Behavior Change Community MP

Base line Survey Orientation Program Report

2010-02-24T08:58:00.000-08:00

Behavior Change Communication Program, UNICEF
Base line Survey Orientation Program Report
Objective- Orientation on Base Line data collection for strategizing the BCC intervention in 4 blocks of Guna district.
Date: 18th February 2010
Resource Person:
• Mr.Kripashankar Yadav: Consultant , UNICEF
• Mr.Rajeev Mohan: IIDM, Bhopal
• Mr.Ramveer Singh Raghuvanshi, DHO, Guna
• Mr. Anand, Block Coordinator IMNCI, Guna
• Mr. Jayant, Jan Abhiyan Parishad
Partner Agencies:
• Sushil Shiksha Samiti
• Sonali Public Shiksha Samiti
• Virat Vikas Samiti
• Yugbodh Shiksha Samiti
Participants: 39
Venue: Hotel Sara, Guna
Proceedings:
• The baseline survey would be undertaken in 210 villages of Guna district covering 4 blocks: Guna, Aaron, Radhogarh, Chachora
• Mr. Rajeev Mohan from IIDM shared all the 4 formats on baseline data collection and behavioral aspects namely Mothers, Community, Youth and Children.
• Mr. Ramveer Singh Raghuvanshi was shared the survey formats and requested for inputs on the same. He shared that the questionnaires have been designed keeping the ground situations in mind, and that it will facilitate both UNICEF and the Health Department in strategizing micro-level interventions in the target villages. He also applauded the support by NGO partners in strengthening the VHND program and support to the existing mother and child health related schemes in the district.
• IMNCI Being a core program Mr.Anand shared the current scenario, relation to MDG and how NGO partners , field level coordinators and volunteers can play a critical role in strengthening the IMNCI program. This was a two way orientation session with questions and queries of the participants being discussed and resolved.
• Mr.Kripashankar Yadav holded a session on basic baseline data collection at village which includes, household data, and village level data, and monthly data updation format.

