Communication for Behavioural Impact (COMBI): A Toolkit for Behavioural and Social Communication in Outbreak Response

This interagency toolkit was designed on the basis of direct field experiences, where the communication for behavioural impact (COMBI) methodology was used to plan and implement communication in a structured and systematic way, integrated into public health responses to outbreaks of infectious disease. Since 2001, COMBI has been applied to a range of public health challenges. In this publication, it has been adapted to outbreak response. This toolkit from the World Health Organization (WHO), with technical contributions from Food and Agriculture Organization (FAO) and the United Nations Children's Fund (UNICEF), is meant to provide the essential information for responding to an outbreak from a behavioural and social communication perspective.

The document introduces the public health rationale for outbreak response and for this approach, who might benefit from using the toolkit and why: "A method such as COMBI can reveal potential routes for amplification and transmission embedded in deep-seated cultural practices, which are critical to outbreak control but may not be identified in the interviews usually conducted in outbreak investigations." It was designed for developmental communication and health promotion personnel working in multidisciplinary teams to investigate and respond to disease outbreaks: " Sections 1 and 2 describe what an outbreak response is, the kinds of interventions that are necessary and why. They explain the rationale for WHO’s outbreak response strategy and list the steps used in applying COMBI. Section 3 gives practical tools and templates for collecting and analysing data. Section 4 provides essential resources, case studies and fact sheets for reference, as required. Section 5 lists other references, with links to documents, websites and academic papers. The icons interspersed throughout the toolkit signal parts of the text that are essential, worth remembering or illustrate the application of an idea or concept. The online resource allows downloads, ready-to-print blank templates and much of the cited reference material...."




Contents include the following:

• "Section 1: Outbreak readiness: essential knowledge before an outbreak
  • Communication for behavioural impact (COMBI), health education, health literacy, health promotion, risk and outbreak communication, and social mobilization 
  • Outbreaks and outbreak response strategies 
  • What is COMBI? 
  • Critical dimensions of community mobilization in outbreaks 
  • Monitoring and evaluation during outbreaks 
• Section 2: Outbreak response: Actions during an outbreak 
  • Introduction 
  • Programme, managerial and administrative response structure 
  • The seven steps of COMBI planning 
• Section 3: Tools and templates for data collection and analysis 
  • Tools for understanding the organizational context 
  • COMBI planning step 1: Defining the preliminary behaviour objectives 
  • COMBI planning step 2: Rapid situational market analysis 
  • COMBI planning steps 3 and 4: Refining objectives and designing an overall strategy 
  • COMBI planning step 5: Preparing detailed plans of action and a budget 
  • COMBI planning steps 6 and 7: Monitoring and evaluating interventions 
• Section 4: Essential resources, case studies and fact sheets 
  • Anthropological approaches for outbreak response 
  • Marketing concepts and behavioural theories and models 
  • Case studies 
  • Essential facts about major outbreak-prone diseases 
• Section 5: Further references 
  • Anthropological perspectives on outbreaks 
  • Health promotion 
  • Outbreaks and outbreak-prone diseases 
  • Pandemic influenza and avian influenza 
  • Behavioural models and marketing"