Abamecha, F
3 Publications in AERD
Author Publications
Export PDFPerceived sustainability of the school-based social and behavior change communication (SBCC) approach on malaria prevention in rural Ethiopia: stakeholders' perspectives
By Abamecha, F
BackgroundEvidence on what makes the school-engaged social and behavior change communication (SBCC) interventions on malaria prevention more sustainable are limited in literature partly due to its recent emergence. Enrolling the key stakeholders, this study explored the perceived sustainability of the SBCC interventions on malaria prevention through primary school communities in rural Ethiopia.MethodsThe SBCC interventions were implemented from 2017 to 2019 in 75 primary schools and villages in rural Jimma to promote malaria preventive practices. As a part of program evaluation, this study employed a mixed-method to collect qualitative and quantitative data from 205 stakeholders following the end of the program. Data were collected using interview guides and structured questionnaires. The SPSS version 26 and Atlas ti7.1 software were used to analyze the data. Multivariable linear regression modeling was used to identify predictors of the perceived sustainability of the program (SOP).ResultsThe mean score of SOP was 25.93 (SD=4.32; range 6-30). Multivariable linear regression modeling showed that the perceived risk to malaria (beta =0.150; P=0.029), self-efficacy (beta =0.192; P=0.003), and perceived fidelity of implementation (beta =0.292; P=0.000) and degree of adoption (beta =0.286; P=0.000) were positively predicted the perceived SOP. The qualitative result identified various barriers and opportunities to sustaining the program that summarized under three themes which include perceptions about the quality of program delivery (e.g inadequate involvement of stakeholders and staffs, concerns over short project life, immature sustainability efforts), school settings (e.g schools' malaria priority, schools' climate and quality of coaching) and the outer settings (e.g existing structures in the health and education systems).ConclusionThe study identified key predictive variables such as stakeholders' perceived risk to malaria, self-efficacy, perceived fidelity of implementation and degree of adoption that could help to improve the sustainment of the school-based SBCC approach on malaria prevention and control. Further longitudinal study should be conducted to examine the rate of decline in program components over time and how improved sustainability would contribute to the effectiveness on malaria preventive behaviors among students.
Acceptability and feasibility of the school-engaged social and behavior change communication approach on malaria prevention in Ethiopia: implications for engagement, empowerment, and retention (EER) of education sectors in malaria elimination efforts
By Abamecha, F
Background Evidence on process outcomes such as acceptability, and feasibility of behavior change communication interventions are important in program evaluation to understand how, and why such a program works. However; documented evidence on the issue is not available as far as the social and behavior change communication (SBCC) on malaria is concerned. Enrolling the frontline providers this study measured the acceptability and feasibility of the school-engaged SBCC strategy on malaria prevention in malaria-endemic settings of Ethiopia. Methods A school-engaged SBCC strategy involving various communication and capacity-building interventions aimed to advance malaria preventive practices in primary schools in Jimma were implemented from 2017 to 2019. A cross-sectional study was conducted with 205 key stakeholders at the end of the intervention. Both acceptability and feasibility were measured using standardized tools. Data were collected using a structured questionnaire and filled by the study participants. The SPSS version 26 was used to analyze the data. Multivariate general linear modeling was performed to identify the predictors of acceptability and feasibility of the program. P-value < 5% was considered to decide statistical significance. Results The result showed the mean scores (M, range = R) of acceptability and feasibility of the program were (M = 25.63, R = 6 to 30) and (M = 19.35, R = 5 to 25) respectively. The multivariate linear modeling showed acceptability was affected by self-efficacy; (beta = 0.438, P < 0.001), community support; (beta = 0.417, P < 0.001), school climate; (beta = - 0.16; P = 0.003), perceived malaria threat; (beta = 0.40, P < 0.001) and knowledge; (beta = 0.229, P = 0.013). Similarly, feasibility was influenced by self-efficacy; (beta = 0.352, P < 0.001), community support; (beta = 0.591, P < 0.001), school climate; (beta = - 0.099, P-value < 0.030) and perceived malaria threat; (beta = 0.172, P = 0.002). Conclusion With a considerably high level of acceptability, the school-engaged SBCC strategy to enhance malaria preventive practices seems feasible. The SBCC strategy targeting personal factors such as malaria threat perceptions, knowledge and skills on the program, and contextual factors that include school social climate and community support would be fruitful to facilitate the implementation of the program. The result implicates the benefit of intensifying such a strategy to engage, empower, and retain the education sectors in malaria elimination efforts and beyond.
Acceptability of peer learning and education approach on malaria prevention (PLEA-malaria) through primary schools communities in rural Ethiopia: peer educators' perspectives
By Abamecha, F
Background Evidence on peer educators' experiences of implementing the school-based educational interventions on malaria prevention would be used as inputs for malaria eliminating efforts. This study explored the acceptability of the school-based peer-learning and education approach on malaria prevention (PLEA-malaria) among peer educators in Ethiopia. Methods This process evaluation study was aimed to examine the success of the school-based PLEA-malaria that was implemented in 75 primary schools in Jimma from 2017 to 2019. A mixed research method was employed to collect post-intervention data from 404 peer educators and key stakeholders. Data were collected using a structured questionnaire and interview guide. Multivariable linear regression modelling was performed using SPSS software version 26.0. Atlas ti 7.5 for windows was used to analyse the qualitative data. The result was presented by triangulating the findings of the qualitative and quantitative methods. Results The mean score (M, range = R) of acceptability of PLEA-malaria was (M = 20.20, R = 6-30). The regression modelling showed that age; (beta = 0.264, 95% CI 0.266 to 0.632), GPA; (beta = 0.106, 95% CI 0.008 to 0.074), parental readiness for malaria education; (beta = 0.184, 95% CI 0.711 to 2.130), frequency of peer education; (beta = 0.232, 95% CI 1.087 to 2.514) and team spirit; (beta = 0.141, 95% CI 0.027 to 0.177) were positively associated with the acceptability while this relationship was negative for the number of ITN in the household; (beta = - 0.111, 95% CI - 1.182 to -0.13) and frequency of parent-student communication; (beta = - 0.149, 95% CI - 1.201 to - 0.293). The qualitative study identified facilitators of PLEA-malaria (e.g. team formation process, outcome efficacy, presence of schools' structures, schools priority, and support) and barriers (e.g. low commitments, threat appraisal, response efficacy, and PLEA-malaria implementation gaps). Conclusion The results suggested that the acceptability of the school-based PLEA-malaria was higher implying the strategy is promising in promoting malaria prevention in primary schools. Considering factors related to personal, access to malaria preventive services, school system, and social support in education and behaviour change interventions would be important to improve the acceptability. The relationship about how an improvement in the level of acceptability would in turn influences malaria preventive behaviours among the students should be investigated.
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