FOR MID-LEVEL MANAGERS - newconceptinfosys.net

SOCIAL AND BEHAVIOUR CHANGECOMMUNICATION TRAINING

FOR MID-LEVEL MANAGERSDuration: Two Days

2014

For more copies contact:Communication for Development SectionUnited Nations Children's Fund73 Lodi Estate, New Delhi, IndiaE-mail: [email protected]: www.unicef.org www.unicefiec.org www.unicef.org/india/Telephone: +91-11-24690401

SOCIAL AND BEHAVIOUR CHANGECOMMUNICATION (SBCC)TRAINING

FOR MID-LEVEL MANAGERSDuration: Two Days

3

CONTENTSDAY I Session 1 - Inauguration and Introduction 4Session 2 - Changing Paradigms in Development Communication 5Session 3 - Introduction to the ‘Tarang’ Communication Module 7Session 4 - Introduction to Communication 8Session 5 - The Behaviour Change Process 12Session 6 - Qualities of a Good Communicator 18Session 7 - Introduction to Interpersonal Communication; The

GATHER Concept20

Session 8 - ReviewandReflectionsoftheDay 22

DAY IISession 1 - RecallofDayISessions 24Session 2 - Understanding Social Inclusion and its Importance in

Social and Behaviour Change Communication24

Session 3 - Social Inclusion (Continued) 29Session 4 - How to Conduct a Group Discussion 31Session 5 - UseofaCommunityDialogueTool 34Session 6 - Understanding Teamwork 38Session 7 - Planning and Organising a Village Health and Nutrition

Day42

Session 8 - Creating a Village Health Plan and Developing a Village SBCC Plan

43

Session 9 - ValedictorySession 44

Annexures 45

Session No.

Topic Time Methodology

1 Inauguration and Introduction

10:00 to 10:30 Introduction and pairing of participants

2 Changing Paradigms in Development Communication

10:30 to 11:15 Presentation and discussion

11:15 to 11:30 Tea break (15 minutes)3 Introduction to the 'TARANG'

Communication Module11:30 to 12:15 Presentation and

discussion4 Introduction to

Communication12:15 to 13:00 Exercise(railway

compartment) and discussion

13:00 to 14:00 Lunch break (60 minutes)5 The Behaviour Change

Process14:00 to 15:00 ‘Shanta’sStory’followedby

discussion6 Qualities of a Good

Communicator15:00 to 15:30 Plenaryanddiscussion

15:30 to 15:45 Tea break (15 minutes)7 Introduction to

Interpersonal Communication; The GATHER Concept

15:45 to 16:45 Film: ASHA, Ek Nai Subah and discussion

8 ReviewandReflectionsoftheday

16:45 to 17:15 Feedback from participants

Session 1Picture cards cut into two (draw different pictures on a card (4”x 3”) and cut each into two pieces. The number of cards should be half the number of participants plus the two facilitators and each should get a piece when cut). The cards could also be of the letters in the alphabet.Session 2Writing board and marker pensSession 3PowerPoint presentation on making of the new Social & Behaviour Change Communication ModulesSession 4• Pictureofarailwaycompartment• Blackboard and chalk or chart

paper and sketch pen

• Film Rachanatmak Ravayya• VCD player and laptop with LCD

projectorSession 5Story cards, blackboard and chalk orchart paper and sketch pensSession 6Chalk and blackboard or Chart paper and marker penSession 7• CDofthefilmASHA,Ek Nai Subah,• CDplayerandTV• Writing board and marker pens • Chart paper and sketch pensSession 8• Writing board and chalk or marker

pens • A paper ball

LIST OF TRAINING MATERIALS

DAY I PROGRAMME SCHEDULE

For Mid-Level Managers4

SESSION 1 INAUGURATION AND INTRODUCTION

SESSION OUTCOMES

At the end of the session, participants would have:

• Introducedeachother,creatingafriendlyenvironment.

MATERIALS REQUIRED

• Picture cards cut into two [draw different pictures on cards (each 4”x 3”) and cut each into two pieces. The number of cards should be half the number of participants plus the two facilitators and each should get a piece when cut]. The cards could also have the letters of the alphabet.

METHODOLOGY

Pairing using picture cards.

PROCESS

1. Oneofthefacilitatorsbeginsthesessionbysaying,“OnbehalfoftheInstitute(TrainingCentre) and facilitators’ team, Iwelcomeeachoneof you to today’ssessions on introducing the new SBCC module for field functionaries andcommunity volunteers.With communicationbecomingcentral todevelopmentprogramming, we hope that this module will be a great help to all in reaching out to families and communities to bring about social and behaviour change. We will be discussing details of the module during the course of the sessions.”

“But before that, let’s start by introducing ourselves. Some of you may beacquaintedwitheachotherandsomeofyoumaynot.Solet’strytogettoknoweach other through a simple exercise.”

2. Now put the cards cut into halves in a box the centre of the room and mix them up well. Ask each participant to come and pick a card. The two facilitators too should pickacardeach.Onceeveryonehasacard,telltheparticipants,“Eachofushasacardwithhalfapicture.Wenowhavetofindoutwhohastheotherhalfofthepicture.Pleasemovearoundandfindoutwhohastheotherhalfofthepicture.Onceyoufindthatpersonstaytogetherasapair.Start.”

3. If the total of participants and facilitators is an odd number, ask the person left outtojoinanypair;oroneofthefacilitatorsshouldnotpickacardandjoinoneof the pairs making it a triad. Once all the participants are in pairs each person should:sayhis/hername;whathe/shedoes;alsobrieflyshareoneprogrammecommunicationactivitythathe/shehasseeninthecourseofworkwhichhe/shefelt was either successful or not successful.

