Health Communication Component, Pakistan

From 2014-2018, the Johns Hopkins Center for Communication Programs (CCP) led the Health Communication Component (HCC) in Pakistan, an initiative that worked to improve maternal, newborn and child health and family planning in the country’s southeastern Sindh province.

The project envisioned a Pakistan where individuals, families and communities advocate for their own health, practice positive health behaviors and engage with a responsive health care system. Central to accomplishing those goals was the development of the “Bright Star” campaign. HCC described a “Bright Star” as someone working to improve the health of his or her family, community or country. HCC’s aspirational mass media campaign and comprehensive approach to community mobilization encouraged people to come together to spark meaningful behavior change to improve maternal and child health.

The Health Communication Component worked to assist Pakistanis with advocating for a stronger health care system in their country.

During these five years, the Health Communication Component:

  • Helped develop the popular television serial Sammi, which used engrossing characters and engaging storytelling to raise awareness of social issues and prejudices rarely discussed in mainstream Pakistani society. Sammi has reached more than 9 million viewers through television and social media.

  • Designed several toolkits to engage community members in discussions around the issues of gender, health, and social norms.

  • Developed mobilization tools – both print and digital – to help frontline health workers counsel their clients and lead community meetings on issues of maternal and child health, nutrition and immunization as well as family planning. One such tool, the IPC toolkit, equipped more than 7,500 health workers to reach more than 2 million community members.

  • Established partnerships, including with local universities, to help Pakistanis create their own behavior change programming.

  • Implemented a family planning campaign that reached more than 95,000 people through community fairs and more than 10 million people through mass media, including two short films. The successful campaign spurred an increase in referrals for family planning from 8,230 to 11,686 per month.

With the mass media products created in the Bright Star and Lady Health Worker campaigns, the project reached an estimated audience of 38.5 million people.

  • Community Mobilization Activities, and Community Media Activities under the Family Planning Campaign – including health talks, health stalls, mohalla (neighborhood) meetings, flotillas, and grand mela events and Bright Star outreaches – spread over 10 districts – directly reached 128,520 people.

  • Overall, more than 10,600 individuals were exposed to the project work, including 6,260 Lady Health Workers, 2,340 government personnel, 41 university students and 1,571 Community Health Workers (CHWs) who have received job aids and tailored training.

Project Activities

Sammi, A TV Serial Drama

Hailed by critics and viewers alike, the 2017 Pakistani television drama Sammi was called a “stand out” by the English-language publication The News on Sunday, while the website Hip In Pakistan called it the show “no one should miss.”

But this popular series was more than just entertaining. Sammi uses engrossing characters and engaging storytelling to raise awareness of social issues and prejudices rarely discussed in mainstream Pakistani society – with the ultimate goal of encouraging behavior change.

Sammi also tackled some of the underlying and deeply rooted social and gender norms of a society where discrimination against women is acceptable, and where traditional, cultural and religious practices impact the acceptance and practice of healthy behaviors surrounding family planning and maternal and child health, including visiting health clinics and adopting modern contraceptive methods.

Bright Star Family Planning Campaign

This harmonized multi-level campaign included behavior change communication activities at the community, mid- and mass media levels. The campaign materials included two short films, two television commercials (TVCs), two radio spots, 250,000 flyers and annual calendars to be used during the mass, mid and community level media activities. HCC conducted the campaign in ten intervention districts.

Goals of the campaign were to:

  • Increase knowledge and access to family planning services
  • Increase the contraceptive prevalence rate
  • Reduce unmet need for family planning

Roshan Mustaqil, a Distance Education Smartphone app for Lady Health Workers

The Roshan Mustaqbil app is an adaptation of a paper-based toolkit designed to improve interpersonal communication among Lady Health Workers. The app includes two sections: An mCounseling section featuring 44 short video clips designed to be used during counseling sessions: 22 depicting a negative scenario and 22 depicting positive attitudes and healthy behaviors. The app also features an mLearning section that includes 21 instructional videos and self-directed activities to help improve the IPC skills of LHWs. A pilot study was carried out in the Matiari district to assess the feasibility and usability of using the app to improve LHW job performance.


