13,565 Evidence and Impact Data: Selections from the SBCC Summit, The Drum Beat 760, June 27 2018

Safer sexual behaviours, Health service utilisation, GBV reporting, ART monitoring, FP referrals, Highest-HIV-burden communities, Breastfeeding boost, LBW babies, Contraceptive uptake, Bed nets, Multiple sexual partners, Condom use, Young fathers, Handwashing, Women and careseeking, Critique of the draft Declaration from a What Works perspective, Take the survey

“…donors and others who support the field, and development policy makers who want to prioritize it, face major challenges in understanding what works and what does not work, what they can expect from an investment in this area and explaining its impact to sometimes skeptical publics.”

For your review and possible use, some of the evidence and impact data presented at the Summit follow. (Any additions to the quoted material, deemed necessary by the editor for clarity, are indicated by square brackets; URLs open as PDFs.) You can search for other data in the collection of all Summit presentations at this link – filtered for the Evidence and Results tag (click through each of the days).

• 1. Safer sexual behaviours – 1.7 times more likely to use a condom at first sex
  Presented by Sue Goldstein, Soul City Institute for Social JusticeFrom the Summit poster presentation Can Children’s Clubs Prevent HIV Infection among Young Women and Girls? A Long-Term Retrospective Cohort Study of the Soul Buddyz Clubs in South Africa, with a further summary here on The CI platform: “The Soul Buddyz Clubs (SBC) were established by the Soul City Institute (SCI) in 2003 as a response to the demand from children watching the Soul Buddyz television drama series….Ex-Buddyz were less likely to engage in a number of risky sexual behaviours. They were significantly more likely to be HIV negative (AOR [adjusted odds ratio] 2.92; 95% CI [confidence interval] 1.26 – 6.77, p = 0.013).”
• 2. Increases in health service utilisation – facility deliveries up by 7%
  Presented by Cathryn Wood, Development Media International (DMI)From the abstract of the Summit presentation Results from the First Cluster RCT to Test Whether Mass Media Can Change Life-Saving Behaviours in a low-Income Country: “In the first year of the intervention [in Burkina Faso], under-five primary care consultations increased by 35% (p < 0.001), new antenatal care attendance by 6% (p = 0.004), and facility deliveries by 7% (p = 0.004). This represents the first RCT [randomised controlled trial] to demonstrate that mass media alone can change health-seeking behaviours at a population level. [However] The study did not detect an impact of the campaign on the primary outcome of post-neonatal child mortality.”
• 3. Gender-based violence (GBV) – 59% decrease in reported cases
  Presented by Agnes Watsemba, RTI InternationalFrom the abstract of the Summit presentation Stepping Stones Methodology (SSM) Reduces Gender Based Violence in Closed Community Settings: “On average, a 59% decrease in reported GBV cases was observed across the 3 barracks (49 to 20 cases in a month) [in Uganda]. Naguru barracks showed the highest decline at 67% (from 12 to 4 cases); followed by Ntinda barracks at 59% (from 22 to 9 cases) and Kireka barracks at 53% (from 15 to 7 cases). All women reported that as a result of SSM [the Stepping Stones Methodology], they felt empowered to deal with GBV in their households. All the police officers also reported that they are better equipped to handle GBV cases. The Police Commandant in Charge and the police officers reported a general shift in appreciation of SSM as an innovative and impactful approach to behavior change verses the traditional behavior change approaches.”
• 4. Anti-retroviral treatment (ART) monitoring – increased 50%
  Presented by Fiona Songon Amado, FHI360From the abstract of the Summit presentation Integrating Social Behavioral Change Communication (SBCC) for Increased ART Enrollment: Evidence from Uganda: “These [health workers and interpersonal communication agents equipped with viral load communication materials] were able to increase eligible PLHIV [people living with HIV] seeking viral load monitoring services from 55,580 in January to 82,991 by the end of March 2017. A national viral load dash board was established to monitor progress of viral load suppression. Before the campaign, the viral suppression stagnated at 83.40% in January and February 2017. In the subsequent month of April, viral load suppression increased to 85.70%.”
• 5. Community meetings and family planning (FP) – 132,111 referrals
  Presented by Leanne Wolff, Johns Hopkins Center for Communication ProgramsFrom the abstract of the Summit presentation The Influence of the Mother-in-Law on Young Couples’ Family Planning Decisions: “A total of 14,889 women and men [in Sindh, Pakistan] participated in in-depth community meetings, and approximately 50,000 men and women in the mela [village gathering] events. A service delivery project working in the same districts witnessed a marked increase in numbers. According to the data, which only looked at CHWs [community health workers], 132,111 referrals were made through the campaign period, with almost 99,000 receiving some form of FP service. Anecdotal evidence, observation and follow-up showed that women were ready to seek FP services and the husband’s mother was ready to support her son and daughter-in-law during FP adoption.”
• 6. Highest-HIV-burden communities or districts – 25% to 40% decline
  Presented by Emily Harris, USAIDFrom the Summit presentation A PEPFAR Perspective on HCD & Measurement: “In the 10 African countries (63 districts) implementing DREAMS, the majority (65%) of the highest-HIV-burden communities or districts achieved a 25-40 percent or greater decline in new HIV diagnoses among young women. Importantly, new diagnoses declined in nearly all DREAMS intervention districts.”

