Social and Behavior Change Communication Activities
Review and Analysis of Existing BCC Materials (Flipchart)
Purpose:
The overall purpose of this activity was to collect and review the already existing BCC materials relevant to SUAAHARA program, identify its strengths, gaps,
Areas of improvement and based on findings recommend one comprehensive BCC package for SUAAHRA.
As a part of review, a total of 99 IEC/BCC materials developed by various governmental and non-governmental organizations were collected and reviewed
thoroughly taking in-light of message comprehensiveness, accuracy, consistency, culturally appropriateness, image and gender and social inclusion prospective.
The materials primarily included Flip Chart, Poster, Booklet, Leaflets, and Pamphlets etc. A detail inventory of all the materials reviewed has been developed
highlighting purpose, strengths and gaps of each material along with programmatic recommendations.
Materials review process was guided by the following points:
- Are the materials relevant to SUAAHARA program?
- How can we make best use of already existing materials that are relevant to SUAAHARA and save time through revision/adaptation
- Who are the primary and secondary audience of BCC materials and how are the materials be used?
- Are the messages consistent with ENA+ training package of SUAAHARA program?
Taking the above mentioned point, materials developed by the Government Counterpart (Child Health Division) and SUAAHARA implementing partners i.e.
Helen Keller International (HKI), Save the Children (SAVE), Nutrition Promotion Consultancy Services (NPCS) and Nepal Water for Health (NEWAH) on
nutrition were further reviewed in-depth, analyzed and recommendation made for adaptation, revision and future improvement.
Materials review process also took into consideration the intended audience of SUAAAHRA program i.e. Female Community Health Volunteers (FCHVs) who
will be the primary resources promoting nutritional and hygiene behaviors at household and community level and linking community with health service. The
other key audience included mothers of under 2 years of age and their families of SUAAHARA program districts.
The following BCC materials were reviewed and analyzed:
1. Essential Nutrition Behaviors for Healthy Mother and Child - produced by HKI
2. CHD/UNICEF - Newborn baby and Childhood Nutrition - produced by CHD/MOHP/UNICEF
3. Food Behavior based Flipchart for FCHV- produced by NPCS
4. Nutrition Related Information - produced by NPCS/UMN/CHD Nutrition Section
5. Lets attention for child nutrition, save from malnutrition - produced by MoAC, Food Technique and Quality Control Dept/ CHD Nutrition
Section/World Vision
6. Child Protection Donation Program: Newborn baby and Child Nutrition - produced by MoHP/UNICEF/ Ministry of Local Development
7. Mother Child Micro nutrition and Anemia - produced by MoHP/CHD, Nutrition Section/World Vision Third Issue 2063
8. How to do poultry farming in the local level? - produced by HKI / USAID / Nepal Govt.
9. Vitamin 'A' - Village Level Training
1
Comparative Chart Highlighting Key Message/Content of BCC materials targeted for Female Community Health Volunteers (developed by 4 partners) and its
consistency with SUAAHARA ENA+ training package
Message content as per
ENA+ training package
Picture ID
Essential Nutrition Behaviors for
healthy mother and child – HKI
Why nutrition matters?
- Global and national nutrition
situation
- Under nutrition
- Growth Flattering 1000 days
- Essential nutrition action
 Every 5 out of 10 children under 5 years
in Nepal suffer from anemia.
 Most children suffer from anemia within
2 years of age since birth
 Iron, Vit A and Iodine deficiency among
woman and children
 Causes of malnutrition
 Breastfeeding with 1 hour of birth
 Importance of breastfeeding for child
and mother
 Exclusive breastfeeding
 Brestfeeding behaviours
 Breastfeeding frequencies
 Good attachment and positioning
 Mother should pay attention during
breastfeeding
 Every 5 out of 10 children under 5 years
in Nepal suffer from anemia.
 Most children suffer from anemia within
2 years of age since birth
 Growth faltering "1000 days"
 Effects of malnutrition
 Management of malnutrition
 Types of malnutrition
 Protein Energy Malnutrition
conditions
 Iron/Vit A deficiency problems
 Food containing Iron/Vit A