Additional Project Materials and Products

Source: Johns Hopkins Center for Communication Programs, USAID

Date of Publication: October 13, 2020

Smart Client and Smart Couple: Digital Health Tools to Empower Women and Couples for Family Planning

To prepare women and men for more effective FP decision-making communication before, during and after a counseling visit, under its global activities, the Health Communication Capacity Collaborative (HC3), a project under the Johns Hopkins Center for Communication Programs (CCP) developed two “smart client” tools – one prioritizing women, and one prioritizing couples. The tools are mobile-phone, SMS- and interactive voice technology (IVR)- based and are designed to provide information and introduce practical skills to help women and their partners be informed, empowered and confident clients.

Both tools were pretested in Nigeria and Cote d’Ivoire, and larger user studies were conducted with both tools in Kaduna, Nigeria to evaluate the effects of the tools. Participants in the user studies had very positive feedback about the content and their experience using the tools. Furthermore, both tools had a significant positive impact on users’ beliefs and intentions related to family planning.

The Smart Client and Smart Couple tools have been developed with the intention that they can be adopted and adapted by other FP projects seeking another channel for reaching their target audience.

The following tools and reports are available:

Source: Johns Hopkins Center for Communication Programs

Date of Publication: October 13, 2020

Country Focus: Ghana

Private Sector Malaria Prevention

PSMP is a three-year project funded by the United Kingdom Department for International Development (DFID) and operated by the Johns Hopkins Center for Communication Programs (CCP). The purpose of the PSMP is to catalyze private sector engagement in malaria control, in particular in the supply and distribution of Long Lasting Insecticidal Nets (LLIN).

Communicate for Health Ghana (C4H), 2014-2019

The C4H project worked with the Government of Ghana, the Ghana Health Service/Health Promotion Department (GHS/HPD) and local Ghanaian and international development partners to influence behavior change in family planning; nutrition; maternal, newborn and child health; malaria prevention and treatment; water, sanitation and hygiene (WASH); and HIV/AIDS. The project built on USAID’s legacy of improving health and nutrition in Ghana, including support for improved health communication. Partners were FHI360, VOTO Mobile (now Viamo), Creative Storm Networks and Ghana Community Radio Network.

Project objectives were to:

  • Support the Government of Ghana’s efforts to influence positive behavior change in the health areas described above
  • Strengthen the capacity of the GHS/HPD to effectively develop, coordinate and deliver evidence-based social and behavior change campaigns, including monitoring and evaluation
  • Develop and strengthen the capacity of local SBC organizations to deliver quality health communication programming

Voices for a Malaria-Free Future, 2010-2013

Voices for a Malaria-Free Future (Voices) was led by CCP since 2006 and is closely aligned with the United Against Malaria (UAM) campaign, which used soccer as the catalyst to raise global awareness and galvanize worldwide commitment to end malaria deaths by 2015.

Ghana Behavior Change Support Project

The Ghana Behavior Change Support (BCS) Project, 2009-2013, was a 4 year United States Agency for International Development (USAID) supported project managed by CCP with CARE and PLAN International in partnership with the Ministry of Health and the Ghana Health Service (GHS).

The overall purpose of the project was to assist the GHS at the national, regional and district levels to support its efforts to achieve health related millennium development goals through sustained and coherent social and behavior change communication (SBC) interventions. BCS aimed to increase demand and use of commodities and services and create positive behaviors in the areas of: Maternal Neonatal & Child Health Family Planning Malaria Prevention & Treatment Nutrition Water, Sanitation, & Hygiene. Projects include The GoodLife, Live it Well Campaign, 2010-2014 and the Aha ye de Campaign.

Why is This Man Smiling? Vasectomy Promotion Campaign, 2003

In 2003, the Ghana Health Service, the U.S. Agency for International Development (USAID) Mission in Ghana, and EngenderHealth (under its former cooperative agreement) collaborated on a pilot program in Accra and Kumasi metropolitan areas to explore whether vasectomy is a viable contraceptive choice when site interventions that focus on issues of quality and access are coupled with effective and strategic interventions aimed at public awareness. The aim was to make this method available and put the choice into the hands of Ghanaian couples.

