C-Change Communication Strategy HEO - Family Planning FINAL26!10!11

7/31/2019 C-Change Communication Strategy HEO - Family Planning FINAL26!10!11

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larevalo@lare

Social and Behavior ChangeCommunication

Strategy

1. Draft for Stakeholder Input

USAID/Guatemala

Health and Education Office

Family

Planning

September 2011

This literature is made possible by the generous support of the American People trough the United States Agency for International

Development (USAID) under the terms of Agreement No. GPO-A-00-07-00004-00. The contents are responsibility of the C-Change

project, managed by FHI 360, and do not necessarily reflect the views of USAID or the United States Government.


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Family Planning

Communication Strategy

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Table of Contents

SUMMARY OF ANALYSIS...................................................................................... 3

Problem Statement ....................................................................................... 3

Information / Research gaps ......................................................................... 3

Required Changes ..........................................................................................3

Theory of Change: ........................................................................................ 4

COMMUNICATION STRATEGY...................................................................................................................................................................4

Final Audience Segmentation ....................................................................... 4

Audience....................................................................................................... 5

Women ......................................................................................................... 5Men............................................................................................................... 6

Local NGOs .................................................................................................. 7

Civil Society .................................................................................................. 7

Doctors ......................................................................................................... 8

Nurses .......................................................................................................... 8

Community Agents ....................................................................................... 9

Clinical Support Staff ..9

Strategic Approach ..................................................................................... 10

Positioning .................................................................................................. 10

Key Information........................................................................................... 10

Channels, Activities & Materials.................................................................. 11


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SUMMARY OF ANALYSIS

Problem

Statement

Unmet need for contraceptives and poor birth spacing among rural,indigenous women in Guatemala is contributing to unplannedpregnancies, increased health risks and poor maternal and child health.

The role of men, mother-in-laws, and the church in decision makingnegatively influence a womans ability to take action in reproductivehealth decisions. Limited access, poor quality health service, healthprovider biases, and poor client provider interaction further limitsuccessful o u t c o m e s . Deep g e n d e r /cultural norms and a lackof accurate and culturally appropriate information about family planningprevent women and men from seeking appropriate modern familyplanning services.

Information/

Research Gaps

Formative research providing further knowledge about theinformation, motivation, capacity to act and normative behavioramong the selected audiences

What is the role of the mother-in-law: what are her barriersand aspects that would help her promote family planning

Has USAID or other groups identified windows of opportunity,to integrate mothers-in-law as a resource and partners?

What are successes with male involvement (in any type of programand specifically in family planning)?

Which modern methods are consistently available?

What are culturally appropriate and language specific channels andactivities that have been successful or seem promising?

Are there religious organizations who have been potential partners

in family planning to influence the social norms, potential partners?

Required

Changes

Familiarity with modern contraceptive methods

Ability to choose the appropriate family planning methodfor themselves

A belief that modern contraceptive is widely used and importantThe ability and confidence of women to have an assertiveconversation with family health providers, husbands and mother-in- laws about their needs and options

Increase in positive provider client interactions

Improved communication about family planning betweenhusband and wife

Increased number of couples that use family planning methods Culturally appropriate materials with guiding points

Community leaders understanding and endorsing family planningprograms to improve quality of life and health of families

Doctors openly talking about modern FP during office visits

Promote respect for sexual and reproductive rights of the


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clients by health care providersbased on the legal framework

HCPsbecoming a trusted source of information

Theor y of

Change:

Tipping Points:

Better communication between husband and wife

Better client oriented services

Young new clients better informed

We expect spousal communication concepts to help move the tippingpoint for change on the demand side for family planning. Concepts thatsupport our assumptions can be found in: theory of social norms thatfocus on changing perceived norms and stigma against family planning;diffusion of innovations and social learning theory addressing self-efficacy and using role modeling to support the expected change; andelements of the positive deviance approach to address not only barriersto change but existing assets; media theories that can set agendas,

persuade, frame, model, and reinforce new gender constructs/roles.We also expect client-oriented services to move the tipping point forchange on the supply side. The concepts that these assumptions arebased on are used in models of patient centered communicationfunctions related to consumerism, physician patient relationship andhealth literacy. Concepts from the diffusion of innovations, theory ofsocial learning, and social norms will support service re-orientation Thetheory of organizational change including organizational policies,structure of programs/services, and institutionalization of practices isimportant as is are media theories to promote services, help withagenda setting, framing, persuasion, modeling, reinforcement, and

perceived norms;. All are based on elements of ecological models,specifically intrapersonal factors and interpersonal processes.