 Complementary feeding after 6 months
with continuation of breastfeeding
 Reasons of complementary feeding
 Locally available nutritious and energy
dense food
 Food frequency
 Complementary feeding after 6 months
with continuation of breastfeeding
 Reasons of complementary feeding
 Introduction to locally available
nutritious food
 How to make food energy dense
Breastfeeding practices/
Lactation management
- why breast feeding matters
- timey initiation of breast
feeding
- exclusive breastfeeding and
continuation of BF
- LM Anatomy and
Physiology, composition of
breast milk
- Good attachment and
positioning, breast feeding
beliefs and myths
Complementary feeding
practices
-Contribution that breast milk
makes to complementary feeding
- Characteristics of
complementary feeding for each
IYCF-CHD
NPCS Flipchart
NEWAH
NEWAH does not
have BCC
materials
(Flipchart)
particularly
targeted of FCHVs
Breastfeeding within 1 hour of birth
Importance of Colostrum
Exclusive breastfeeding
Good attachment and positioning
Breastfeeding frequencies and duration
 How to prepare rice flour liquid
 How to prepare nutritious rice
gruel (sarbottam)
 Importance of complementary food
 Pay attention to prevent nutritious
minerals
2
age group (6-9, 9-12.12-24)
(food, amount, texture, variety,
hygiene)
- Importance of ASF
Care and feeding sick child
- Feeding during and after
illness
- Responsive feeding
- Hand washing with soap
during critical time
- Health care seeking ORT
and Zinc during diarrhea,
IMCI
Essential Hygiene Actions
- Assumption and principle of
hygiene promotion
- Hand washing with soap at
critical times
- Latrine use
- How hygiene and sanitation
contribute to nutrition
Women's Nutrition
- Malnutrition in life cycle
- Nutrition for pregnant &
breast feeding mother
- Healthy timing and spacing
- Avoid smoking
Others:
 Iodine
 complementary feeding for each age
group (6-9, 9-12, 12-24 months)
(variety, frequency)
 Responsive feeding
 Preparation of super (sarbottam) flour
 How to make food energy dense and
Preparation of nutritious rice gruel
(JAULO)
 Food for sick child (0-6, 6-24 months
old) during and after sick
 Preparation of super (sarbottam) flour
 Preparation of nutritious rice gruel
(JAULO)
 Food Frequency
 complementary feeding for each age
group (6-9, 9-12, 12-24 months) (variety,
frequency)
 Less nutritious foods
 Balance diet: body protection food,
body growth and development
food, energy providing food
 Importance of food and nutrition
 No messages

 Hand washing: before cooking/
fooding/breastfeeding, after washing
baby's feces, after using toiletary
 Personal hygiene: Toilet use, hand
washing, nail cutting
 Personal hygiene




 No messages
 Food during pregnancy period
 Food during breastfeeding

Early Childhood Development
 Stimulation
 Growth monitoring
 No messages
 Growth monitoring

 Importance of Kitchen Gardening

Food during pregnancy period
Food during post natal
during adoloscent
anti natal care
Katchen Gardening
 Kitchen garden (production of homebased food)
 Village-home sample Agricultural
Garden
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Detail Analysis of Flip Chart developed for FCHVs by HKI, CHD and NPCS
Helen Keller International
IYCF-CHD
NPCS Flipchart
NEWAH
NEWAH does not have
BCC materials particularly
targeted of FCHVs
Strengths:
 Covers majority of the ENA + messages
 Pre/Pilot tested among FCHVs under Aama
project
 Already endorsed by the Government of
Nepal
 Illustration/pictures used are clear and
consistent through out
 GESI consideration in some instances
Gaps:
 Some important ENA + messages/content are
missing
- Healthy Timing and Spacing Pregnancy (FP)
- Danger of smoking to health
- How Germs can pass into our body and
importance of hand washing
- Proper handling of food
- Community Led Total Sanitation
 Content covered does not include
comprehensive messages
 Slides are not presented in sequential order (as
per the ENA+ package)
Strengths :
Messages are based on National IYCF strategy
Involvement of several stakeholders in the
design process
 Pre tested among the FCHVs
 Guides the user to lead discussion and make it
participatory
 Messages are comprehensive
 GeSI consideration
 Pictures are very clear and consistent
 Also talks about personal hygiene
 Handy and easy to carry
 Good color combination
Gaps:
 Mostly focused on IYCF messages and does
not cover messages on
- HTSP/ family planning
- Smoking
- Women’s nutrition
- Construction and use of latrine
- Proper handling of food
- Pictures and messages are overloaded in some
slides


Strengths:
Messages are clear and concise
Good quality of material. Pictures are real
and attractive
 Also talks about nutrition for pregnant and
lactating mothers besides complementary
feeding
 Also has separate messages on vitamin A,
Iodine, Iron, kitchen gardening and also a
bit on hygiene


Gaps:
Messages are only focused on food
(balance diet, types of food, energy giving
food, food helping in physical and mental
development etc.)
 Key ENA+ messages are missing
(Breastfeeding, lactation management, care
and feeding of sick child, FP, smoking,
EHA etc.)