Source: Johns Hopkins Center for Communication Programs

Date of Publication: October 7, 2020

Country Focus: Malawi

Malawi BRIDGE I and II

BRIDGE was designed to energize change in the way Malawians think and speak about HIV/AIDS and more importantly, in how they act.

BRIDGE is an acronym for:

  • Belief in a better future (hope)
  • Risk is shared by everyone (personalized risk)
  • I can STOP AIDS (personal responsibility, action, self-efficacy)
  • Discussion about HIV/AIDS (openness, destigmatization)
  • Gender equity (girls’ empowerment and changed men’s behavior)
  • Emphasizing the positive (action orientation, community assets, positive role modeling)

The project’s objectives were:

  • Increase the median age at first sex
  • Increase condom use by adults with non-r
  • Decrease unmarried youth 15-24 having sex in last 12 months
  • Decrease number of men reporting more than one sexual partner during the last 12 months
  • Increase condom use by unmarried youth

Support for Service Delivery Integration (SSDI)

In 2011, USAID Malawi awarded the five year, US $100 million Support for Service DeliveryIntegration (SSDI) Project, consisting of three separate, but interrelated Cooperative Agreements: SSDI-Services, SSDI-Systems and SSDI-Communication. SSDI Services works withthe Government to achieve improved service delivery; SSDI Systems to improve policies, management and leadership; and SSDI Communication to support social and behavior change communication (SBCC). SSDI-Communication was implemented by JHU/CCP in collaboration with Save the Children. SSDI-Communication developed and disseminated behavior change communication materials on 6six priority health areas- family planning and reproductive health, malaria, HIV/AIDS, maternal, neonatal and child health, nutrition, and WASH, all under the Moyo ndi Mpamba (Life is Precious) campaign.

Moyo ndi Mpamba Campaign

This campaign, the title of which means “Life is Precious, Take Care of It!” was part of the Support for Service Delivery Integration (SSDI)-Communication project, implemented by the Johns Hopkins Center for Communication Programs (CCP) and partners in Malawi from 2011-2016.

Other SSDI project materials here

Source: Johns Hopkins Center for Communication Programs

Date of Publication: October 7, 2020

Country Focus: Mali

Communication et Promotion de la Sante, Keneya Jemu Kan, 2014-2019

The main objective of the USAID | Communication et Promotion de la Santé/Keneya Jemu Kan project is to promote key health behaviors and increase demand for and use of high impact health-related commodities and services by men, women and children in Mali. Health areas included MNCH, FP/RH, Malaria, HIV, Nutrition, and WASH.

The project’s Intermediate Results include:

  • Increased adoption of key healthy behaviors and increased demand for and use of high impact health services and related health products at the community and household levels
  • Demonstrated Malian capacity to conduct research, and design, test, implement and evaluate Social and Behavior Change Communication (SBCC) and Social Marketing (SM)
  • Increased availability of socially marketed high impact health service-related products and expanded non-public services in USAID target geographic areas

Materials here – http://www.projet-kjk.ml/mediatheque-2/

Source: Johns Hopkins Center for Communication Programs

Date of Publication: October 7, 2020

Country Focus: Nepal

Breakthrough ACTION Nepal

Between 20182020, CCP is implementing a USAID-funded SBC systems strengthening project in collaboration with the National Health Education Information and Communication Center (NHEICC) and Family Welfare Division (FWD). The project first assessed SBC capacity at the federal, provincial (Karnali Province) and project municipalities in Jumla and Surkhet. Based on the assessment findings, CCP worked closely with NHEICC, Karnali Ministry of Social Development (MoSD), Karnali Health Directorate (HD), and municipality elected representatives (executive committee) and health staff to address SBC capacity gaps through trainings, mentoring, practical, learning by doing activities.

