COMBI: Addressing dengue by targeting human behavior

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The Pan American Health Organization (PAHO), a regional network of the World Health Organization (WHO) based in Washington DC, has formulated a new strategy called Communication for Behavioral Impact (COMBI) to address the global dengue problem.

COMBI is an integrated marketing communication approach aimed to encourage the community to adopt desirable behavior towards the attainment of health goals. WHO used this approach to address global health challenges such as the elimination of leprosy, control of tuberculosis, lymphatic filariasis and other non-communicable diseases.

COMBI integrates health education, information education and communication (IEC), market research, advertising techniques and community mobilization to achieve the ultimate goal of behavioral impact in health.

In a study, PAHO identified that the major obstacle to effective implementation of selective, integrated mosquito control is the inability of the health sector or the project implementers to mobilize and coordinate resources needed to achieve and sustain behavioral impact among populations at risk of dengue.

Achieving behavioral results is a major challenge, according to PAHO, because existing programs only focus on changing people’s knowledge and raising awareness. “Knowledge of the disease is not enough. Regrettably, an informed and educated individual is not necessarily a behaviorally responsive individual,” PAHO revealed.

COMBI begins with identification of behavioral objectives, followed by a Situational Market Analysis (SMA) of factors influencing the attainment of the overall goal and the behavioral goal. SMA involves listening to people and learning about their perceptions and obstacles to the proposed behavior.

For integrated communication actions, PAHO formulated a COMBI guidelines which include: advocacy for healthy behavior in the business sector; social mobilization or participatory research; publicity or appropriate advertising through media; advocacy to school children, volunteers, social development workers and point-of-service promotion by emphasizing easily accessible or readily available vector control measures and other treatments against dengue.

With COMBI, health practitioners, implementers, and stakeholders will be guided in conceptualization, implementation, and monitoring of communication actions. It also becomes a platform for increased community participation towards adoption of the identified human behaviors necessary in the elimination and control of dengue in the community.

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