SOLOMON ISLANDS NATIONAL UNIVERSITY

SCHOOL OF NURSING & ALLIED HEALTH SCIENCES

COMBI PROJECT
REPORT

DIPLOMA IN PUBLIC HEALTH

(HEALTH PROMTION)
HP 632 MAJOR ASSIGNMENT
Presented by: Nelson Resta
Sanjeev Jilini
Hezilyn Samani
Ibukana Galo
Alfrence Oscar
MALARIA IN <5 YEAR OLD CHILDREN AT
KUKUM AREA
 Communication Behavioral Impacts (COMBI)

• This report is focus on Malaria and its effect on the growth or

health of children range from 0-5 year of age.

• This report was carried out at kukum area with the

collaboration from Kukum Health Centre in Honiara.

• We are trying to analyze the contributing factors to malaria

situations in children <5 years of age especially on:
knowledge capacity of the care givers, compliance to bed net
use, simple preventive measures etc.
 Introduction

• This communication action plan was designed

in targeting mothers or caregivers of <5 years
children in Kukum area with high prevalence
rate of malaria cases
• Malaria is the leading cause of death amongst
children worldwide.

• Lack of Sanitation hygiene and negligence of

caregivers especially on children preventive
precautions is said to be the major cause.
(WHO, 2012)
 1.0 The overall goal

• To reduce the current Malaria case from

92.5% in children <5 years at kukum area to
50% by December 2017.
 2.0 The Behavioural objective…

 To increases the Knowledge capacity of caregivers

or mother of children < 5 years in Kukum area on
the importance of preventing malaria cases to 50
% by the end of December 2017.
 To reduce the number of cases in <5years children
having Malaria in Kukum catchment area from
92.5% to 50 % by the end of December 2017
 3.0 The situational market analysis and the precise behavioral goal:

• In the situational market analysis we use the

following ten steps to find the current
behavioral issues of our target group to
perceive their insights
Mantra #1 Current situation-knowledge levels,
attitude, current behavior, behavioral trend

 Poor waste disposal (breeding sites for

mosquito)
 Parents knowledge capacity low

 Ignorance/no care attitude

 Chemical strength reduce in bed net(LLIN)

 Mantra #2 Market segmentation
Target 1

 Care givers or parents of <5 year children

 Target 2

 Those leaders to be consulted:

 Fathers

 Health Workers(Malaria department)

 Community Leaders
 Mantra #3 Force field analysis
3.1 Barriers.

 Communication barriers. (understanding of language)

 Lack of knowledge.
 Finance
 Ignorance
 Lack of support and commitment by government
organization, community, family
 3.2 Enablers

 Educate mothers on the importance malaria

prevention
 Organized and motivate leaders
 Appropriate posters language material
 Evidence base awareness and campaigns
 Commitment of influential people in
communities.
 3.3 Desired behavior.
 

 Care givers to adopt the attitude of sleeping <5year child

under a bed net
 Feed nutritious food to <5 year child with more greens to
strengthen immune system.
 Improve household hygiene, replace window screens and
provide ventilation.
 Proper waste disposal to avoid breeding ground for mosquito
 3.4 TOMA

 This tool was used to identify the perceptions of the

offered behavior of the care givers or parents
specifically on the cost of time.
 From interview parents just ignore the value of
preventing malaria and this has increase the
prevalence of malaria cases in <5 year old children in
Kukum
 3.5 DILO
• Daily routine of targeted audience

06:00am Wake up

07:00am Worship/Prepare Breakfast/prepare kids for school

08:00am-11:00am marketing/other private business

11:00am-13:00pm Prepare food for lunch/Lunch

1:00pm-4:00pm shopping

4:30pm- Social program

6:00pm-7:00pm Dinner/Listening radio messages

8:00pm Relax with family

9:00pm Prepare for bed

10:00pm Bed time (with no net/use damage net) till next day
 3.6 Moment in life of analysis (M.I.L.O)