BCC Update

2010-02-20T03:59:00.000-08:00

Madhya Pradesh -BCC UPDATE
(January to Dec. 2009)
Communicating for behaviour change -“Integrated district approaches - Guna and Shivpuri
A BCC intervention, structured in the light of the UNICEF Country Strategy, is being made in Guna and Shivpuri with the support of 8 NGO partners and District Administration. The program has an impressive presence in 8 blocks of 2 intervening districts through a strong team of 4000 village volunteers, 68 cluster coordinators and 8 block coordinators.
The village volunteers and cluster coordinators are using various communication activities to bring about the following 4 behavioural changes amongst the target village communities:
People wash their hands with soap & water after defecation, after handling children faeces and before handling/having food.
Mothers initiate breastfeeding within one hour of giving birth, and practice exclusive breastfeeding during the first six months of the baby’s life.
Parents enrol their girls in Class 1 when they reach the age of five and ensure that they complete a primary education.
Sexually active young people already engaged in risk behaviuors adequately protect themselves.
A number of women's groups, youth groups and PRIs have been formed/activated and strengthened to promote changes in mindsets and behaviours at the household and community level.
Community groups activated/strengthen in 496 villages
From January to Dec 09 around 3.6 lakh peoples have been reached through interpersonal communication and Folk performance/Special events.
The major outcomes of 6 months-
About 8836/11016 women who delivered in last 12 months initiated breast feeding with in one hour of the delivery.
Complimentary feeding was initiated for more than three-fourth (11025) of 14369 children who completed age of six months.
449/680 schools in target area observed regular hand washing with soap before mid day meals.
About 80 youth approached the nearest ICTC for HIV testing every month.
In addition to communication on 4- Key behaviours the VVs and CCs supported the health functionaries in organizing routine immunization session in high risk Villages, by counselling families during RI sessions, facilitating meetings and motivating the families for vaccinating the missed children. The biggest turn around has been the opening up of the youth of the area and their readiness to talk on the issues of HIV & AIDS.
Village Volunteer Conventions-“Apana Utasav in Guna and Shivpuri” In order to acknowledge and appreciate the hard work put in by the village volunteers under BCC and Integrated Planning intervention, special conventions titled “Apna Utsav” were organized in Guna and Shivpuri in February & March 2009.
The objective of the programme was to rejuvenate the enthusiasm in the volunteers and to accelerate the mission activities in 2009. Over 1800 Village Volunteers participated in 3 conventions.
The volunteers were honoured for their hard work by Dr. Hamid El Bashir, State Chief of UNICEF in presence of Mr. Bhai Shelly, Programme Communication Specialist, senior district officials, and representatives of partner NGOs, academicians, media & other philanthropic groups.
Village volunteers shared their experiences and expressed their commitment to work for the cause. During the convention, details of different government schemes and expected role of village volunteers was also shared.
Before concluding the programme all the volunteers took the oath to motivate the people in their village to adopt the 4-key behaviors.
Accessing communities through community radio“Radio Dhadkan in Shivpuri”
UNICEF has partnered with Sambhav and Ideosync Media Combine to establish and run a community radio pilot project in Shivpuri. Inaugural ceremony of Dhadkan Community Radio 107.8 FM was held on 17th Feb. 09. Community Radio (CR) serves communities within 15 km radius around, covering Shivpuri town and about 51 surrounding villages with approx. population of 1.71 Lakhs. Dhadkan is being run with the help of 1 Station In-charge, 2 supervisors 6 Field Reported and 75 village level facilitators.
Salient Features
The CR team developed around 300 programs on Education, health, Women and Child Development, Agriculture, Livelihoods, Local Folk, Songs, Comedy Audio Drama, Religious songs and informative programs.
The Field reporters continuously narrow cast the developed programs in the community.
The CR team is also organizing regular meetings with listeners groups for identifying the subject from community for program development.
Disseminating facts for Life-“Partnership with NYKS and BS&G
UNICEF has associated with two major cadre based partners to spread and promote the messages from Fact For Life (FFL) in Guna & Shivpuri. Partnering with Nehru Yuva Kendra Sangathan (NYKS). The popular tele-serial Kyunki Jina Isi Ka Naam Hai based on Facts For Life (FFL) is being promoted by the youth groups of NYKS, both in Guna and Shivpuri.
In all 157 viewers groups have been formed in the two districts for collective viewing, discussion and subsequent action on the messages from the tele-serial.
Alliance with Bharat Scouts & Guides (BS&G), MP Association State wide intervention has been planned with BS&G for promotion of FFL messages through its units & patrols reaching about 5.5 Lakh children directly.
In Guna, 86 units & 344 patrols of scouts & guides aged 11-16 years are working - within schools, in the families and in the communities to develop 100% hand washing schools.
Other Initiatives -“Strengthening systems and functionaries”
1. Convergence of BCC and IEC activities through BCC Cell
BCC Cell established in Health Department Guna. Cell is functional by 1 st August 2009 in Guna in the CMHO office. Introductory meeting of BCC Cell already held with active participation of all district level officers from Health, WCD, PHED, RD, B S&G, Education, NSS and NGOs. Training of Resource groups (MTs) on IPC and communication skills completed. BCC Cell has helped NRHM to develop the BCC plan for 2010 and focusing IPC capacity building for Health workers. Also supporting Department in building capacities of Village Health Committees.
2. Customized Communication Material
A range of communication material has been developed and is being widely used in the 2 integrated districts.
IPC module for VVs “Chalo kare batain Char” - Customized training module and handbook to be used by the village volunteers has been developed for promotion of the 4 key behaviours.
IPC training module - An IPC training module has been developed to sharpen the interpersonal communication skills of the field functionaries of the line departments like health, dwcd, education etc.
Audio Docudramas - Audio docudramas have been developed and recorded for promotion of key messages on hand washing, early/exclusive breastfeeding and HIV prevention.
3. MSC Stories
The changes induced by the intervention are being tracked, both quantitatively and qualitatively.
The NGO teams have been trained in identifying and documenting Most Significant Change (MSC) stories from the field. 413 MSC stories reflecting the behaviour change have been penned till date.
Meta & content analysis show that stage of behaviour change is gradually shifting from Pre/Contemplation to Preparation & Practicing.

