13,189 Global Health Stories, The Drum Beat 733, April 26, 2017

The Drum BeatGlobal Health Stories – The Drum Beat 733
April 26, 2017

In this issue:

OVERALL IMPACTThe Influencers, Partnering for Impact, Pathways to Change
THE STORY IN BANGLADESHUjan Ganger Naiya and Natoker Pore
THE STORY IN ETHIOPIABiiftuu Jireenyaa and Jember
THE STORY IN SOUTH SUDANOur Tukul and Life in Lulu
THE STORY IN INDIAAnanya, Mobile Kunji, Mobile Academy, and Kilkari

This issue of The Drum Beat draws inspiration and content from the recently launched microsite Global Health Stories, which is BBC Media Action’s story of how and why their programmes inspired communities to help millions of women have safer pregnancies and healthier babies in Bangladesh, Ethiopia, South Sudan, and India. Global Health Stories narrates – through human stories, research data, films and graphics – what BBC Media Action has learned about communication and health over the last 5 years of the projects, such as the need to go beyond increasing people’s knowledge to spark discussion and debate, change attitudes, and shift unhelpful norms. Funding for this work came from the United Kingdom (UK) Department for International Development (DFID).
From The Communication Initiative Network – where communication and media are central to social and economic development.
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  • *…Around 93 million people watched or listened to the health programmes across Bangladesh, Ethiopia, India, and South Sudan between 2012 and 2016…
  • * In Bangladesh, compared to those who did not watch the TV programmes, women who watched were: 2.5 times more likely to have attended antenatal care (ANC) and 1.6 times more likely to have delivered in a health facility or with a skilled attendant…
  • * In Ethiopia, compared to those who did not listen to the radio programmes, women who listened were: 2.2 times more likely to have attended ANC, twice as likely to plan for a health facility delivery, and 1.4 times more likely to have delivered in a health facility or with a skilled attendant…
  • * In South Sudan, women had made changes such as taking rest during pregnancy or exclusively breastfeeding their babies – and they attributed these changes to listening to the programmes…
  • * In India, 1 in 5 women who saw the public service advertisement (PSA) said they discussed birth spacing with their spouse, 1 in 10 said they visited a health facility for family planning advice, and 4% said they went to a health facility to get contraception…
  • Relevant CI summaries:
  • 1. The Influencers – Bringing about Health Change in Bangladesh and Ethiopia – BBC Media Action
    This film shows how BBC Media Action helped women in Bangladesh and Ethiopia have safer pregnancies and healthier babies. They did this by inspiring pregnant women and those who influence them, like their husbands and mothers-in-law, to believe they can and should do things differently. In Bangladesh, influencer characters tell their story through the TV drama; the viewer sees, for example, a mother-in-law who starts off as resistant and traditional, not allowing her daughter-in-law to undertake good practices, before a shift occurs as the drama progresses. [Apr 2017]
  • 2. A Bigger Splash – Partnering for Impact: Lessons from BBC Media Action’s Work to Improve Maternal and Child Health
    by Sophia Wilkinson
    Drawing on BBC Media Action’s work on maternal and child health with governmental and non-governmental organisation (NGO) partners in Bangladesh, India, and Ethiopia, this paper discusses: the value of these partnerships for successful health communication; the part played by media and communication in wider health interventions; ways to include those without access to mass media; how to spark discussions that underpin journeys of change; and techniques for working together to produce long-lasting results. [Jan 2017]
  • 3. Pathways to Change: Media, Communication and Health – BBC Media Action
    As explained in this film, each of BBC Media Action’s health projects is underpinned by a theory of change – how they expect media and communication to lead to change. For instance, in the case of antenatal care (ANC), to test if a series of changes were on the right track, they used structural equation modeling powered by data collected from large-scale surveys with thousands of people. This analysis uncovered the underlying pathways between their media programmes and having a safe pregnancy and birth. [Apr 2017]
  • Voice of a BBC Media Action blogger:
  • 4. Health communication changes lives by reaching millions
    by Sophia Wilkinson
    Explains how health communication can make a big difference at scale… [Apr 2017]

…32 million people watched the TV drama and factual show and PSAs; over 60,000 people attended community screenings and discussions; and an estimated 2.5 million people made personal contact with a health worker trained in communication skills by BBC Media Action…