After each of themhas done this, whichmay take about 5minutes, ask theparticipants to sit with their partners. Now ask each one to introduce his/her partner. The facilitators also join in.

CONCLUDING THE SESSION

Concludethesessionbythankingthemforactivelyparticipatingintheexerciseandalso for sharing their experiences in programme communication. Tell the participants that we will build on the discussions in the subsequent sessions.

10:00 to 10:30 (30 minutes)

SBCC Training : Module 3 5

SESSION 2 CHANGING PARADIGMS IN DEVELOPMENT COMMUNICATION

SESSION OUTCOMES

At the end of the session, participants will be able to:

• Describe the changes that have taken place in development communication in order to bring about the desired behaviour changes.

METHODOLOGY

PowerPoint presentation and discussion

MATERIALS REQUIRED

Writing board and marker pens

PROCESS

Startthesessionbysaying,“Overthelastfewdecades,therehavebeensubtleshiftsinthewaydevelopmentcommunicatorshaveapproachedcommunicationstrategiesin influencingbehaviourchange. Ithasbeenaprocessofevolutionandtodaywehave a much more comprehensive approach to handle social and behaviour change within development programming.”

1. Ask the participants to tell how they/their department have perceivedcommunication in the past.

2. Askthemtotellthedifferencebetweenthe‘familyplanning’campaignsofthe1970s and the ‘polio campaign’ of recent times. What communication tools were used then and now?

3. Oncetheparticipantshavefinished,sumup,coveringthefollowingpoints:• In the 1950s and 1960s when development was measured using the Gross

National Product (GNP) as the indicator where capital-intensive approaches and centralised planning were the norm, it was believed that mass media would raise the aspirations of the people and bring about desired behaviour changes. A large number of radio stations and newspapers were used to disseminate messages targeting populations in the hope that this would help bringaboutchanges.Thiswasaone-wayapproach.

• Itwasthoughtthatmassmediawasimportantbecauseonlythroughthemcould the countries with limited resources hope to provide information to vast numbersbydisseminatingthemessagesattheraterequiredfordevelopment.

• It was then felt that mass communication alone would not produce the desired results, but that there was need for the dissemination of messages through opinion leaders. This brought in the initial concepts in interpersonal communication strategies where individuals within communities were inductedtospreadmessagesandinfluenceindividualsandfamilies.

• The 1970s and 1980s focused on bringing about individual behaviour change and the concept of Behaviour Change Communication (BCC) came intobeing.BCCiscloselyassociatedwithSocialMarketingStrategieswhichwere seen as a means to promote a particular behaviour or social change through communication.

10:30 to 11:15 (45 minutes)


• Almost simultaneously the concept of Information, Education andCommunication (IEC) was also evolving where the emphasis was on dissemination of messages through production and use of audio visuals and print materials.

• In all the above approaches the concept of stakeholder participation was totallymissing.Theideathatstakeholdersshouldnecessarilyparticipateinthecommunicationprocesswasbroughtoutasearlyasinthe1960swiththeworkthatwasbeingdoneinLatinAmericabyPauloFreire.Thisdidnotcatchthe attention of communication planners at that time.

• However, with human rights based programming gaining ground in the late 1990sandearly2000swhereparticipationbecameacriticalrightofeveryindividual, family or community, the concept of participatory approachesto communicationgainedprominence. Theparadigm that every individual,familyorcommunityhastheright tomake ‘informedchoices’stressedtheimportance of empowering them with the right knowledge and skills to make such choices. Communication is no more seen as a top-down approach where families and communities are targets for behaviour change. Today,development communication is considered to be a multi-stakeholder and participatoryprocesswheretheinvolvementofallstakeholdersisimportant.

• Today‘development’isseenascreatinganenvironmentinwhichpeoplecanreach their full potential and lead productive, creative lives in accordance with their needs and interests. According to the UNDP Human Development Report 2012, people are the real wealth of nations and emphasis should be on the needforexpansionoftheirchoicessothattheyleadlivesthattheyvalue.

• Intoday’sdevelopmentcontextitisimportanttounderstandthatwidesocialacceptanceabouttheneedforspecificchangehasbecomeapre-conditionforindividualbehaviourchange.Changeisofteninfluencedbyotherpeople’sexpectations,whichisinturnshapedbythecurrentsocialandculturalnorms.Therefore it is important that communication strategies address social change, creating community norms. Social and Behaviour Change Communication(SBCC) addresses both social and individual behaviour change.

4. Sum up the discussions with the following:We have seen that communication approaches have been evolving over time and todaythereisamuchmorecomprehensiveunderstandingoftheprocess.Someofthe areas that require our communication activities are given below:


Conclude the session with the following:• Thus, we see that a communication plan should address various stakeholders at

various levels and that the approaches at different levels could be different or a mix of different approaches, depending on the need.

To b

e re

ache

dCo

mm

unic

atio

n Ap

proa

ches

Social: Institutions and policies

Largelythrough advocacyand mass

media

Implementing agencies and functionaries

Through training and capacitybuilding

Community

Communitydialogue and mobilisation, community

media

Individuals and families

Interpersonal communication,

IEC and counselling


SESSION 3 INTRODUCTION TO THE ‘TARANG’ COMMUNICATION MODULE

TEA BREAK 11:15 to 11:30 (15 minutes)

SESSION OUTCOMES

At the end of the session, participants will be able to:• Describe the background against which the module has been developed, the

principles used in developing the modules and the contents of the different items.• List the items in the modules and their use at various levels.

