Behaviour Change Communications
Effective communication is key to changing unhealthy public behaviours and improving the knowledge and skills of health workers to better provide quality services. However, the priority given to behaviour change communications (BCC), including human resource and budget allocations, tends to be low. There are few external support agencies able to work strategically in both technical and communication fields, including addressing communication challenges in diverse cultural settings. This can lead to sporadic, fragmented, even tokenistic approaches to BCC with few checks on real impact.
Changing unhealthy behaviours through improved knowledge, awareness and practices can have a significant impact on public health. Improvements in personal hygiene can lead to better neonatal, child, maternal and other health outcomes. Similarly, the effective training of health workers and introduction of new protocols, procedures and strategies depends, to a great extent, on the priority given to communication efforts.
We use innovative approaches to BCC including local radio, community video, peer-to-peer interviews and social auditing.
We bring expertise in:
- Design of context sensitive behaviour change communications strategies, programmes and campaigns at national, regional and district levels both for the public and health workers.
- Training of government and non-government staff on communication methods and tools including print, radio, video, and participatory methods (e.g. street theatre, participatory video).
- Studies on the effectiveness of BCC strategies including the use of innovative approaches such as the participatory ethnographic evaluation research (PEER) approach.
- Reviews of communication pathways at health facilities (e.g. related to quality of care) and the role of social auditing in managing expectations and improving services.
Options began its communications support to Nepal’s Ministry of Health in 1997 through the Nepal Safe Motherhood Project (NSMP). This project supported the Nepal Health Education and Information Communications Centre (NHEICC) for strategy development, planning, materials production, radio programming and the training of 11 NGOs at community level to increase the demand for maternal health services.
This work continued under the Support to the Safe Motherhood Programme (SSMP, 2005-10) in partnership with communications experts at Johns Hopkins University and specialist NGOs at regional level. Options also pioneered the use of PEER at community level in Nepal in order to identify knowledge gaps, understand how communities get their information and improve programme communications (including developing context specific materials in local languages).
Regional radio programmes were produced as well as the formation of local radio listeners’ clubs as part of the BCC approach. We used participatory video – where cameras are in the hands of community members - to collect testimonies on maternal health issues. The resulting documentary proved instrumental in winning government support for the fledgling ‘Aama’ maternity incentives programme.
As part of the Nepal Health Sector Support Programme (NHSSP, 2010-17), we have worked with Ministry of Health divisions and centres to support targeted BCC activities, including intensive public awareness campaigns to end gender-based violence. Advisers have also assisted the National Health Training Centre to improve health worker training on gender equality and social inclusion through the development of improved curricula and resource materials. The development and mainstreaming of social auditing at health facility level featured strongly, with both service users and health staff provided with opportunities to feedback on services and prepare plans for improvements.
- We helped NHEICC develop a strategy, materials and budget for the promotion of maternal health in Nepal including the use of innovative tools and methods such as local radio, radio listeners’ groups, PEER and participatory video.
- We worked to develop the capacity of NGOs in 11 districts in BCC leading to improved community understanding of maternal health issues, increased demand for health services and the networking of women’s groups to advocate for a rights-based approach to health service delivery.
- We supported Family Health Division to develop a strategy, guidelines, advocacy, promotional and monitoring tools and materials for the implementation of the highly successful national ‘Aama’ maternity incentives programme.