Promising Practices Communication Science Social Change and Poshan

“Promising Practices” Communication Science, Social Change and Poshan Abhiyaan K. Viswanath, Ph. D Ananya Awasthi, BDS, MPH Ramya Pinnamaneni, MBBS, MPH Harvard T. H. School of Public Health Dana-Farber Cancer Institute Dana-Farber/Harvard Cancer Center

What do we mean by “Promising Practices”? • Evidence-based • Nutrition • Communication science • Social and Behavioral Science • Practical • Feasibility • Potential for Scale • Culturally proximal

What does SBCC Science tells us about human behavior? • Exposure! • Message platforms • • Mass media Interpersonal Group support Community mobilization • Messages • • Model behaviors Norms: support from others Stories Culturally proximal • Sensitive to barriers

Why do stories matter? • Able to model good behavior • Reduce counter-arguments • Transportation • Engage and involve • Draw on emotions • Powerful vehicles for cultural practices

Key Themes of POSHAN Abhiyaan - Jan Andolan

Our methods for building evidence • Analysis of existing data • 2015 NFHS • Scientific Literature • • Low and Middle-Income Countries 2014 -2020 SBCC practices in nutrition “Grey Literature” • National and State Consultations

Stories from the States: Exemplar promising practices

Culture as a vehicle • Using festivals or celebrations • God Bharai: Focus on pregnant women (UP, MP & Tripura) • First meals • Annaprashan Diwas (Madhya Pradesh, Gujarat, Tripura) • Engage all family members • Demonstration • Involvement devices : “katori” and spoon for a standardized measure • Pratham Aaahar (Annaprashan): Promote complementary feeding (Assam) • Matri Amrit: Pregnant women (Assam) • Upari Aahaar Abhiyaan Diwas: Complementary feeding (Bihar) • Poshan Bathukamma: Demonstration of nutritious foods in Telangana • Poshan Raths (Odisha) • Focus on tribal population

Narratives as a vehicle • Amma Ki Smritiyaan (Uttarkhand)* • Target mothers • Traditional recipes • Bhajan Sandhyas (Himachal Pradesh) • Healthy foods for mothers • Poshan Vatika: (Chattishgarh) • Using folk dances and songs • Pregnant and lactating women • Promote healthy nutrition • Connect with festivals and life markers such as Annaprashna *Not sure if this can be considered a narrative approach but has the potential to be a powerful platform

Community Mobilization • Cooking competitions that involve husbands (Telangana) • Walkathons (Antenatal Care in Puducherry) • Mass Bangle Ceremonies (promote ANC visit in Tamil Nadu) • Sanjhi Sehat programme with NRLM (SHGs of pregnant women in MP) • Nutri-gardens & hot cooked meals (Assam, Haryana, MP & Maharashtra) • Improve diet diversity • “Millet Mela, ” “Food mela, ” “Poshan Mela” (Karnataka, Puducherry, Tripura)

Scaling up

The ICT Revolution: Tapping into the potential • 2018 • Total telephone subscriptions: 1. 2 • Wireless: 1. 1 billion • Broadband: 511. 9 million • Internet users: 496 million

Association between different types of media use and making at least eight antenatal care visits, stratified by urbanicity

Mass and Telecommunications Using ICTs • Potential for scalability • Vast reach • Examples • Poshan Helpline (Chandigarh) • Pregnant women and young mothers • Telehealth counseling • Follow-up on Whats. App • Hello Sakhi, Hello Doctors (Gujarat) • Mothers • Healthy nutrition • Youtube videos and Prashar Bharati • POSHAN Vani (Kerala) • Anganwadi workers • Recorded messages • Jan Manch platform (Himachal Pradesh) • Adolescent girls • Healthy nutrition • Social and outdoor media

Next steps • Overall report • What works? Promising practices with examples • Platforms for scalability and delivery • Analysis of existing data • Lessons from literature • COVID-19 • Case studies • Testing some of the practices and materials • What messages work? • What platforms are helpful? • Recommendations