Health Communication Capacity Collaborative (HC3) Nepal

Between 2013 and 2017 CCP partnered with the Government of Nepal under the USAID-funded HC3 Nepal Project, with a focus on improving reproductive health outcomes among youth, adolescents, migrants and marginalized and disadvantaged groups through a targeted national family planning campaign. This national-level project worked closely with NHEICC and the former Family Health Division in order to support a comprehensive, evidence-based campaign and advocacy among these groups. Nepal HC3 also developed the overall institutional and technical capacity of NHEICC through workshops and targeted technical assistance. The program worked diligently, developing high quality family planning communication materials and conducting community outreach activities

Three videos which describe the HC3 project are:

Response to 2015 Earthquake

The project coordinated and contributed to the SBC effort such as emergency response activities to support communication related efforts immediately after the 2015 earthquake.

Smart Jeewan (Smart Life) Family Planning Campaign

The Smart Jeewan (Smart Life) family planning national campaign designed to increase modern FP method use among priority populations featured innovative audience segmentation by lifestyle and social status, rather than age, reaching migrant workers and young couples after the birth of their first child. To extend its influence, the program partnered with Western Union to provide campaign information along with financial remittances and used mHealth and social media, including Facebook to engage people.

Suaahara II

Suaahara II is a five-year (2016-2021), $63 million integrated program dedicated to improving the health and nutrition status of women and children who fall within the 1,000 days period, from conception until a child reaches 24 months of age. This period is recognized as the crucial timeframe during which nutritional interventions have optimal impact on child growth and development. In selected districts, Suaahara II supports the Government of Nepal (GON) in expanding health and nutrition services that target adolescents. In particular, the project addresses anemia, reproductive health, menstrual hygiene, food diversity, social attitudes towards delayed marriage and pregnancy, and health service utilization.

Suaahara I

Between 2011 and 2016 CCP was an implementing partner in USAID’s Suaahara integrated nutrition program in Nepal, was responsible for providing strategic and technical direction and leadership in the areas of SBCC, social mobilization and advocacy. Suaahara increased demand for various services provided through the health system by using dynamic and innovative communication channels, such as the Bhanchin Aama (Mother Says) Communication Platform.

Maternal and Child Health Integrated Program (MCHIP)

In 2010 CCP provided technical assistance to the JHPIEGO-funded MCHIP program to pilot community-based calcium supplementation for pregnant women by developing a communication strategy, research and monitoring tools and interpersonal communication materials.

SSMP (Support to Safe Motherhood Program)

Between 2006 and 2008, CCP worked with Options to implement the DFID-funded Support to Safe Motherhood Program (SSMP) in Nepal. CCP worked with the Government of Nepal to build capacity to institute a minimum package of essential maternity services. The Center provided technical support for the SBC component of the SSMP program and, in particular, supported stakeholders in planning, implementing and monitoring the Safe Motherhood IEC Strategy. Overall, CCP worked to promote dialogue between women and providers on quality of care, and increasing equity and access at the district level. SSMP led to increases in full antenatal care (45% to 60%), delivery in a health facility (21% to 40%), essential newborn care (9% to 35%) and birth preparedness and complication readiness (4% to 12%).

SUMATA Initiative

The SUMATA initiative was launched on March 8, 2002 as a multilevel SM behavior change initiative designed to support the efforts of the Government of Nepal to reduce the high maternal mortality rate in Nepal. The initiative primarily addresses husbands and mothers-in-law, calling them to care for their wives/daughters-in-law during pregnancy, birth, and the postpartum period; to share love, information, and the workload; and to prepare for childbirth and any complications that could occur during that stage. In districts with upgraded Emergency Obstetric Care services, SUMATA includes complication readiness, recognition of danger signs, and seeking emergency care, if required. SUMATA is an acronym for Care, Share, and Prepare.

Nepal Family Health Program (NFHP)

From 2001 to 2006, in collaboration with the Nepal Ministry of Health, CCP provided technical assistance under the USAID-funded Nepal Family Health Program (NFHP) to reduce fertility and protect family health through increased FP and MNCH services using mass media such as radio programs and IPC.