  • Relevant CI summaries:
  • 5. Ujan Ganger Naiya and Natoker Pore
    Lack of knowledge, social and cultural barriers, and inequitable access to services are limiting the uptake of healthier maternal and neonatal practices in Bangladesh. The project focused on the following package of outputs: the TV drama Ujan Ganger Naiya (Sailing Against the Tide), the discussion show Natoker Pore (After the Drama), PSAs, ringtones, and a community toolkit for NGO and health workers. By entertaining the audience with dramatic stories set in a rural village, the project was formulated through research to encourage safer and healthier pregnancy and birth practices through social and behaviour change communication.
  • 6. Impact Data – Ujan Ganger Naiya and Natoker Pore
    BBC Media Action used a randomised control trial (RCT) in 2 locations in Bangladesh (rural and urban) to test the impact of the health drama, with and without the additional effects of the complementary discussion show. One finding: Compared with the control, watching the health drama positively affected 4 of 5 knowledge areas (need to go for ANC in the first trimester, need to exclusively breast-feed in the first 3 days, need for 4 or more ANC check-ups, and need to always go for ANC), and watching the health drama and health discussion show positively affected 5 of 5 (also: need to start breast-feeding within an hour) knowledge areas.
  • Voice of BBC Media Action bloggers:
  • 7. Pushing boundaries: a TV birth in Bangladesh
    by Georgis Bashar
    Reflects on the process of conducting the field research and developing Ujan Ganger Naiya’s storylines in a conservative country, which involved the director turning to a professional midwife to show the actresses how to portray giving birth convincingly…. [Oct 2014]
  • 8. The TV drama helping improve the health of garment factory workers in Bangladesh on their lunch break
    by Dr Faisal Mahmud
    Describes a collaboration that involved screening episodes of Ujan Ganger Naiya for factory garment workers, followed by a discussion among the women about the drama and how they can apply it to their own lives… [Sep 2016]
  • 9. Can mass media cause change? A randomised control trial finds out
    by Paul Bouanchaud and others including a team from BBC Media Action
    Explores the use of an RCT to investigate how watching Ujan Ganger Naiya and Natoker Pore affects the “key drivers” of healthy behaviour among women of childbearing age… [Jul 2016]
  • 10. Inside a randomised control trial: insights from Bangladesh
    by the BBC Media Action Research and Learning team
    Examines some of the methodological challenges of conducting an RCT and ensuring randomisation in the field – which nonetheless led to a study that “was successful…” [Jul 2016]
  • See also:
    The Drum Beat 667 – Putting the Audience at the Centre of Research

…21 million people listened to the radio shows and a series of radio PSAs, and listening groups shared information with an estimated 8,000 families…

  • Relevant CI summaries:
  • 11. Biiftuu Jireenyaa and Jember Radio Programmes
    Presented by a male and female presenter team, both radio programmes use interviews, discussion, and fly-on-the-wall encounters between health workers and women to improve reproductive, maternal, neonatal, and child health (RMNCH) in Ethiopia. While the primary intended audience is women of childbearing age, the programmes are also designed to appeal to their husbands, as men tend to have control over the household radio and play a crucial role in either promoting or blocking the family’s access to health care.
  • 12. How Listening Groups Are Adding Value to the Ethiopian Health Development Army and Impacting the Wider Community
    “Listening groups, based on BBC Media Action’s health programmes [Biiftuu Jireenyaa and Jember], are adding value to the Ethiopian government’s Health Development Army, a network of volunteers tasked with learning about key health behaviours and leading others in their communities. Volunteers report gaining new and valuable knowledge on maternal and child health practices and growing in confidence to better support others in the community through one-to-five networks.” [Aug 2016]

