The Effects of a Community Video Approach to Support Healthy MIYCN Behaviors Authors: Leanne Dougherty (SPRING), Marjolein Moreaux (SPRING), and Chaibou Dadi (CESAF)

Presentation Objective Present the quantitative evaluation results of a mixed methods research conducted in Niger to evaluate the community video approach

Background Sahel context faces harsh climate conditions, food insecurity and high levels of malnutrition Social behavior change and communication (SBCC) in rural areas presents unique challenges due to poor access to mass media Limited evidence is available on using community video for maternal, infant, young child nutrition (MIYCN) and hygiene behaviors

SPRING/Digital Green Program in Niger (2015) Collaboration between SPRING/Digital Green and 3 USAID/Niger programs - REGIS-ER (NCBA CLUSA), LAHIA (Save the Children) & Sawki (Mercy Corps) 80 established Hausa-speaking community groups, in 20 villages in the Maradi Region In collaboration with Digital Green, REGIS-ER, Save the Children and Mercy Corps, the Niger proof of concept was implemented in a total of 80 community groups over the course of one year in 20 villages in Maradi region, Niger between January and December 2015. Development and dissemination of 10 videos by community facilitators working with 4 distinct groups in each participating village

Four Target Population Groups 10 to 25 members from four existing groups established by the implementing projects (REGIS-ER, Sawki and LAHIA) have been selected in each village to receive the intervention (community video screenings and facilitated discussions). These groups are pre-formed by SPRING partners and are currently convening for other types of group activities and cover the populations specified below. Men’s groups (model husbands selected by health center 25-60+) Adolescent girls (12-18) Women of reproductive age (WRA) (15-49) Influencers including grandmothers, husbands, religious leaders Over the course of implementation (Jan-Aug 2015), the project reached 1,644 primary group members. Of the 1,644, there were 1,278 women and 366 men. Women of reproductive age Men Adolescent girls Key influencers

Mixed Methods Evaluation Research Questions Acceptability by beneficiaries and mediators Effect in terms of changing knowledge, attitude, and adoption Cost per “adoption” of behavior and cost per person reached

Quantitative Study Objective: Measure the effectiveness of the facilitated videos and home visits, focusing on responsive feeding and handwashing behaviors Methods: Three rounds of data collection: Baseline (April 2015) Second survey (June 2015) Endline (August 2015) Analysis: Bivariate analysis Second survey done a week and a month and a week after the videos were shown. Then the endline was 2-3 months later to try to assess maintenance of the behaviors after initial trial and indication of diffusion.

Sample Size Approximately 300 women with a child between 6-23 months at each data collection point Women of reproductive age (15-49) 10 to 25 members from four existing groups established by the implementing projects (REGIS-ER, Sawki and LAHIA) have been selected in each village to receive the intervention (community video screenings and facilitated discussions). These groups are pre-formed by SPRING partners and are currently convening for other types of group activities and cover the populations specified below. Men’s groups (model husbands selected by health center 25-60+) Adolescent girls (12-18) Women of reproductive age (WRA) (15-49) Influencers including grandmothers Over the course of implementation (Jan-Aug 2015), the project reached 1,644 primary group members. Of the 1,644, there were 1,278 women and 366 men.

Handwashing

Handwashing Behavior A designated place to wash hands increased from 14% to 59% after exposure to the video in intervention families as measured at baseline and endline.

Handwashing Behavior The percentage of households with handwashing stations that had soap and running water also increased to 96.2%.

Responsive Feeding

Responsive Feeding Behavior The percent of women who said a child was helped by a responsible person at the last meal (i.e. any adult or older sibling) increased from 87.7 percent at baseline to 92.7 percent at endline. *There was a small decline observed from the second survey to endline which may be explained due to the farming season. During August, most women spend additional time in the field away from the home and there is increased food insecurity making it potentially more difficult to have a responsible person help a child at their last meal. The percent of women who said that their child had a separate plate increased from 69.8 percent at baseline to 96.6 at endline and the percent of women who said that their child was less than an arms length from a responsible person at the last meal increased from 64.5 percent at baseline to 79.5 at endline. Results indicate that women were 1.9 times more likely to say that a child was less than an arm’s length from a responsible person at the last meal and 5.1 times more likely to have a separate plate 4-8 weeks when compared to baseline following exposure to the video while controlling for age, parity and educational attainment, age and sex of the child. This effect increased at endline where women were 2.9 times more likely to have a responsible person within arm’s length of the child at the last meal and 11.3 times more likely to have a separate plate for the child when compared to baseline. Figure 5 presents results from the responsive feeding behavior models.

Conclusions The participatory community video approach is effective in producing lasting improvements in MIYCN and hygiene behaviors. Community video is an effective and successful tool when implemented as part of a wider set of interventions.

Contact information: marjolein_moreaux@jsi.com leanne_dougherty@jsi.com

Thank you! For more info in SPRING: www.spring-nutrition.org/CommunityVideo For full research report: https://www.spring-nutrition.org/publications/reports/seeing-believing For more info on the responsive feeding indicator: Go to TS8.3