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Welcome to Vol. 18 of ‘Behaviour Change Matters’. In this edition we shall see how communication plays the key to social behaviour change in difficult settings and amongst different communities around the country. In our recent SBCC Alliance meet, UNICEF and partners came together for collaboration and commitment towards Knowledge Management. We take you to Gujarat’s Centre of Excellence that has adopted an institution driven approach to amplify SBCC interventions in the state. Communication works best when it is coupled with entertainment; take a sneak-peak into UNICEF’s special tele-series called Duur Se Namaste that brings you the story of a close-knit community, challenged and changed by the COVID-19 pandemic. And continuing to believe in learning as you have fun, Poshan ki Potli talks about a card game that has transformed the nutrition knowledge of rural women in Bihar.
Sid Shrestha Chief - Social and Behaviour Change, UNICEF India

UNICEF and partners come together to share the lessons and challenges of SBCC, creating a future path for better collaboration and strengthening Knowledge Management

Staying true to the principle of “power of partnerships”, UNICEF and its partner organisations met to strengthen the social and behaviour change community emphasising on the theme – SBCC in the New Normal. The meeting held on 2nd August 2022 was the first face-to-face since the COVID-19 pandemic started and was organised in a hybrid mode. With a clear reflection on past success, the meet helped define and underline the agenda for SBCC strategies that will be required to carry the best practices related to nutrition and behavioural science and knowledge management to the international communities in future. Siddartha Shrestha, Chief, Social and Behaviour Change, UNICEF India, emphasised on improving joint advocacy for issues like health, education and nutrition by building evidence-based policy briefs which will make advocacy easier for all. Siddartha believes that designing a ready repository of SBCC strategies could help build resources that could be externalised and shared with various ministries. Also, enhancing knowledge and strengthening social and behaviour change agenda will help to tackle difficulties in measurement of SBCC strategies.

Objectives and vision for the SBCC KM have been an integral part of the SBCC Alliance where learning from success and failures, avoiding duplication of resources, constructive critiquing and solution provision is discussed. ©UNICEF/India/AjayAhuja

Past success and lessons learnt During the meet several past successes were highlighted that have transpired even during the COVID-19 pandemic in the sphere of SBCC. Mentioning about the joint efforts made by all organisations in the field of SBCC, Siddhartha pointed out how everyone contributed towards Risk Communication and Community Engagement even during the peak of the pandemic. Another major success was seen in the SBCC South Asia Summit that proved to be inclusive and involved all the sector-based organisations in the South Asian region instead of being only India-centric. Creative ideas that help bring change The keynote speaker Shri Pravir Krishna (IAS), Ex MD TRIFED, spoke about Tribal Communication and Tribal Experience. The focal point of this presentation was on how changing the environment and designing a creative idea can bring about desired change. In this case, it was to bring together SBCC with enterprise development to enable tribal people to work as entrepreneurs. As an example, a unique development communication strategy that was utilised to eradicate poverty among the tribals suffering due to the exploits of the middlemen and to enable them to become entrepreneurs was discussed. The aim was for the tribals to get at least 70 per cent of the entire value chain. Through the health, nutrition and development communication programme with UNICEF in the Haat Bazaars, which are the economic hub for the tribals, they were able to vaccinate 10 crore people. Fifty thousand Vandhan Centres, where about 10 lakh people were working in about 50,000 tribal start-ups all over the country, saw huge success even during COVID-19 times. Messages of vaccination and nutrition were communicated through their products, branding, marketing and packaging.

