The Community Health Worker Malaria Social and Behavior Change Toolkit

"To end malaria, CHWs [community health workers] need to help their communities find the tools, knowledge, and systems to fight malaria."



This toolkit was developed to provide guidance on how to incorporate social and behaviour change (SBC) content into community health worker (CHW) training and materials in the context of malaria prevention programmes. Developed by the RBM Partnership to End Malaria Social and Behaviour Change Working Group in collaboration with Breakthrough ACTION, it is designed to be adapted by national malaria programmes, implementing partners, and other stakeholders.



The toolkit explains the importance of SBC to malaria prevention and the key role that CHW can play in supporting SBC. "SBC is an interactive process that enables individuals, families, and communities to adopt and sustain healthy behaviours, such as seeking care for fever, sleeping under or caring for a mosquito net, or finishing their malaria medication. SBC interventions aim to influence key behaviours, social norms, and barriers that influence them by addressing individual, social, or structural determinants (factors) of desired changes. CHWs can use SBC approaches to help families and communities better understand malaria (what they know), improve attitudes toward malaria behaviours (how they feel), shift perceptions about malaria (how they understand or interpret something), and shift social norms (what they believe is acceptable). This process leads to sustainable, long-lasting change to meet the goal of ending malaria."



Specifically, the toolkit was formulated to provide those who train CHWs with resources that can help to ensure that CHWs can:

• Distinguish between SBC and social and behaviour change communication (SBCC), behavioural factors, and their roles in influencing malaria behaviours among community members.
• Identify and integrate SBC approaches into regular community activities to strengthencommunity uptake and maintenance of malaria prevention and treatment behaviours.
• Understand how to use monitoring and supportive supervision data to improve the quality of care.

The toolkit consists of six modules. Modules 1-4 are intended to be used by CHW trainers when working with CHWs who conduct regular service delivery and health promotion activities. Modules 5 and 6 are geared more towards CHW supervisors, mentors, and implementing partners. The modules are as follows:  



Module 1. Principles of Social and Behaviour Change: This module defines SBCC, outlines the seven principles and considerations that lay the foundation for successful behaviour change, and discusses the barriers and facilitators of behaviour change.



Module 2. Social and Behaviour Change Approaches for CHWs: This module demonstrates the role of SBC before, during, and after a client seeks care from a CHW and the types of SBC approaches CHWs can use (e.g., interpersonal communication, community dialogues, or digital health). It also looks at existing platforms for SBC interactions, such as churches and mosques, community centres, and schools.



Module 3. Community Mobilisation Strategies: This module defines community mobilisation strategies and describes specific roles CHWs may play in implementation.



Module 4. Malaria Prevention, Testing, and Treatment Behaviours to Be Promoted: CHWs have an important role in SBC for promoting malaria prevention, testing, and treatment behaviours. This module describes key malaria-related behaviours and recommendations for CHWs to promote key messages and behaviours, which must be contextualised using local data to ensure relevance for CHWs' communities.



Module 5. Monitoring and Assessing Behaviours in the Community: Intended primarily for supervisors of CHWs and managers of CHW programmes, this module describes the important role of monitoring community-level behaviours and data sources that may be used by CHWs.



Module 6. Supportive Supervision of Community Health Workers' Social and Behaviour Change Activities: Intended primarily for supervisors of CHWs and managers of CHW programmes, this module outlines SBC components that can be incorporated into existing supportive supervision of CHWs to improve the quality of care.