1. Behaviour Change Communication in Aapni Yojna Anoop Khanna Assistant Professor Indian Institute of Health Management Research

2. Need for BCC Environment building Environment building Establishing need for facilities Establishing need for facilities Generating community participation Generating community participation Women participation and empowerment Women participation and empowerment Utilization of facilities Utilization of facilities Improving health and hygiene practices Improving health and hygiene practices Sustainability Sustainability

3. Positioning of BCC in Aapni Yojna

4. Influence of Ideation Element on Behaviour BEHAVIOR Knowledge Attitude Self Image Perceived Risk Norms Self Efficacy Emotion Social Influence Personal Advocacy

5. Thinking about it (But haven’t done it. May be, because they don’t know how to do it, its benefits, lack confidence or have some fear) Action They are trying out the behaviour Maintenance They perform the behavior regularly, as a part of their life. Advocacy They encourage others to perform the behavior Not Aware They are unaware of behavior OR They are performing harmful behavior but do not consider stopping Relapse They have gone back to their old ways Behavior Change Model suggested by Prochaska and DiClemente BCC Model Adopted in Aapni Yojana

6. Approach The behavior change model used in Aapni Yojna had a mix of diffusion approach and participatory approach. The behavior change model used in Aapni Yojna had a mix of diffusion approach and participatory approach. Elements of diffusion approach focused mainly on knowledge transfer leading to behavior change. Elements of diffusion approach focused mainly on knowledge transfer leading to behavior change. The elements of participatory approach focused mainly on community involvement as a catalyst for individual and community development. The elements of participatory approach focused mainly on community involvement as a catalyst for individual and community development.

7. Implementation of BCC strategy The nature of implementation structure of Aapni Yojna required behavior change at different levels. Intrapersonal level: influence of an individual’s knowledge, attitudes, and beliefs on his or her behavior. Intrapersonal level: influence of an individual’s knowledge, attitudes, and beliefs on his or her behavior. Interpersonal level : how significantly other people such as family members, friends, and co-workers’ influence an individual’s behavior. Interpersonal level : how significantly other people such as family members, friends, and co-workers’ influence an individual’s behavior. Community level :organizational settings and their influences, social structure, and other societal influences. Community level :organizational settings and their influences, social structure, and other societal influences.

8. Implementation Process 1. Review of the Current Situation 2. Environment Building 3. Identifying Target Behaviors 4. Identification of Potential Change Agents 5. Formation of Community Level Organizations 6. Developing and Pre-testing Messages and Materials

9. Major BCC Initiatives Health Education in WG, SHGs Health Education in WG, SHGs Health Education and Training of SPAs & SU Beneficiaries Health Education and Training of SPAs & SU Beneficiaries School Sanitation Programme School Sanitation Programme Users Education Programme Users Education Programme Health Education for Adolescent Girls Health Education for Adolescent Girls Cleaning Campaigns Cleaning Campaigns

10. BCC Initiatives : Communication Team Programmes Health Camps Health Camps Village Sanitation Rallies Village Sanitation Rallies Video story-based intervention Video story-based intervention Puppet Shows and Cultural Programmes Puppet Shows and Cultural Programmes Demonstrations Demonstrations

11. BCC Initiatives : Other Methods Local songs Local songs Poems Poems Body Mapping Body Mapping Posters and picture cards Posters and picture cards Slogan writing on wall Slogan writing on wall Model aid health discussions Model aid health discussions Quiz, competitions, etc. Quiz, competitions, etc. Role pays Role pays Nukkar Naatak (Dramas) Nukkar Naatak (Dramas)

12. Impact The impact of the interventions is evident. (successful constitution of groups, initiation of activities, and participation of community members in project activity) The impact of the interventions is evident. (successful constitution of groups, initiation of activities, and participation of community members in project activity) Most of the people have adopted hygienic practices Most of the people have adopted hygienic practices Remarkable change in the perceptions and practices regarding menstrual hygiene among adolescents Remarkable change in the perceptions and practices regarding menstrual hygiene among adolescents People have become more sensitized about the cleanliness of their houses as well as of the surroundings People have become more sensitized about the cleanliness of their houses as well as of the surroundings

13. Impact A substantial decrease in the incidence of certain diseases, mainly those related to water and hygiene behaviours A substantial decrease in the incidence of certain diseases, mainly those related to water and hygiene behaviours utilization of the facilities created under the project is also appreciable utilization of the facilities created under the project is also appreciable Feeling of confidence and self-efficacy among the women Feeling of confidence and self-efficacy among the women

14. Critical Factors for Success Selection of the most critical target behaviors Selection of the most critical target behaviors Appropriate channels for communication Appropriate channels for communication (Women’s groups, PRIs, Water Committees, etc.) (Women’s groups, PRIs, Water Committees, etc.) Adopting a systems approach that actively integrated all components of the initiatives. Adopting a systems approach that actively integrated all components of the initiatives. An element of participatory approach, with gender. An element of participatory approach, with gender. Focus on both the health and non-health benefits of the project. Focus on both the health and non-health benefits of the project. A system of transparency, accountability and trust. A system of transparency, accountability and trust.

15. An Important Insight Small commitments generated at the beginning lead to big ones. The commitments initiated with facilitating in the water distribution system gradually expanded to taking over the entire management of water distribution system in the village, health education and cleanliness in the village. The commitments initiated with facilitating in the water distribution system gradually expanded to taking over the entire management of water distribution system in the village, health education and cleanliness in the village.