Health Education Campaign to Improve Behavioral Aspects of Malaria in Rural East Nusa Tenggara Province Indonesia: Protocol for a Cluster-Assigned Quasi-Experimental Study (Preprint)
Authors: Guntur Robertus Dole , Lobo Maria , Sihotang Dony Martinus , Bria Yulianti Paula , Kusumaningrum Damai 
Published: October 2024

BACKGROUND

Malaria is a major health issue distributing across 85 countries globally including in Indonesia. Indonesia is in the progress to achieve malaria elimination and currently the high burden of malaria is in the rural eastern part of the nation including in East Nusa Tenggara Province where the number of malaria cases increased significantly during COVID-19. To achieve malaria elimination, malaria awareness should be measurable and integrated in malaria policy. Currently malaria awareness of rural community in the region is low and interventional studies to improve malaria awareness of rural community were less documented in Indonesia.

OBJECTIVE

The aims of the study are to investigate the impact of local wisdom-based health education campaign combining local music, sub-district leader’s voice and loudspeaker to change behavioral aspects of malaria of the rural community. Specifically, we want to assess the effect of this intervention on (1) the improvement of malaria awareness index of rural community and their associated factors, (2) the change of appropriate malaria treatment seeking behavior (AMTSB) and their associated factors, (3) the enrichment of knowledge and practice of malaria prevention measures and their associated factors, (4) the enhancement of the use of long-lasting insecticide-treated nets and their associated factors.

METHODS

This study applied a cluster-assigned quasi-experimental study with a pre-test and post-test both in the control and intervention groups. Thirteen villages were in the intervention group and twelve villages in the control group. Health education campaign is conducted in the intervention group once a week for 20 weeks. Before and after the campaign, household survey was conducted to record behavioral aspects of malaria in relation to general knowledge of malaria, AMTSB, and malaria prevention measures knowledge and practice. 894 respondents participated before and after intervention. The improvement of malaria awareness index, AMTSB, good level of malaria prevention measures knowledge and practice will be determined based on the difference score in each index before and after intervention in both groups. The chi-square test would be applied to assess the difference score before and after intervention. Binary logistic regression will be applied to determined important risk factors associated with the change in each index.

RESULTS

The intervention has been conducted since the last week of August 2024 and it will be finished on the second week of January 2025. The project is in the progress to draft some papers that will be published in peer-reviewed journals

CONCLUSIONS

This study will be expected to provide significant findings to comprehensively investigate the change of behavioral aspects of malaria due to local wisdom-based malaria education campaign. These results could help stakeholders in Indonesia to develop malaria health policy based on the local context to support the global effort to become a malaria-free zone by 2030.