Dr Ritu Ghosh, Regional Manager, Behavior Change Communication Asia, Nutrition International explained how “a mascot can do wonders” - exploring the experience from Double Fortified Salt (DFS) Project in Madhya Pradesh and Gujarat. The presentation revolved around how involving the community in strategy development can prove to be immensely beneficial. As part of a campaign for DFS Vanya Salt, the Lali Campaign was launched to create awareness and acceptance around the product. To bust the myths and misconceptions against the product, Lali, the mascot, was introduced. The character was designed by the community members during the process of strategy development which proved to be an effective mitigation strategy. Since there was a lot of misinformation circulating, Lali proved to be an effective communication tool across different media platforms. The campaign was scaled-up from a few districts of Madhya Pradesh to the entire state and now DFA Vanya Salt is available at subsidised rates of Rs. 1 per kg. Sophia Lonappan, Risk Communication and Public Health Officer, World Health Organization – India, believes that the SBCC Alliance was a much needed platform to learn innovations and challenges from partner networks. “Strategic and focused discussions on SBCC innovations undertaken for fortification were great to learn about, specially through the varied state and partner experiences. The deliberations reiterated the importance of making communities as centre of response and the need to recognize community leaders as vital assets if we are to look at longer term behaviour change,” she said. Future objectives for SBCC The two main agendas at SBCC Alliance were to share the SBCC experience and best practices related to nutrition and behavioural science as well as an in-depth discussion on how the knowledge management platform can be strengthened in a more sustainable way and to see if it can go beyond India to the international community. It was observed that going beyond the Social Ecological Model and Behavioural Drivers Model, a behavioural science approach needs to be adopted to look beyond the changes in the mind and the environment and go on towards changing other important factors like availability of services. It was further realised that decisions must be pushed into System 1 thinking of human behaviour to bring about change in rational choices. We also need to look at how the proven experiences can be scaled up all over the country and possibly overseas. A rich discussion on Knowledge Management (KM) was then initiated by section Chief Siddartha Shrestha and Tamara Abu Sham, SBC Specialist, UNICEF India. Looking back at Phase 1 from 2018, the objectives and vision for the SBCC KM were set where learning from success and failures, avoiding duplication of resources and replication and scale-up, constructive critiquing and solution provision were highlighted. Mapping relevant materials and strategies, creating a shared vision and conducting usability tests are some of the steps to create a one-stop shop for KM SBC users. The central focus is to move from a vertical to a more horizontal approach in KM. Rina Dey, Communication Specialist from Alliance for Immunization and Health highlighted the need to address the audience of this initiative, how the materials and strategies be made available in a simple and crisp manner, and how local languages should be prioritised for all materials being made available. Tamara Abu Sham remarked that a dedicated group of editors who can conduct a quality check of the materials and strategies that will be collated for the KM initiative would be beneficial and crucial to maintain the quality of materials. Participants from different organisations volunteered to be part of the KM platform team set up by the SBCC Alliance. “Kudos to the UNICEF team for getting all the practices and partners together ! Of course, the content of the discussion was very rich and I hope UNICEF takes the lead in taking it to the next level, especially on the Knowledge Management front. We look forward to that”, said K Laxmikant, Senior Director, SBC, Pathfinder. Looking ahead The SBCC Alliance meet proved to be an opportunity for UNICEF and partners to commit to KM and strengthen the systems in order to collate and channelise the information on strategies, experiments, materials and research related to SBCC. The agenda for the next SBCC Alliance meeting shall aim to discuss the lessons related to knowledge expansion in the past.  Pooja Sehgal, Lead - Health Communications, Bill & Melinda Gates Foundation feels that the SBCC Alliance is an opprtunity to bring together people working on similar challenges for similar audiences, helping to learn, collaborate and build networks. “This is even more relevant when the themes are relatively new or emerging and evolving, and everyone is largely in the initial phases of the learning journey, like for Social and Behaviour Change. The SBCC Alliance offers a great platform for such knowledge sharing conversations - always a pleasure to participate in these discussions”, she said.

A look at UNICEF Gujarat’s all round interventions towards strengthening systemic capacity for SBCC in the state through Centre of Excellence, with support from USAID 

Behaviour change is not only about changing people, but it is also about changing the environment in which they are. UNICEF Gujarat has adopted an institution driven approach, collaborating with people and partners at individual, community and institutional level through community influencers, platforms and networks, academic institutions, faith-based organizations, industry associations, government agencies and private sector to amplify SBCC interventions in the state. This has resulted in setting up one of a kind, and the first, within the oldest and largest public university of India, Gujarat University’s Centre for Development Communication under Department of Communication, Journalism and Public Relations - Centre of Excellence in Communication for Social and Behaviour Change (CoE-CSBC).   CoE-CSBC was set up with an objective of providing thought leadership for adapting different social behaviour change models leading to system strengthening, capacity development, building social capital, strengthening community platforms, and mega-partnerships at large scale. It is the first of its kind academic hub that aided policy advocacy through evidence based behavioural research and supported capacity development in Government of Gujarat, civil society, and other community-based networks.  

