Malawi (2005): TRaC study on malaria prevention and diarrhea prevention and treatment. Round One.

This study was conducted to obtain baseline indicators of important behaviors and factors impacting the health of children under five nationwide with respect to malaria and diarrheal disease. Future survey rounds will be conducted approximately every two years to monitor changes in these indicators. In addition to providing a means of tracking the change in key indicators over the life of the project, the results of this baseline study are being used to inform the programmatic decision-making of the Chitetezo ITN, Mbwezera Chitetezo insecticide treatment, Thanzi ORS and WaterGuard point-of-use water treatment social-marketing programs. A key feature of the study is the inclusion of segmentation analysis. Segmentation involves dividing the at-risk population into those that perform the desired behaviors, and those who do not. The differences between these groups of Ãà‚ƒÃ‚ƒÃ‚ƒÃ‚‚˜behavers and ˜non-behavers are then analyzed, enabling us to identify the opportunity, ability and motivation factors (OAM, see Annex 4) that influence or correlate with the desired behaviors. Armed with this information, we are better able to focus our program efforts and resources on modifying those particular factors and thus inducing sustained behavior change. For example: if there are no differences in perceived availability to purchase ITNs between users and non-users, then we know that availability is not a barrier to use. If, however, there are differences in motivation, then we know that we should focus on enhancing the identified motivation factors that correlate with ITN use. As part of the segmentation analysis, we also segment behavers and non-behavers based on their different population characteristics (age, education, religion, etc.), to enhance our ability to target the high-risk groups and/or non-users. By including segmentation in this and in future surveys, PSI/Malawi will ensure even greater use of evidence for programmatic decision-making. This is designed not to replace subjective judgment, experience and intuition, but rather to complement it. Methodology: The study assessed indicators among primary caregivers of children under five resident in every district of the country apart from Likoma Island (excluded for logistical reasons). A sample size of N=2,725 was aimed for, with 2,880 (predominantly female) respondents being interviewed and analyzed. A total of 149 Enumeration Areas (EAs) were identified for the survey, from 128 Traditional Authorities (TAs). The selection of the sample in each TA employed a ˜Probability Proportional to Size (PPS) sampling scheme. The interviews were administered to the primary caregiver in each household.