behavioural change communication

BEHAVIORAL CHANGE COMMUNICATION

Dr. Srinivas Rao

1st year PG

Community Medicine

CONTENTS

INTRODUCTION.

HEALTH EDUCATION

BCC

ROLE OF BCC IN PROGRAMS

REFERENCES

INTRODUCTION

• The 6th report on world health situation states that health has to be attained &cannot be imposed ; thus the 1st requirement for attainment of health is a commitment by both people and the govt.

• Adequate education in general is essential for the development of this commitment.

HEALTH EDUCATION

The process by which individuals and groups of people learn to behave in a manner conducive to the promotion ,maintenance or restoration of health (John M Last)

The declaration of Alma-Ata(1978) emphasized the need for individual and community participation. The dynamic definition is as follows:

“A process aimed at encouraging people to want to be healthy , to know how to stay healthy , to do what they can individually and collectively to maintain health , and to seek help when needed”.

PRINCIPLES OF HEALTH EDUCATION

1. Community involvement in planning health education is essential. Without community involvement the chances of any programme succeeding are slim.

2. The promotion of self esteem should be an integral component of all health education programmes

3. Voluntarism is ethical principle on which all health education program should be built without it health education programs become propaganda. Health education should not seek to coerce but should rather aim to facilitate informed choice.

4. Health education should respect cultural norms and take account of the economic and environmental constraints face by people. It should seek positively to enhance respect for all.

5. Good human relations are of utmost importance in learning.

6. Evaluation needs to be an integral part of health education.

7. There should be a responsibility for the accuracy of information and the appropriateness of methods used.

8. Every health campaign needs reinforcement. Repetition of messages at intervals is useful.

IEC

• IEC can be defined as an approach which attempts to change or reinforce a set of behavior in a target audience regarding a specific problem in a predefined period of time.

• It is multidisciplinary and client centered in its approach.

• Embodied in IEC is the process of learning that empowers people to make decisions, modify behaviors and change social conditions.

• Activities are developed based upon needs assessments, sound educational principles, and periodic evaluation using a clear set of goals and objectives

BEHAVIOUR CHANGE COMMUNICATION(BCC)

• Studies revealed that traditional IEC methods have stopped giving information and creating awareness but BCC is characterized by its direct approach towards changing behavior.

BCC must be research based client centered benefit orientedservice linkedprofessionally developed , andlinked to behavior change

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Why BCC?The increasing area of interaction

Objectives of BCC activities

Major objectives for health are to enable people:

- To define their own problems and needs

- To understand what they can do about these problems with their own resources combined with outside support

- To decide on most appropriate action to promote healthy living and community well being

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Defining tasks and educational objectives

Planning an evaluation system

Preparing and implementing an educational programme

Implementing evaluation

Principles of BCCThe Educational Spiral

STEPS OF BCC

Role of BCC in HIV/AIDS

• Increase knowledge : BCC can ensure that people are given the basic facts about HIV and AIDS in a language or medium that they can understand and relate to .

• Stimulate community dialogue : BCC can encourage community and national discussions on the basic facts of HIV/AIDS & the underlying factors that contribute to the epidemic, such as risk behaviors and risk settings, environments and cultural practices related to sex and sexuality .


• Promote essential attitude change : BCC can lead to appropriate attitudinal changes about, for eg, perceived personal risk of HIV infection, belief in the right to and responsibility for safe practices and health supporting services etc .

• Advocate for policy changes : BCC can lead policymakers and opinion leaders toward effective approaches to the epidemic.

• Improve skills and sense of self-efficacy: It can focus on teaching or reinforcing new skills and behaviors, such as condom use, negotiating safer sex and safe injecting practices .


• Create a demand for information and services: BCC can spur individuals and communities to demand information on HIV/AIDS and appropriate services.

• Reduce stigma and discrimination: Communication about HIV prevention and AIDS mitigation should address stigma and discrimination and attempt to influence social responses to them .


• Promote services for prevention and care : BCC can promote services for STIs, intravenous drug users (IDUs), orphans and vulnerable children (OVCs); voluntary counseling and testing (VCT) for mother-to-child transmission (MTCT); support groups for PLHA; clinical care for opportunistic infections; and social and economic support.

Insights

• BCC has its roots in behavior change theories

• BCC practitioners use a combination of theories and practical steps that are based on field realities, rather than relying on any single theory or model.

• Rationale behind “staging” people is to tailor therapy to a person’s needs at his/her particular point in the change process.

Presentation 2

BCC GOALS FOR HIV/AIDS

• Program goal: Reduce HIV prevalence among young people in urban settings in country.

• Behavior change goals:

• Increase condom use

• Increase appropriate STI care-seeking behavior

• Delay sexual debut

• Reduce number of partners

• BCC goals:

• Increase perception of risk or change attitudes toward use of condoms

• Increase demand for services

• Create demand for information on HIV and AIDS

• Create demand for appropriate STI services

• Interest policymakers in investing in youth-friendly VCT services (services must be in place)

• Promote acceptance among communities of youth sexuality and the value of reproductive health services for youth (services must be in place)

Role of BCC in RCH

• Multiple influences & influencers are needed to make BCC strategies effective.

for eg: mothers-in-law are known to influence the birth spacing behavior of newly married couples. She will also play a significant role in pregnancy, delivery and infant nutrition, perhaps discouraging immediate and exclusive breast feeding. So, they will be an important target group for BCC for young mothers.

BCC in NRHM

CHALLENGES

• BCC vs. IEC. In practice, IEC has often resulted in the production of discrete communication materials. The use of the term BCC is part of an effort to establish communication as strategic and integrated into entire programs.

• Integrating BCC into all programs. BCC is a component of all successful interventions and must be included in their original design. However, in reality this doesn’t always happen.

• Limited training resources

• Political and physical environments. In some countries, geography and populationaldiversity can complicate the development of BCC programs. This is especially the case where vast distances must be covered, or multiple languages and cultural traditions included, in a single country program.

• Sustainability. To be effective, BCC strategies and components must evolve constantly to meet the changing needs of target populations. This requires the continuous input of human and financial resources.

• Budgets.

• Linkages and coordination. For BCC to be effective, their messages and information should be coordinated. Building and maintaining linkages and coordination is an ongoing challenge.

Sunderlal , Adarsh , Pankaj ,Text book of community medicine, 4th edition , chp 2, P 3-48

J . Kishore , national health programs of India, 11th edition , p 157,220,230

WHO TRS 690(1983).New Approaches to health Education inPrimary Health care.

REFERENCES

http://www.hivpolicy.org/Library/HPP000533.pdf

http://en.wikipedia.org/wiki/Behavior_change_communication

WHO, AFMC Text book of Public Health and CommunityMedicine , p 622

behavioural change communication

Health & Medicine