Behavioral Change Communication- Baseline Assessment Workshop

2010-02-19T21:50:00.000-08:00

Behavioral Change Communication- Baseline Assessment Workshop
Date: 19th February 2010
Venue: Hotel Tourist Village Shivpuri

UNICEF and 4 of its NGO partners namely Rachna, CID, Sambhav and Parhit have been involved in the Behavior Change Communication program for Safe Childhood in 4 blocks of Shivpuri district Madhya Pradesh. The program focuses on building up a convergent approach of development hand-in-hand with the local administration focusing on four key behaviors i.e. Exclusive Breastfeeding, Handwashing, Girl Child Education and HIV/AIDS.

A one day orientation workshop was organized on 19th February 2010 at Hotel Tourist village, Shivpuri for all the NGO partners on base line data collection on critical indicators related to the four key behaviors which will later on be updated and assessed through mid term and end term data analayis. The survey would be undertaken in 220 villages of Shivpuri district.

The workshop was coordinated by Mr.Rajeev Bhargava from IIDM, Bhopal who shared four formats for data collection namely village data, youth, women and children. Post Lunch Mr. Dheerendra Singh Jadon, DPO, WCD joined in the interaction with all the survey trainees and oriented them on various schemes being implemented by WCD to ensure reduction in IMR, MMR, Malnutrition and promotion of Girl Child Education through Laadli Laxmi Yojna, Mangal Diwas and Weighing and Pre-Education interventions.

SSHE being identified as one of the major components in the field of hygiene, mortality and disease control, Mr.Durgesh Agrawal, shared information with the participants on SSHE concepts and how the existing manforce of the BCC program can significantly contribute to better information transfer from children to the household level. Another important intervention of UNICEF and GoI is the IMNCI program focusing on ensuring survival and reduction in IMR , A session was undertaken by Mr.Shivshankar, Consultant, IMNCI, UNICEF on the concept of IMNCI and integration of BCC program in the same.

The workshop was followed by Mr.Kripashankar Yadav, Consultant, UNICEF sharing baseline data collection, updation and finding based interventions in the field, added by Mr. Nageshwar Patidar sharing on the tools and techniques of data collection.

The workshop concluded by Mr. Nabil from Sambhav highlighting the role of community workers and the importance of working in convergence with existing service delivery systems for sustainable results.

Village Volunteers Meet in Shivpuri (Block Shivpuri and Pichore) Video

2009-12-23T01:45:00.000-08:00

http://sambhavvideos.blogspot.com/2009/12/village-volunteer-meet-shivpuri.html

Saving lives of children and women in Guna district of Madhya Pradesh: Just a call away

2009-12-22T00:54:00.004-08:00

http://www.unicef.org/india/health_4745.htm

A new model for newborn child survival in rural India

2009-12-22T00:54:00.003-08:00

http://www.unicef.org/infobycountry/india_47221.html

Promoting use of iodised salt in Guna

2009-12-22T00:54:00.001-08:00

http://www.unicef.org/india/health_2990.htm

Community radio educates and entertains rural India

2009-12-22T00:50:00.003-08:00

http://www.digitalopportunity.org/news/community-radio-educates-and-entertains-rural-india/?searchterm=

