Population Council Research that makes a difference

India accounts for one-quarter or more of maternal and child mortality worldwide, and contributes to over one-quarter of the death and disease burden attributable to nutritional risk factors among children under age five. India's northern states, including Bihar and Uttar Pradesh (UP), account for a large proportion of this disease burden. While reviews of family health interventions have documented that simple home- and community-based interventions implemented at scale can considerably reduce the burden of maternal, newborn, and child mortality and morbidity and malnutrition, the adoption of these interventions has remained unacceptably low.

A well-aligned communication strategy that includes culturally contextualized messages on family health delivered through mid-level and mass media can play a key role in modifying high-risk practices and shaping demand for the adoption of preventive family health practices. In Bihar in 2005–06, almost half (49 percent) of women and 22 percent of men had not heard nor seen any family planning messages in mass media, wall paintings, or billboards, and only 19 percent of women had contact with a frontline family planning worker. Following the Council’s involvement in a landscaping study in Uttar Pradesh that aimed to develop an evidence-based behavior change communication (BCC) strategy, the Council also contributed to a study in Bihar to assess the factors influencing attitudes, perceptions, and practices of family health behaviors.

A comprehensive behavior change intervention will soon be implemented for changing key behaviors, with a bearing on family health indicators. A range of issues need to be considered when developing a comprehensive communication strategy for behavior change in rural Bihar. Key lessons for developing a BCC strategy include the need to focus on women, particularly young mothers and newly married couples, mothers-in-law and other "wise" females in the family, husbands, and health providers as key target audiences for improving selected behaviors. Because health providers often cannot reach small hamlets at a distance from villages and health facilities, special efforts are needed to focus on difficult-to-reach and poorly developed villages. Women from marginalized groups like scheduled castes and those with no education also require special focus. BCC strategies to improve family health behaviors can be implemented in partnership with media agencies.

Newspapers currently publish few items on health and development themes. In order to increase coverage of health issues a communication strategy will need to tailor communication approaches to each newspaper's priorities, making health an attractive issue for public debate, and train journalists to cover these issues effectively.