• This is the personal daily routine program of

the targeted group
Mantra #4 S.W.O.T analysis

Strength Weakness Opportunity Threat

-Lack 0f -Lack nutrients -Minimum access of -Possession of old
knowledge needed for body health services bed nets with low
capacity defense   chemical strength
       
-Unhealthy -Ignorance and no   -Bed net expire
environment care attitude  
 
-No bed nets, old
nets, damage
nets available
 
 Mantra #5 Customer. Needs, Wants, Cost, Convenience

Needs Wants Cost Convenience

       
-Improve -More nutritious -Life expectancy -Unavailability of
knowledge food to boost (Mortality/Morbidit new bed net
capacity on immune system y)  
malaria     -Expiry net-
  -Close care from -Family expense chemical strength
-Hygienic caregivers in daily for medical cost reduce
environment life routine e.g. drug,
New Bed net transport, medical
(Household) record book,
diagnosis
 Mantra # 6 Positioning

• With questionnaire care givers or mothers

should have a clear knowledge or fair
understanding on malaria reduction through
prevention with high percentage.
 Mantra # 7 Competitors

 Weather pattern (rainy season, mosquito

breed)
 Unhealthy waste disposal

 No care attitude (ignorance)

Mantra #8 Communication Situation/issues

Popular Traditional Source influence Useful media triggers

Media/Channel media action

-SIBC Radio Not applicable -MHMS –Health -Drama

-Clinical program promotion -Mobile text message
  -Kukum health Centre -Radio testimony
  awareness
 Mantra #9 Further Research

 LLIN treatment survey

• Mass blood survey on <5 years infant in
kukum
 Mantra #10 Program Pre-Requisites 

• These are program pre-requisites for a COMBI program

 Ready availability of training for caregivers on malaria disease

and prevention
 Availability of evidence mass cleanup campaigns program
involve everyone lived in Kukum area
 Availability of VBDCP distribution of new bed nets for kukum
area

 
 4.0 The overall strategy for achieving the stated behavioral
result:

 Review and strengthen policy  Educate caregivers who have children

<5yrs on the following:
 Mobilize stake holders through
o Importance of sleeping under mosquito.
meetings and workshops
o Personal protection methods.

 Advocate for social mobilization

 Malaria campaign

 Mobilize community leaders. .  Home visit, follow up and

counseling(interpersonal)
 Workshop for caregivers and
mothers on malaria prevention  Radio talk back shows

 Health Awareness:  Develop appropriate IEC materials.

• Mass media Programs.
 5.0 COMBI PLAN OF ACTION
FIVE KEY AREAS
Administration
Community Mobilization
Interpersonal Communication
Advertising
Point of service promotion
ACTION
 Consultation with MHMS,
- Malaria (VBDCP)
- Environmental Health Division
- Health Promotion
 Faith-based Awareness,
 Major campaign,
 Mass Blood Survey (MBS)
 Distribution of IEC material,
 Letter of notification,
 Community support (advice, encouragement, counseling
 Social marketing
 Bill board
 Street banner
 Mobile text message
 Radio jingles
 Radio talk back show
 Health talk
 Malaria screening
 Treatment for positive case
6.0 Management and implementation of COMBI

• The implementation of the COMBI plan will be co-ordinate by the

Ministry of Health specifically the Health Promotion Unit, Vector Borne
Disease Control Program and the Staff at Kukum Area Health Centre. The
involvement of other Government Ministries will be the foundation to
instrumentally solidify the project: Ministry of health services, NGOs,
Women groups, Church leaders, Community leaders and funds agencies
for assisting the project, Rotary club and Global Fund. An evaluation is
needed to see the strength and weakness of the program and report
back to concern Ministries or Kukum clinic for further actions needed
 7.0 Monitoring the project

• The program will be monitored and evaluated

quarterly by the Ministry of Health and other
concerned NGOs or stakeholders. This is so
that quarterly report is updated and feedback
given to Kukum Area Health Centre.
 8.0 Behavioral impacts assessment
These indicators to be observed and analyze
COMBI objectives/ organized program Activities in line with program Monitoring & Evaluation Successful indicators
 
