PSI/Kenya Malaria Communication Campaigns

PSI/Kenya's malaria programme supports the government to achieve universal coverage of LLINs by distributing LLINs through three channels:

• Routine distribution of LLINs - Free nets are available only to pregnant women and children under the age of 1 year old. They can be accessed during pre-natal and post-natal clinic visits in over 3,500 public health facilities in 56 malaria districts. These routine nets are blue in colour.
• Social Marketing of LLINs: The project began in 2001 with the launch of the branded conventional net Supanet. Supanet was packed with a net treatment kit – Powertab. In recent years, socially marketed nets are now pre-treated and so are no longer distributed with Powertab. The social marketed nets are distributed through rural retail outlets at a subsidised cost of KShs50 and are green in colour.
• Mass Distribution of LLINs: In order to achieve a rapid catch-up of universal coverage, the Division of Malaria Control (DOMC) together with partners undertakes mass net distribution campaigns every 3-4 years in malaria endemic and epidemic regions.
• Mini campaigns: In 2008 after the shift to free distribution of nets, there was a need to reach remote communities in areas such as Lamu, Tana River, and Tana Delta districts of Coast province. To ensure that these areas were accessed for the net distribution, PSI/Kenya worked with the respective District Health Management Teams (DHMTs) and organised the distribution of LLINs to all health facilities. PSI/Kenya distributes nets through mini campaigns based on need.

PSI/Kenya embarked on communication campaigns to drive net ownership and to complement these distribution efforts. The initial 3 campaigns they developed and implemented were Ghost Children, Sweet Dreams, and Malaria Ishindwe (defeat Malaria). Running from 2004 to 2006, the main objective of the Malaria Ishindwe campaign was to increase net ownership and use among rural at-risk groups and communities. In 2006 and 2008, the Abuja malaria targets were increased, which led to two grant extensions for the project. In 2008, the new goal was to ensure 100% ownership and 80% use by the end of 2010, and, to meet these targets, the communications and distribution strategies were further refined.

Also, with net ownership on the increase, communication efforts shifted towards increasing use of LLINs. To achieve this, the Mbu Nje, Sisi Ndani (mosquitoes out, all of us in) campaign was launched in September 2009. The Mbu Nje, Sisi Ndani was created based on lessons learned and the finding that social norms were the biggest driver and determinant of net use. In other words, consumers were more likely to purchase and use a net if they believed everyone was doing the same.

The Mbu Nje, Sisi Ndani campaign adopted an integrated approach with radio as the major source of information, complemented by interpersonal communications through community-based organisations and other contracted agencies. Supported by the United Kingdom's Department for International Development (DFID), PSI partnered with the Kenya Scouts Association, where 21,600 scouts adopted over 150,000 homes with each scout adopting about seven homes for one year. The scouts received training in what causes malaria, how one can get it, how nets help prevent the spread of the disease, and how to correctly hang a mosquito net. Scouts would ask at each of their adopted homes if they could see the sleeping area to ensure the bednets are hung properly. Each scout in the scheme is also issued with a project booklet containing questions that help them to record how many people live in a home and how many of them sleep under a treated mosquito net.

Malaria

According to PSI, in Kenya, malaria accounts for 30% of outpatient attendances and 19% of hospital admissions. The Government of Kenya recognises malaria as a health and socio-economic burden and considers malaria control a priority investment. Results from the Kenya Malaria Indicator Survey (KMIS) 2007 indicated that net ownership had risen to 47.7% up from 6% recorded in the Kenya Demographic and Health Survey (KDHS) 2003. The KMIS 2007 also reported 39% of children under 5 years of age slept under a LLIN the previous night in households that had LLINs.

Malaria has moved from being the leading killer of children under 5 years to the fourth position after pneumonia, diarrhea, and other infections. According to PSI/Kenya, this is mainly credited to these malaria interventions. The KDHS 2008 reported a significant drop in child mortality (children dying in the first year of life) from 77 to 52 deaths per 1,000 live births between 2003 and 2008. Death of children under five significantly decreased in the same period, from 115 to 74 deaths per 1,000 live births. The decrease was attributed to increases in child vaccination coverage and ownership and use of LLINs.