Malaria Social and Behavior Change Communication: Indicator Reference Guide

"Social and behavior change communication (SBCC) has been a critical component of effective malaria control strategies. Despite its important role, however, robust monitoring and evaluation (M&E) of SBCC programs has been challenging. One of the major barriers is a lack of clarity about appropriate indicators."

This guide provides programme staff, government personnel, and donors with a set of priority indicators for tracking the results of malaria social and behaviour change communication (SBCC) programmes. Developed by the Roll Back Malaria Partnership SBCC Working Group, it specifically seeks to:

• compile indicators that stakeholders have found useful;
• define these indicators so they can be used consistently;
• facilitate SBCC M&E by making indicators and survey questions available in one place; and
• provide examples and suggestions for choosing indicators, tailoring them for local contexts, and using them at different stages of a programme cycle.

The guide is organised into three parts:

Part 1: Guidance on Selecting and Monitoring Indicators - introduces the M&E Framework and provides broad guidance on selecting indicators for specific programme needs, tips for adapting indicators for different contexts or behaviours, and suggestions for selecting questions for different data sources. It also looks at how to take gender into account when designing programmes.

Part 2: Priority Indicators - provides details on 17 priority indicators. Examples of an indicator are: proportion of people who recall hearing or seeing any malaria messages within the last six months, or proportion of people who name mosquitoes as the cause of malaria. The indicators fall into several categories: recall, knowledge, risk and efficacy, norms, attitudes, behaviours, and programme outputs. For each indicator, the guide offers detailed information on the indicator's purpose, its definition (including numerator and denominator), how it can be disaggregated, how data on this indicator can be used and interpreted, and its strengths and limitations.

The guide also suggests additional indicators related to the priority indicators that may be of interest to programmes. Results on these indicators can be obtained by conducting sub-analyses on the priority indicators or by collecting additional data.

Part 3: Annexes - these include the following:

• Annex 1: Theories of Communication and Behaviour Change - In this section, six commonly used behaviour change and communication theories (such as the Extended Parallel Processing Model, the Social Learning Theory, and the Theory of Planned Behavior) are discussed. While the theories share some similar elements, each emphasises slightly different constructs and processes.
• Annex 2: Checklist for Reporting on Malaria SBCC - The checklist asks writers to: describe the SBCC intervention; provide a rationale for the strategy, choice of SBCC outcomes, and methods of creating comparisons; and discuss the effects, causal mechanism, and generalisability of the results. It aims to improve transparency, increase efficiency during the publication process, and identify which SBCC approaches work best in different contexts.
• Annex 3: Survey Questions and Measurement Methods - This section offers a list of survey questions and measurement methods that can be used to measure the indicators around recall, knowledge, risk and efficacy, norms, attitudes, behaviours.
• Annex 4: Case Studies for Choosing and Adapting Indicators and Questions - This section includes a case study on selecting indicators based on the programme's stage and a case study on adapting indicators and questions to seasonal malaria chemoprevention.
• Annex 5: References - This section lists the variety of surveys implemented in different countries by different partners on which much of the guidance in this document is based.

This second edition of the guide builds on the first edition, which was published in 2014 (see Related Summaries below). The initiative to develop standard malaria SBCC indicators was started in 2011, when 15 organisations got together to share their survey tools. Following the publication of the first edition, the RBM SBCC Working Group actively sought feedback on the guide from its members during various meetings. This expert committee, which eventually became the M&E Task Force, then drafted this second edition, which differs from the first edition in the following ways:

• It has a more streamlined set of priority indicators with less emphasis on experimental indicators.
• It includes health providers as an intended audience.
• It considers data sources beyond national household surveys.
• It offers additional guidance on how to select and prioritise indicators for different purposes - specifically, programmatic design, implementation, and evaluation.
• It offers additional guidance and examples on data use and interpretation.