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COMBI as strategy against disease |
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Posted on 1 August 2008
Under ADB Regional Technical Assistance (RETA) 6108, PRIMEX has assisted the Department of Health - National Center for Disease Prevention and. Control- Infectious Disease Office (NCDPC-IDO) and the local government units (LGUs) in launching the pilot Dengue COMBI project in Barangay San Jose in the city of San Fernando, Pampanga and Barangay Puguis in La Trinidad, Benguet. Both communities are known to have a high number of dengue cases. The COMBI project for the two pilot sites was designed based on an analysis of the interplay of various factors, such as topography and human settlement patterns, the culture factor (e.g., use of verbal and non-verbal language), socialization (e.g., information sharing), organizational entry points (e.g., presence of community structures), and the management capacity and political climate in the local health office. COMBI was first introduced by the World Health Organization (WHO) in the design and implementation of behaviorally-focused social mobilization and communication programs for the elimination of leprosy in India and Mozambique, the prevention of lymphatic filariasis in India and Zanzibar, TB prevention and control in Bangladesh and Kenya, and dengue prevention and control in Malaysia. It is an approach well suited for achieving behavioral impact in the prevention, control, and elimination of communicable diseases. The DOH COMBI project started with the conduct of surveys in the pilot sites in order to determine the knowledge, attitudes, and practices (KAP) of residents regarding dengue and to determine whether having the correct knowledge in dengue prevention is significantly related to correct responses to dengue risks in the community. The PRIMEX consultant team prepared the survey instruments which were then reviewed by DOH. Surveys revealed that desired practices at home do not automatically lead to a risk-free dengue environment (San Fernando) and that there was no significant difference in having the correct knowledge and the right action (La Trinidad). The survey was followed by community mapping to narrate the dengue situation, the history of dengue outbreaks, and the identified hotspots. This was followed by the conduct of focus group discussions (FGDs), the results of which signified the need for behavioral change. Key messages were drawn from the series of FGDs which were then developed into IEC materials. DOH helped finalize the materials that are now being piloted. The Project was launched in Puguis, La Trinidad, Benguet on 24 June 2008, where more than 200 people from different sectors were joined by the Provincial Governor, the Municipal Mayor, councilors, and barangay officials, who then signified strong political will to sustain the preventive initiative. In San Jose, San Fernando City, Pampanga, a crowd of more than 500 people consisting of parents, children, community health volunteers, elementary and high school students, nursing students, school personnel, local officials including the Mayor, Vice-Mayor, City Councilors, barangay captains from all over the City, local health officials, ADB, and the Consultant Team attended the launch held on 30 June 2008.
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An innovative approach to planning and implementing social mobilization, known as Communication for Behavioral Impact (COMBI), is now being pilot-tested in two barangays in Luzon in a concerted move to involve communities in combating alarming incidences of dengue.