Radio Communication Program

Between 1994 and 2001, CCP developed the Radio Communication Program in collaboration with Nepal’s Government, the National Health Training Council (NHTC), the National Health Education Information and Communication Council (NHEICC) and the Family Health Division (FHD). CCP provided technical assistance for the communication strategy which integrated mass media, distance education, and IPC and counseling. These activities improved contraceptive service quality, empowered clients to seek contraceptive information and services and promoted concepts of “responsible husband” and “well-planned family”. Men and women in intervention districts had significantly higher knowledge and more positive FP attitudes and behaviors compared with non-intervention districts.

Source: Johns Hopkins Center for Communication Programs

Date of Publication: October 7, 2020

NURHI II

In the second phase of this project, 2015-2020, NURHI worked to contribute to achieving the national goal of increasing mCPR to 36% by 2018. Funded by the Bill and Melinda Gates Foundation and TJ Mather, its core partners included JHCCP, ARFH and CCPN, and its mandate was the scaling up, institutionalization and sustainability of the proven NURHI model to new geographies.

The primary outcome was a positive shift in family planning social norms at the structural, service, and community levels that drives increases in modern contraceptive use (CPR) in Kaduna, Lagos, and Oyo states.

Project materials from NURHI I and NURHI II are here.

Source: Bill and Melinda Gates Foundation

Date of Publication: October 7, 2020

Country Focus: Pakistan

Health Communication Component, 2014-2018

From 2014-2018, the Johns Hopkins Center for Communication Programs (CCP) led the Health Communication Component (HCC) in Pakistan, an initiative that worked to improve maternal, newborn and child health and family planning in the country’s southeastern Sindh province.

The project envisioned a Pakistan where individuals, families and communities advocate for their own health, practice positive health behaviors and engage with a responsive health care system. Central to accomplishing those goals was the development of the “Bright Star” campaign. HCC described a “Bright Star” as someone working to improve the health of his or her family, community or country. HCC’s aspirational mass media campaign and comprehensive approach to community mobilization encouraged people to come together to spark meaningful behavior change to improve maternal and child health.

The Health Communication Component worked to assist Pakistanis with advocating for a stronger health care system in their country.

Source: Johns Hopkins Center for Communication Programs

Date of Publication: October 5, 2020

Report on National Family Health Campaign

This is a report on the “Life is Precious, Take Care of It” campaign in Zambia. This campaign was created to convey positive messages and positive social norms around health for Zambians under this unifying theme.

Breakthrough ACTION Zambia a United States Agency for International Development (USAID)-funded initiative to improve the health and well-being of Zambian families. Breakthrough ACTION Zambia is implemented by a consortium of partners led by the Johns Hopkins Center for Communication Programs (CCP).

With its unifying theme, the national family health campaign offers Zambians a single communication platform to address five key family health issues: maternal and child health, reproductive health, malaria prevention, HIV prevention, and nutrition.

Source: Breakthrough ACTION/Johns Hopkins Center for Communication Programs

Date of Publication: September 30, 2020

Breakthrough ACTION Zambia

Breakthrough ACTION Zambia (2017-2020) worked to increase the adoption and maintenance of healthy behaviors among Zambian individuals, families, and communities.

Breakthrough ACTION works with beneficiaries and stakeholders to design and pilot innovative interventions.

All activities are evidence-informed and theory-based, focusing on three primary objectives:

  • reduce barriers to adoption of priority social and individual behaviors;
  • strengthen functional linkages between health facilities; and
  • improve the capacity and commitment of Zambian institutions to fund, coordinate, design and implement effective SBC programming

Breakthrough ACTION’s overarching campaign – Life is Precious, Take Care of It – addresses the psycho-social, cultural, and structural barriers to care-seeking. The campaign places special focus on men and adolescents, encouraging greater uptake of health services at local clinics. A variety of multimedia approaches and materials are used to reach the target populations, including targeted mass, community, and social media, Men’s and Adolescent’s Health Days, testimonials from national and community champions, and posters and job aids for health care workers.

During the course of the project, the Zambia team worked with BA’s Compass team to develop a stand-alone Zambia Compass to gather and share country-specific materials for the country’s SBC professionals.

Breakthrough ACTION Zambia materials are here.

Source: Breakthrough ACTION/Johns Hopkins Center for Communication Programs

Date of Publication: September 29, 2020