Ghana: Keeping Net Use Messages Fresh and Cool

This 4-page case study shares the experience of Ghana's Aha Ye De (Twi for "It's Good Here [under the net]") campaign in keeping net use messages fresh and relevant over a 3-year campaign. The Ghana Behavior Change Support (BCS) project, a four-year project funded by the United States Agency for International Development and managed by the Johns Hopkins University Center for Communication Programs, created the Aha Ye De campaign as the umbrella brand for all its malaria messages to support continuous distribution of long-lasting insecticide-treated nets (LLINS). "Aha Ye De sought to boost use and demand for nets by positioning net use as a lifestyle decision for people from all walks and stages of life."

The brief outlines the Extended Parallel Processing Model (EPPM) approach used by the campaign, which combined threat and empowerment messages to encourage behaviour change. Mass media, print, and community activities were designed to reinforce each other and were pretested to ensure their acceptability to audiences. Print materials included posters, stickers, and a flipchart for use at the community level. "The campaign ran in three six-month bursts in 2011, 2012 and 2013 with activities ramping up during the high transmission season and during LLIN mass distribution and hang-up activities. Implementers monitored whether messages were reaching their target audiences and whether there were additional topics or barriers that needed to be addressed." This continuous monitoring allowed for messages to be adapted and changed as needed.

The case study outlines the activities undertaken as part of the campaign. These included the production of a music video by a popular musician, a television spot about net usage, mini-documentaries about children who have suffered the effects of severe malaria, a docudrama focused on malaria during pregnancy, and the Good Life Game Show television programme. Radio discussion programmes were aired in eleven districts, featuring panel discussions with radio listeners calling in to ask questions and the airing of recorded spots and songs on malaria prevention and management. This was complemented by community outreach and mobilisation.

According the case study, evaluation data found that "the campaign has had high reach: four out of five adults (81%) in the campaign's target regions have been exposed to Aha Ye De." As a result, the campaign is helping eliminate attitudinal barriers to net use. For example, the "proportion of respondents who did not use a net the night before because 'nets are not necessary' or 'nets are uncomfortable' decreased from 8% to 4% and 13% to 6% respectively."

Lessons learned are identified as follows:

• "Emotion can be a powerful aid to behaviour change. For example, parents who strongly fear the consequences of severe malaria may be more motivated to change their behavior. Moreover, emotional content may cause messages to stand out from the multitude of messages that compete for audiences' attention. The campaign's use of a variety of emotional appeals kept it memorable for audiences.
• The campaign showed how net use fits into various peoples’ situations - from "hip" youth, to courting couples and parents - positioning it as an effective personal lifestyle choice. This helped individuals see how an "old" message like net use was still relevant to their lives.
• It is vital to identify methods that can help programs monitor behaviour change communication campaigns in real time. By using the existing omnibus survey in Ghana, BCS discovered that there were widespread concerns about LLINs being too hot and confusion on how to properly care for and repair LLINs. Due to the rapid turnaround in data availability when using omnibus-type surveys, BCS was able to develop additional spots to address these concerns."

The case study concludes that "malaria communication needs to evolve constantly to keep up with message fatigue and sustain a culture of net use. Maintaining this culture of net use - characterized by the belief that everyone is at risk, the consequences are severe, and that net use is easy and effective - will remain increasingly important as transmission levels decline."

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