Through its journey from 2020 till now, the activities conducted by the Centre have resulted in setup of key state level platforms for driving social and behaviour change - State level civil society coalition (Gujarat Samajik Sangathan), Community Media Association (including Community Radio and Traditional/folk media), Tribal Youth Fellowship and CoE-CSBC is now becoming an independent institution as Institute for Social and Behaviour Change (ISBCA).  Youth as change agents for SBC  Leveraging the immense potential of youth as agents of social and behaviour change, several initiatives were undertaken offline in 2020, and subsequently in a hybrid mode to promote COVID Appropriate Behaviour, COVID Vaccination, reduce vaccine hesitancy, promoting mental health and extending psychosocial support to the communities at large. This resulted in creating several platforms and mass campaigns which were led by the youth and young influencers of Gujarat. Nearly 300 youths from Ahmedabad schools and colleges were inducted and empowered through the Young Ambassadors Programme. Approximately 79 sessions were conducted with young people on COVID-19. They reached out to 1,690 adolescents and overall, 129 young ambassadors were registered to curb the adverse effects of COVID-19.     The success of Young Ambassador programme led to many impactful campaigns and creating state level engaging platforms. Tailor-made social media strategy and communication campaign aimed at developing a community-based model to meet the basic needs at the time of lockdown was designed. This led to establishing state level interactive collaboration platform Gujarat Youth Forum which leveraged the power of youth influencers of Gujarat in advocating CAB and COVID-19 vaccine. A state level campaign called Gujarat Na Karamveer (hardworking hero of Gujarat) was launched to create a mass movement in fight against COVID-19. Over 10,000 youth volunteers were trained in CAB, CAB+ which then disseminated the messages at community level. For an inclusive SBC programming, CoE-CSBC pioneered the launch of Tribal Youth Fellowship in 2021 to train young tribal youth in promoting CAB+ and vaccine among their communities and empower them to facilitate government schemes and flagships.     CoE-CSBC enhanced the capacities of all the departments through the design, development, and dissemination of key RCCE messages in Gujarat. 500 leaders of dairy cooperatives reaching to 2 lakh audience, 8 lakh SHG and 16,000 PRI members, 2 lakh ICDS and health functionaries, 40,000 ASHA and AWW functionaries and about 10 faith based organizations were trained and engaged in CAB, CAB+ communication. Urban Micro-planning through COVID Resource Centers In 78 out of targeted 80 informal residential settlements in Ahmedabad (nearly 12,000 HHs with 60,000 people) micro-planning exercises were undertaken by local committees to develop COVID response micro-plans. COVID Resource Centres were established to provide support on mental health, nutrition, and institutional reopening.

COVID Vijay Raths Five outdoor publicity vehicles travelled across all 33 districts of Gujarat for 44 days with more than 400 song and drama division artists of PIB/ROB reaching out to public with key behavioural messages in folk art forms. These vehicles termed as ‘COVID Vijay Rath’  covered approximately 8000 kms, more than 21 districts, travelled to more than 720 villages/towns, performing no less than 600 folk arts and reached out to 7.9 lakh audiences.   Intensifying voices through community radio  Community radio channels were mobilised to spread COVID messages through various creative campaigns. Over 21 lakh people including children,  women,  migrant  workers, fisher   folk community,   slum   dwellers,   saltpan   workers   and   members   from   the   minority communities,  spread  across  900  villages  of  10 blocks  in  Kutch  district of Gujarat were reached out through innovative programmes like Patipen (slate and pencil), Tu Jiyro Ai (to be alive), VijayRath (victory cart) and Bhag Corona Bhag (run corona run)

A state level coalition of 230 community-based organizations called ‘Gujarat Samajik Sangathan’ was formed in 2022 to centralize the SBC interventions in the state. ©UNICEF/India/2022

Gujarat’s traditional and folk media artforms 230 traditional and folk media artists groups were trained to build community awareness and engagement on health, nutrition, and education issues along with COVID communication. 40 traditional and folk media artists intensively engaged and went to four districts to advocate adoption of CAB and C-Vax through 60 performances, reaching out to 41 villages of Gujarat.  The cohort of 230 organizations would work closely with communities in generating insights for designing behaviour change interventions in key health and wellness and nutrition programmes.    SBC interventions in Gujarat are scaling up to now support the global agenda of using behavioural insights for effective programming. As the first step towards this, CoE-CSBC is now being envisioned as an independent institution – Institute for Social and Behaviour Change (ISBCA). This will be an institute of eminence in SBC established in Gujarat. The Government of Gujarat entered partnership with UNICEF during pre-Vibrant Gujarat summit events on 5th January 2022 to establish this institute in partnership with Gujarat University. ISBCA will promote and apply behavioural insights within policy and programmes. It aims to use its behavioural insights capability as a communication, policy, and research tool to improve policy and programme outcomes through a better understanding of human behaviour.
A 30-episode edutainment television series promotes good health practices during COVID-19, supported by UNICEF and USAID India in partnership with Doordarshan