MATERIALS REQUIRED

• Writing board with chalk/marker pens• PowerPoint presentation, LCD projector and laptop or computer

METHODOLOGY

PowerPoint presentation and discussion

PROCESS

1. Thefacilitatorbeginsthesessionbysaying:“Wewillnowhaveabriefintroductionto the new Social & Behaviour Change Communication Module that has been developed. Much work had gone in to its making including review of existing modules and materials, field visits to states and interactions with variousstakeholdersat thestate,district,blockandfield level. The facultyof varioustrainingcentreswerealsometandtheirinputstaken.Iwillnowtakeyouthrougha PowerPoint presentation that summarises how the modules were made and whattheycontain.”

2. NowstartthePowerPointpresentationandgothroughtheslidesonebyone.

3. Allow participants to raise questions during the presentation. Answer them based on the module.


Concludebysayingthatinthefollowingsessionswewillhaveadetailedlookatsomeoftheimportantsessionsfromthe5-DaytrainingModule.

• TheSBCCmodulesthatarebeingintroducedarelargelytoaddresscommunicationneedsatthecommunity,familyandindividuallevels.ThemodulesdealwithIPC,Counselling,IECandCommunityDialoguetools.

• We will discuss these in detail in the next few sessions.

11:30 to 12:15 (45 minutes)


SESSION 4 AN INTRODUCTION TO COMMUNICATION

SESSION OUTCOMES

At the end of the session, participants will be able to:• Describe the communication loop with the different steps therein.• Explain the need for the communicator and the receiver to be on the same

wavelength for effective communication to happen.• Give examples of why one-way communication invariably leads to distorted

messages.

MATERIALS REQUIRED

• Thepictureofarailwaycompartmentasshowninthelessonplan• Blackboard and chalk or chart paper and sketch pen• Film Rachanatmak Ravayya• VideoplayerandTVorlaptopandLCDprojector

METHODOLOGY

• The‘railwaycompartment’exercise.• Follow-up discussions.• ConcludewiththefilmRachanatmak Ravayya.

PROCESS

1. Ask for 10 Volunteers. One of the facilitators takes Volunteer #1 and leaves the traininghall.He/shegivesthevolunteerthepictureoftherailwaycompartmentandtellshim/hertostudyit(2minutestostudythepicture).

2. The facilitator informs the Volunteerthathis/hertaskwillbetoconveywhatisinthe picture to volunteer #2.

3. Once the Volunteer isreadytodescribethepicture,askhim/hertocomeintothe training room. Now the other nine Volunteers are taken out of the training hallbythesecondfacilitator.ThenVolunteer #2 from among them is called in. Ask Volunteer #1 to describe what was in the picture to Volunteer #2. Tell him/herthathe/shecanonlylistentowhatVolunteer#1issayingandcannotaskanyquestionsforclarification.OnceVolunteer #1 has completed describing the picture,askhim/hertositamongtheparticipantsandnottotalktoanyone.

4. Now call Volunteer #3 into the training hall. Ask Volunteer #2 to describe what he/she heard from Volunteer #1 to Volunteer #3. As before, Volunteer #3 cannot askanyquestions.OnceVolunteer #2 has completed, ask him/her to sit next to Volunteer#1,butnottospeakanything.

5. Repeat the process till Volunteer#6isbriefedbyVolunteer #5. Now ask Volunteer #6 to tell all the participants what he/she understood about the picture. The descriptionhe/shegiveswillbeverydifferentfromwhatisreallyinthepicture.

6. Showthepicturetoalltheparticipantssothattheyareabletoseethedistortionsthat have taken place.

12:15 to 13:00 (45 minutes)


7. Nowtelltheparticipantsthattheexerciseisnotyetover.CallinVolunteers7and8. Give the picture to Volunteer #7 and ask him/her to study itso that he/she can describe it to Volunteer #8. Volunteer #8 should not see the picture. Once he/she is readytodescribethepicture,takeitaway.NowaskVolunteer#7 todescribe the picture to Volunteer #8. Tell Volunteer #8 that he/she can ask questions to get clarifications. Once Volunteer #7completes describing the picture to the satisfaction of Volunteer #8, ask Volunteer #8 to describe the picture to all the participants. Once again show the picture to all participants sothattheyareabletomakeoutthedistortions.

8. Tell the participants that there is one more part to the exercise. Call in Volunteers #9and10andgivethepicturetoVolunteer#9.Askhim/hertostudythepicturesothathe/sheisabletoconveywhathe/sheseestoVolunteer#10.Oncehe/sheisready,askhim/hertodescribethepicturetoVolunteer#10andtellhim/her there are no restrictions. He/she can even show the picture and describe it. Now tell Volunteer #10 to describe the picture to the participants. Stop the exercise here; ask all participants to go back to their original seats.

9. Asktheparticipants,“Whatdidweseehere?Whatwerethedifferencesinthethree parts of the exercise? Which team/pair was able to give the best description of the picture?”Ask the following questions and note the answers:

• Howmanywomenarethere?• Howmanypersonsarethere?• Howmanychildrenarethere?• Whichlanguagehasbeenusedbytherailwaysonthecompartmentpartitions,

bypassengersontheirluggage?(Facilitatortonote:Doessomeonepointoutthateverythingiswritteninmirrorimage?)

10. Why did that team/pair succeed? Allow sufficient time for the participants toreflectandsharetheirviews.

11. The points emerging from the discussions are noted on the board.

12. Asktheparticipantswhethertheyhavehadanyexperiencewheremessagesgotdistorted.Havefivetosixparticipantssharetheirexperiences.


