Health Systems Strengthening

Transforming Lives through Development Communication

Posted On
Wednesday, May 16, 2018


Rhea John

Knowledge Distiller

Everyone has seen those posters in the health centre, the videos on hand-washing or mid-day meals, the text messages on immunisation days. But specialists in development communications argue that it’s time to move on from simply creating ‘IEC’, or Information Education and Communications materials. They recognise that printing a poster or creating a video is not the end, nor even a necessary means, for development communications. The end is improving development outcomes: improving, in this case, the health of the individuals and communities addressed. The tools need to be whatever it takes to reach them. This is where ‘Social and Behaviour Change Communication’ (SBCC) comes in.

The UNICEF Communication for Development (C4D) program today released the report that documents its efforts on SBC cover the last 5 years in India. Through a number of different projects and campaigns—from big-ticket ones like the Swacchh Bharat Abhiyan to state specific ones like the Mamata Abhiyaan in Madhya Pradesh—they’ve supported the work of six departments of the Government of India, worked with 14 State governments, and built the capacity of thousands of local-level providers to better engage those they hope to influence.

How do they do it?

The C4D team identifies 6 key pillars of their work.

First, they focus on system strengthening: the program builds foundations for integrating SBCC into program design, right from the beginning. There are now SBCC Cells in 8 State governments, and in Madhya Pradesh for instance, has SBCC officers in every district and block. To support this renewed focus, they also help the government, development partners, and communities leverage financial and non-financial resources from each other.

Doordarshan, for instance, telecasts the adolescent-focused TV series, AdhaFULL.

The second pillar is an upstream focus: policy contributions to build inclusion, effectiveness and scale into the existing government programs for raising awareness on issues like child marriage, HIV prevention or accessing healthcare. Often this contribution is at the program level: For instance, helping the government put in place an effective monitoring framework and overarching strategy for the communications campaign of the Integrated Diarrhoea Control Fund (IDCF) made it more effective.

The third pillar is strengthening both systems and programs by empowering the field workers that implement SBCC on the ground. Quality assurance in training, in both materials and human resources, have resulted in 2500 trainers in various states who teach frontline workers across states how to engage their communities on health, education, WASH nutrition, HIV, life skills, child protection, and in other fields.

A Dhaara panel of community activists peer influencers and program officers working on the ground to deliver SBCC

This is supported by the fourth pillar, partnerships: Links between different actors and stakeholders ensure a convergence of efforts, reinforcing focus and sharing best practices and resonate change through a wider network. Stakeholders that C4D has tried to connect include the Community Radio Association, the WASH Alliance, Entertainment Education Alliance, SBCC Alliance, different academic institutions, media and research organisations, CBOs and NGOs. But it also includes exploring non-traditional (and often difficult) partnerships: the Sishu o Matru Surakhya program in Odisha links up with faith healers in tribal-dominated districts, to ensure that they refer cases they recognise as being beyond their expertise.

To complement and amplify the interpersonal component of SBCC, media-based initiatives form the fifth pillar of the C4D approach. These range from traditional approaches, like wall paintings, theatres, community radio and puppet shows, to new technology-enabled forms including video messaging, like Fazli Babu Bolchen in Bengal, to the Nugget mobile game. And it’s working: the AdhaFULL transmedia package has reached 121 million users so far.

Using puppet shows to communicate key social messages in a school

All of these strategies and tools require an evidence-based approach, and so the final pillar of the approach is knowledge management. Research done by the program on what the challenges are, how to address them, and how to improve the effectiveness of current approaches and systems, are shared among C4D’s partners and others through the Dhaara learning series, policy briefs, and papers, and not least through the IEC Warehouse (

What are the key learnings for development communications professionals from this holistic approach?

One is that many challenges remain in implementing a consistently successful and scientific SBCC program: one of the main ones is generating evidence on how much communications strategies contribute to program success. Another is addressing the diverse and specific social norms that cause delays in health-seeking behaviour: at the family level, in decision-making, at the community level, with accessing services, and at the facility level, with demanding and receiving quality healthcare. The role of key influencers is also crucial: peer educators (for instance, trained NSS volunteers in Visakhapatnam) have had a great impact on the thinking, behaviours, and aspirations of adolescents they engage with.

The effectiveness of SBCC may still require more work, but the impact of these SBCC programs was consistently on display at the event in Delhi today. Perhaps no-one put it more poignantly than Sushmaji, a Sarpanch of the first child marriage-free village in Rajasthan. She shared her own experience of witnessing child marriage in her family and resisting it for herself and explained that she is now a forerunner against early marriage and norms, and for girls’ and boys’ education and rights. She announces with pride that she was elected unopposed at the last election! The role of SBCC is to support the courage and dedication of champions of social change like Sushmaji. And they remind us just how much more there is to learn!

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