This post was originally published on BBC Media Action’s Insight Blog on April 10, 2017.To mark the launch of BBC Media Action’s Global Health Stories site, Sophia Wilkinson explains how health communication can make a big difference at scale – for less than the cost of a can of Coke per person.
“But what about the impact?”
This is the question I’m asked the most after I’ve told an audience that, quite literally, millions of people listen to our radio shows and watch our TV programmes about health. The other question I routinely get is:
“I don’t care how big your audience is! What I want to know is whether anything has changed?”
What people often don’t realise is that the more people you reach, the bigger the difference you can make. You don’t have to choose between the two.
Skillfully designed and well-executed media and communication projects can not only change behaviour and norms, they can do so at scale. Offering both quality and quantity, such interventions should be immensely attractive to those working to solve the world’s costliest and most widespread health challenges.
I’m going to brag. In Ethiopia alone, some 21 million people listened to our radio shows about different aspects of pregnancy, birth and newborn health over the course of just one year – and 14 million did so regularly. This means in the three states where we surveyed – Amhara, Oromia and SNNPR (Southern Nations, Nationalities, and Peoples’ Region) – almost half of all adults listened to our shows.
But aside from professional pride, why does this box office success matter when you’re not looking to drive up profits from ticket sales?
It matters because of the scale of the challenges we’re trying to solve.
In Ethiopia, out of every 1,000 babies born, 29 will die before they’re even a month old and 48 won’t make it to their first birthday. And every year, 13,000 Ethiopian women die due to pregnancy-related complications.
Of course, we all know that the death of many of these mothers and newborns could be avoided. But it’s not just about providing good quality, accessible health services. It also requires lots of people to do things differently in their day-to-day lives. Millions. Not just hundreds.
The Ethiopian women who listened to our shows did just that. They were more likely to have: one,received antenatal care, two, made arrangements for having their baby in a health facility and, three, given birth in a facility or with a skilled attendant looking after them.
And this wasn’t due to wealth, or education, or proximity to services – our research controlled for these factors – and while it doesn’t provide causal data, this analysis helps us to be more confident in these results.
There are other reasons why reaching lots of people matters. As the World Development Report: Mind, Society, and Behavior highlighted back in 2015, human beings are very social animals. We don’t like being alone. We live and work in communities, big and small. We have friends. We spend time with our families.
Of course, one consequence of spending time together is that how we behave is deeply influenced by what those around us are doing, or what we think they’re doing and expect us to do. It follows that if more and more people start doing something, we can expect a snowball effect. Reaching more people will create a bigger splash.
Finally, reach matters when it comes to delivering value for money. Another accusation frequently bandied about is that media projects are expensive, especially if high-quality television dramas are part of the mix. Well, yes, if only a few hundred people watch that drama then it wouldn’t be very cost-effective to produce.
But it cost us just 23 pence per person to reach 93 million people in Bangladesh, Ethiopia, India and South Sudan with potentially life-saving information, using all manner of communication tools, from TV dramas to community discussions. Critics might dismiss our programmes as ‘all talk and no action’, but people are taking their newfound knowledge and doing things differently because of it.
Just take a look at what our research in Bangladesh is telling us:
Those who listen and watch our programmes have access to health information to help them make healthier choices…and for less than the cost of a can of coke. Sounds like a pretty good investment to me.
If you want to find out more about how BBC Media Action used media and communication at scale to improve maternal, newborn and child health, go to Global Health Stories. Sophia Wilkinson is BBC Media Action’s Acting Head of Health and Resilience; she was previously the organisation’s Senior Health Adviser. Sophia’s most recent publication is A bigger splash – partnering for impact, which reflects on BBC Media Action’s maternal and child health partnerships with governmental and NGOs in Bangladesh, India and Ethiopia. Springboard’s Member Insights blog shares news, insights and accomplishments from our community members. Please contact Jenna Groman if you are interested in contributing to the Member Insights blog.
Michael Magongo is an “Indvuna” or head of a governing body known in Swaziland as the ”Inner Council,” which means he is second-in-command to the Chief.
In a country where nearly one in three adults ages 18-49 are living with HIV, including stakeholders from all levels of society in mitigating the impact of HIV is essential.
The Health Communication Capacity Collaborative’s (HC3) work in Swaziland began in 2014 with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and USAID, with the specific aim of reducing new infections and supporting those living with HIV. A key strategy for HC3 Swaziland has been to work closely with chiefs and their wives by training them on health communication strategies and ensuring they have the most up-to-date information to share with their communities, as well as continuing to meet with them and update them on HC3’s work.
The training sessions, led by HC3 interpersonal communication facilitators, are designed to help the leaders and their wives recognize the important role they play in helping to keep their communities healthy and supported through community-level HIV prevention and care activities. During the first three years, 80 chiefs and their spouses were trained on topics such as leading community engagement activities and creating safe spaces for adolescent girls and young women as part of PEPFAR’s DREAMS initiative.