A meeting held quarterly for Meeting / workshop Group meetings /Assess Evaluating the indication
Government Ministries, NGOs and  
stakeholders to advocate the  
established program

Organize workshops for Health Health talks Group meeting /Assess Participant express in % and sum
professionals and care givers or  
mothers  

Organize quarterly major campaign Health professionals/ stakeholders Training on health for care givers or Sum / % of the issue
mothers  
Create IEC materials posters, banners, Nonverbal message communication Practice creativity % in expression
leaflet, display  
and distribute them to Kukum area
general population

Mass Media program fortnightly by Mass media, Air Casting and News Getting relevant education Effective knowledge on malaria
Radio talk back show, FM, and 1 articles information  
article once a week through Solomon  
Stars

Quarterly evaluation of the program Evaluation / Monitoring process Compilation of monthly reports with Combination percentages evaluation
to see its effectiveness so that care data to analyze and come up with and final report.
givers see the usefulness of it final report  
 
 
9.0 Schedule -Calendar/Time-line/Implementation Plan:

TIME PERIOD KEY ACTIVITIES RESPONSIBLE

1st week of July 2016. Personal Training Malaria training officer

  Health personals and HPD –Health
  stakeholders workshop Communication unit &
  Kukum clinic Supervisor
 

2nd week July 2016 Stake holders meeting HPD and VBDCP staff
3rd week July 201 Review national malaria HPD, MHMS, National
policy Vector Borne Unit.

4th week July to 1th week Development and pre- HPD, VBDCP staff and
Aug testing of IEC materials Health Com
2016 Unit.
 
2st week August 2016 Dissemination of IEC HPD staff and
materials Kukum clinic staff.

3st week Aug to 4th Malaria Campaign to HPD and VBDCP staff
week 2016 target group

1st week Sep 2016 to Mass media. Radio talks Media groups- MHMS,
1st week October 2016 back shows and radio SIBC
health programs. Solomon Star
Solomon star Articles
2nd week Oct 2016 1st evaluation and HPD- VBCDP staff
stake holders meeting- and project
3rd quarter 2016 committee
Progress Report

1st week Nov 2016 to Health talks and Nurses Kukum clinic
3rd week November counseling during child HPD and VBDCP staff
2016 welfare clinic HCC

Ongoing 1st week Feb Home visit and follow up Nurses Kukum clinic,
to 1st March 2017 HPD and VBDCP staff,
HCC

Ongoing 2nd week/4th Malaria workshop , HPD,VBDCP

week March 2017 Kukum area
Ongoing 1st week April to Home visit and follow up Home visit and follow  

4th week 2017 up

Ongoing 1st week May Meeting for stakeholders HPD- VBDCP staff HCC
2017 and 2nd quarter 2nd  
evaluation
Ongoing 2nd week May Stake holders and health HPD- VBDCP staff HCC
2016 officers
report  

Ongoing 3rd week May Malaria campaign. Home HPD- VBDCP staff HCC
visit ,follow up and  
counseling
Ongoing 4th week May Stake holders meeting and HPD- VBDCP staff HCC
2017 discussion
Progress Report  

4th week July 2017 Presentation of awards to HPD/VBDCP staff HCC

most clean home Nurses Kukum clinic  
1st week/4th week July 2017 2nd Malaria workshop for
care givers and mothers.
Kukum area

1st week/4th week Aug Home visiting and follow up HPD/VBDCP staff HCC
2017 Nurses Kukum clinic

1st week /4th week Sep Presentation of awards to HPD/VBDCP staff HCC
2017 most clean home Nurses Kukum clinic

1st week /4th Oct 2017 Conducting of summative Stakeholders/HPD/VBDCP

Evaluation

3th week Nov to 1st week to Compilation and final report HPD/VBDCP Officers
December 2017 analysis
 10.0 BUDGET
Activity Items Unit cost Sub Total Budget cost
 
