The Drum Beat 612: Impact Series #5 - WHO Communication-for-Behavioural-Impact (COMBI) in the Field

• Seeing a doctor in the first 12 weeks of pregnancy: before COMBI Campaign (69%); after COMBI campaign (81%);
• Taking folic acid in the first 12 weeks of pregnancy: before COMBI Campaign (32%); after COMBI campaign (76%);
• Taking iron tablets for at least 2 months during pregnancy: before COMBI Campaign (62%); after COMBI campaign (88%); and
• Knowledge of danger signs: before COMBI Campaign (59%); after COMBI campaign (91%).

This issue of The Drum Beat is the final in a series of 5 that highlight specific examples of the impact that communication is having on development in a myriad of ways. These examples are culled from presentations shared at a meeting hosted by UNAIDS and The Communication Initiative on March 29 2011 ("Social and Behavioural Change Research Results: Strategic Implications") in Geneva, Switzerland. You may notice that each of the Drum Beat issues included in this series is shorter than normal; our goal is to hone in on just a few illustrations of the most compelling impact data to emerge from the Geneva meeting - with the hope that you will delve deeper as your interests drive you.

In this fifth presentation, "WHO Communication-for-Behavioural-Impact (COMBI) in the Field: An Example of Evaluation and Research Challenges", Asiya Odugleh-Kolev and John Parrish-Sprowl describe and share evaluation results of COMBI (Communication for Behavioural Impact), a process which blends strategically a variety of communication interventions intended to engage individuals and families in considering recommended healthy behaviours and to encourage the adoption and maintenance of those behaviours.

For a more complete summary of "WHO Communication-for-Behavioural-Impact (COMBI) in the Field: An Example of Evaluation and Research Challenges" on The CI site, please click here.

To access the full presentation directly, please click here.

 

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HISTORY AND CONTEXT: COMBI


1.    History of COMBI
In 1994, Dr. Everold Hosein offered the first "Integrated marketing communication for behavioural impact in health and social development" course at New York University in the United States. In 2000, the World Health Organization (WHO) began promoting the COMBI methodology for planning communication and social mobilisation actions.

2.    What Is COMBI?
In brief, the COMBI process involves multiple channels at multiple levels to connect schools, communities, health service providers, local authorities, and agencies in pursuit of a behavioural objective around these communication action areas: mobilising decision-makers and communities, conducting interpersonal communication, creating and distributing promotional materials and advertising, and organising point-of-service promotion.

 

• As of this writing, The CI site has 36 additional items exploring COMBI. To explore them, click here.

RESULTS


3.    A WHO global programme to eliminiate lymphatic filariasis that integrated COMBI impacted these people:

• In India (Tamil Nadu), the project reached out to 28.0 million; the coverage rate was 74%.
• In Kenya, the project reached out to 1.2 million; the coverage rate was 81.2%
• In the Philippines, the project reached out to 4.5 million; the coverage rate was 73.6%.
• In Sri Lanka, the project reached out to 9.5 million; the coverage rate was 86%.
• In Zanzabar, the project reached out to 1.0 million; the coverage rate was 83%.

4.    In Moldova, an effort drawing on COMBI to promote positive mother and child health/antenatal care behaviours as part of a United Nations Children's Fund (UNICEF)/Ministry of Health and Social Protection campaign had these results:

• Seeing a doctor in the first 12 weeks of pregnancy: before COMBI Campaign (69%); after COMBI campaign (81%);
• Taking folic acid in the first 12 weeks of pregnancy: before COMBI Campaign (32%); after COMBI campaign (76%);
• Taking iron tablets for at least 2 months during pregnancy: before COMBI Campaign (62%); after COMBI campaign (88%); and
• Knowledge of danger signs: before COMBI Campaign (59%); after COMBI campaign (91%).

5.     In Fiji, the WHO used COMBI to address a measles outbreak in 2006. The Ministry of Health (MOH) subsequently reported that 89,747 (98%) of children intended to be reached had received the measles-rubella vaccine as of May 24. Among 20 Fijian subdivisions, two had reported coverage <95%: Suva (91%) in the Central Division and Macuata (90%) in the Northern Division. No serious adverse events from vaccination were reported.

 

•  For more evaluation data on this initiative, click here.

6.    In 2007, WHO conducted an informal stock-taking survey of COMBI practitioners. Amongst the findings: It is necessary to have a critical mass of professionals able to plan and implement communication strategically. This involves building capacity in the areas of: behavioural theory, communication models, psychology, marketing, anthropology, and monitoring and evaluation; community development approaches; networking and building and sustaining partnerships; adult learning and brain-friendly techniques; negotiation and advocacy skills; interpersonal and group communication; facilitation and training skills; graphic design; advertising; public health; and journalism (print and broadcast). When training, it is important to move beyond didactic, presentation-based courses by: bridging the knowledge-practice gap, applying adult-based learning, being relevant and continuously adapting to a given context and the needs of participants, securing organisational commitment, providing opportunities to apply skills (e.g. through seed-funding and mentoring), and promoting and supporting local knowledge sharing and documentation of what works and why.

WHO notes that, in addition to the findings shared in this presentation, COMBI has been utilised to address both communicable and non-communicable diseases in a number of contexts around the world. COMBI is being applied by Ministries of Health and UN agencies - e.g., the United Nations Children's Fund (UNICEF), the United Nations Development Programme (UNDP), the United Nations Population Fund (UNFPA), and others - to achieve measurable behavioural results through strategically applied communication.

To request further information about impact-related documents and presentations, please contact:
Asiya Odugleh-Kolev
oduglehkoleva@who.int

There is an upcoming conference, Integrated Marketing Communication for Behavioral Impact (IMC/COMBI) in Health and Social Development, held in Collaboration with the WHO in New York, July 9-27 2012. For details about this experience, to learn how to apply, and to access contact information, click here.

For a more complete summary of "WHO Communication-for-Behavioural-Impact (COMBI) in the Field: An Example of Evaluation and Research Challenges" on The CI site, please click here.

To access the full presentation directly, please click here.

This issue of The Drum Beat was written by Kier Olsen DeVries.

The Editor of The Drum Beat is Kier Olsen DeVries.

Please send additional project, evaluation, strategic thinking, and materials information on communication for development at any time. Send to drumbeat@comminit.com

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