Behavioural change communication

BEHAVIORAL CHANGE
COMMUNICATION
Dr. Srinivas Rao
1st year PG
Community Medicine

CONTENTS
INTRODUCTION.
HEALTH EDUCATION
BCC
ROLE OF BCC IN PROGRAMS
REFERENCES

INTRODUCTION
• The 6th report on world health situation states
that health has to be attained &cannot be
imposed ; thus the 1st requirement for
attainment of health is a commitment by both
people and the govt.
• Adequate education in general is essential for
the development of this commitment.

HEALTH EDUCATION
 The process by which individuals and groups of
people learn to behave in a manner conducive to the
promotion ,maintenance or restoration of health
(John M Last)
 The declaration of Alma-Ata(1978) emphasized the
need for individual and community participation. The
dynamic definition is as follows:
“A process aimed at encouraging people to want to
be healthy , to know how to stay healthy , to do what
they can individually and collectively to maintain
health , and to seek help when needed”.

PRINCIPLES OF HEALTH EDUCATION
1. Community involvement in planning health
education is essential. Without community
involvement the chances of any programme
succeeding are slim.
2. The promotion of self esteem should be an
integral component of all health education
programmes

3. Voluntarism is ethical principle on which all
health education program should be built
without it health education programs become
propaganda. Health education should not
seek to coerce but should rather aim to
facilitate informed choice.
4. Health education should respect cultural
norms and take account of the economic and
environmental constraints face by people. It
should seek positively to enhance respect for
all.

5. Good human relations are of utmost
importance in learning.
6. Evaluation needs to be an integral part of
health education.
7. There should be a responsibility for the
accuracy of information and the
appropriateness of methods used.
8. Every health campaign needs reinforcement.
Repetition of messages at intervals is useful.

IEC
• IEC can be defined as an approach which
attempts to change or reinforce a set of behavior
in a target audience regarding a specific problem
in a predefined period of time.
• It is multidisciplinary and client centered in its
approach.
• Embodied in IEC is the process of learning that
empowers people to make decisions, modify
behaviors and change social conditions.

• Activities are developed based upon needs
assessments, sound educational principles,
and periodic evaluation using a clear set of
goals and objectives

BEHAVIOUR CHANGE
COMMUNICATION(BCC)
• Studies revealed that traditional IEC methods
have stopped giving information and creating
awareness but BCC is characterized by its
direct approach towards changing behavior.

BCC must be research based
client centered
benefit oriented
service linked
professionally developed , and
linked to behavior change

14
Why BCC?
The increasing area of interaction

Objectives of BCC activities
Major objectives for health are to enable
people:
- To define their own problems and needs
- To understand what they can do about
these problems with their own resources
combined with outside support
- To decide on most appropriate action to
promote healthy living and community well
being

16
Defining tasks and
educational objectives
Planning an evaluation
system
Preparing and implementing an
educational programme
Implementing
evaluation
Principles of BCC
The Educational Spiral

Role of BCC in HIV/AIDS
• Increase knowledge : BCC can ensure that people
are given the basic facts about HIV and AIDS in a
language or medium that they can understand
and relate to .
• Stimulate community dialogue : BCC can
encourage community and national discussions
on the basic facts of HIV/AIDS & the underlying
factors that contribute to the epidemic, such as
risk behaviors and risk settings, environments and
cultural practices related to sex and sexuality .

• Promote essential attitude change : BCC can lead
to appropriate attitudinal changes about, for eg,
perceived personal risk of HIV infection, belief in
the right to and responsibility for safe practices
and health supporting services etc .
• Advocate for policy changes : BCC can lead
policymakers and opinion leaders toward
effective approaches to the epidemic.
• Improve skills and sense of self-efficacy: It can
focus on teaching or reinforcing new skills and
behaviors, such as condom use, negotiating safer
sex and safe injecting practices .

• Create a demand for information and services:
BCC can spur individuals and communities to
demand information on HIV/AIDS and
appropriate services.
• Reduce stigma and discrimination:
Communication about HIV prevention and
AIDS mitigation should address stigma and
discrimination and attempt to influence social
responses to them .

• Promote services for prevention and care : BCC
can promote services for STIs, intravenous
drug users (IDUs), orphans and vulnerable
children (OVCs); voluntary counseling and
testing (VCT) for mother-to-child transmission
(MTCT); support groups for PLHA; clinical care
for opportunistic infections; and social and
economic support.

Insights
• BCC has its roots in behavior change theories
• BCC practitioners use a combination of
theories and practical steps that are based on
field realities, rather than relying on any single
theory or model.
• Rationale behind “staging” people is to tailor
therapy to a person’s needs at his/her
particular point in the change process.

BCC GOALS FOR HIV/AIDS
• Program goal: Reduce HIV prevalence among
young people in urban settings in country.
• Behavior change goals:
• Increase condom use
• Increase appropriate STI care-seeking
behavior
• Delay sexual debut
• Reduce number of partners

• BCC goals:
• Increase perception of risk or change attitudes
toward use of condoms
• Increase demand for services
• Create demand for information on HIV and AIDS
• Create demand for appropriate STI services
• Interest policymakers in investing in youth-
friendly VCT services (services must be in place)
• Promote acceptance among communities of
youth sexuality and the value of reproductive
health services for youth (services must be in
place)

• Multiple influences & influencers are needed
to make BCC strategies effective.
for eg: mothers-in-law are known to influence
the birth spacing behavior of newly married
couples. She will also play a significant role in
pregnancy, delivery and infant nutrition,
perhaps discouraging immediate and exclusive
breast feeding. So, they will be an important
target group for BCC for young mothers.

CHALLENGES
• BCC vs. IEC. In practice, IEC has often resulted
in the production of discrete communication
materials. The use of the term BCC is part of
an effort to establish communication as
strategic and integrated into entire programs.
• Integrating BCC into all programs. BCC is a
component of all successful interventions and
must be included in their original design.
However, in reality this doesn’t always
happen.

• Limited training resources
• Political and physical environments. In some
countries, geography and populational
diversity can complicate the development of
BCC programs. This is especially the case
where vast distances must be covered, or
multiple languages and cultural traditions
included, in a single country program.

• Sustainability. To be effective, BCC strategies
and components must evolve constantly to
meet the changing needs of target
populations. This requires the continuous
input of human and financial resources.
• Budgets.
• Linkages and coordination. For BCC to be
effective, their messages and information
should be coordinated. Building and
maintaining linkages and coordination is an
ongoing challenge.

 Sunderlal , Adarsh , Pankaj ,Text book of community medicine,
4th edition , chp 2, P 3-48
 J . Kishore , national health programs of India, 11th edition ,
p 157,220,230
 WHO TRS 690(1983).New Approaches to health Education in
Primary Health care.
REFERENCES
 http://www.hivpolicy.org/Library/HPP000533.pdf
 http://en.wikipedia.org/wiki/Behavior_change_communication
 WHO, AFMC Text book of Public Health and Community
Medicine , p 622

Behavioural change communication

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