Detecting the high-risk mother

2009-12-22T00:50:00.001-08:00

http://www.unicef.org/india/health_3059.htm

UNICEF animators make positive behavioural difference in Shivpuri district, MP

2009-12-22T00:49:00.001-08:00

http://www.unicef.org/india/resources_950.htm

Community Radio- Shivpuri

2009-12-22T00:48:00.000-08:00

“Dhadkan” a Community Radio initiative of UNICEF in Shivpuri, Madhya Pradesh

http://www.unicef.org/india/media_4961.htm

Converging on Child BCC

2009-12-22T00:42:00.000-08:00

NGOS has been working in Shivpuri and Guna District with UNICEF support now for almost 5 years. The intervention was initiated with the Behaviour Development Intervention aimed at addressing the “aspiration” generated among the people to change their current status by improving their existing knowledge, attitudes and practices and their demand for availability of services which are their basic rights. Village women identified and trained by NGO became change agents as animators, going house to house to converse and convince their own community members to strengthen and adapt good practices, which are beneficial for their children and women and to give up harmful practices. Significant positive change came in exclusive breastfeeding rates including colostrums feeding and improved personal hygiene. Animators formed a crucial link between the people and service delivery centers - anganwadi, school or health sub-centre. However, it was realized that the services, in spite of the best efforts of NGO and his team, were not reaching the villages and more importantly the hamlets. The ANM would come to the main village but not to the hamlet, as people from the hamlet did not exert collective pressure nor had proper means to do so apart from the lone animator. At numerous villages the ANM would not come for months together or the Anganwadi worker will have no dalia to distribute. Again there was no effective means to inform the people about the prevailing state of services managed by the line-departments at the block and district levels or was there any way in which these departments can be held accountable. This led to designing of the Integrated Village Planning Intervention- Village Planning enables the community to use the constitutionally recognized forum of Gram Sabha to articulate their aspirations for change as well as to analyze and take action on issues that can be responded to at the village level. The need now is to support this with a structure, which is capable of responding to the demands articulated in the village plans that needs outside community interventions for realization. There is a further need to create a system whereby pressure can be exerted on this formal structure to respond in time.

Project Background and JUSTIFICATION

In the tribal district of Shivpuri alone, more than 4,500 children suffer from acute malnourishment. Unicef officials say close to 1,000 have been classified into Grade 4 - which means they are critical The tribals in Shivpuri district of Madhya Pradesh earn their livelihood by working in illegal mining. However, the working conditions are so appalling that most of the workers suffer from advanced tuberculosis with no hope of survival. And with medical facilities being practically non-existent, their suffering is often compounded. According to official figures, 860 people in Shivpuri district have respiratory disorders while 38 serious TB patients were admitted to hospitals. But of them, only one man has stayed while the others left without recovering because of the unhealthy conditions. "There is an acute shortage of staff in the hospital. There is only one nurse instead of the requirement of four. There are only two ward boys, one of whom is working in the chief medical officer's house," said Dr R K Jain, Nodal officer, District TB Hospital, Shivpuri.A UNDP India report lists fourteen districts in Madhya Pradesh that have the worst gender ratio, fertility rate and female infant mortality rate at age 2.

Ø Poor immunization coverage

Ø Uneven and scattered distances of villages from sub-centers.

Ø Dacoit effected area, decreasing the visits and outreach of health workers to villages.

Ø Migration population, often leaving villages and going to nearby areas in search of work.

Ø Very low coverage of health services among tribal communities.

Ø Illiteracy

Ø Outreach to roads in rainy seasons cuts off the villages from any service.

Ø Very low percentage of visits by ANM or any health worker

Ø Low prevelance of using family planning methods

Ø Significant amount of STI cases reported among females

Ø Very low cases where complete ANC has taken place, or complete doses of IFA tablets has been taken.

Ø High prevalence of child marriage among girls

Ø High rates of illiterates, very few people surveyed have received formal education to satisfactory levels.

Ø People not keen on using methods for delaying pregnancy

In Madhya Pradesh, the number of mothers who had at least 3 antenatal care visits prior to their delivery has increased from 27.1 percent in 1998-99 to 40.2 percent in 2005-06, according to the preliminary findings of latest National Family Health Survey.

For pregnant women in the villages of this vast, sprawling, picturesque state in central India, however, there is a reality beyond numbers. At 379 per 100,000 live births, the maternal mortality ratio in the state remains among the highest in the country.

Shivpuri and Guna are the two districts in Madhya Pradesh piloting MAPEDIR (Maternal and Perinatal Death Inquiry & Response). In Shivpuri, a recent collective brainstorming session of MAPEDIR interviewers helped dispelled many myths and provided important insights into how best to detect the ‘high-risk’ mother in time.

