Strategic Communication for Zika Prevention: A Framework for Local Adaptation

"Effective behavioral communication is essential as it empowers families and communities to make informed decisions regarding Zika prevention measures to protect themselves and their families."

This strategic communication framework from the Health Communication Capacity Collaborative (HC3) provides step-by-step guidance and illustrative content for creating a strategy to communicate accurately and effectively about Zika risk and prevention. It builds on the messaging developed in the United Nations Children's Fund (UNICEF)'s Risk Communication and Community Engagement for Zika Virus Prevention and Control guidance (see Related Summaries, below), and it is intended to guide country-level communication strategies. This framework follows a systematic process and provides content that is meant to be readily adaptable by any communication programme. It is intended to be used in a multi-stakeholder participatory process led by the Ministry of Health (MOH). This framework is not designed as a "one-size-fits-all" model but, rather, as a basic foundation, which can be adapted and expanded upon to create communication strategies tailored to the local context and to the specific phase of the Zika response.

A communication strategy provides a "roadmap" for social and behaviour change communication (SBCC) efforts and ensures that communication activities and outputs are coordinated to achieve agreed-upon goals and objectives. It is based upon evidence and typically outlines the following elements: Intended Audiences; Behavioural Communication Objectives; Indicators; Key Messages; Communication Channels; Implementation Plan; and Monitoring and Evaluation Plan. Communication strategies provide a foundation for designing activities for behaviour change programmes, including community-level activities, mass media programming, interpersonal communication (IPC) and counseling, along with other strategic approaches. (Table 1 on page 32 provides an overview of strategic approaches that can be used in risk communication.) HC3 stresses that adaptations to any strategy may be necessary to respond to the evolution of Zika prior, during, and after an outbreak, new research findings and data, unexpected events, changing priorities, or unforeseen results.

This framework covers 4 key foundational elements of SBCC and example content that can be adapted to the specific country context:

• Analyse Evidence: Understand the evidence base on Zika virus transmission, disease, and prevention (updated information can be found, for example, on the World Health Organization (WHO) website and the Centers for Disease Control and Prevention (CDC) website).
• Utilise Models: Behaviour change theories can be used at each step of the Strategic Communication Framework, including situation analysis, designm and evaluation. They can also inform development of a conceptual guide for the programme. The report describes two models that are relevant to Zika communication: the Social Ecological Model (SEM) and the Extended Parallel Process Model (EPPM). In brief, within the SEM, individuals' decisions and behaviours are understood to depend on their own characteristics, as well as the social and environmental contexts in which they live. The social and environmental contexts, therefore, influence individual behaviours relating to Zika virus prevention. The EPPM stipulates that for individuals to take protective action, they must (i) feel threatened by the consequences of a particular behaviour and, at the same time, (ii) feel able to take the necessary action to avoid that threat and believe the action will be effective in mitigating the threat.
• Tailor Strategy: Adapt the Strategic Communication Framework to develop a country-specific strategy. This is the heart of the framework. It lays out the main components of a communication strategy for Zika virus prevention, including situation analysis, audience segmentation, strategic design, and monitoring and evaluation (including indicators). The framework offers guidance for developing each of these components, provides illustrative examples, and includes links to additional resources.
• Implement: Create an implementation plan detailing who will be responsible for what activities and when. This section of the report offers guidance to clearly define partner roles and responsibilities, activities, timeline, budget, and management.
• Examples of strategic design by audience segment for local adaptation: This section provides example strategic design and illustrative key Zika messages. This framework includes five potential primary audiences (pregnant women, women of reproductive age who are not pregnant, adolescents, male partners of women of reproductive age, and health care providers) and two influencing audiences (community groups and journalists). The strategic design provides a menu of objectives, calls to action, and supporting messages for each audience, which can be selected and adapted for local use.
• Useful Tools: The final section offers tools and templates to help create or refine a Zika SBCC strategy, including a strategic design template by audience, a message map, an example budgeting tool, and an implementation plan template.

HC3 suggests using a consultative process with a range of Zika stakeholders at the country level, including government representatives, service providers, and civil society stakeholders. The MOH may act as the primary convener. It is recommended that an interactive and consultative workshop, or series of workshops, be held to complete sections of this framework. "Participation of individuals and/or groups directly affected is crucial from the start."

"To be most effective, Zika communication efforts should also be matched with efforts to expand and increase access to family planning and maternal and child health services, including services for children with disabilities, and to train and equip healthcare providers."

Click here for the 79-page framework in English in PDF format.
Click here for the 84-page framework in Spanish in PDF format.