This SBCC Implementation Kit (or I-Kit) provides practical guidance on developing a

communication strategy for social and behaviour change communication (SBCC).

Social and behaviour change communication is used throughout this I-Kit. Implicit in this
term are other names which have been used to describe this field, including behavior
change communication, demand side, strategic communication, health communication,
and advocacy, communication and social mobilization (ACSM).

Social and Behavior Change Communication

Social and behaviour change communication (SBCC) uses science and data as well as
creative ideas to focus on:

 Changing or positively influencing social norms in support of long-term,

sustainable behaviour change at the population level
 Fostering long-term, normative shifts in behaviour in support of increasing the
practice of healthy behaviours
 Improving health services provider-client interactions
 Strengthening community responses to issues
 Influencing decision-makers and family and peer networks
 Increasing demand for health services and products
 Increasing correct use of health services and products
 Influencing policy
 Encouraging an increased capacity for local planning and implementation of
health improvement efforts

To be most effective, SBCC efforts should be matched with efforts to expand services,
increase access to commodities, and train and equip providers to meet increased
demand for products and/or services. Without these links, audiences may become
discouraged and will eventually stop paying attention to the messages.

Communication Strategy Process

The communication strategy may be developed for a variety of purposes and in a variety
of ways, from a three-person team that needs to deliver a marketing communication
strategy to promote a product to a national task force developing a broad multi-sectoral
action plan to an organization that needs to rebrand its services. A team of stakeholders
may work together in a participatory workshop setting to develop the strategy document
or a core working group (from a few people to a whole team or task force) may work on
the strategy development, consulting with stakeholders as needed.

Stakeholders include public, private and NGO (or civil society) sector agencies, relevant
Government Ministries, service delivery groups, audience members, advertising
agencies, research organizations, media and technical experts. Participation of
individuals and/or groups directly affected by the challenge is crucial from the start.
 Their active involvement can help increase program impact and can lead to long-term
sustainability.

The I-Kit includes eight steps in the strategy development process and tools in each one
to help compile the needed information. The tools and exercises are not meant to be a
strict formula to follow. Rather, the steps are flexible guidelines to be used according to
the situation and can thus be adapted according to need. For example, you may already
have much of the background work completed and an idea of what challenge to address.
In this case, you may want to begin with steps after the Analysis Step. In other
instances, all that may be available are research results which have yet to be analyzed
so you would want to begin right at Step 1.
Detailed examples of SBCC programs are in the sidebar to illustrate how these steps
have been implemented in the field. Most of the lessons in this I-Kit are derived from
health communication experience, but the lessons can also be applied to other sectors
such as education and democracy and governance.

Before you begin...

The development of a communication strategy is a process that needs to be informed by
insights, data and evidence. To prepare for your Strategy Development workshop or
working group, it is recommended you complete Step 1, Analysis of the Situation, prior
to starting. This will help ensure you have as complete a picture as possible of the
challenge, the current situation and the group(s) most affected by the challenge.
This preparation may include a literature review on the current situation for the issue of
concern, the major barriers and facilitators to social and behavior change, and emerging
issues. The literature review may also provide information on programs/campaigns in
other countries that have addressed the same challenge or that focused on similar
groups or contexts. Information on the current communication situation in your country
should be included as well, to give participants an idea of what approaches are currently
used and who is currently implementing SBCC programs.

You may find you need to supplement current information with additional research to
guide program planning. This additional research could include collecting further
qualitative or quantitative data or conducting a secondary analysis of existing data.

Lessons
1. Step 1: Analyse the Situation
 
2. Step 2: Audience
 
3. Step 3: Communication Objectives
 
4. Step 4: Strategic Approaches
 
5. Step 5: Positioning and Strategy Outline
 
6. Step 6: Implementation Plan

7. Step 7: Monitoring and Evaluation

 
8. Conclusion

Now that the communication objectives have been determined, two tasks will help
describe how the SBCC program will meet these objectives This “how” will be the strategic
approaches used to achieve the communication objectives. Typically, a communication strategy
will include several approaches, especially if addressing multiple audiences across the social
ecological levels. The approaches chosen drive the SBCC program and help ensure consistency
and coordination among partners and synergy across program interventions.
The strategic approaches can be incorporated into a goal-oriented campaign. Campaigns
include a combination of approaches (usually including mass media in addition to community-
based approaches) and provide multiple opportunities for exposure through a consistent theme
that links program activities together. A campaign provides benefits to the individual and/or
society, typically within a given time period, by means of organized communication activities .
Strategic approaches are often depicted through a strategic framework, which shows how
activities will contribute to objectives. The process for developing a strategic framework is
described in Task 2.
What You Need to Know to Get Started