54 maternal deaths were investigated till February 2007 from various blocks in Shivpuri as part of the ongoing MAPEDIR. The preliminary analysis of the data is throwing up new, interesting findings that can be used as local evidence to spur district-level action.
A common misconception: only those women who had multiple pregnancies were “high risk”. But while sharing their experiences, public health nurses, ANMs, lady health visitors and NGO field staff who are tracking maternal deaths in the district discovered that even those who had had just one child or were expecting their first child could be potentially at high risk of maternal death due to sudden complications. (Source:UNICEF)

Objective of the intervention:

· Initiating efforts to identification of 4 key behaviors as a felt need.

· Ensuring 4 key behaviors are being practiced, sustained and promoted.

· Working in convergence with community based groups and other stakeholders to ensure a convergence approach to development.

· Amplify village planning as a mode to promote participatory development.

Key strategies

· Strengthen IPC and community dialogue sessions to promote four key behaviours

· Strengthening local groups, PRIs and SHgs and ensure their involvement in promotion of key behaviours and linkages with services

· Strengthening system of service delivery by improve linkages of community with available services.

· building leadership among excluded groups to ensure their full participation of service delivery system.

· work closely with key service institutions ( health, ICDS, education, Rural Development, PHED ) and will further linkage with NREGA and BRGF

· Documentation of success stories related to behaviors, service delivery or community empowerment that would impacting women and children.

Expected Outcomes-

a) 4-Key Behaviours

i) Colostrums/ Exclusive breastfeeding

· 100 % mother initiate colostrums feeding in an hour

· 80 % mothers continue exclusive breastfeeding – no water, only milk until 6 months

ii) No girl, below 14 is out of School

· 100% out of school girls (aged between 5-14 yrs) identified.

· Identifying 100% girls who are admitted in schools but not attending schools.

· 100% families of out of schools girls and the school girls not attending schools counselled and ready to send school from new sessions.

· 90 % girls completing class VIII.

iii) Hand washing with soap

· 90 % schools practicing hand wash with soap before MDM.

· 80 % families practicing hand wash with soap before eating and after defecation.

iv) HIV/AIDS

· 90% of youths (15-24 yrs) list at least three ways of HIV prevention.

· 80% of youths (15-24 yrs) observe safe sex practices (use of condom, sex with single partners, etc.).

b) Strengthening community Groups

As the social mobilization is also an important component of the Behaviour change communication program. The strengthening of the community groups needs to be focused following minimum deliverables needs to be insured in the HR villages-

Activating VHSC-

l All the members of VHSCs have orientation of their role and responsibilities.

l All the members understand the Health and sanitation issues and activities they can carried out in their villages.

l Members aware of the various Health related facilities available and know about various referral centre (like Call Centre, SNCU, NRC, PHC, CHC, ICTC, TB, Dist Hospitals etc)

l Members should know the various health and sanitation related schemes.

l Monthly structured meeting of the committee regularized.

l Village action plan developed and started implementing it.

Activating PTA

l All the members of PTA have orientation of their role and responsibilities.

l All members understand the Education status of the villages. (Like teachers, Attendance in the schools, School facilities, School basic problems, SSHE, MDM etc.)

l Members are actively participating in planning for improvement in school education status and environment and sanitation.

l Members actively participate in monthly meetings.

l Members motivate the parents of non school going children’s/ and drop out children’s sending them to school.

l Regularly monitor the quality of education provided in the school, MDM and Hygiene education.

Forming and Strengthening the Youth Groups-

l The youth group formed with participation from all type of community. (Every member should knows that he is the member of the group).

l The members of the youth group have been given a training on STD/RTI and HIV/AIDS with different tools (Kissa Goi, Flip book) and games etc.

l All the members are aware of Major STI problems, safe sex practices and HIV transmission routes.

l The misconception related to Stigma and Discrimination in HIV should be clear to youths.

l The member should know about the various facilities ICTC, PPTCT, ARTs and CCCs.

l The members have started discussing on HIV and STI issues.

l The members started spreading information in peer groups.

