Impact of Social Behavioural Change for reducing risk of climate-sensitive infectious diseases in the emergency context of Cabo Delgado, Mozambique: a pre-post intervention study

Background: Mozambique’s minimal contribution to global gas emissions contrasts sharply with the significant impact climate change has on the region, particularly in terms of frequent droughts, cyclones, and floods. These climate-related disasters exacerbate vulnerabilities related to food security, human health, and economic growth. This study evaluates the impact of a Social Behavior Change (SBC)-based intervention on preparedness against water-borne diseases (WBDs) and vector-borne diseases (VBDs) among communities in Cabo Delgado, Mozambique. Methods: This prospective, before-after, community-based study was conducted in six districts of Cabo Delgado province from October 2022 to December 2023. The intervention focused on promoting WASH practices and preventive measures through the Mozambican Ministry of Health’s "Familia Modelo" strategy. Data were collected via face-to-face interviews with 1602 households at both baseline and endline. Results: The study demonstrated significant improvements in key areas, including the availability of latrines, mosquito nets, food drying facilities, and sanitary landfills. Handwashing facilities, safe water treatment, and storage systems showed the largest increases. The median preparedness score improved from 3 (IQR 2–4) to 6 points (IQR 4–7) out of a maximum of 7 points (p < 0.0001). However, a small percentage of households lost access to certain amenities, and challenges persisted, particularly among internally displaced persons (IDPs), who did not show significant improvement in preparedness due to their unique challenges. Conclusions: The intervention improved preparedness in several domains, emphasizing the effectiveness of SBC approaches in reducing risk factors for climate-sensitive diseases. However, continued efforts are needed to address vulnerabilities, particularly among IDPs and overcrowded households. Education and community-based actions remain crucial for enhancing adaptive responses to climate hazards and mitigating the detrimental effects of climate change on public health.