1. Barrier to Long Lasting Insecticide treated net (LLIN) Utilization Among the Trained Resource Persons in Community: Experience from USAID – JU – ACP Malaria Project in Ethiopia Zewdie Birhanu International SBCC Submit 8-10 Feb, 2016 Addis Ababa 1

2. Presentation Outline  Background  Methods  Results  Conclusions 2

3. Background  Despite remarkable progress, malaria remains global public health concern  In 2014,  198 million malaria illnesses  584, 000 deaths from malaria (WHO, 2014).  In 2014 2,627,182 Malaria cases in Ethiopia (EMOH, 2014)  In line with a global vision to attain long-term malaria elimination, Ethiopia is aimed to achieve near zero death from malaria by 2020.  Despite tremendous progress in reduction of malaria burden, behavioral gaps remains important challenges 3

4. Cont…  The behavioral gaps comprise: Limited and inconsistent use of LLIN Poor health service seeking behavior In appropriate use of anti-malarial drugs Poor Acceptance of Indoor Residual Spray  These calls for the need to focus on community empowerment to promote appropriate use of malaria preventive measures 4

5. Cont…  Supported by USAID-Ethiopia, Jimma has been implementing SBCC through school and religious in Jimma Area, in five districts  The project uses volunteers who cascade down key malaria actions and messages; includes  School teachers  School students/anti-malaria club members  Religious leaders 5

6. Cont…  To be effective, Volunteers (lead persons) need to be  a real model /example in using malaria prevention methods to impress and influence others  people tend to learn from what we do than what we talk  Identification and addressing of barriers faced by others  Therefore, we assessed LLIN utilization among volunteers prior to training as lead person 6

7. Methods  The project ( SBCC) is being implemented in 5 districts of Jimma Zone Oromia, Ethiopia  LLIN utilization and related barriers were assessed for all enrolled project volunteers  The assessment was qualitative in nature and was part of the training  During training session, participants (n=195) were grouped into 4 categories based on LLIN ownership and usage patterns 1.Without LLIN 2.Non-users 3.Intermittent/irregular users 4.Consistent/regular users 7

8. Methods… Each group separately discussed  Specific barrier to LLIN use  How to alleviate those specific barriers  Finally, the group presented their discussion to groups  The discussion was recorded 8

9. Results 9 Summary of LLIN Utilization status among volunteers Key points Often volunteers lack consistent experience with behavior being promoted Important to empower them to live the behavior Higher LLIN use by female may reflects success of conventional SBCC on LLIN use Key points Often volunteers lack consistent experience with behavior being promoted Important to empower them to live the behavior Higher LLIN use by female may reflects success of conventional SBCC on LLIN use

10. Results … 1. Volunteers without LLINs  Not provided with LLIN  No sufficient LLIN for all family members  Did not know where to obtain them 2. Non-users : Reasons  No previous infection  Perception of insusceptibility  Lower perceived severity  Negligence  Shape of the LLIN  Discomfort due to the chemical 10 Each category did have their own reasons for not using LLIN

11. Results … 3. Consistent users  Had history of malaria infection  Had history of malaria infection in the family  Motivated by information from different sources [reading, media, friends, health workers] 4. Intermittent users  Being away from home  Forgetfulness to hang the LLIN  Carelessness  No previous infection  Vary with seasonal variations of mosquito  Shape of the LLIN 11

12. Conclusion  Volunteers are important resource to promote malaria preventive actions  However, it is crucial to recruit or improve their behavioral experience before they serve as a change agent  They need to a role model to impress and influence others  Required to live the challenges and barriers to help others 12

13. “This study was made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of the authors and do not necessarily reflect the view of USAID or the United States Government.” 13

14. Thank you!! 14