COMMUNICATION STRATEGY

Final Audience

Segmentation

Demand Women Directly affectedas they areultimately end users of familyplanning

Men Directly affected as they

should ideally share familyplanning decisions andresponsibilities, and/orrespect the womansdecisionto choose family planningmethod(s)

Local NGOs Directly influencing. Important


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AudienceDesired

Changes

Barriers Communication

ObjectivesWomen Increased use

of familyplanning/empowerment

Increased birthspacing

Partner

Lack of respect fromservice providersThe mother-in-lawSocial norms and

Increased number ofwomen who canidentify more than onemodern contraceptivemethod

Increased number of

Final Audience

Segmentation

role in promoting family

planning and counseling

users

Civil Society Directly influencing. Advocacyand lobbying for localgovernments to invest in andprioritize family products and

services

SupplyDoctors Directly influencing. From the

users perspective, the mosttrusted supplier of familyplanning products andservices, yet not frequentlyprioritizing promotion of familyplanning as s/he tends toperceive it as somebodyelsesrole (usually nurse orsocial worker)

Auxiliary Nurses Directly influencing. Majorrole in promoting,recommending and supplyingfamily planning products inhealth centers, clinics andhospitals

Community agents Directly influencing. Activerole as educator regardingimportance and benefits offamily planning and promoterof family planning products

and services at thecommunity level, includingreferrals to specific providers

Clinic Support Staff Directly influencing. Highlytrusted source of information

of any type, including familyplanning in public healthcenters, clinics and hospitals


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AudienceDesired

Changes


Objectives

Women Decreasedunmet need

stigma of familyplanning (somethingwrong with womanseeking familyplanning)

Religion Healthcaresystem not oriented toMayan patients;

Women donttrustside effects of modernfamily planningmethods and donttrust the healthcaresystem.

women who are able tochoose appropriatefamily planning methodfor themselves

Increased number ofwomen who reportthey believe use ofmoderncontraception iswidespread in thecommunity

Increased number ofwomen who report

talking to a healthworker about familyplanning methods andasking about sideeffects

Increased number ofwomen who reportpositive provider-clientinteraction on familyplanning at healthfacilities

Increased number of

women who reporttalking to their partner

Men Increased useof familyplanning

Increasedsharedresponsibilityon familyplanning

Increasedrespect forwomens right

to choosefamily

lannin

Machismo Religion Social norms and

stigma of familyplanning (man decideshow many and when tohave children;

woman using family

planning means she ischeating on him) Healthcare system

schedule and locationof services dontworkfor mens schedules

Increased number ofmen who report talkingto their partner aboutfamily planning

Increased number ofmen who approve ofthe use of moderncontraceptive methods

for child spacing andfor limiting the numberof their children

Increased number ofmen who report talkingto a health workerabout family planningmethods

methods)


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AudienceDesired

Changes


Objectives

(demandinggrandchildren from thewomen)

Lack of confidencility

Local NGOs More and betterpromotion offamily planning

Improved qualityof services

Weak technicalcapacity

Conflict of interestswith demands fromchurches

Increased number ofproviders who practicepositive interpersonalcommunication skills tocounsel clients on familyplanning

Increased number ofproviders who report

counseling patients onfamily planningmethods

Increased number ofproviders who provideaccurate information onthe effectiveness andside effects of moderncontraceptive methods

Increased number ofproviders who become a

trusted source of familyplanning

Increased number ofproviders who believethat fellow providersare trusted sources offamily planning

Ci vil S ociet y Improvetechnicalcapabilities

Empowered CiviSocietyorganizationsand groups whoare advocatesfor familyplanning

Political pressures tolimit advocacy andlobbying efforts

Competing issues and

resourses

Increased number ofcommunity leaders whobelieve that familyplanning programs help

their quality of life and

Doctors Im roved Social norms (nurse is Increased number ofteamwork lower in the power providers who practice


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AudienceDesired

Changes


Objectives

Doctors

Client orientedin the deliveryof services in amulticulturalenvironment

Recognize thevalue of familyplanning

More andbetterpromotion offamily planning

Improved qualityof services

hierarchy, plus thefamily planningpromotion is the role of

the nurse or the socialworker)

Health systemdemands limitattention to the clientto the minimumrequired

Academic backgroundon family planning(extremely weak)

positive interpersonalcommunication skills tocounsel clients onfamily planning

Increased number ofproviders who reportcounseling patients onfamily planningmethods


