Council researchers designed a behavior change communication strategy to reduce disease and improve family health outcomes in Uttar Pradesh, India.
Communication strategies play a key role in addressing the social and structural barriers to the adoption of healthy behaviors. Through targeted communication strategies aimed at changing individual and community health behaviors (i.e., behavior change communication), public health practitioners have made impressive strides in reducing disease and improving family health outcomes.
Yet, while the Indian government has consistently articulated its commitment to behavior change communication (BCC), in 2005–06 as many as 40% of women residing in Uttar Pradesh had not heard or seen any family planning message in the mass media, and only 20% had contact with a frontline health worker.
In response, the Population Council embarked on an initiative in 2009 to help the government design an effective behavior change communication strategy to improve family health outcomes in Uttar Pradesh. Working through a consortium, Council researchers:
- Identified the factors that influenced behavior change.
- Developed an evidence-based comprehensive BCC strategy aimed at improving reproductive, maternal, and child health outcomes in Uttar Pradesh, Bihar, and other northern states in India.
The study, conducted from 2009 to 2011, focused on the behaviors that, when not followed, are responsible for nearly half of all maternal and newborn deaths:
- institutional delivery and access to emergency obstetric care services;
- postnatal care for mothers and newborns;
- early and exclusive breastfeeding;
- appropriate complimentary feeding;
- postpartum contraception; and
- compliance with immunization schedules.
The study used quantitative and qualitative methods to identify the facilitating factors and barriers for each behavior and to examine the effectiveness of various communication modes for relaying messages to target audiences. Researchers conducted a survey with over 15,000 women as well as in-depth interviews with over 300. In addition, the study examined the role of various communication methods—including those aimed at women without access to modern media—and developed partnerships with television and radio stations, advertising agencies, and emerging technology companies (e.g., mobile phones).
Based on their findings, Council researchers and their partners developed an integrated BCC strategy to improve family health outcomes in Uttar Pradesh, along with a set of measurable outcome indicators to assess the intended behavior change.
The strategy, outlined in the resulting book, Shaping Demand and Practices to Improve Family Health Outcomes: Designing a Behavior Change Communication Strategy in India, is widely used throughout India and has contributed significantly to shaping demand and practice to improve family health outcomes in Uttar Pradesh and India. The Population Council also replicated the study in Bihar, with results outlined in volume two of the same title.
Since the conclusion of the study, donors have begun to invest heavily in BCC in India. The Population Council has emerged as a leader in the field, partnering with the Indian government and UNICEF to design BCC strategies in Bihar and Delhi, and working with other development partners on BCC initiatives throughout the country.