Wesawthreedifferentcommunicationstyleshere.

Case 1: The communication was one way where the listener could not ask anyquestions;he/shecouldonlylistentothevolunteer.


• Whenamessageisconveyedbyoneperson,theothershouldreceiveitwithoutdistortions. This can be ensured when the receiver gives a feedback to the sender and repeats themessageso thatclarificationscanbeprovided ifneeded.Soeffective communication should have a loop which ensures that the sender and the receiver have the same understanding.

• So when we communicate with women, families and communities it is veryimportantthatwetakefeedbackfromthemandlistentothemverycarefullytoensurethatthemessagehasbeenisunderstoodclearly.

• Ask the participants what, in their opinion, are the do's and don’ts for good, effectivecommunication.Listentosomeresponses,andthendisplaythechartbelow.

Case 2: Thelistenerwasfreetoaskquestionsandgetclarifications.Inthiscasethemessagewasbetterdeliveredcomparedtothefirstcase.

Case 3: The messenger and the listener were able to discuss the picture while looking at it. The listener fully participated in deciding what the picturedepicted.She/hewasnotjustasilentlistenerwhocouldonlyaskquestionsbutwasactivelyinvolvedindecidingwhatthepicturedepicted.Thethirdcommunicationstylegavethebestdescription.

When the message is not clear, it often gets distorted. • Some new things get added and some information goes missing. Little things

assume big proportions and big things are trivialised.• Ofthemanyfacts,onlyafewaretransmittedastheyarepassedfromoneperson

to another. • Veryoften,unusualinterpretationsaregiven,andoftenthesehavemuchtodo

with a person's mind, temperament and prejudices. • Thesecanalsoendupasrumoursorastory.Therefore, for communication to be effective there has to be a dialogue where the communicatorandlistenerareactivelyinvolvedandinteractwitheachother.

Draw the diagram as shown below on the board.

Message

Feedback

Channel

Sender Receiver


Part 2: VCD Rachanatmak Ravayya1. Telltheparticipantsthatyouwillbeshowingthemashortfilmtilled"Rachanatmak

Ravayya and that they should watch the film carefully and contribute to thediscussions that follow.

2. Tellthemthattheywillbeviewingthefilmintwopartsandthataftereachpartthere will be a discussion.

3. Screenthefilmandstopatthepointwhen,aftertalkingtothemother,theASHAworker takes the umbrella and walks into the village.

4. Ask the participants the following questions: What did you see here? HoweffectivelydidtheASHAworkercommunicatewiththemother?Whatwentwronginthecommunication?Askthemtorecallthecommunicationloopandreflectonwhattheysawbasedontheprinciplesofgoodcommunication.Ask“Whatcouldhave been done to improve the communication?”

5. Generateadiscussion;giveparticipantstimetoreflectandsharetheirviews.

6. List the points that emerge on the white board or on the chart paper.

7. Nowscreentherestofthefilm.

8. Attheendofthefilm,asktheparticipantsthefollowingquestions:Whatdidyouseeinthispartofthefilm?WhydidtheASHAgetapositiveresponse?WhatarethepositivefactorsASHA'swayofcommunications?

9. As the participants respond write the points on the board or chart paper.


Using the points listed on the board or chart paper and referring to the communication loop reiterate the reasons for communication failure as well as for effective communication.

Effective Communication

Do's

• Involveyourreceiverinthefeedback process (remember Case 2 and 3 from the exercise).

• Trytodevelopasharedexperience of communication as equal partners (remember Case 3 from the exercise).

• Act on the feedback and create opportunitiesforclarifications(remember Case 3 from the exercise).

Don’ts

• Avoidone-waycommunication(remember Case 1 from the exercise).

• Avoidlengthycommunication.In order to be effective communication should be broken into short pieces (rememberhowlengthycommunication was less effective in Case 1, and how small pieces of information coming one after another improved the communication in Case 3).


SESSION 5THE BEHAVIOUR CHANGE PROCESS

LUNCH BREAK 13:00 to 14:00 (60 minutes)

SESSION OUTCOMES

At the end of the session, participants will be able to:• List the different steps involved in the behaviour change process.• Relate personal experiences to the different steps in the behaviour change process.• Articulate the role of the communicator in each step of the behaviour change

process.• List the barriers that could occur in each stage of the behaviour change process.

MATERIALS REQUIRED

• Storycards• Black board and chalk or chart paper and sketch pens

METHODOLOGY

The session is divided into three parts:

Part I:Tellingastoryusingthestorycards.

Part II:Presentingthefirstchartdepictingthesevenstepsinbehaviourchange.

Part III: Conclusion.

PROCESS

Part I: Telling a story using the story cards

1. Usingthestorycardstonarratethefollowingstory

Ĭ Shanta’s Story

Sumitra, the ASHA of village Rampur, was concerned that a few families in the village were not bringing their babies for immunisation. So, she decided to visit their homes and explain to them the importance of immunisation and the need to get their children immunised. One of the houses she visited was that of Shanta, aladywitha6-month-oldbabywhohadneverbeenimmunised.WhenSumitra discussed the need to immunise her son, Shantasaid thather familydidnotbelieve in immunisation and that her mother-in-law and husband, Ramlal, would never allow her to immunise the child. Sumitra, in a very friendly and caringmanner, explained to ShantawhyimmunisationwasimportantthatandaskedhertoattendtheVHNDthefollowingWednesdayalongwithherbaby.Shanta promisedtodiscussthiswithherfamily.

