Malaria Behavior Survey

How might we ensure that malaria control and elimination programs effectively respond to the full range of SBC challenges?

Countries: Angola (2023), Benin (2021), Burundi (2024), Cameroon (2020), Cote d’Ivoire (2019, 2024), the Democratic Republic of the Congo (2021), Ghana (2022), Kenya (2022), Liberia (2021), Malawi (2021), Sierra Leone (2019), Tanzania and Zanzibar (2021), Zambia (2024)

Health Area: Malaria

Context and Insights

In 2017, malaria programs lacked standardized, validated survey questions about malaria-related behaviors and their drivers to inform malaria SBC activities. Generally, formative research for malaria SBC was not typically based on behavior change theory, did not examine a comprehensive array of behaviors or factors driving or inhibiting those behaviors, or were one-off data collection activities that did not rely on validated tools or standard indicators. As a result, many programs in malaria-endemic countries faced data gaps around the factors most relevant to malaria prevention and treatment behaviors and many national malaria SBC strategies were developed with minimal quantitative data. SBC activities designed without such insights risked resulting in activities that might fail to fully address the needs of individuals and communities.

The Solution

Developed with the U.S. President’s Malaria Initiative (PMI) and Breakthrough ACTION, the Malaria Behavior Survey (MBS) is a standard, theory-based tool to collect data on a comprehensive array of malaria prevention and treatment behaviors and the drivers of those behaviors. The underlying conceptual model behind the MBS is the Ideation model of behavior change, which explores a range of psychosocial factors (called ideational factors) associated with behaviors. Understanding these factors helps malaria program planners prioritize and determine the most strategic focus of SBC activities, for developing national malaria SBC strategies, and can also be useful for planning malaria service delivery and vector control programs, among other uses.

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“The National Malaria Control Program was a part of the MBS from beginning to end; it is our survey and we have been able to use the results in a number of reports, applications, and strategies.” — National Malaria Control Program Kenya

“The MBS lets us be targeted in our strategies, focusing on the most significant determinants driving malaria behavior.” — Programme National de Lutte contre le Pludisme Côte d’Ivoire

“The [MBS] dashboard has helped my program and supplied us with the data we need to develop the SBC strategies our country needs.” — Mwinyi Issa Khamis, Head SBC/Insecticide-Treated Nets Unit, Zanzibar Malaria Elimination Program

The Innovation

This is the first survey that collects standardized and validated malaria social and behavior change data on structural and behavioral determinants of malaria-related behaviors. A web-based data visualization dashboard presents the MBS results in a highly accessible format for country stakeholders to quickly access priority data points to inform their programs.

The Evidence

Implementing the MBS across multiple countries has produced rich data sets and key insights into priority areas for SBC programs in those countries. Countries such as Côte d’Ivoire, Cameroon, the Democratic Republic of the Congo, Malawi, and Kenya has used the data to inform their five-year malaria SBC strategy. Every country has used MBS results to inform malaria SBC activities. For example, Côte d’Ivoire stakeholders have also used the results to inform the design of mass media and community engagement materials that have been consistently used during the 5 years since that survey was fielded. Several countries have incorporated MBS data into funding proposals for the Global Fund to fight AIDS, Tuberculosis and Malaria to justify their proposed SBC investments. Prior to the MBS, SBC data was rarely included in such proposals.

Scale-Up & Adapt

Thirteen countries have implemented the MBS between 2018–2024: Angola, Benin, Burundi, Cameroon, Côte d’Ivoire, the Democratic Republic of the Congo, Ghana, Kenya, Liberia, Malawi, Sierra Leone, Tanzania & Zanzibar, and Zambia. In 2023, Côte d’Ivoire was the first country to implement a second MBS five years after the first one, benefitting from being able to view trends over time as well as adapting SBC programs to changing priorities as informed by the new results.

The comprehensive MBS toolkit and MBS country results are available in English, French, and Portuguese on the MBS website.

Who can I speak with about this solution?

Gabrielle Hunter, Malaria Technical Lead, Breakthrough ACTION

Other resources

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This website is made possible by the support of the American people through the United States Agency for International Development (USAID). The Breakthrough awards are supported by USAID’s Office of Population and Reproductive Health, Bureau for Global Health, under Cooperative Agreements: #AID-OAA-A-17-00017 and #AID-OAA-A-17-00018. Breakthrough ACTION is based at the Johns Hopkins Bloomberg School of Public Health’s Center for Communication Programs. Breakthrough RESEARCH is based at Population Council. The contents of this website are the sole responsibility of Breakthrough ACTION and Breakthrough RESEARCH. The information provided on this website is not official U.S. Government information and does not necessarily represent the views or positions of USAID, the United States Government, Johns Hopkins University, or Population Council.