…Just under 1 million people listened to the interactive radio magazine show…

  • Relevant CI summary:
  • 13. Our Tukul and Life in Lulu Radio Programmes
    The Our Tukul radio magazine and Life in Lulu radio drama are working to address RMNCH in South Sudan. Our Tukul packages interviews, opinion, and expert advice from around the country into an entertaining and interactive programme broadcast nationally; partner radio stations from the Catholic Radio Network are trained to conduct field interviews and feed these back into the programme. Life in Lulu takes the audience to Lulu, a fictional village where residents deal with the same health challenges that face people all around the country.
  • Voice of BBC Media Action bloggers:
  • 14. South Sudan: reaching out to mothers and babies amid conflict
    by Daniel Realkuy Awad Barnaba
    Describes challenges the Our Tukul and Life In Lulu team faced when fighting broke out in December 2013, including the ways in which the conflict has left its mark on the team and the programmes, too… [Jun 2014]
  • 15. Prevention is better than cure
    by Betty Duku
    Discusses the team’s production of a number of episodes of Our Tukul to help people prevent, identify, and treat cholera in a country that has seen 1,484 cholera cases and 25 deaths since an outbreak in August 2016… [Feb 2017]
  • 16. “You runaway”: the challenges of research in South Sudan
    by Trish Doherty
    Explains the importance of conducting research in conflict-affected countries like South Sudan, despite the risks, considering that audience feedback often directly leads to programme changes… [Aug 2016]

…22 million people watched one of the TV PSAs; over 7,580 frontline workers were trained through Mobile Academy; and 350 supervisors were trained over the lifetime of the project in Odisha…

  • Relevant CI summaries:
  • 17. Ananya
    Aiming to reduce child mortality, improve maternal health, and reduce infectious diseases in India, this multi-platform approach consists of 3 complementary strands: (i) Empowering community health workers: Mobile Academy and Mobile Kunji – 2 mobile phone services for community health services (CHWs) – supported by a deck of cards with life-saving messages; (ii) Using mass media – what are meant to be humorous and engaging adverts about specific family health behaviours such as birth spacing: Ek Teen Do (One, Three, Two) and Gaanth Baandh Lo (Tie A Knot To Remember). These are accompanied by a 36-part long format radio programme, Khirki Mehendiwali (Mehendi Opens a Window); and (iii) Mobilising the community – interactive and entertaining street theatre performances incorporating family health information.
  • 18. Health on the Move: Can Mobile Phones Save Lives?
    by Yvonne MacPherson and Sara Chamberlain
    This policy briefing focuses on how the mobile phone offers opportunities for saving lives by discussing Mobile Kunji, Mobile Academy, and Kilkari, a mobile messaging service for pregnant women and mothers. The briefing identifies 3 aspects of mHealth that render it such a potentially robust healthcare tool: reach, design, and scale. Taking into consideration barriers produced by low literacy and by variations in the alpha-numeric symbols in various languages in Bihar, India, the programme looked to interactive voice response (IVR). This speaks to recommendations included here, such as the fact that detailed research is central to the planning and delivery of mHealth solutions, and content must be localised, engaging, and culturally resonant. [Feb 2013]
  • Voice of BBC Media Action bloggers:
  • 19. Dr Anita guides the way
    by Ankita Sukheja
    Discusses the strategy of Dr Anita, a fictional doctor whose voice is part of Mobile Academy and Mobile Kunji, and the training of health workers carried out as part of the mHealth initiative… [Sep 2015]
  • 20. Taking mHealth nationwide
    by Sara Chamberlain
    Discusses the national roll-out of Kilkari, Mobile Kunji, and Mobile Academy… [Nov 2014]
This issue of The Drum Beat was written by Kier Olsen DeVries.
The Drum Beat is the email and web network of The Communication Initiative Partnership.

Full list of the CI Partners:
ANDI, BBC Media Action, Bernard van Leer Foundation, Breakthrough, Citurna TV, Fundación Imaginario, Fundación Nuevo Periodismo Iberoamericano (FNPI), Heartlines,Johns Hopkins Bloomberg School of Public Health Center for Communication Programs, Maternal and Child Survival Program (MCSP), MISA, Open Society Foundations, Oxfam Novib, PAHO, The Panos Institute, Puntos de Encuentro, SAfAIDS, Sesame Workshop, Soul City, STEPS International, UNAIDS, UNICEF, Universidad de los Andes,World Health Organization (WHO), W.K. Kellogg Foundation

The Drum Beat seeks to cover the full range of communication for development activities. Inclusion of an item does not imply endorsement or support by The Partners.

Chair of the Partners Group: Garth Japhet, Founder, Soul City garth@heartlines.org.za

Executive Director: Warren Feek wfeek@comminit.com

The Editor of The Drum Beat is Kier Olsen DeVries.
Please send additional project, evaluation, strategic thinking, and materials information on communication for development at any time. Send to drumbeat@comminit.com

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