Enabling 26,000 Mothers to Raise Healthier Children

Enabling 26,000 Mothers to Raise Healthier Children

White Rice x UNICEF

BEHAVIOUR CHANGE COMMUNICATION

Challenge

In Sindh, Pakistan, one in every two children under the age of five suffers from stunted growth. With malnutrition on the rise, there is a major disconnect between intended behaviors and the day-to-day life of the mothers in rural villages.

Approach

To address this, White Rice partnered with UNICEF to develop a Social Behaviour Communication Change (SBCC) program, focusing on the first 1000 days of an infant’s life as a crucial window for caregivers to practice healthy behaviors. The grassroots program, Misaali Maa (Exemplary Mother), engaged with 26,000 mothers directly and 100,000 indirectly across three districts of Sindh focusing on fundamental nutritional and hygiene behaviour changes.

We conducted initial behavioural research to assess and engage with stakeholders at every level. Rich insights were generated through day-long observations of actual behaviours and routines of mothers, as well as by shadowing health and community workers. Additionally, the use of projective methods to uncover deep aspirations, combined with a visual ethnography of homes, played an essential part in gaining critical insights for the program design.

The program roll-out process was initiated by the training and capacity building of 2,000 outreach workers. Monitoring processes utilized the platform of Whatsapp and RapidPro to share pictures, videos, and qualitative data about the roll-out and to generate a more comprehensive dialogue surrounding intervention interactions.

Touch Points with participants included:

  • Home Visits: 6 planned home-visits over 12 weeks were conducted for each mother. The visits centered around home-based activities and nudges to remind mothers of crucial behaviours. Training guides and mobile-based messaging were also used during home-visits.
  • Community Branding: Materials were created for local visibility to aid recall and generate conversations in the community around the campaign. Logos and wall chalking were designed to show a mother that aligned with aspirational findings.
  • Mother clubs: These community sessions created a space for pregnant mothers and mothers with children younger than two years to exchange stories and advice, and learn from each other. The club activities included ‘emotional-demos,’ spot the difference activities, games, role-playing, audio stories, recognition awards for best performers, and public declarations. Wristbands were given out and worn by members to help build association and unite the mothers, creating a sense of community.

Impact

The campaign impact was evaluated through a Participatory Video Most Significant Change (PVMSC) technique, wherein story circles were conducted, directly engaging 11,000 participants of the program. The PVMSC process engaged the broader community in dialogue while revitalizing the program.

Through this qualitative assessment, 90% of mothers reported at least one change in behaviour. Fundamental behaviour changes included improvement in household cleanliness, breastfeeding in the first six months, feeding colostrum, and taking supplement tablets. Mothers also reported an increased sense of confidence and conviction in the decisions they were making for their children, even when faced with familial pressure. As a result of the success of the program, recommendations made were incorporated by the Sindh Government Nutrition and Stunting Program.

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