4


Messages in some slides are overloaded and
there are some grammatical mistakes
Some illustrations are not appropriate
Area of Improvement:





Review and revision of messages ensuring
consistency t with SUAAHARA ENA+
Package
Comprehensiveness
Sequential order etc
Geographical consideration ( Mountain/Hills
& Tarai districts)
GESI consideration ( message, image)
Simplification of messages as far as possible
Linking messages into behavior change action
Key Questions /Recommendation

What should be the format ???
- flip chart ??? as FCHVs already have many
* How can we make it innovative???, handy, user
friendly, pictorial, attractive for both the user
and client.
- Flip handbook with key messages??
- Spiral book/ cue card ???
- Laminated discussion posters ??
- What else ???
 Durable
 Localization
 Since HKI developed messages/flip chart has
already been endorsed by GON, it should be
made as base for revision.
 Some missing messages/ images can be
adopted/adapted from CHD developed flip
book.
- There is also a need to develop materials that
clients can use as the household level as
reference particularly for key messages
- Flyers, leaflets, brochure, posters, ????

This Flip Chart does not fit in for
SUAAHARA ENA+ package but we can
take out some relevant messages and images
for SUAAHARA BCC materials
5
The ENA+ EHA Messages
1. Optimal breastfeeding during the first six months ^ dlxgf;Dd lzz'nfO{ :tgkfg dfq u/fcf}+
2. Optimal complementary feeding at 6 months with continued breastfeeding up to two years
aRrfnfO{ @ jif{;Dd yk vfgf ;lxt cfdfsf] b"w v'jfpg' kb{5 .
3. Optimal nutrition care of sick and severely malnourished children, and targeting moderately undernourished
children for prevention education
la/fdL / clt s'kf]lift aRrfsf] kf]if0f :ofxf/ u/f}+ / /f]syfd lzIffsf] nflu
s'kf]lift aRrfx?nfO{ nlIft u/f}+ .
4. Prevention of Vitamin A deficiency for women and children dlxnf / aRrfnfO{ le6fldg P
sdLx'gaf6 /f]syfd u/f}+
5. Promotion of adequate intake of iron and folic acid, and prevention and control of anemia for women and children
kof{Kt dfqfdf cfO{/g / kmf]lns Pl;8 lng k|f]T;fxg u/f}+ / dlxnf tyf aRrfnfO{
/QmcNktfsf] /f]syfd tyf lgoGq0f u/f}+ .
6. Adequate intake of iodine by all members of the family kl/jf/sf ;Dk"0f{ ;b:ox?n] kof{Kt
dfqfdf cfof]l8g lng] u/f}+ .
7. Optimal nutrition for women (especially during pregnancy and lactation period) dlxnfsf] nflu kf]if0f
:ofxf/ -ljz]iful/ uef{j:yf / :tgkfg u/fpg] cj:yfdf_
8. Promotion of child spacing and family planning hGdfGt/ / kl/jf/ lgof]hgsf] k|aw{g .
9. Dangers of smoking to the health of mother and baby cfdf / aRrfsf] :jf:Yosf] nflu w'd|kfg
vt/fk"0f{
10. Treatment and safe storage of drinking water vfg]kfgL z'l4s/0f tyf ;'/lIft e08f/0f .
11. Hand washing with soap or ash at critical times (after defecation or handling feces and before preparing food,
feeding children, and eating) hf]lvdk"0f{ ;dox?df ;fa"g jf v/fgL kfgLn] xft w'g]
u/f}+ -lbzf ul/;s]kl5 cyjf lbzf kvfNbf /
6
vfgf tof/L ug'{ cl3, aRrfnfO{ Vjfpg' cl3 / vfg' cl3_
12. Safe disposal of feces lbzfsf] ;'/lIft lj;h{g .
13. Proper storage and handling of food to prevent contamination ;+qmd0faf6 arfpg vfgfsf] plrt
e08f/0f tyf Joj:yfkg
14. Community construction and use of affordable latrines ;fd'bflos rkL{sf] lgdf{0f tyf k|of]u
7