Zanzibar Malaria Elimination Program

The Tanzania Capacity and Communication Project (TCCP) provided ongoing technical assistance to the Zanzibar Malaria Elimination Program (ZAMEP) from October 2013 through the second quarter of 2016. TCCP provided support to ZAMEP in three key ways:

  1. The implementation of a study on the characteristics of malaria hotspots.
  2. The development of continuous distribution implementation guidelines.
  3. The creation, production, and distribution of social and behavior change communication (SBCC) materials.

Hot Spot Characterization Study

Thirty areas in Zanzibar are characterized as “hot spots” because they experience routine malaria outbreaks. In order to better understand the characteristics of these hot spots, TCCP supported ZAMEP in the design, implementation, and analysis of a study on three key factors:

  • Knowledge, attitudes, and practices (KAP) related to malaria within these communities.
  • Comprehensive entomological and environmental investigations.
  • Screening of households for malaria using sensitive diagnostic techniques.

The study aimed to characterize the human behavior, intervention coverage and usage, and environmental and entomological factors within these hot spot areas in order to determine whether hot spots are in some way different from non-hot spots where large numbers of clinical cases are not seen. TCCP supported ZAMEP in investigating KAP specifically related to bed net use and treatment seeking for fever, recall of ZAMEP’s SBCC campaigns, and the effectiveness of these campaigns in targeting key behavioral determinants. The results of this study served as the baseline for ZAMEP’s continuous distribution strategy and fed into the creation of targeted SBCC.

Continuous Distribution and Implementation Guidelines, Supporting Materials, and Monitoring & Evaluation

TCCP collaborated with other Johns Hopkins Center for Communication Programs (CCP) malaria experts to guide ZAMEP through the process of developing continuous distribution and implementation guidelines for long lasting insecticide treated nets (LLINS). Strategic planning exercises allowed ZAMEP and TCCP to gather the needed information to create the guidelines and tools for use during continuous distribution, including a training manual, planning tools for routine use, reporting forms, other data capture tools, and a PowerPoint presentation for advocacy purposes.

Once ZAMEP began to implement continuous distribution, TCCP supported the initiative’s monitoring efforts. TCCP conducted supportive supervision visits to health facilities where issues such as data compilation and adherence to standard operating procedures were identified and resolved.

To determine the success of the continuous distribution strategy, TCCP worked with the President’s Malaria Initiative to support ZAMEP in implementing an evaluation and incorporating the results of that evaluation into re-planning.

Creation of SBCC Materials

TCCP supported ZAMEP in the creation of SBCC materials to support malaria control on Zanzibar. These materials were informed by the characterization study and designed to strategically support ZAMEP’s continuous distribution strategy. More specifically, ZAMEP aimed to target imported cases of malaria from Zanzibar’s sea and air entry and exit points, and address the threat posed during the peak malaria transmission period that usually occurs immediately after a rainy period has stopped.

ZAMEP and TCCP developed four radio and television segments that were aired on national radio and television. Additionally, TCCP developed a “traveler’s guide,” two posters, a billboard, and two television animations to support the campaign. Campaign media will be strategically placed near ports of entry, and aired on ferries and at airports.