14:00 to 15:00 (60 minutes)


On VHND, Sumitra noted that Shanta had not brought her babyfor immunisation and so, after the session, she took the AWW to Shanta’s house and was fortunate to meet both - Ramlal and his mother. She explained to them too the need for immunisation. After much persuasion,theyagreedtoimmunisethe child. As the ANM was still in the village theywereable toadministerthe first doses of polio andDPT aswell as BCG. Sumitrawasveryhappy.She told Shantaandherfamilythatthey should bring the baby for thesecond dose of vaccines on the next VHND the following month.

A week later, Sumitra visited Shanta’s housetofindouthowthebabywasandalsotoremindthemtobringthebabyforthe second dose. Shanta’s mother-in-law complained that the child was restless after immunisation and had fever all through the night. Sumitra explained that it was normal for some babies to get fever after immunisation and that there was no cause for concern.

On the next VHND, Shanta did not come to the PHC. Sumitra sent the AWW helper to Shanta’s house again, but she refused to come since her family was against any furtherimmunisation since the child had fever the previous time and theyhad also heard that it could cripple the child. The child, thus, missed the second dose.


Sumitra thendecidedthattheonlywayto ensure that the child got immunised was to convince Ramlal. She spoke to the Sarpanch and also to two of Ramlal’s neighbours who were his friends. Together theyhadalongdiscussionwiththefamilyinforming them that all the children in the village were being immunised and that there had been a marked reduction indiseases.Theyalsotoldthefamilythatit is the right of every child to getimmunised and that parents should not be guilty of not taking care of thehealth of the child. Both - Ramlal and

his mother were convinced and even accompanied Shanta to the PHC where the child received the second dose of vaccines. Since then the parentshavebeenverycarefulandhave ensured that the child receives all vaccinations, including against measlesandVitaminAprophylaxis.Shanta now actively advocates onthe need to get babies immunised.

2. Onceyoucompletenarratingthestory,askthefollowingquestions:• Whatdidyouthinkofthestory?DoyoufindfamilieslikeShanta’s who are

reluctanttofollowyouradvice?• How did Sumitra handle the case?Did she try to findout the reasons for

Shanta’s husband’s and mother-in-law’s opposition to immunisation? Did Shanta’sfamilyacceptheradviceandgetthechildimmunisedasadvised?

• How did Sumitra finally convince the family and win Shanta’s support in promoting health care?

• What is it that Sumitracouldhavedonebetter?(Likecounsellingthefamilyatthetimeoffirstimmunisation)

3. Allowsufficienttimefortheparticipantstoreflectandsharetheirviewsoneachof the above questions: Keep asking questions to elicit the following:

4. DuringherfirstvisittoShanta’s house, Sumitra was able to create an awareness as well as a desire in Shanta to get the child immunised. But Ramlal and her mother-in-lawinfluencedheranddissuadedherfromimmunisingthechild.


• OnthesecondvisitwiththeAWW,theywereabletogetRamlal, his mother and Shanta to agree to test the desiredbehaviourchangebygettingthebabyimmunisedwiththefirstdose.

• But, again, the fact that the baby had feverandalsothattheywerenotfullyconvincedaboutthecause,stoppedthefamilyfrombringingthechildforthesecond dose.

• SumitraagaininfluencedandmotivatedthefamilybybringingintheSarpanch and two of Ramlal’s friends and was successful in getting the second dose administered.

• Inthismanner,thefamilyrealisedthatitwasgoodtogetthebabyimmunisedandtofollowtheadviceoftheASHAandthereforetheycontinuedtobringthechildforimmunisationandotherservices,therebysustaining the behaviour change.

Part II: Presenting the first chart depicting the seven steps in behaviour change 14:00 to 15:00 (60 minutes)

Leading from the discussions on Shanta’sstoryinPartI,initiatediscussiononthebehaviourchangecycle.

Step 1 in the change process is to become AWARE of a change that needs to take place. Write 'Aware' on the board and discuss how Shanta became aware that immunisation is good for the child. This awareness could come from a neighbour, a relative or a friend or through the ASHA or the AWW or the ANM or any otherfunctionary.Itcouldalsobethroughthemedia–newspaper,radioorTV.Oncethesamemessageisheardseveraltimes(e.g.,everychildshouldbeimmunised,everychild should be in school, institutional deliveries are safest for mother and child etc.), one develops a DESIRE to test the change. This is Step 2 of the change process. Write ‘Desire’ on the board as shown in the chart and draw an arrow indicating that awareness leads to a desire for change. Now that one desires the change, one will lookatwaystomakethechangeandthiscouldbeacquiringanewSKILL (as in the caseoftheskilltobreast-feedababytherightway)orKNOWLEDGE (as in the case offindingoutwhenandwhereone’schildcanbeimmunised).

1

2

3

45

6

7

The Behaviour Change Process

Dropouts

Dropouts

Dropouts

Dropouts

Dropouts

Dropouts

Awareness

Desire

Knowledge Skill

Tries OutRepeats

Maintain

Sustain

THE BEHAVIOUR CHANGE PROCESS


Therefore, Step 3 isacquiringthenecessaryskillorknowledgetomakethebehaviourchange. Write KNOWLEDGE (in Shanta’s case the knowledge was where to get the immunisationdoneforherbabyaswellasknowingthescheduleofimmunisation)or‘Skill’(asinthecaseofbeingabletobreastfeedachildtherightway)ontheboardas shown in the chart and draw an arrow to indicate that desire leads to acquiring thenecessaryknowledgeand/orskilltomakethatchange.

