Transcript Formative Research and Behaviour Change Communication National IAPSM Conference

Formative Research
and
Behaviour Change Communication
National IAPSM Conference
2004
Chandigarh
Nemat Hajeebhoy
Aga Khan Foundation, India
Nemat Hajeebhoy
What is Behaviour Change ?
AWARENESS
ACTION
NORMS
Nemat Hajeebhoy
Levels of Behaviour Change
HOME
COMMUNITY
HEALTH
CENTER/ NGO
POLICY
Nemat Hajeebhoy
NEGOTIATE INDIVIDUAL
BEHAVIOR CHANGE
CHANGE COMMUNITY
NORMS & PROBLEM SOLVE
TRAINING &
CAPACITY BUILDING
ADVOCACY
Malnutrition & Child Mortality
Others
Diarrhea
Peri-natal
Malnutrition
Complications
55 %
Malaria
Nemat Hajeebhoy
ARI
Measles
Food Security & Malnutrition
Availability
FOOD
SECURITY
Access
Utilization
Nemat Hajeebhoy
MALNUTRITION
Food Aid ….. BCC …???
FOOD AID
Nemat Hajeebhoy
?
BCC
The goal therefore is to identify
feasible, acceptable & effective
strategies
to
improve
health
related behaviours with program
beneficiaries playing an active role
in the process
Nemat Hajeebhoy
What is Formative Research ?
It is the process of collecting
information for use in developing
interventions appropriate for a
designated
audience.
The
information collected guides the
development or design of activities,
programs and materials or products.
Nemat Hajeebhoy
Methodology
Step 1 : Data Collection & Behavioural Analysis
Review
Conduct Exploratory research
In-depth interviews
Focus Group Discussions
Observations
24 Hour Recall
PRA Exercises
Nemat Hajeebhoy
Methodology: Behavioural Analysis
Options
Barriers
Motivators
Nemat Hajeebhoy
Methodology
Step 2 : Develop & Test Recommendations
Review
Exploratory Research
Trials of Improved Practice
Nemat Hajeebhoy
Methodology : TIPs
Also known as household trials, TIPs
involve a series of visits to selected
homes to test new behaviours to
improve child nutrition / health.
Nemat Hajeebhoy
Methodology: TIPs
POST TRIAL
(Visit Two)
PRE TRIAL
(Visit One)
TRIAL
COUNSEL
&
NEGOTIATE
24 hour recall
Counseling Guide
Nemat Hajeebhoy
PERIOD
FEEDBACK ON
BEHAVIORS
TRIED/NOT TRIED
24 hour recall
Feedback Form
Methodology
Step 3 : Revise recommendations and
develop Behaviour Change Strategy
BEHAVIOUR CHANGE STRATEGY
Audience
Nemat Hajeebhoy
Message
Channel
Methodology
Step 4 : Programme Implementation
DEVELOP TOOLS
Materials & Media
Monitoring & Evaluation
SKILL TRAINING
Nemat Hajeebhoy
Methodology
The TIPs approach of ‘designing by dialogue’
provides professionals the opportunity to
visit families, listen to what mothers and
other caregivers have to say about their
problems and to FIND SOLUTIONS.
Professionals learn more from beneficiaries
and beneficiaries have more faith in the
advice they receive because they have had a
chance to express themselves and feel that
their particular situation has been taken
into account.
Nemat Hajeebhoy
Strengths of Formative Research
 Process is flexible and can be tailored
to a variety of country and program
context
• Bridge between program planners and
the community
• Methodology promotes an
understanding of practical changes.
Nemat Hajeebhoy
Strengths of Formative Research
• It develops and tests recommendations
in the same household settings where
behaviours need to be practised.
• Using these methods promotes attitudes
such as willingness to learn from
mothers and an understanding of
practical changes to recommend
Nemat Hajeebhoy
Strengths of Formative Research
Where program personnel are directly
involved it has been found to motivate
health personnel to take a sincere
interest in learning appropriate ways
of working with caregivers to resolve
feeding problems.
Nemat Hajeebhoy
Core Team
• Researcher
• Experts
• Program Personnel
Nemat Hajeebhoy
If the research is planned carefully to
collect only essential information this
approach can be completed relatively
rapidly.
Nemat Hajeebhoy
The ADP Jagriti / LINKAGES
Experience
Period :1997 - 2001
Aim : To test an innovative behaviour
change methodology that introduces or
reinforces simple, culturally appropriate
& nutritionally effective practices
within the ADP Model
Nemat Hajeebhoy
ADP Jagriti /LINKAGES
• Sehaspur Block,
Dehradun Dt.
Uttaranchal
• ~ 85,000 Population
• Breastfeeding
• Complementary
Feeding
Nemat Hajeebhoy
Programme Results
70
62
60
49
50
40
%
29
30
22
20
10
0
Nemat Hajeebhoy
17
9
8
1
Initiate < 1hr
Initiate < 24 hrs
Fed All Colostrum
Don't give
prelacteals
Baseline
Endline
NFHS
Programme Results
100
90
80
70
60
50
% 40
30
20
10
0
90
77
Baseline
Program
NFHS II
42
6-<10
months
Nemat Hajeebhoy
71
10-<12
months
A Mother’s explanation of why
breastmilk is best :
“The milk that a mother has is not just milk - it has
love in it. The most important part is that the
love with which a mother breastfeeds her child
cannot be replicated when other (top) milk is
given … there is no diet like love. Since this
(breast) milk is produced at the time of birth why
should we not give it… the child will not only get
milk but will also get love”
Nemat Hajeebhoy