Honorable Mduduzi Small Joe Dlamini of the Ministry of Tinkhundla Administration and Development
The Government of Swaziland has acknowledged the importance of this work and HC3’s commitment to strengthening the capacity of local leaders. The Honorable Mduduzi Small Joe Dlamini of the Ministry of Tinkhundla Administration and Development stated that “HC3 has acknowledged leaders not only as vehicles but also as influential people capable of contributing to the reduction of HIV in their communities and as beneficiaries of HIV prevention information because without it, they are also at risk.”
In Swaziland, HC3 has had great success in working with and training local chiefs and their wives to help lead the response to HIV. Read more about HC3’s use of health communication to fight Swaziland’s HIV crisis in the multimedia story, Using Health Communication to Fight Swaziland’s HIV Crisis: Addressing the World’s Highest HIV Rate.
Join HC3 April 25-27, 2017 for a discussion on Springboard to talk about some of the work that HC3 has done with leaders. We welcome you to share your own experiences of working within traditional leadership structures.
HC3 meets with stakeholders and partners in Jamaica in April 2017.
As part of USAID’s Zika response in Latin America and the Caribbean, the Health Communication Capacity Collaborative (HC3) Zika team provided technical assistance in social and behavior change communication (SBCC) for Zika to the Ministry of Health of Jamaica in April 2017.
HC3 conducted a desk review of key documents in Jamaica’s Zika communication response and held introductory one-on-one meetings with key stakeholders to learn about Zika communication activities to date, lessons learned, challenges encountered, recommendations, key research findings and upcoming plans. HC3 also conducted site visits to gather insights from critical audiences: tire shop owners/operators, residents of a settlement in order to better understand their water drum usage, and health providers and pregnant women at a health center on its antenatal care day.
HC3 then facilitated a two-day working meeting to develop a message guide for Zika communication segmented by audience that addresses communication gaps and supports the transition from emergency to endemic communication. The guide that will be developed is meant to be a very practical, Ministry-approved package that all stakeholders can use and adapt for their work to ensure harmonized communication.
When improperly sealed, water drums are another breeding ground for mosquitoes.
Partners and stakeholders included:
Jamaica Ministry of Health: Health Promotion and Protection; Environmental Health and Vector Control; National Family Planning Board-Sexual and Reproductive Health Agency; Family Health Unit
Pan American Health Organization
International Federation of Red Cross and Red Crescent Societies (IFRC) and Jamaica Red Cross
Jamaica National Youth Service
An HC3 site visit with tire shop operators. Aedes aegypti mosquitoes, carriers of Zika and other infectious diseases, frequently use tires as their breeding grounds.
(First published April 10, 2017, on the HC3 website)
In this time of local ownership and scaled-back resources, it is imperative that organizational performance be linked with organizational sustainability.
The PROGRES_SBCC assessment team at Yayasan Cipta Cara Padu, Indonesia.
Gauge an organization’s development and performance across a spectrum of 12 domains
Assess an organization’s transition toward institutional, programmatic and financial sustainability
Draft and implement capacity and institutional development plans that can help an organization elevate its performance and progress along the development continuum
The PROGRES assessment tool draws from and builds upon existing institutional strengthening tools developed and used by MSH while implementing USAID-funded projects in Kenya, Tanzania, Ethiopia, South Africa and Nigeria.
Focus on Sustainability
PROGRESS_SBCC assessment with Nigerian Inter-faith Action Association.
PROGRES_SBCC provides a general overview of organizational capacity through a participatory process and facilitates the identification by civil society organizations (CSOs) and government institutions of areas within their organizations requiring support to foster sustainability and resilience. The program can also be adapted for use by organizations working in areas outside of health.
Sustainability is separated into three distinct areas: institutional, financial and programmatic. PROGRES_SBCC allows organizations to see how specific organizational capacity domains contribute to each area of sustainability. The program illuminates where organizational stunting occurs, so that capacity-building efforts can focus not only on under-performing domains but also on those domains that are impeding an organization’s sustainability.
The tool gathers data on an organization’s capacity along a broad range of performance parameters. PROGRES_SBCC breaks these down into 12 organizational capacity domains divided into seven core domains and four optional domains; assessment of the latter will depend on the mandate of the organization being assessed. These domains include:
PROGRES_SBCC assessment in progress at the Uganda Health Marketing Group.
Governance and Leadership
Finance, Operations and Administration
Human Resources Management
Social and Behavior Change Communication
Monitoring, Evaluation, Reporting and Knowledge Management
Advocacy, Networking and Alliance Building
Service Delivery and Quality Assurance
Coordination and Collaboration
Grants and Sub-grants Management
Each domain has sub-domains with three to six ideal practices within each sub-domain. The domains and sub-domains in the tool are also created to be adaptable according to the organization’s context.
Join the discussion
Join MSH and HC3 from April 11-13, 2017 to learn about the PROGRES_SBCC tool, see examples of its applications and explore solutions to some of the most pressing performance challenges that surface: mobilizing resources, management of SBCC programs and monitoring and evaluation of results.