Click here and follow the instructions to access all the presentations from the Summit.

In order that the numerous Summit presentations are located and accessible as an integral part of a comprehensive platform, network, and community for this field of work, The CI will be incorporating many of them within our Groups process over the next few months. But you can access all of those submitted by presenters at this link at this time.

• 7. Breastfeeding – increase from 29% to 63%
  Presented by Aida Shambetova, JSIFrom the Summit presentation Adapting Nutrition and Hygiene Training and SBCC Materials and Approaches for Part-Time Community Nutrition Volunteers SPRING/Kyrgyz Republic: “Many nutrition outcomes improved significantly between baseline and endline in intervention areas….[T]he % of women taking iron for 90+ days almost doubled (22-40%)….Women’s dietary diversity also improved markedly – % women consuming at least 5 food groups 38% to 71%….A significant increase in exclusive breastfeeding practices from 29% to 63%….[There was d]eclining consumption of junk food among younger children.”
• 8. Low birthweight (LBW) – 9.4% – intervention group; 22.1% – comparison group
  Presented by Morseda Chowdhury, the University of SydneyFrom the abstract of the Summit presentation Balanced Plate Nutrition Education: Change in Birthweight in Rural Bangladesh: “The mean birthweight in the intervention group was 127g[rams] (95% CI 64-190) greater than that in the comparison group (2866 g vs 2740 g; P<0.001). The prevalence of LBW was 9.4% in the intervention group and 22.1% in the comparison group (P<0.001). Multivariable analysis revealed that the odds of having LBW was 68% lower in the intervention group than in the comparison group (P=0.015) when adjusted for other variables in the model taking cluster effect into account.”
• 9. Contraceptive uptake – increase from 26% to 41%
  Presented by Stephen Sitati, IPAS Africa AllianceFrom the abstract of the Summit presentation C4C Project: Improving Contraceptive Uptake and Method Mix Among Youths 15-24 in 7 Counties in Kenya: “Results [of the Choice for Change (C4C) project] show significant difference (x2=65.4540, p=0.000) in sites where there was both demand and supply interventions compared to supply only sites. In the 101 sites with both demand and supply, the proportion of young women receiving long-acting reversible contraceptives (LARC) increased from 26% (9,730) at baseline to 41% (13,344) after one year of implementation compared to 64 supply side only sites from 20% (6,960) at baseline to 30% (8,047) after one year of implementation. We have seen improved contraceptive update and method mix between LARC and short-term methods in all categories with better percentage in facilities with mixed interventions.”
• 10. Bed nets – 9.3% increase
  Presented by Bolanle Olapeju, Johns Hopkins Center for Communication ProgramsFrom the abstract of the Summit presentation Effects of a Malaria Treatment and Prevention Campaign on Caregivers: Use of Bed Nets in Nigeria: “The proportion that slept under a net was 72.4% among the caregivers that were exposed to the media campaign compared to 72.1% among those that were not exposed. This apparent lack of variation in net use between the two groups is possibly due to the significant differences in the sociodemographic characteristics that are associated with net use and/or campaign exposure. PSM [propensity score mapping] adjusted for this selection bias and the results showed a significant increase of 9.3 percentage points in the prevalence of net use (p<0.01).”

• You might also be interested in:
  The Drum Beat 757 – AMPLIFYING VOICE: Selections from the SBCC Summit
  The Drum Beat 758 – SHIFTING NORMS: Selections from the SBCC Summit
  The Drum Beat 759 – CHANGING BEHAVIOUR: Selections from the SBCC Summit

