Influence of Maternal Exposure to Malaria Social and Behavioral Change Messages and Effectiveness of Communication Media on Bed Net Use and Malaria Infection in Malawi

Background: Malawi is a malaria-endemic country. A national malaria communication strategy was adopted to disseminate malaria messages with the aim of improving knowledge and adoption of malaria interventions. Objective: To examine the effect of maternal exposure to malaria messages and the medium through which such messages are delivered on insecticide-treated net (ITN) use and malaria infection among children under 5 years of age in Malawi. Methodology: Utilizing the data from the 2017 Malawi Malaria Indicator Survey, 2,055 children (aged under 5 years) and 1,886 children (aged 6–59 months) were analyzed for ITN use and malaria infection outcomes, respectively. Components of exposure to malaria messages were tested for association with ITN use and malaria infection outcomes using multiple logistic regression models. Results: Children whose mothers had reported hearing any malaria-related message in the past 6 months were more likely to sleep under an ITN and less likely to have malaria infection compared with those whose mothers had not heard any malaria-related message. Region and sex of the child were effect modifiers on the relationship between exposure to any malaria-related message and malaria infection. Knowledge regarding cause or protection methods partially mediated the relationship between exposure to any malaria message and malaria infection. Discussion and Conclusion: Health workers were an effective communication channel. Strengthening topic-specific malaria messages and building the capacity of health workers while alternately strengthening other message outlets may prove vital for effective malaria communication.