NOVEMBER 2021 - The United Republic of Tanzania’s archipelago of Zanzibar has experienced 19 major outbreaks of cholera over the last half-century, resulting in nearly 500 deaths.

Though sustained promotion of safe hygiene and sanitation practices and facilitation of supportive social norms is central to mitigating transmission of cholera, Social and Behaviour Change Communication (SBCC) is often limited to outbreak periods. Inadequate engagement of important influencers and insufficient analysis or disaggregation of behavioural and socio-cultural factors prevent the timely engagement of high-risk groups with tailored approaches and messages.

Aligning with the Ending Cholera A Global Roadmap to 2030, the Revolutionary Government of Zanzibar committed to eliminate cholera by 2027 under the Zanzibar Comprehensive Cholera Elimination Plan (ZACCEP). The three-pronged plan proposes sustained multi-sectoral collaboration through mass cholera vaccination and through strengthened WASH and social and behaviour change communication.

Under the ZACCEP, in partnership with UNICEF, the Government developed a cholera elimination social behaviour change communication strategy, which is the first of its kind.

Through the strategy, campaigns link personal hygiene and cleanliness to broader health, development, social justice, and education impacts beyond cholera prevention. Messages emphasize that when appropriate actions are taken by individuals and communities, cholera prevention efforts yield a multiplier effect for the wellbeing of all Zanzibaris.

Under this initiative, sustained and scaled engagement across target groups has resulted in strengthened community preparedness, with champions activating communities to sustain new norms that underpin cholera prevention. Trainers of trainers (TOTs), including national and subnational government SBCC focal persons, over 100 Community Heath Volunteer (CHV) supervisors, over 1400 CHVs, and nearly 300 school WASH teachers have undertaken training to reinforce their skills on cholera prevention and interpersonal communication. Nearly 300 religious leaders including imams, sheikhs, priests, madrassa teachers and Sunday school teachers, along with over 160,000 school WASH club champions have been engaged to raise awareness on cholera prevention actions.

While an assessment is yet to be conducted, implementation reports from the Ministry of Health show improvement in hand hygiene practice at household level, institutions, and public areas due to the multiple engagement and awareness raising campaigns, especially in the context of COVID-19.