Forming and Strengthening Women’s Groups-

l The active women’s group formed with participation from all type of community. (Every member should knows that he is the member of the group).

l All the members understand the importance of Early Initiation of the Breast Feeding, Colostrums feeding, Ex. Breast feeding till age of 6 months, Hand washing before handling food and after defecation, and immunication.

l Members aware of the various Health related facilities available and know about various referral centre (like Call Centre, SNCU, NRC, PHC, CHC, ICTC, TB, Dist Hospitals etc)

l The members of group started home visit to Pregnant women’s and Lactating women’s for discussing about Breast feeding, Hand washing and Immunization.

l The group covering all pregnant women in their village by home visits.

Hand washing in the school before MDM

l All the school Children knows the benefits of Hand washing with soap before Eating and after defecation. All should know the correct steps of Hand Washing.

l A place of Hand washing is fixed and all knows about it.

l The regular supply of Soap and availability of water is insured by school teachers, PTA or villagers.

l The school based monitoring system is established for monitoring the regular hand washing of every child before MDM.

C)Strengthening Capacities of village Volunteers-

VV must have knowledge about 4-Key Behaviours with various FAQs asked by community.
VV must have knowledge of various services and referral points.
VV must be supporting all health services.
VV provide IPC to target audiences.
VV regularly update the monitoring chart in their village.
VV participate and facilitate the meetings of various community groups, thematic meetings and special event.
VV regularly update the village health status report and information about target groups.

Behavior Change Communication

2009-12-22T00:32:00.000-08:00

Behavior change communication (BCC) is the strategic use of communication to promote positive health outcomes, based on proven theories and models of behavior change. BCC employs a systematic process beginning with formative research and behavior analysis, followed by communication planning, implementation, and monitoring and evaluation. Audiences are carefully segmented, messages and materials are pre-tested, and both mass media and interpersonal channels are used to achieve defined behavioral objectives.

Behavior change communication (BCC) is part of an integrated, multilevel, interactive process with communities aimed at developing tailored messages and approaches using a variety of communication channels.

BCC aims to foster positive behavior; promote and sustain individual, community, and societal behavior change; and maintain appropriate behavior.

Before individuals and communities can reduce their level of risk or change their behavior, they must understand basic facts about reproductive health and HIV/AIDS, adopt key attitudes, learn a set of skills, and be given access to appropriate commodities and services.

People must also perceive that their environment supports behavior change, maintaining safe behavior (including abstinence), and seeking appropriate treatment for prevention, care, and support.

The terms BCC and IEC are commonly used. What exactly do they mean and what is the difference between BCC and IEC?

Information, Education and Communication:

IEC is a process of working with individuals, communities and societies to:

- develop communication strategies to promote positive behaviors which are appropriate to their settings.

Behavior Change Communication”

BCC is a process of working with individuals, communities and societies to:

- develop communication strategies to promote positive behaviors which are appropriate to their settings; AND

- provide a supportive environment which will enable people to initiate and sustain positive behaviors.

What is the difference between BCC and IEC?

Experience has shown that providing people with information and telling them how they should behave (“teaching” them) is not enough to bring about behavior change. While providing information to help people to make a personal decision is a necessary part of behavior change, BCC recognizes that behavior is not only a matter of having information and making a personal choice. Behavior change also requires a supportive environment. Recalling the interventions model, we learned that ”behavior change communication” is influenced by “development” and “ health services provision” and that the individual is influenced by community and society. Community and society provide the supportive environment necessary for behavior change. IEC is thus part of BCC while BCC builds on IEC.

An introduction to BCC programs

Before designing a BCC intervention, it is important to be clear about exactly whose behavior is to be influenced and which aspect of their behavior should be the focus for change. Communities are made up of different groups with different risk and vulnerability factors. Even within the same broad group, there may be subgroups with distinct characteristics. Different target groups will require different approaches. Therefore, when making decisions about which target groups and which factors to address, it is necessary to consider:

§ which target groups are most vulnerable;

§ which risk / vulnerability factors are most important;

§ which factors may be related to the impact of conflict and displacement;

§ which target groups and risk / vulnerability factors the community wants to address;

§ what could be motivators for behavior change;

§ what could be barriers to behavior change;

§ what type of messages will be meaningful to each target group;

§ which communication media would best reach the target group;

§ which services/resources are accessible to the target group;

§ which target groups and risk / vulnerability factors are feasible in terms of expertise, resources and time.