Strategic Approaches

 Advocacy
Advocacy operates at the political, social and individual levels and works to mobilize
resources and political and social commitment for social change and/or policy change.
Resources can include political will and leadership as well as money to fund the
implementation of policies or programs. Advocacy aims to create an enabling
environment at any level, including the community level (i.e. traditional government or
local religious endorsement), to ask for greater resources, encourage allocating
resources equitably and remove barriers to policy implementation. Guidelines for
advocacy as a process are provided in the ASK Approach.
 Community-Based Media
Community-based media reach communities through locally-established outlets. Such
outlets include local radio stations and community newsletters/newspapers as well as
activities such as rallies, public meetings, folk dramas and sporting events.
 Community Mobilization
Community mobilization is a capacity-building process through which community
individuals, groups or organizations plan, carry out and evaluate activities on a
participatory and sustained basis to improve their lives, either on their own initiative or
 stimulated by others. A successful community mobilization effort  not only works to solve
problems at the community-level but also aims to increase the capacity of a community
to successfully identify and address its own needs.
 Counseling
Counselling is based on one-to-one communication and is often done with a trusted and
influential communicator such as a counsellor, teacher or health provider. Counselling
tools or job aids are usually also produced to help clients and counsellors improve their
interactions, with service providers trained to use the tools and aids.
 Distance Learning
Distance learning provides a learning platform that does not require attendance at a
specific location. Rather, the students access the course content either through a radio
or via the internet and interact with their teacher and fellow classmates through letters,
telephone calls, SMS texts, chat rooms or Internet sites. Distance learning courses can
focus on training communication specialists, community mobilizers, health educators and
service providers. (See Information and Communication Technology for examples on
eLearning.)
 Information and Communication Technology (ICT)
ICT is the fastest growing and evolving approach, with an increasing reach throughout
the world. This approach includes digital media such as web sites, e-mails, listservs,
Internet news feeds, chat rooms, virtual learning and eLearning, eToolkits and message
boards. Digital media is unique in being able to disseminate highly tailored messages to
the intended audience while also receiving feedback from them and encouraging real-
time conversations, combining mass communication and interpersonal
interaction . Interactive digital media providing such tailored health information can be
effective in helping people manage diseases, access health services, and obtain social
support or provide assistance in changing behaviors. Through such media, the audience
can generate and share information and ideas. Social media is a sub-set of digital media,
and examples include Facebook, Twitter, Linked In, blogs, eForums, and chat rooms.
Additional information on eLearning can be found at Global Health eLearning
Center and PEPFAR eLearning Initiative. More information on eToolkits can be found at
K4Health’s eToolkits Technical Brief.

mHealth: mHealth Fact Sheet and mHealth Toolkit.

ICT: Utilizing ICT in Demand Generation for Reproductive, Maternal, Newborn & Child Health:
Three Case Studies and Recommendations for Future Programming. For a guide on developing
mobile health communication strategies, refer to mBCC Field Guide: A Resource for Developing
Mobile Behavior Change Communication Programs.
 Interpersonal Communication (IPC)/Peer Communication
Interpersonal and peer communication are based on one-to-one communication. This
could be parent-child communication, peer-to-peer communication or communication
with a community leader or religious leader. For more information, see When to Use IPC.
 Mass Media
Mass media can reach large audiences  cost-effectively through the formats of radio,
television and newspapers. According to a review, mass media campaigns that follow the
principles of effective campaign design and are well-executed can have small to
moderate effect size not only on health knowledge, beliefs, and attitudes, but on
behaviours as well. Given the wide reach of mass media and the potential to reach
thousands of people, a small to moderate effect size will have a greater impact on public
health than would an approach that has a large effect size but only reaches a small
number of people. Thus mass media can have a major public health impact  given its
wide reach.
 Social Mobilization
Social mobilization brings relevant sectors such as organizations, policy makers,
 networks and communities together to raise awareness, empower individuals and groups
for action, and work towards creating an enabling environment and effecting positive
behaviour and/or social change.
 Support Media/Mid-Media
Mid-media’s reach is less than that of mass media and includes posters, brochures and
billboards.

