16-18 January 2013
Addis Adeba
Ethiopie
Rocio BERZAL
C4D Specialist Niger
1

Promoting social and behaviour change for Child survival
Setting the basis - (from 2006 to mid-2008)
• Research LANCET, pilot design, secure resources (HR and financial)
• Identify & develop coordination mechanisms (national and local)
1.
Social & Behaviour change communication
• IPC / community workers + participatory communication for individual change
(proximity and traditional media, cinema, theatre, community radios…)
• Community empowerment / participation for collective change (community learning, community-led design, implementation and M&E of action plans)
2.
Social Mobilization
• Creation of partnership and networks (trad. chiefs, women, youth)
• Media campaigns
3.
Advocacy
• Local (imams, traditional chiefs) and national levels (partners)

From Collective learning…
Introduce approach, build trust
…To Collective action:
Participatory community assessment
Village plan of action
Meetings to discuss the progress
Annual celebration of champions
Community advocates

Community assesment
Promotion KFP
ACTION
Scaling up: communities, agents of change
ANALYSIS
• Celebration of progress
• Certification «communauté Modèle»
SITAN
DIFFUSION
CONTACT
• Amplication horizontale et verticale
PLAN
PLAN
Community plan of action
DIFFUSION
ACTION
Community self- diagnosis
SITAN
ANALYSIS
CONTACT
Identify acteurs
Establish trust relationships
Using stimulus guiding dialogue

• Facilitators/ volunteers
• Supervisors (NGO)
• Step 1
• Identification of problem
Step 7
Sharing responsabilitie s (relais, village chief and religious
• Step 2
• Involving leaders and participants
Catalyseurs
• Traditional Mass media/ actors of change
• Community Dialogue
• Step 3
• Clarification perceptions
Training
• Etape 4
• Expression of individuals and collectifs needs
(census/ cartographie)
• Modern Mass media
Step 5
• Evaluation current situation
• Vision
• Establish’ objectifs
• Reaching consensus about activities
Step 6
Analyse and action plan
Step 8
Social
Mobilisation
• Collective action
Step 9
Implementatio n activities
Step 10
Community based monitoring system
Step 11
Participatory assessment
Step 12
Recognition of model families and villages
Changements individuels
• Individual Changes
Social Influence, personal advocacy
• Competencies
• Ideation : Knowledge, Self-
Confidence, Risk Perception, subjective Norms, self Image,
Emotions, Self-efficiency,
•
• Intentions
• Behavior
• Social Changes
• Leadership
• Level and equity of participation
• Information equity
• Collective Selfefficiency
• Ownership
• Social Cohesion
• Social norms
•

Community-based monitoring form allows gathering data on KFP adoption and sharing /discussing indicators with health workers at village level.
The purpose of the village action plan is outline different actions to help the practices adoption.
A problem of supply/resource issues could be outlined in the action plan to stress this issue and find solutions, included advocacy actions.
Monitoring tool.pptx

FROM 140,000 TO 2 MILLION FAMILIES
Communes
5
Total pop.
140,331
Children 0-5
28,766
Scaling up in 5 regions with 6 NGOs (from mid-2009)
Communes
30
Total pop.
1,076,159
Children 0-5
183,859
Scaling up through other programme entry doors (from mid 2011)
WASH, EDUCATION, CASH TRANSFER
Communes
15 (WASH/HEALTH)
8 (CASH TRANSFER)
4 (EDUCATION)
Total pop.
600,000
280,000
120,000
Children 0-5
120,000
56,000
24,000

(INS Survey and LASDEL study in 2012)
• Individual behaviour changes are supported and accelerated
Practices
Early breastfeeding initiation (within 1 hour after delivery)
Exclusive breastfeeding
Vitamine A (one dose received in the past months)
Women hand washing with soap
Mothers using ORS treatment
Intervention zones
88.7%
77.4%
86.8%
78.9%
58.3%
Control zones
76.5%
53.7%
79.1%
76.2%
29.1%
• Social change: increased participation, sense of ownership, change of social norms (EBF, assisted delivery..), the community enters in a dynamic of change (various initiatives related to hygiene, education..)

Organization of transportation of pregnant women to the health centers
Husbands more supportive of health facility attendance
The “community cart” gives community members access to health services

“You can see the change by looking at the health of our children. I think I can convince the others. When women saw my baby recently they all commented on how healthy my baby looked”.

mbassadors
Local media trained in KFP becomes spokespersons and organizes public broadcasts with population

Volunteers create demand for products and health services among the population
Volunteers generate knowledge and information about care-seeking and monitor behaviours
Volunteers assist the health staff of the health center by holding communication sessions for patients

Increasing alliances to scale –up coverage focused on ICCM, nutrition and social safety nets:
• MDG Initiative at level of 8 health districts supported by EU
• Modelling a community-based nutrition program to reduce and prevent chronic malnutrition
• Safety nets: Cash transfer + KFP in 1,000 villages
• Alliance with WFP in 1200 CRENAMs and 29 Health Districts
• Alliance with UNFPA, Mens involvement initiative « Schools for husbands » in 1 region

Proportion of child lives saved in 2009, by intervention or risk factor reduction (List JHU team)
Careseeking for malaria
9%
Vit A supp.
9%
Careseeking for pneumonia
8%
ORS + Zinc
5%
Reduction in nutrition
19% Measles vaccine
5%
19% lives saved
Others
(<2% each)
11%
ITN ownership
25%
Hib vaccine
4%
Changes in BF practices 3%
TT in preg 2%

• LANCET series 2003, 2004
• Proposal for Spanish Government : Fomentar la incorporacion de practicas familiares a fin de promover la supervivencia del niño en Niger, Unicef Niger, 2008
• KAP study on KFP, KONE Mariatou, Niger, juillet 2008
• EDSN MICS III 2006, EDSN MICS IV 2012. INS NIGER
• Narrative of an Action Research project in Communication for Social and Behavior
Change, in five municipalities of Maradi and Zinder, Niger. Manuela Varrasso
• Enquête quantitative sur les Pratiques Familiales Essentiels. INS, Niger. Avril 2012.
• La promotion des Pratiques Familiales Essentiels au Niger, LASDEL-Avril 2012.
• Figueroa M.E., Lawrence Kincaid D., Rani M., Lewis G., Communication for Social
Change: An Integrated Model for Measuring the Process and Its Outcomes,
Communication for Social Change Working Paper Series I, The Rockefeller Foundation and Johns Hopkins University Center for Communication Programs, New York, 2002
• LANCET. Reduction in child mortality in Niger: a Countdown to 2015 country case study
Agbessi Amouzou, Oumarou Habi, Khaled Bensaïd, and the Niger Countdown Case
Study Working Group
• Qualitative research to identify solutions to local barriers to care-seeking and treatment for diarrhoea , malaria and pneumonia in Niger. Juliet Bedford, 2012
• Review/analysis of UNICEF Community-Led Total Sanitation and Essential Family
Practices Communication for Development Interventions in Niger. Karen Greiner 2012
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