across the country, reaching 40 000 secondary school students with messages about effective malaria prevention methods and the importance of seeking early treatment. After each performance, THT youth conduct workshops with students to disseminate detailed information about malaria more formally. Through the programme, the campaign has established 40 youth clubs at the district level in Morogoro, Tanga, Mwanza, and Dar es Salaam, providing 930 youth with the skills and knowledge to actively participate alongside their icons.

Along with working with youth, the programme has worked with community-based change agents to disseminate information, using both mass media and household visits to promote bednet use, and engaged district leaders and stakeholders in malaria awareness. By educating and empowering communities and individuals to take steps to prevent and control malaria, strategic communications activities hope to contribute to the NMCP’s efforts to ensure that all Tanzanians benefit from malaria interventions.

Another aspect of the communications programme is the Communication and Malaria Initiative in Tanzania (COMMIT), implemented by a broad range of partners consisting of Johns Hopkins Bloomberg School of Public Health Centre for Communication Programs, Jhpiego, PSI, and many Tanzanian non-governmental organisations. The partnership seeks to promote a culture of correct malaria practices at the community level, as well as to promote individuals' belief that they can take the necessary steps to prevent and treat malaria. The COMMIT programme developed radio campaigns such as "Two Minutes of Wisdom" and "Pata Pata (Get it)", as well as a feature film called "Chumo". (see Related Summaries below for more information on these programmes)

The evaluation findings found the following communication related impact:

• The Rural Communication Initiative has reached more than 8.8 million people with malaria messages. In two of COMMIT's target regions, 65% of the residents had seen either a road show or mobile video unit presentation in 2008–2009. Importantly, 77% of those who had been exposed to malaria messages and events had put all their children under an ITN the previous night, while only 35% of those not exposed to the messages did so.
• 86% (April 2010) and 72% (September 2010) of people surveyed had heard a malaria message on the radio within the previous month. Of the 72% who had heard a message, 81% reported taking an action (44% made sure the family sleeps under a bednet every night, 15% went to buy a mosquito net; 14% stated they went for a malaria test early when symptoms presented themselves, and 8% discussed the importance of sleeping under an ITN).
• The surveys note that actions by children after listening to the programme Pata Pata include asking their parents to listen to the programme with them, convincing parents to obtain ITNs, persuading the family to sleep under an ITN, and repairing holes on the ITNs already hanging.