Task 1: Identify Strategic Approaches

Process: Facilitated discussion

Tools: Choosing Strategic Approaches
Output: Strategic approaches finalized
The strategic approaches describe how the objectives will be achieved. They will guide
the development and implementation of activities and will determine the vehicles, tools
and media mix that your team will use. Within each approach, you will have multiple
vehicles, use various tools and rely on a mix of approaches to communicate to your
audience(s). The approaches will convey your messages, be mutually reinforcing and be
the routes of message delivery.
 Refer to findings from formative research and information gathered during Step
1 to help determine the most appropriate approaches. The context of the situation can
help determine opportunities for possible approaches as well as limitations to what can
or cannot be used.
 Determine which approaches will best reach intended audience(s):
 What would the intended audience find most appealing?
 What will best influence the intended audience?
 What would be most effective in motivating change? Who does the
intended audience trust?
 What would be most credible?
 What will best reach the intended audience?
 What will achieve the greatest impact?
 What times are best for the audience?
o If mass media or social media will be used, when is the audience
most likely to tune in? (watching TV, listening to the radio, accessing the internet,
logging into on-line social networks)
 If community-based approaches will be used, when is the intended
audience available? Are there already established community-events on which you can
piggy-back activities?
 Consider the types of messages which will be used:
 Which approaches are the most appropriate for conveying these
messages?
 If skills need to be modeled, can the approaches effectively model and
demonstrate specific behaviors?
 Refer to the table “Choosing Strategic Approaches” as well as A Theory-Based
Framework for Media Selection in Demand Generation Programs for additional
considerations when determining approaches.
 Combine multiple approaches to help increase reach and increase repetition of
the messages. This will increase exposure and further reinforce the messages being
delivered.
 What mix of approaches will reach a large proportion of the audience
efficiently and effectively (and still fit within your budget)?
Choosing Strategic Approaches
 CONSIDERATIONS APPROPRIATE APPROACHES

Complexity of the Face-to-face communication allows for dialogue and

Challenge discussion with your audience.
Mass media can model complex behaviours.
Social media can encourage discussions about the
challenge, through e-mails, text messages, chat rooms, or voice
mails.
If your audience can read, written materials allow the
audience to refer back to them as often as they would like.

Sensitivity of the
Interpersonal approaches and one-on-one communication work
Challenge
well when discussing sensitive topics.

Effectiveness of
An approach may be more or less effective depending on the
Approach to
Address Challenge challenge being addressed. For example, a a recent synthesis of
meta-analyses s on the effectiveness of health communication
interventions found entertainment education formats to be well
suited for motivational messages and moving social norms, face-
to-face counseling seems to help people learn about and adhere to
more effective strategies to quit smoking, and media campaigns
were better than interpersonal interventions without media for
HIV/STD prevention.

Literacy
If audience is not literate, an approach which does not rely on the
written word will be more effective.

Desired Reach
Mass media, most internet-based interventions, and many
mHealth interventions have an advantage in their potential reach
and can provide regional and national coverage. Such approaches
can deliver messages to scale.

Cost Consider the cost – and the cost effectiveness (in terms of
cost per person reached) of the various approaches and determine
how best to use your budgeted funds.
Tools which help calculate the value for money and
quantify the impact of approaches can be found
at http://www.nsmcentre.org.uk/resources/vfm

Innovation
Consider using approaches that are new and fresh for your
audience. Using an approach that is unexpected can make it more
 CONSIDERATIONS APPROPRIATE APPROACHES

appealing and interesting to your audience.

Youth
Consider age or generation because some mobile-based or social
media approaches may appeal more to young adults.

Useful Resources
Health COMpass: An interactive and collaborative resource for high quality Tools and
Project Examples to build capacity in social and behavior change communication.
K4Health Toolkits: Toolkits provide quick and easy access to relevant and reliable health
information in one convenient location, intended for health program managers, policy
makers and service providers.
Advance Family Planning Advocacy Portfolio: A compendium of best practices and tools
in advocacy for family planning.

ACSM: Advocacy, Communication, and Social Mobilization

CCP: Center for Communication Programs

CHCT: Couples HIV Counseling and Testing

CHW: Community Health Worker

FGC: Female Genital Cutting

GHS: Ghana Health Service

HCT: HIV Counselling and Testing

IDU: Injecting Drug Users

IPC: Interpersonal Communication

JHHESA: Johns Hopkins Health and Education in South Africa

K4Health: Knowledge for Health

M&E: Monitoring and Evaluation

MOH: Ministry of Health

NURHI: Nigeria Urban Reproductive Health Initiative

PACTO: Active Prevention and Communication for All

PAIMAN: Pakistan Initiative for Mothers and Newborns

SBCC: Social Behavior Change Communication

SMS: Short Message Service (text message)

USAID: United States Agency for International Development