Now that one has acquired the knowledge and/or the skill, Step 4 will be to TRY OUT thatchange(e.g. takingthechild for immunisationfor thefirst timeorstartingtoconsumeIFAtabletsasadvisedbytheASHA).WriteTRY OUT on the board as shown in the chart and discuss this as the fourth step in the change process.

Individuals analyse the experience of trying out the change behaviour and if theassessment is negative (as in Shanta’s case), the person drops out from the process; if it ispositivethetendencyistotry itoutonceagain, inotherwordsREPEAT the action.ThisisStep5ofthecycle.WriteREPEATontheboardasshowninthediagramand discuss the same with the participants.

If the experience of Step 5 was good, one will tend to repeat the action; in other words MAINTAIN (Step 6) the behaviour and soon it becomes a SUSTAINED (Step 7) behaviour change or a habit. Write MAINTAIN and SUSTAIN on the board as in the chart with the arrows linking them and discuss these steps with the participants. The behaviourchangecycleisthuscompeted.

Mention, also, that there could be new awareness coming in and there could be a changecycleevenon thesamebehaviour following thesamecycle: forexample,switching from a ‘pinch of salt and a scoop of sugar’ to the use of ORS packets.

Inform the participants that in the actual training the participants participate in a group discussion, sharing their experiences on the behaviour change process followed by group presentations. This part is being skipped due to shortage of time. The intention here is to give glimpses of a few sessions in the module.


Using the diagram that was drawn in Part II of the session and the discussions, completethechartindicatingthatatanystepofthecycleonecoulddropoutfromthe behaviour change process unless there is someone motivating and ‘facilitating’ the person to make that change.

An enabling environment consists of

• Supportive relatives and neighbours.• Functionaries and volunteers and other opinion leaders through their

sustained encouragement, through counselling and dialogue and provisionofqualityservices.

• The communication media through supportive messaging.


ThisiswheretheASHAortheAWWortheANMoranyotherworkershouldmonitorandsupport the individual tocarryonwith thechangeprocess.Weknowofmanycaseswhereinfantsdropoutaftertakingthefirstorseconddoseofimmunisation.Ifwearetopreventsuchdropoutsweneedtofollowupwitheachfamily‘atrisk’andsupport them in understanding the need for the changed behaviour. Therefore it is critical that an ENABLING ENVIRONMENT is created and sustained to help individuals, families and communities make the desired change. An enabling environment would consist of the following:

• Supportive relatives and neighbours.• Functionaries and volunteers and other opinion leaders through their sustained

encouragementthroughcounsellinganddialoguing,provisionofqualityservices.• The media (press, radio, TV etc.) through supportive messaging.In conclusion, ask the participants how they found the entire session. Ask themwhatthemajorlearningoutcomeswereandwhethertheywereabletorelatetothebehaviour change process. Tell them that we will be further building on the concept andworkingonbehaviourchangeinthecomingdaysaswell.

THE BEHAVIOUR CHANGE PROCESS AND THE FRONTLINE FUNCTIONARIES ROLE

1

2

3

45

6

7


Dropouts

Dropouts

Dropouts

Dropouts

Dropouts

DropoutsAwareness

Desire

Knowledge Skill

Tries OutRepeats

Maintain

Sustain

Discussbenefits and risks

Project, Request tobecomeyour

advocate

Provide skill and support

Motivate, Create supportive

environment

Motivate, Reinforce, Maintain

supportive environment



Motivate, Maintain

supportive environment, Handling of problems


SESSION 6 QUALITIES OF A GOOD COMMUNICATOR

SESSION OUTCOME


• List the knowledge skills and values/attitudes required of a good communicator.

MATERIALS REQUIRED

• Chalk and black board or chart paper and marker pen• Chart: Knowledge, Communication Skills, Values

METHODOLOGY

Lecture and discussion

PROCESS

Asktheparticipantswhatcompetencymeans.Generateadiscussion.Concludebysaying that competency is the ability of a person to carry out an activity or a task effectively, producing the desired results.

1. Thenask,“Whataretheessentialingredientsthatconstitutecompetency?”.Generateadiscussiononthis.Concludebysayingthatcompetencyconsistsofthreekeyelements:Knowledgeofthetask,skillstoperformthetaskandtheright values and attitudes that make one perform the task well. In the case of a communicator, the skills required are good communication skills. There is a chart given at the end of the session which lists knowledge, skills, values, etc. Itwillbeusefulifthischartisdisplayedinthetraininghallanddiscussed.Thiswillmakethenextstep(drawingcomparativefigures)moremeaningfulandwillimproveparticipationandthequalityofdiscussions.

2. Draw Figure 1 on the board or chart paper where the communicator has good knowledge, lower communication and much lower values and attitudes. Ask the participants what would be the performance of such a communicator. Generate a discussion on this.

3. Draw Figure 2 where the communicator’s communication skills are good, but knowledge and values are poor. What would be the performance of such a communicator?

4. Next, draw Figure 3 where the person has high values but less knowledge and communication skills. Discuss how this person would perform.

5. Draw Figure 4 where the communicator has less knowledge, low communication skills and low values. How would such a person perform?

6. Finally, draw Figure 5 where the communicator has all three aspects –knowledge, communication skills and values in equal amounts. What would be the performance of such a person?


From the above discussions it can be seen that a good communicator should have theknowledge,skillsandtherightvaluesandattitudestobeeffectiveinthefield.Lackofanyoneoftheabovequalitiesmakeshim/herineffective.Weneedtobemotivated and committed to bring about change within communities. Then we will findwaystoacquiretheknowledgeandskillstoperformourtasksbetter.

