Communication for Behavioral Impact
The strategies for the prevention and control of dengue include prompt diagnosis of fever cases, management or elimination of larval habitats in and around homes, work settings, schools, etc, and reducing human vector contacts
A major obstacle to effective implementation of selective/ integrated mosquito control has been the inability to achieve and sustain expected desired behavior. Despite growing levels of knowledge and awareness about dengue and mosquitoes, adopting and maintaining effective and feasible new behavior which remains a challenge.
Communication for behavioral impact (COMBI), espoused by WHO, is an innovative approach to fill this gap to mobilize individual and family action, utilizing social mobilization and communication to bring measurable change in behavior. It helps to plan, implement and monitor a variety of communication actions intended to engage individuals for adoption of healthy behaviors.
COMBI objectives include the clear identification of the target audience, a detailed description of the behavior being promoted and the frequency of the behavior, the measurable impact that is desired over a specific time period: In other words the objectives should be ‘SMART’ (specific, measurable, appropriate, realistic, time-bound).
- Specific: who or what is the focus; what change(s) are intended.
- Measurable: specified quantum (e.g. % change intended).
- Appropriate: based on target needs and aimed at specific health-related benefits.
- Realistic: can be reasonably achieved.
- Time-bound: specific time period to realize the objectives.
COMBI thus entails purposive and tailor-made strategic communication solutions intended to engage a specific target audience into responsive action. In developing the preliminary objectives, suitable recommendations for action by different segments should be considered.
- Whose behavior should be changed to bring about the desired outcomes? Who is the target audience?
- What is required to be done? Is it feasible? Is it effective?
- Why are they not doing it now? What are the barriers and motivators?
- What activities can address the factors most influential to change behavior?
- Are materials/products/services needed to support those activities? If yes, are those easily available? If not, what should be done?
The behavioral objectives, target groups and key messages currently used are stated below:
Behavioral objectives and target groups:
- To prompt housewives in 80-90% of homes in MOH areas to remove dengue breeding sites in their houses and surroundings at least once a week
- To prompt principals and teachers in 80-90% of schools to keep their school premises free of dengue breeding sites through regular inspections every Monday and Thursday
- To establish “ Dengue Prevention Committees” in all government institutions to inspect and remove dengue breeding sites in their premises and surroundings at least once a week
- To motivate patients with fever for more than 02 days to seek treatment from a qualified doctor
- Every Sunday for 30 minutes, inspect your house and surrounding for dengue breeding sites. Remove or destroy them
- Every Friday for 30 minutes, inspect your school premises for dengue breeding sites. Remove or destroy them
- Seek treatment from a qualified doctor, if you have fever for more than 02 days
- Do not take pain killers/ anti-inflammatory drugs, if you have fever
Enforcement of law against offenders
Enforcement of law against the offenders who are keeping dengue mosquito breeding places in his/her premises which will endanger the lives of others.
Mosquito Control in Schools
To be engaged on a weekly basis
Check for and eliminate mosquito breeding in the following places:
- Discarded receptacles in open areas and under bushes in school premises Open and closed drains
- Cement lined ground ponds
- Tree holes, bamboo stumps and leaf axil
- Refuse bins and bin covers, especially when unused
- Scupper drains in common corridors
- Flower pots, plant pots and saucers and other ornamental structures
- Air-conditioner trays
- Unused equipment and other items for e.g. canvas sheet, dustpan, tyres, broken plastic chairs etc at storage areas
- Cement rooftops and roof gutters
- water storage tanks
- Unused/ broken cisterns and bowls of toilets
- Any other water-bearing receptacles
Maintain mosquito breeding free environment even in the school vacations, since several activities including examinations are held in the schools
School Hostel or Boarding House
Carry out the above mosquito control measures at the school hostel or boarding house too.
Vacant School buildings and constructions in schools.
- In vacant schools or schools undergoing constructions/demolition, eliminate mosquito breeding sites in discarded items left behind.
- Seal/ cover up all toilet bowls/ cisterns/ gully traps with suitable mosquito proof material.
- Check weekly water storage containers and other water collecting/ stagnated containers and receptacles.
Removal/ elimination of mosquito breeding in school premises
Following measures can be taken to eliminate mosquito breeding in the school premises during the inspection
- Ensure the water storage tanks are properly covered and all drainage outlets are sealed
- Collect and Burn, bury or dispose the discarded containers properly
- Use larvivorous fish in ground level water storage tanks
- Discourage planting water holding plants in its axils
- Take immediate action to remove unwanted stored (inventory) items
- Clean blocked roof gutters
Report to the school management committee all the breeding detected and the potential breeding habitats observed so that appropriate interim or permanent measures can be taken to eliminate the potential breeding grounds.
Mosquito Control in Construction Sites
Check for mosquito breeding in the following places:-
- Discarded receptacles and building wastes in the worksite and site offices.
- Building materials, canvas sheets, equipment and machinery.
- Puddles on the concrete floors of all upper levels and basement
- Water storage drums, tanks and containers.
- Bulk waste containers
- Lift wells
- Safety barriers
- Rooftops and water tanks
- Treatment plants
- Any other water-bearing receptacles
Destruction of mosquito breeding
Destroy/ eliminate all mosquito breeding sites found during the inspection Report to the construction site supervisor and the head of the institution of the relevant authority all the breeding detected and the potential breeding habitats observed so that appropriate interim or permanent measures can be taken to eliminate the potential breeding grounds.
It is not mandatory to conduct fogging at construction sites. Fogging treatment should only be done when there is an impending disease outbreak or epidemic situations in the area.