Social and Behavior Change Strategy
Decisions about whether to access MNC services and adopt healthy behaviors are influenced by social factors, such as social norms, religious beliefs, social support, cultural traditions, myths and rumors, local or national policies, and the role of women in reproductive health decision-making. SBC strategies use communication to promote and support recommended MNC practices among women, their families, and health agents; address changes in related socio-cultural norms; and build a supportive environment for recommended MNC practices.
SBC activities may include providing women with information about available MNC services and benefits of adopting healthy behaviors during pregnancy, holding group-based discussions to address myths and misconceptions about MNC, and engaging community leaders to build support for appropriate care-seeking. SBC activities should be designed strategically to address key barriers and enablers for recommended MNC practices identified during the situation analysis. Development of an SBC strategy can help ensure that all messages and materials are designed strategically for the appropriate target audiences.
For instance, if the lack of optimal breastfeeding is a problem among a target population, an SBC strategy can help change misconceptions and promote better practice through behavior change communication (BCC), community mobilization, and advocacy. Specific BCC messages will depend on the barriers and enabling factors that were uncovered during the situation analysis, but they could include messages such as those in the following box.
Examples of Essential Breastfeeding Messages
Initiate breastfeeding within 1 hour of birth.
Colostrum is good for the baby.
Exclusively breastfeed (no other liquids) the baby for the first 6 months.
Breastfeed on demand, day and night, for an adequate time at each feeding. Offer second breast after infant releases the first.
Correctly position and attach infant at the breast.
Practice good breast care.
Continue breastfeeding until the child is 24 months old.
The Lactational Amenorrhea Method is an efficacious family planning method, but for it to work, all three criteria (the baby is under 6 months; the mother is still amenorrheic; and she practises exclusive or quasi-exclusive breastfeeding on demand, day and night) must be met.
An enabling environment is key to improving maternal and newborn health. Efforts to increase appropriate MNC are much more likely to be successful and sustainable if they promote broader social change in addition to individual behavior change. Projects can contribute to the process of policy change through advocacy. Creating demonstration sites can contribute to assuring that the right policies are in place to ensure this enabling environment. Some priority areas include treatment of newborn infections; community-based use of misoprostol to prevent PPH; community-based provision of injectable contraceptives; and task-shifting certain medical interventions to less skilled providers.
Key Resources for SBC:
- ACCESS, 2007. Demystifying Community Mobilization: An Effective Strategy to Improve Maternal and Newborn Health
- JHU/CSHGP, 1995. A Review of Maternal Care Messages and Curricula Used in PVO Child Survival Projects
- WHO, 1997. Safer Motherhood, Safer Womanhood: Rethinking Reproductive Health Communication Strategies for the Next Decade
- MCHIP, 2014. Social and Behavior Change TRM