 
Administration Stationeries $ 1000   $144 000.00
Transport expense $ 3000  
Office rent $ 2000 x 18 months $ 36 000.00
salary $ 1000 x 3 officers x $ 108 000.00
  36 fortnights
 
 

Malaria Perdium $100 x 5 days x 5 $ 2 500.00 $ 6 250.00

Campaign   officers $ 2 250.00
Transport hire $ 450 x 5 days $ 1 500.00
Venue Hire $ 300 x 5 days  
$ 3000 x 18 months  
 

IEC material Printing $ 8,000   $ 10 000.00

Distributing $ 1,000  
Street banner $ 1,000  
 
 
Mass Media SIBC Jingles $ 500/Month x 18   $ 19 100.00
  Radio talk back show months $ 9 000.00
Radio health $ 500 $ 500.00
program $ 500/Month x 18 $ 9 000.00
Mobile Text message months $ 600.00
  $ 600  
   

Monitoring and Stationeries $ 4000.00 $ 4 000.00 $ 8 900.00

evaluation Allowance $ 100 x 5 officers x5 days $ 2 500.00  
  Transport /Fuel (diesel) $ 200L x $12.00 $ 2 400.00  
       
       
     
   
   

House to House Transport / fuel $ 200L x $12.00 $ 2 400.00 $ 3 650.00

awareness Officers 5 $ 50 x 5 days x 5 officers $ 1 250.00
 
 

Stake holders Allowance $ 100 x 15 participants x 5 $ 7 500.00 $ 25 500.00

meeting   days  
Caterings $ 80per meal x 3 meals x $ 18 000.00
15 participants x 5 days  
   
 

TOTAL $ 217 400.00

 10.1 Total Budget Summary

ACTIVITIES BUDGET COST

Administration $ 144 000.00
Malaria campaign $ 6 250.00
IEC material $ 10 000.00
Mass Media $ 19 100.00
House to House awareness $ 3 650.00
Stake holders meeting $ 25 500.00
Monitoring and Evaluation $ 8 900.00
Total $ 217 400.00
 11.0 Summary and Conclusion

• Malaria is an endemic disease and a continues public health problem both locally and
globally

• The developing countries in the tropics are the most affected ones including Solomon Islands
and other pacific Island countries. The disease is caused by malaria parasites called
plasmodium. It is a thriving problem in Solomon Islands with high mortality rate for <5 years
children, the most probable causative factors of this problem were: parents knowledge
capacity, breeding sites for mosquito due to poor waste disposal, poor environmental
sanitation and management as a result the mortality trend has accelerating.

• In addressing this issue a COMBI plan must be addressed between the Partnership
organizations such as the current Government, through the responsible Ministry like the
ministry of Health, NGOs and other sectors to help address this health issue.
Malaria cases for Kukum clinic as of 2014 to 2016 February
Total population for this age group in kukum is 4 according to kukum clinic record

Year/Month Cases Total cases Type of species

2014
M F PF PV Mix

January 0 0 0 0 0 0
February 0 0 0 0 0 0
March 0 1 1   1  
April 0 0 0 0 0 0
May 0 1 1 0 1 0
June 4 0 4 2 2 0
July 0 0 0 0 0 0
August 0 0 0 0 0 0
September 1 0 1 1 0 0
October 0 0 0 0 0 0
November 0 0 0 0 0 0
December 1 1 2 0 2 0
2015     9 cases      
January 0 0 0 0 0 0
February 1 0 1 1 0 0
March 2 1 3 1 0 2
April 2 2 4 3 1 0
May 7 9 16 10 5 1
June 0 1 1 1 0 0
July 0 4 4 3 0 1
August 2 0 2 1 1 0
September 0 0 0 0 0 0
October 0 0 0 0 0 0
November 3 2 5 4 1 0
December 0 1 1 1 0 0
2016     37 cases      
January 7 8 15 5 10 0
February 10 16 26 11 15 0