All PROGRES_SBCC tools are available on the HealthCOMpass, including an instructional video, worksheets, and the User’s Guide. Take a look at the tools and join the discussion to talk about how PROGRES_SBCC can benefit you!
You must be a registered Springboard member to participate. To register:
Paul Kagwa is the Acting Commissioner for Community Health and Assistant Commissioner for Health Promotion in the Uganda Ministry of Health (MOH). He specializes in health promotion, community advocacy and media engagement and offers additional expertise in research, community engagement and human resource development.
Dr. Kagwa plans and coordinates SBCC programs and partnerships that the MOH is a stakeholder in. He found his work on Uganda’s containment efforts during the Ebola epidemic to be particularly rewarding, but notes that resource mobilization and the urgent demand for quick results and solutions can be an ongoing challenge.
Last November, Dr. Kagwa gave the keynote address at the Health Communication Practitioners/Springboard Uganda Community of Practice event in Kampala, focusing on how to use the life stage approach as part of an “umbrella SBCC strategy” that the MOH is developing. “This approach works to understand how and when to influence behaviors/ decisions, segment target audiences in relation to their life cycle and identify and address unique needs of audiences at various stages/cycles for 18 identified thematic areas,” Dr. Kagwa said at the event. Read more about the event here.
“Let’s share what we learned… and translate key learning into strategies that will improve SBCC planning and implementations in our communities.”
– Jude Ssenyonjo, FHI 360
Jude Ssenyonjo is a Capacity Strengthening Advisor for Social and Behavior Change Communication (SBCC). He works at FHI 360 for the USAID-funded Communication for Healthy Communities (CHC) Project. In this role, Jude provides strategic oversight to the Government of Uganda Ministry of Health and US Government implementing partners to design and implement SBCC capacity strengthening activities aimed at standardizing SBCC interventions in the country.
Jude holds a Master of Public Health Degree from the University of Birmingham and a Bachelor’s Degree in Sociology and Geography from Makerere University, Kampala.
Jude has 16 years of experience in SBCC planning and implementation in all health areas, including planning and facilitating SBCC trainings. In addition to FHI 360, he has worked on numerous projects in support of Marie Stopes International Uganda, Johns Hopkins Center for Communications Programs (CCP) and the Elizabeth Glaser Pediatric AIDS Foundation.
Jude values team work, is result oriented and works well in a multi-cultural setting.
Springboard highlights members periodically to acknowledge their contributions to the site.
“Springboard has really provided [a] platform to be more informed about health related communication.”
– Ayodele John Alonge, University of Ibadan
Ayodele John Alonge specializes in health communication, health information systems and health information management. He is particularly interested in health communication in the area of HIV/AIDS.
Ayodele earned a Bachelor Degree in Library and Information Studies and a Masters Degree in Publishing and Copyright Studies from the University of Ibadan, Nigeria. He now works at the University of Ibadan as an Emerging Technology Librarian, where he is in charge of research and application of new technologies to use for information and education resources management.
Ayodele is also a CARTA PhD Fellow at the School of Journalism and Mass Communication at the University of Nairobi, Kenya. In this program, he conducts research on the use of social media for HIV/AIDS communication amount young people. This research will lead to his PhD in Communication and Information.
Ayodele uses Springboard to stay up to date on trends in health communication and to interact with health information and communication professionals around the world. He says Springboard has been an invaluable platform to be more informed about health related communication and has supported his doctoral research.
In his free time, Ayodele enjoys listening to soft rock and country music. He also writes and reads poems.
Springboard highlights members periodically to acknowledge their contributions to the site.
“I use Springboard to exchange ideas, practice and information with professionals from all sectors to improve my project and to learn together.”
– Mahmudul Hasan, Centre for Injury Prevention and Research Bangladesh
Mahmudul Hasan is passionate about creating positive social change in Bangladesh by empowering people with essential information. He specializes in communicating the right message to the right person at the right time through the right channel.
As a Communications Specialist at Centre for Injury Prevention and Research Bangladesh(CIPRB), Mahmudul works to reduce injury fatalities and morbidities. He previously worked in communications for USAID’s Justice for All Program, World Vision Bangladesh and Habitat for Humanity Bangladesh. He attended Islamic University and earned a Masters of Arts in English.
Mahmudul understands the importance of social and behavior change communication (SBCC) and applies it across his work. While at World Vision Bangladesh, he participated in a recent SBCC project focused on hygiene and sanitation promotions. He’s currently using SBCC tools at CIPRB to reduce drownings in Bangladesh.
Mahmudul thinks Springboard is a great site to share learning and resources. He uses Springboard to exchange ideas, practice and information with professionals from all sectors. It helps him improve his projects and he enjoys learning from other Springboard members.
In his free time, Mahmudul enjoys spending time with friends. He also stays up to date with recent technology that can be used for communications, media relations and public relations.
Springboard highlights members periodically to acknowledge their contributions to the site.