• 11. Multiple sexual partners – 28% decrease
  Presented by Abdul Dosso, Johns Hopkins Center for Communication ProgramsFrom the abstract of the Summit presentation The Super Go Program: A Playful Approach to Social and Behavior Change of Adolescent Girls and Young Women: “After their participation in the [Côte d’Ivoire Super Go] program, it appears that the practice of having multiple partners has decreased significantly by 28 points. Also, it appears that girls’ systematic use of condoms increased significantly by 30 points. Regarding transactional relationships, 11% of girls reported having had sex in exchange for money or gifts, this percentage decreased to 3% after their participation in the program, which represents a significant reduction. The program helped participants overcome their fear of HIV testing and they had high motivation for screening. The percentage of participants who were tested for HIV increased significantly from 55% to 76%. Additionally, it appears that there is enthusiasm to receive the HIV test results and a clear increase of the communication of the test results to the partners of the participants.”
• 12. Condom use – 17% increase
  Presented by Paul Hutchinson, Tulane UniversityFrom the abstract of the Summit presentation Empowering Youth for Social Change through the Shujaaz Multimedia Platform in Kenya: “Early exposure to Shujaaz digital media (i.e., more than a year prior to the survey) was associated with a 17.7 percentage point increase in ever using a condom, a 14.1 percentage point increase in ever using modern contraception, and 20.0 percentage point increase in recommending a condom. On the income generation side, both analogue and digital media were associated with improved outcomes at multiple levels, including using financial tools such as mobile money and discussions of financial matters with adults. Importantly, exposure to Shujaaz digital media was associated with a KSH 2,822 (US$26.81) increase in monthly income.”
• 13. Young fathers – significantly less violent
  Presented by Esther Spindler, Institute for Reproductive Health, Georgetown UniversityFrom the abstract of the Summit presentation REAL Fathers: Lessons from Scaling a Violence Prevention Program: “Preliminary analyses show promising results, replicating the positive effects found in the pilot. Young fathers participating in the intervention in Northern Uganda were significantly less likely to use IPV [intimate partner violence] (aOR 0.46, CI 0.24, 0.88, p<0.05), justify the use of IPV (aOR 0.51, CI 0.29, 0.90, P<0.05) and report being violent with children (aOR 0.54, CI 0.32, 0.94, p<0.05), as compared with fathers in the control group. They reported increased confidence using non-violent discipline with their child (aOR 2.91, CI 1.52, 5.60, p<0.0) compared to control fathers. In Karamoja, REALfathers reported significantly lower rates of IPV (aOR 0.54, CI 0.4, 0.73, p<0.01), improved couple communication (aOR 1.33, CI 0.1.02, 0.1.73, p<0.05) and improved attitudes on gender equitable caregiving and childcare (aOR 1.65, CI 0.1.24, 0.2.18, p<0.01).”
• 14. Handwashing with soap – up 24%
  Presented by Libertad Gonzalez, Netherlands Red CrossFrom the abstract of the Summit presentation Why CATS/PHAST Approaches Did Not Work in North Delta Locality (Kassala Province); Sudan: “The endline data in Telkook locality showed an increase in latrine coverage of 62% compared to the baseline with 83% of the respondents in the household interview reporting having a latrine. Handwashing was a recurrent theme in MSC (Most Significant Change) stories in Telkook, revealing a deep understanding of the transmission paths for diarrhoeal diseases. In North Delta, none of the MSC stories included comments on handwashing. There was noted progress for those who reported washing their hands with soap or alternative in Telkook with a 24% increase on those respondents who report the practice.”
• 15. Women’s groups – 1.05 times more likely to seek care for their sick children
  Presented by Moyosola Bamidele, Mercy CorpsFrom the abstract of the Summit presentation The Impact of the 100-Women’s Ggroup (100WG) for Empowerment and Improved Rural Livelihoods on the Economic and Social Wellbeing in Bauchi State, Nigeria: “The results show that women affiliated to 100WG were 1.05 times more likely to seek care for their sick children and were 0.65 times less likely to use self-medication than women in the control group. Women in the 100WG significantly attended more ANC [antenatal care] than the women in the control group. A higher percentage of women in 100WG had applied for loans and actually received the requested assistance that on regression analysis was statistically significant. Women in 100WG were found to have higher participation in entrepreneurial activities, and in participating in making decisions on household disposable income and on healthcare in contrast to the women in the control group.”
• 16. Critique of the draft Summit Declaration – WHAT WORKS?The draft Summit Declaration was shared for critique and comment. Critique from the “What Works” perspective included:

  * from Gina Margillo: “If this is both an internal and external document, I think we can be more assertive and secure in declaring ‘Social and behavior change communication – including entertainment education ARE critical in addressing the SDGs. Evidence shows that SBCC has been fundamental in meeting humanity’s most pressing challenges – from HIV to Ebola, from gender discrimination and violence to infant mortality, from malaria to climate change to access to justice.”

  * from Ramakrishnan of Ideosync: “I suggest that we add to this section here: ‘We are committed to rigorous analysis of what works and to turning our failures into lessons learned. We ensure our work is informed by evidence but are also willing to take the risks that go along with innovation.’ By saying: ‘We also reaffirm our commitment to participatory processes of evaluation of SBCC, and to making communities active participants in the process of questioning, reviewing and reflecting on the process of social and behaviour change through communication.’”

  * from Simon Heliso Kuka: “On evidence of impact we may have to throw in a word or two to highlight on of the points raised by one of the speakers – evidence nurturing. In some areas SBCC and related new approaches such as BE [behavioural economics] are just at their infancy. Promising methods should be encouraged and support to ‘log’ what is working and what is not.”

  FINAL SUMMIT DECLARATION RELEASED – click here to view it.

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