Television has emerged as one of the most trusted communication mediums in recent studies. Most audiences respond to and recall most of the messages they watch in specifically crafted Entertainment Education (EE). Such inventions can be a powerful tool to engage people and generate behaviour change, as the aim is to not only change the level of knowledge among viewers but also impact their attitudes, and eventually alter their practices. Duur Se Namaste is produced by UNICEF and supported by USAID, with the EE principles of educating viewers while entertaining them. The show will be broadcast on Doordarshan, the national television network, and will have an outreach component to facilitate wider reach and deeper engagement with the audiences. The initiative also has a strong monitoring and research component for impact assessment and learning for the sector. Quirky characters, serious messages Duur Se Namaste (greet from a distance) is a show where a close-knit community comes together in the ‘new normal’ resulting from their experiences and lessons of COVID-19 pandemic. The 30-episode television series has been designed in a storytelling format with elements of humour, drama and comedy and a host of memorable characters. As the story moves forward, the audiences will witness family feuds, turf wars, chilling ambition and also a budding love story. While the male lead character Vishu is always ready to help others but is lost in his own life, Geet the female lead, dreams of success and fame but finds herself caught between the old and the new. Vishu and Geet’s love story faces some interesting twists and turns woven alongside COVID-19 communication messages that finally help the whole neighbourhood find new meaning to their lives.

The show promotes the COVID-19 vaccine while dealing with reasons for vaccine hesitancy and the need for continuing COVID Appropriate Behaviour (CAB). It also highlights issues of mental health among adults and ways to support children as they return to school. An interesting element in the show is COVID-19 virus itself, that plays the narrator and throws up many challenges at people, forcing them to confront who they really are ! Transforming lives through communication Duur Se Namaste follows the everyday life of its characters, weaving in the messages on COVID-19 vaccination, CAB and navigating life in a changed world. It promotes vaccine eagerness, counter hesitancy and also takes on the many myths around the vaccines. It also encourages ambassadors of the vaccine and CAB among viewers of the show to spread messages within their families and community. The narrative moves forward with positive stories of vaccination and demonstrates how CAB has to be adopted in everyday situations taken from real life. It also empowers audiences with information on social protection schemes and other safeguards during the uncertain times brought on by the pandemic. There is focus on mental health challenges being faced by women and children due to the long nature of pandemic, isolation and lesser space for social interactions. It also highlights the need for fortified nutrition, continuation of education, mental health support for children, especially girls and adolescents as they deal with COVID-19. Duur Se Namaste aims at community outreach through UNICEF state offices and NGO partners, while building strong roots on social media and ensuring concurrent monitoring and baseline/endline assessments. The show has started to broadcast new episodes every Sunday at 11 am on DD National channel and YouTube, with repeat telecasts every Saturday at 6 pm. Triggering the right conversations UNICEF is a pioneer in the space of Entertainment Education in India; starting conversations on social norms surrounding women’s rights and empowering through unique initiatives like Jeena Isi Ka Naam Hai (2008-11) and adolescent health with Adha Full (2016-18). While most interventions tackle existing norms, with Duur Se Namaste, UNICEF is bringing the focus on setting up new norms of behaviour (CAB) and following new practices such as wearing face masks, handwashing/sanitising and social distancing. The show also triggers conversations on closely held beliefs on education and nutrition, mental health, the value of girl child, among others.

Watch as the lives of a close-knit community are touched, changed and challenged by the COVID-19 pandemic; the pandemic that gives them a choice of stepping up to be heroes, or carrying on with their old ways and becoming side characters, or worse, villains!
Building nutrition awareness amongst the women of Bihar with a unique fun-filled card game
In a remote corner of Bihar’s Nawada district, ten women, who are a part of a local SHG group of Pakribarawan Block sit on a floor mat in a dark room flanked by an open corridor. They sit cross legged, talking animatedly to one another, holding cards that have images of locally sourced foods, as they attempt to put together a nutritious meal for their families.   “Tell me,” one of them asks, “how will you cook this okra dish for your daughter-in-law now?” The other woman smiles and replies, “With a little oil and onion, we will fry it.” Another chimes in, “You can’t fry everything, it’s not healthy.” The room is filled with joyful chit-chat that revolves around food and cooking skills.   Whenever these women get together they have upfront conversations about various aspects of their daily food related issues, be it the rising cost of vegetables in the local market or new and healthy recipes they have learnt about. Thanks to Poshan ki Potli, a game developed by Seeking Modern Applications for Real Transformation’s (SMART) social gaming vertical – The Civic Games Lab. The game helps the women learn and grow as well as develop social bonds and friendships as they get together with a bunch of cards that has helped them evolve their food habits.

