BCC Messages and Materials

This tab focuses on materials and messages for iron-folic acid supplementation and suggest integration of other interventions to control anemia but the formative research leading to the identification of these messages and development of the materials can be expanded to include helmith and malaria control, improving dietary intake, and other areas. Click here for an excellent presentation on demand-side issues for IFA supplementation.

In most countries, when women are given iron folic-acid (IFA) tablets, the only message they receive is “take one per day.” There are no additional messages that reinforce why women should be taking IFA, how long they should take them for, or that side effects, such as black stools, constipation, or indigestion, may occur and how to manage them. Women within and among countries may have varying opinions and views about anemia, its symptoms and importance, and how to prevent and treat it. Mothers may also have different opinions about how anemia and taking IFA supplements affects the health and size of their babies when they are born (Galloway et al, 2004).

Unfortunately, this kind of information is rarely collected but, when it is collected, it can be used to craft evidence-based behavior change communication (BCC) messages and materials, such as counseling cards, to ensure women and mothers practice health behaviors on a daily basis. For the anemia prevention and control integrated package, daily practices should include women, mothers, and children taking or giving iron, sleeping under long-lasting, insecticide-treated nets (LLTNs), and consuming the appropriate foods that will facilitate absorption of available iron. Other healthy practices that are part of the integrated package include women obtaining intermittent presumptive treatment in pregnancy (IPTp) and children being treated for malaria where malaria is endemic. In addition, pregnant women and children one year of age and older should receive twice-yearly deworming medication where the prevalence of hookworm and urinary schistosomiasis is high (20-30% or greater).

Formative research should be conducted with consumers and people who support or influence consumers to use a product. This research is essential in developing evidence-based messages to ensure full-uptake of any regimen. For IFA, women prefer a small, coated (easier to take) and red pill because they associate it with the color of blood. An example of a formative research instrument to determine women’s perceptions of anemia and taking IFA can be found here.

Messages to give with IFA supplementation.   Based on research by the USAID-funded, John Snow, Inc.-implemented MotherCare project, messages and materials for maternal anemia prevention and control programs have been developed and can be found in the resources section here.

Messages and materials also can be developed to use during social mobilization of the community for deworming campaigns or promotion of LLINs use. Existing research on women’s perceptions of anemia and taking IFA supplements has found that they recognize the signs and symptoms of anemia. The multiple causes of anemia, including malaria and helminth infections, should link women’s perceptions of anemia and its negative effects to promote healthy behaviors related to controlling these two infections. Formative research to promote micronutrient supplements for children also has been conducted in developing countries.

MCHIP is soliciting examples of other formative research instruments and studies, messages, and materials that have been developed related to the prevention and control of anemia in women, young children, school-age children, and others using an integrated package or individual components of the package. Our interest is in examples related to improving the dietary intake of iron, the use of IFA supplements, malaria, and helminth control programs. Any age group is of interest. Please share what resources you can on this site by contacting us at sstraubinger@path.org or agottwalt@path.org.