15:00 to 15:30 (30 minutes)


Knowledge, skills and attitudes/values that a good communicator should haveKnowledge Communication Skills Values /Attitudes

• Knowledge of the topic and how it has to be handled

• Knowledge about the target population being addressed–their beliefs, values, traditions, social norms etc.

• Knowledge of the region where one is working

• Knowledge of local leaders, opinion makers, functionaries etc.

• Abilitytobuildrapportwith individuals and groups

• Abilitytoseeoneselfas part one of the community

• Abilitytospeakeffectively

• Abilitytolistenattentively

• Abilitytonegotiateand handle arguments etc.

• Abilitytoanalysesituations and different points of views

• Abilitytousepositivebodylanguageforbest impact

• Abilityto‘emphasise’• Abilitytousedifferent

tools for effective communication–posters,flipcharts,exercises,communitydialogue tools etc.

• Being honest and transparent (ASHA inthefilmRachanatmak Ravayya was thinking something about the motherbutnotsayingit–resultpoorcommunication)

• Respect for all, including the poor and marginalised(Againinthesamefilm,was she respectful to the mother in Part I? What was the change in her behaviour in Part II? The result was good communication)

• Treatingallequallyirrespectiveofreligion,caste,gender,age,physicalcondition and socio-economic status (ASHA did not ask the mother to sit while she herself was sitting in Part I, in Part IIsheactuallysatwiththechildandfedthechild–differenceresultedingoodcommunication)

• Commitment to one’s work and mission (RememberthiswhenyouseethemovieASHA, Ek Nai Subah)

• A sense of fairness and justice (In Part I of ASHA, Ek Nai...youwillseehowtheASHA is being unfair to the mother)

• Abeliefthateveryindividualorfamilyhasthe right to make his/her/its choices and that one’s role is to provide them with the right knowledge and skills to make ‘informed choices’. (In Part II of ASHA, Ek Nai...youwillseehowtheASHAhelpsthemother in making her choice)

TEA BREAK15:30 to 15:45 (15 minutes)

Low K CS V

K = Knowledge, CS = Communication Skills, V = Values /Attitudes

K CS V K CS V K CS V K CS V

High

Medium


SESSION 7 INTRODUCTION TO INTERPERSONAL COMMUNICATION; THE GATHER CONCEPT

SESSION OUTCOME

At the end of the session, participants will be able to:• List what constitutes "Muskurahat" or "GATHER"anddescribe its relevance in

interpersonal communication.• Explain how effective interpersonal communication can be done.

MATERIALS REQUIRED

• ThefilmASHA, Ek Nai Subah• CDplayerandTV• Writing board, chart paper and marker pens

METHODOLOGY

Filmviewingfollowedbydiscussion.

PROCESS

• Explain the concept behind the word "Muskurahat" (eqLdqjkgV)or"GATHER"anddetail what each alphabet in the word stands for as given below:

eqLdqjkgV

eq & eqLdqjk dj vfHkoknu djsaxhAvius dk;Z{ks= esa tc vki fdlh ls Hkh feyrh gSa rc fu'p; gh izlUurk iwoZd eqLdqjkrs gq, feyrh gSaA lkFk gh lkFk] lkeus okys ds in vkSj le;kuqdwy vfHkoknu Hkh djrh gSaA

l & loky iwN dj leqnk; ls tkudkjh ysaxh fd mudh LokLF; laca/kh D;k leL;k,¡ gSa vkSj O;ogkj ifjorZu esa D;k&D;k ck/kk,¡ gSa\loky iwN dj leqnk; dh LokLF; laca/kh leL;kvksa vkSj O;ogkj ifjorZu dh ck/kkvksa dh tkudkjh ysaxhA blls leqnk; dh t+:jrksa dh tkudkjh fey ik,xh rkfd mudks vko“;drkuqlkj lgh ijke“kZ fn;k tk ldsA

dq & dq“ky LokLF; O;ogkj ds fy, mudh vko“;drkuqlkj Ik;kZIr tkudkjh nsaxhAdq“ky LokLF; O;ogkj ij ppkZ djsaxh vkSj mudh vko“;drkuqlkj ¼tksfd fiNys pj.k }kjk irk yx pqdh gaS½ tkudkjh nsaxh] [kkldj vxj vkids lkeus ubZ ekrk gks] xHkZorh L=h gks ;k fQj dksbZ fd“kksjhA dq’ky O;ogkj ij tkudkjh nsrs le; /;ku j[kuk gksxk fd bu ekrk] fd'kksjh ;k L=h dks dksbZ loky vFkok ijs'kkuh rks ugha gS\ lkFk&lkFk] ;g Hkh iwNuk gksxk fd D;k fiNys ckj nh xbZ lykg dks viukus esa dksbZ ijs'kkuh gqbZ\ vxj gqbZ rks og D;k Fkh\ vxj dksbZ u;k elyk gS rks og D;k gS\

jk & jk; cukus esa enn djsaxh( ,d ,slh jk; cukus esa] ftlls ekrk [kqn QSlys djus esa l{ke cusaAekrk ls ckr dj jk; cukus esa enn djsaxhA vxj dksbZ leL;k ugha gks rks tks ckr vPNh py jgh gS mldks vkSj lqn`<+ djsaxhA ;fn dksbZ iz'u ;k leL;k gks rks mlds fofHkUu igyqvksa ij fopkj&foe'kZ vkSj iz'u djsaxhA leL;k ls tqM+h ;fn dksbZ ubZ tkudkjh vkids ikl gS rks mlds fo"k; esa vo'; ppkZ djsaA bl tkudkjh ls gksus okys Qk;ns&uqdlku ij Hkh ppkZ djsaxhA blls ubZ ekrk] xHkZorh efgyk ;k fd'kksjh dks leL;k dk lek/kku ;k iz'u dk mŸkj <w¡<+us esa lgk;rk feysxhA bl izdkj efgyk Lo;a QSlys ysus esa l{ke cusxhA

