Communication for Improving Maternal, Infant and Young Child Nutrition: Developing, Implementing, and Monitoring Social and Behavior Change Communication Activities for a Five Country Project

Background: Maternal and child nutrition during the first 1,000 days – from conception through the age of two – shapes a child’s future. During this critical period, nutrition can have a measurable lasting impact on growth and brain development and prevent disease. CARE’s Window of Opportunity project (2008 – 2012) focuses on this time, using proven, cost-effective social and behavior change communication (SBCC) activities as part of its strategic approach to bring about significant and sustainable improvements in maternal dietary and infant and young child feeding practices. Programming is being supported through a central grant to CARE USA which provides resources to five countries (i.e., Bangladesh, Indonesia, Nicaragua, Peru and Sierra Leone) in three regions.

Program background: SBCC activities are an essential component of the Window of Opportunity project. SBCC is the term used to describe the use of communication activities to bring about change, including changes in individual behaviors of mothers (including self care, adherence, care seeking, and caregiving for children and other family members), other caregivers, and providers; changes in related social norms and collective actions; and creating an enabling environment. The Window of Opportunity’s SBCC approach is largely based on the socio-ecological model for change. This model describes how individual behaviors are influenced by multiple interdependent individual, social, and environmental factors, emphasizing the need for programs to implement strategic complementary communication activities using a wide variety of mutually reinforcing communication channels. Before project implementation, each Window country utilized a systematic planning process, defining optimal practices and behaviors, and identifying audiences and communication interventions at each level. The project uses targeted and tailored communication interventions to facilitate change, address barriers, and reinforce key messages at each level: caregiver, household, community, facility, and enabling environment. SBCC activities include a mix of mass media, traditional or folk media, and interpersonal communication activities.  

Evaluation Methods and Results: The ultimate goal of Window’s SBCC activities is to improve behaviors of health providers, women and other caregivers, members of their households, and facility and community-level health workers. In order to monitor progress, Window developed and uses observation checklists, supervision tools, and reporting forms. Window’s monitoring approaches have proven to be easy to use and widely accepted by country staff. SBCC activities have been modified based on monitoring data. Preliminary results from Window’s endline evaluations indicate significant improvements in maternal dietary and infant and young child feeding practices and nutrition.

Conclusions: SBCC activities are an essential program component for improving maternal, infant, and young child nutrition. It is important to use consistent, locally adapted, actionable messages at each level in order for interventions to be more likely to result in significant improvements.

Implications for research and/or practice: The success of public health programs- especially those that promote behavior change rests on effective communication. Communication in health programming is effective when it is well planned, the audience characteristics are studied and the information being offered is responsive to the needs of the target audience.