Interpersonal Communication & BCC

State Institute of Health & Family Welfare, Jaipur

Listen to Learn Learn to Listen

SIHFW: an ISO 9001: 2008 certified Institution

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IEC

IEC –A one-way process ØFocused on “messages” ØImplicit assumption that awareness creation will automatically lead to behavior change ØEmphasis on creating messages, entertainment and media

SIHFW: an ISO 9001: 2008 certified Institution

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BCC

BCC (Behaviour Change Communication) ØOutcome oriented ØResearch-based ØConsultative process of addressing knowledge, attitudes, and practices through ØIdentifying ØAnalyzing

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ØSegmenting audiences and participants ØRelevant information and motivation ØUsing an appropriate mix of interpersonal, group and mass media channels ØParticipatory methods
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Behavior change
Ø K - Knowledge Ø A - Approval
Ø Ø

Ø I - Intention Ø P - Practice Ø A - Advocacy
Ø Ø

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IPC v/s Mass communication
Characteristics Nature Reach Audience Message Purpose Cost Feedback IPC Personal Fast Specific Focused Expensive Instant Mass communication Impersonal Very fast General Generalized Cheap Delayed Short time Supplements

Helping decision taking Create awareness

Message retention Long time Support of other media Makes it effective

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Classification of Communication Methods
Ø Inter-personal communication ØFriends / Neighbors/ Influential ØMahila mandals/Voluntary organizations ØHealth functionaries Ø Use of traditional media ØPuppetry ØStreet plays/Dramas ØDances ØDrum Beating ØTamashas/Story Telling

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Ø Group communication ØMeetings/Group Discussion/Lectures ØSeminars/Workshop/Panel Discussion ØMelas/Festivals/Exhibitions ØCampaigns Ø Mass communication ØRadio ØTelevision ØPrinted Materials

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Process of communication

Sources ØKnowledgeable ØRespectable
Ø Ø

ØCredible
Ø

ØTrustworthy
Ø

ØFulfilling the promises Ø

SIHFW: an ISO 9001: 2008 certified Institution

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Process of Communication
Target audience ØHomogenous Group ØSegmentation of Audience ØIntended and Un-intended Audience ØSociological/Psychological/Cultural Value system ØKnowledge ØExposure to Media ØWillingness to change ØSocial Participation Ø SIHFW: an ISO 9001: 2008 certified Institution 11 Ø

Attributes of message:7C’s ØCommand Attention ØCater to the Heart and Head ØClarify the Message ØCommunicate a Benefit ØCreate Trust ØConvey a Consistent Message ØCall for Action

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IPC Skills
Listening Ø Keep your mind open Ø Be flexible Ø Find area of interest Ø Listen to ideas Ø Judge content, not delivery Ø Resist distractions Ø Hold your fire Ø Work at listening Ø Capitalize on thought speed •

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Speaking Ø Face the audience Ø Maintain eye contact Ø Use appropriate aids, if you can Ø Use appropriate language Ø Focus on the needs of the audience Ø Be brief, to the point, without ambiguity

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Interviewing/questioning Ø Understand the audience profile Ø Put questions in such a way the audience understand and reply favorably Ø Start questions from simpler to complex Ø The way you ask questions is important Ø Do not put questions in such a way which may embarrass you

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Initiating IPC
Ø Introduce yourself Ø Explain the purpose of visit Ø Establish mutual understanding Ø Allow the audience to speak more and facilitate Ø Win the confidence of the audience Ø Understand his/her problems Ø Analyze whether your interest and his/her problems are the same or different Ø Do not make false promises/pose yourself •
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Sustaining IPC

Ø Create conducive atmosphere Ø Be knowledgeable about the subject Ø Ensure confidentiality of issues shared Ø Clarify the queries raised Ø Give complete information Ø Check whether the receiver has understoo as explained

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Terminating IPC
Ø Leave good impression of yourself Ø Have issues for next meeting Ø Identify contact people/influencers Ø Develop sense of belongingness Ø Give an opportunity for the audiences to come with their real problems

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Core Triggers
Ø Age at marriage > 18 yrs Ø Delay first pregnancy till 21 years Ø Eat three times a day (women and adolescent girls) Ø Eat 3-4 times a day (pregnant women) Ø Early registration <12 weeks

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Ø 3 ANC check ups Ø Institutional Delivery Ø Stay in the hospital for 24 hrs after delivery Ø Immediate health seeking behaviour Ø Immediate and exclusive breast feeding within one hour of birth

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Ø Continue exclusive breast feeding up to six months Ø Keep the newborn warm with skin to skin care Ø Complete Immunization/ Booster / Vitamin A Ø Complementary feeding from six months 4-5 times a day in addition to breast feeding Ø Wash hands with soap after defecation and prior to feeding child

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Ø Increase birth interval to three years Ø Adopt any limiting method after two children even if both are girls Ø Early detection of TB Ø Empty and dry water containers once a week

SIHFW: an ISO 9001: 2008 certified Institution

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Barriers to Behaviour Change
Socio-Cultural Barriers Ø Gender discrimination; son preference

Ø Norm of early child bearing/early marriage Ø Colostrums feeding & other new born care practices Ø Dietary pattern of eating two meals a day, women eat last
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Health Services Ø Lack of regular outreach services at the village level Ø Health provider attitude and low motivation levels Ø Lack of trust in public sector services

Ø

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Socio-Economic and Infrastructure Ø Transport constraints Ø Households with food insecurity

Ø

BCC Ø Too much focus on awareness creation Ø Limited reach of mass media in rural areas Ø Weak systems for BCC supervision Ø Community based BCC (IPC, group meetings, community events) is limited Ø Uncoordinated mass media campaigns


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Priority Areas for a BCC Strategy
Ø Antenatal Care Ø Institutional Deliveries Ø Post Natal & New Born Care Ø Married Adolescents Ø Gender discrimination (female feticide, infant girl, under 5 girl, son preference Ø Unmet need for family planning Ø Nutrition through the life cycle (infant, under three, adolescent, woman)


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Ø Routine immunization Ø Hygiene and safe water practices Ø Marginalized groups and households including urban poor Ø Need for supportive supervision of ASHAs Ø Capacity building of BCC skills for service providers across NRHM Ø Workload definition and structuring of workload for the ASHAs
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BCC Activities in Rajasthan
Ø MCHN Day Ø Home visits by ASHA. Ø Group meetings by ASHA and ANM Ø Swasthya Camps at the block level with video vans (Pilot basis) Ø Child to community BCC for hygiene behavior, routine immunization and prevention of mosquito breeding sites Ø Folk performances and Nukkad Nataks

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Thank you

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