Increased number ofproviders who becomea trusted source offamily planning


Nurses

Improvedteamwork Client oriented

in the delivery ofservices in amulticulturalenvironment

Recognize thevalue of familyplanning -

More and better

promotion offamily planning Improved

quality ofservices

Social norms (lack ofrespect to clients rightto choose familyplanning method)

Work overload blocksactive listening

Not client-orientedPerception of ownrole, as a position ofPower linked to lowwork-related esteem

Increased number ofproviders who practicepositive interpersonalcommunication skills tocounsel clients on familyplanning



Increased number ofproviders who becomea trusted source of


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AudienceDesired

Changes


Objectives

family planning


Communit y

Agents

Improvedtechnicalcapabilities(familyplanning, andcommunicationskills, morespecificallytailoringmessages andlistening to theclient)

No communication withclinicsstaff

Methodologically rigid/quality of trainingreceived - dontadapt their counselingto the clients need

Education level Competitiveness

within communityreduces referrals topeople in the samecommunity and blocksadequate communityservice supply

Increased number ofproviders who practicepositive interpersonalcommunication skills tocounsel clients onfamily planning



Increased number ofproviders who becomea trusted source offamily planning


Clinic Suppor t

Staff

Improvedpositive attitudetowards family

planning andtowards theclients

Improvedteamwork

Able toaccuratelydispel mythsand rumours

Social norms- roledoes not includetraining in family

planning Lack of concept of

client Lack of concept of

service provider

Increased number ofsupport staff whopractice positive

communication skillswhen discussing familyplanning with client.


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Positioning

AudienceDesired

Changes


Objectives

about familyplanning

Strategic

Approach

For those who demandfamily planning productsand services

Deliver interventions to influence socialnorms that stigmatize use of family planning

For those who supply familyplanning products andservices

Developing client-oriented product andservice delivery

Improved client-oriented services will allow men and women to plantogether for happier and healthier families with more resources.

Key InformationWomen Birth spacing helps women be stronger and

healthier for her family and herself Having less children allows for having healthier

children and better quality of life

Modern family planning methods are safe, reliableand accessible to you.

Men It is the mansduty to plan together with theirpartner the number of children they want andthe method with which they are going to spaceor avoid pregnancies

Birth spacing and fewer children allowmore resources for the family and each

Local NGOs Creating client-friendly services increases thenumber of users which will result in astronger, healthier community with more

Civil society Community leaders have the right to demandclient-oriented services that respond to the familyplanning needs of the women in the community.

Communities that invest in famil lannin havebetter chances of economic growth

Doctors Prioritizing family planning helps improve the

overall health of the community and yourclients

Client-oriented services are crucial forsuccessful family planning counseling

Teamwork results in less effort for individual

Nurses The user has the right to choose thefamily planning method she prefers

Different methods have different


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different women Client-oriented services are crucial for successful

family planning counseling Teamwork results in less effort for individual team

members and has greater impact on the client

Community agents The user has the right to choose thefamily planning method she prefers

Counseling needs to be tailored according to the womansneeds Different methods have different advantages

for different women Community-based services are easier to

access for women and result in better familyplanning

Support staff ofhealth providers

The client has the right to be treated with respectThe client has the right to receive correct

information You are an important source of information for the

client and you need to give them accurateinformation.

Channels,Activities &

Materials

Women Radio soap opera (Novela)Community radio talk shows

Interpersonal activities (one-on-one and smallgroup outreach (ferias, community events, etc)

Men Radio spots Community radio talk shows combined with other

topics, such as agriculture, soccer or business Billboards (i.e. dad holding the baby walking side-

by-side with woman) Interpersonal activities (one-on-one and small

group outreach), including counseling at the clinic Home visits that include discussions with the

couple Information tables in soccer games and special

events (ferias, community events, events at clinics,etc.)

Contests, such as feeding the baby with a bottle,

or changing the babys diapersduring ferias and

special events

Local NGOs Training: client-oriented services Quality of service guides

Civil society Training: empowerment Community dialogues

Advocacy through media, forums


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Doctors Client-oriented seminars Team-building activities

Training & role playing active listening, tailoringof products and services

Nurses Client-oriented seminars

Team-building activities Training & role playing active listening, tailoring

of products and servicesCommunity agents Training & role playing active listening, tailoring

messages, recommendations and referrals Meetings and discussions with community

providers to search for common interests andmutual benefits when working together

Support staff ofhealth providers

Training family planning methods, activelistening

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C-Change Communication Strategy HEO - Family Planning FINAL26!10!11

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