Ahmed Syed Masud, Hossain Mohammad Shamim, Kabir Moktadir
Centre for Equity and Health Systems, icddr,b, Dhaka, Bangladesh; James P. Grant School of Public Health, BRAC Institute of Global Health (BIGH), BRAC University, Dhaka, Bangladesh; Centre of Excellence for Universal Health Coverage, James P. Grant School of Public Health, BRAC Institute of Global Health (BIGH), BRAC University, Dhaka, Bangladesh.
Research and Evaluation Division, BRAC, Dhaka, Bangladesh.
PLoS One. 2014 Mar 6;9(6):e90711. doi: 10.1371/journal.pone.0090711. eCollection 2014.
Since 2007, BRAC has been implementing malaria prevention and control programme in 13 endemic districts of Bangladesh under the National Malaria Control Programme. This study was done to examine the role of different communication media in bringing about changes in knowledge and awareness which facilitate informed decision-making for managing malaria-like illnesses.
A baseline survey in 2007 before inception of the programme, and a follow-up survey in 2012 were done to study changes in different aspects of programme interventions including the communication component. Both the surveys used the same sampling technique to select 25 households at random from each of the 30 mauza/villages in a district. A pre-tested, semi-structured questionnaire was used to collect relevant information from respondents in face-to-face interview. Analysis was done comparing the study areas at two different times. Statistical tests were done as necessary to examine the differences.
The intervention succeeded in improving knowledge in some trivial areas (e.g., most frequent symptom suggestive of malaria, importance of using insecticidal bed nets) but not in critical domains necessary for taking informed action (e.g., mode of malaria transmission, awareness about facilities providing free malaria treatment). Inequity in knowledge and practice was quite common depending upon household affluence, location of households in high or low endemic districts, and sex. Of the different media used in Information, Education and communication (IEC) campaigns during the study period, interpersonal communication with community health workers/relatives/neighbours/friends was found to be more effective in improving knowledge and practice than conventional print and audio-visual media.
This study reiterates the fact that conventional media may not be user-friendly or culture-sensitive for this semi-literate/illiterate community where dissemination through 'words of mouth' is more common, and as such, interpersonal communication is more effective. This is especially important for initiating informed action by the community in managing malaria-like illnesses.
自2007年以来，孟加拉乡村进步委员会（BRAC）一直在孟加拉国国家疟疾控制计划下，在13个疟疾流行区实施疟疾预防和控制项目。本研究旨在探讨不同传播媒介在促进知识和意识转变方面的作用，这些转变有助于对疟疾样疾病的管理做出明智决策。
在该项目启动前的2007年进行了基线调查，并于2012年进行了随访调查，以研究项目干预措施不同方面的变化，包括传播部分。两次调查均采用相同的抽样技术，从一个地区的30个村庄/毛扎中随机抽取25户家庭。使用经过预测试的半结构化问卷，通过面对面访谈从受访者那里收集相关信息。通过比较两个不同时间的研究区域进行分析。必要时进行统计检验以检查差异。
该干预措施在一些小方面（例如，最常见的疟疾症状、使用杀虫蚊帐的重要性）成功提高了知识水平，但在采取明智行动所需的关键领域（例如，疟疾传播方式、对提供免费疟疾治疗设施的认识）却没有效果。知识和实践方面的不平等相当普遍，这取决于家庭富裕程度、家庭位于高疟疾流行区还是低疟疾流行区以及性别。在研究期间信息、教育和宣传（IEC）活动中使用的不同媒介中，发现与社区卫生工作者/亲属/邻居/朋友的人际传播在提高知识和实践方面比传统印刷和视听媒体更有效。
本研究重申了这样一个事实，即对于这个半文盲/文盲社区来说，传统媒体可能不够用户友好或缺乏文化敏感性，在这个社区中通过“口碑”传播更为常见，因此人际传播更有效。这对于社区在管理疟疾样疾病方面采取明智行动尤为重要。