Poshan ki Potli game has been playtested with thousands of women in different geographies. After being tested in Jharkhand and Bihar, it was redesigned with support from the Gates Foundation. ©UNICEF/India/2022

What is Poshan ki Potli?

Poshan ki Potli (bag of nutrition) is a card game that pushes women to imagine better diets, helps deepen their understanding of diet diversity and food groups, and at the same time serves as a medium of recipe sharing amongst the participants. The deck of 110 cards can be played in a number of ways. Players can learn about food groups, measure the nutritional value of what they ate yesterday, and find ways to improve what they eat tomorrow.

The game development has adopted a science of nutrition-first lens, with an emphasis on locally grown food items. It uses the language, verbs, metaphors, and quips of the community where it is being played. It borrows heavily from the research conducted by the National Institute of Nutrition (NIN) and others working in this space. The game has been playtested with thousands of women in different geographies. Initially, it was tested in the states of Chhattisgarh and Jharkhand, and after receiving positive feedback from the field, it was redesigned, with support from the Gates Foundation, to be piloted in 20 blocks of Bihar. The game is also being shared and will be played in 10 districts in the states of Kerala, Uttar Pradesh, Odisha, Gujarat, Haryana, Rajasthan and MP as part of the Poshan Ghar initiative supported by UNICEF.  

The call for action

In past two years, COVID-19 has worsened India’s already existing malnourishment problems. The NFHS-5 has revealed that there has been a significant rise in anaemia amongst women and men aged 15-49. The data shows an increase in severe wasting in children under five—from 7.5% in 2015-’16, when the previous round of the survey was conducted, to 7.7% in 2019-’21. Wasting, or low weight compared to height, could be caused by prolonged weight loss and poor nutrition. In 22 states and Union Territories, more women have slipped into anaemia over the last five years. Anaemia levels ranged between 30% to 90% in most states, while in at least 12 states, over 60% of women surveyed were found to be anaemic.

Repeated lockdowns have threatened food security, laying bare the contradictions in India’s food security landscape across all four indicators: availability, access, stability, and utilisation of resources.


Building the knowledge of nutrition

Over the past two years, the game Poshan ki Potli has attempted to fill an important gap in the fight against malnourishment. The game was developed to improve the understanding of diet diversity, build a system of knowledge sharing amongst women, help improve local food consumption, and encourage women to think about other sources of nutrition than what they eat regularly. The effort was to build a game that is interactive, participative and community-driven. One that creates an environment for social and behaviour change and helps participants not only to speak out and have fun but also retain the core messages of better nutrition.

“I have not enjoyed myself so much in a long time. The information on these cards will stay with me. When I go to the market to buy groceries, I will be aware of the nutrition that comes with every item I pick,” said Aarti Devi, a 30-year-old woman from Kotha, Chhattisgarh.

28-year-old Mamta Devi, from Deodha, Bihar says, “This is such a fun way to learn about nutrition. Earlier we were only being told by Didi what to do. But this game is a liberating experience as the cards are speaking out for themselves!”

Poshan ki Potli is also being shared with 10 districts in the states of Kerala, Uttar Pradesh, Odisha, Gujarat, Haryana, Rajasthan and MP as part of Poshan Ghar initiative supported by UNICEF. ©UNICEF/India/2022

Play, learn and bring the change

Poshan ki Potli is a game that centres the participants and makes them stakeholders in their own stories. Once the conversation ends, the facilitator brings the session to a close, asking the women to sort out all the cards according to their food groups. They are required to complete the task in a short span of two minutes. You can see the women quickly getting on their haunches, and begin furiously working together. Shouting excitedly, handing each other the cards, one could hear them say, “Yay! I have the green veggies pile.” - ‘Dark green leafy vegetables’ is one of the 10 food groups identified by FANTA (Food and Nutrition Technical Assistance III Project), others including grains, pulses, nuts, eggs, fruits etc. They then pack the card deck neatly, leaving the session and talking about what they have just played as they walk back together to their homes.

The game Poshan ki Potli was initially built for Digital Green and then modified and tested with SHG groups of JEEVIKA, Bihar Rural Livelihoods Promotional Society, with support from the Bill and Melinda Gates foundation. The creators are now working towards incorporating different foods of states with UNICEF, to make it more relatable for the users.
The documents disseminated by Behaviour Change Matters
do not necessarily reflect an official position by UNICEF.

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