15:45 to 16:45 (60 minutes)


g & gky lq/kkjus ij ppkZ djsaxh] [kkldj vxj dksbZ ijs'kkuh ;k loky gks rksAgky lq/kkjus ij ppkZ djsaxh] [kkldj vxj dksbZ ijs'kkuh ;k tfVy loky gkas rksA bl izfØ;k esa leL;k dk fuokj.k vki&vk'kk nhnh ugha djsaxh vfirq leL;k dk lek/kku <w¡<+us dh {kerk dks c<k+ok nsrs gq, enn djsaxhA lykg flQZ rc gh nsaxh tc dksbZ uqL[ks ;k lq>ko ij O;ogkj djus esa dksbZ ijs'kkuh ;k vM+pu vk jgh gksA gky lq/kjus dh ppkZ dks lekIr djus ds igys de ls de ,d ;k nks ckrksa ij lgefr cukuh pkfg,A leL;k ds lek/kku ds fØ;kUo;u ds rjhds ;k jkLrksa ij Hkh lgefr gksuh pkfg,A

V & fVdkÅ vkSj ljy laca/k dh vk'kk ds lkFk fonk ysaxhAfVdkÅ vkSj ljy laca/k dh vk'kk vkSj iqu% tYnh feyus ds okns ds lkFk fonk ysaxhA fVdkÅ laca/kksa ds fy, le;≤ ij nksckjk fey dj orZeku fLFkfr dh Hkh tkudkjh ysrh jgsaxh rkfd le; jgrs mi;qDr lq>ko fn;k tk ldsA

OR

GATHER

G–GREET the caregivers (establish rapport): It isnecessary toovercomebiasestomeetpeopleasequals.Greetingpeoplepersonallyhelpsinbuildingrapporttoagreat extent.

A–ASK caregivers (gather information): It is important to elicit the needs of the caregivers, prioritising information to make it more relevant. Asking should not be limitedtomeremedicalhistorybecauseotheraspectsofaperson’slife(lifestage,lifestyle, personality, etc.) often impact an individual’s post-counselling behaviourmorethanhis/hermedicalhistory.

T–TELL (provide information): Avoid information overload such as reciting details on all the processes at one time because there is a limit to how much information people can retain. Instead, package the information in smaller module and check for understandingafterdeliveryofeachmodule.Specificinformationorganisedlogicallyisretainedlongerandmorecompletely,especiallyiftheindividualsareencouragedto ask questions.

H–HELP the individual: This is the decision-making or problem-solving moment. The providerishelpingtheindividualsortthroughtheinformation,lifestyleandlife-stageissues to come up with various alternatives, and to consider the advantages and disadvantages of each alternative.

E –EXPLAIN to the individual: Once the individual has made a choice, the provider uses IECmaterial to help the individual remember key information. The provideralso uses IEC material to remind them of important discussion points. IEC materials reinforcekeyinformation,advantagesanddisadvantages.

R –RETURN/REFER/REALITY CHECK: Return visits or referrals should be planned. Ifnecessary,repeattheinformationgiven.

• Discuss each step in Muskurahat orGATHER indetail; clarifyanydoubts thatparticipantsmayhave.

• Once there is good understanding among participants on either of the two words, startshowingthefilmASHA, Ek Nai Subah.

• Stop the film at the point where the four questions are raised and ask theparticipants what the answers could be. Generate a discussion on the same and list all the shortcomings of the ASHA in her communication.

• Oncethisisdone,resumeshowingthefilm.Stopthefilmonceagainwhenthenext set of four questions appear. Get the participants to respond to the questions and note these points on the board or chart paper.


SESSION 8 REVIEW AND REFLECTIONS OF THE DAY

• Resumethefilmagain.Stopthefilmwhenthenextsetofquestionsappearandget the participants to respond to the questions. Link them with either Muskurahat or with ‘GATHER’ and describe how the steps that were discussed in part I of the sessionactuallyhelpedtheASHAingettingpositiveoutcomesincludingbuildingstrong relationships with the families and communities.

• Showthefinalpartofthefilmanddiscussthefilmonceagain.


• Onceagaindiscussthefivestepsin"Muskurahat"orthesixstepsin"GATHER"andrelatethemtowhattheysawinthefilm.

• Highlight the importance of rapport building to ensure that communication becomes effective.

• Recall the session on ‘Qualities of a Good Communicator’ and once again highlight the importance of having the right values and attitude to be an effective communicator.

SESSION OUTCOME

At the end of the session:

• Therewillbealistingofthehighlightsoftheday,thelearningsandfeedbackonthe sessions.

MATERIALS REQUIRED

• Writing board and chalk or marker pens• A paper ball

METHODOLOGY

Getting feedback and comments from participants.

PROCESS

1. Telltheparticipantsthatthisisthelastsessionofthedaywheretheycanreflectonthemajorlearningsoftheday,givetheirfeedbackonthesessionsandanyothercommentsthattheywouldliketomaketheday’ssessionsmoreeffective.Tellthemthatyouwillthrowtheballtoanyoneparticipantandhe/shewillgivehis/her comments and then throw it to the next participant for his/her comments. The comment could be in the form of a learning, an expression of what one felt duringthedayorasuggestiontomaketheday’ssessionsmoreeffective.

2. Make three columns on the board and give the headings LEARNING, FEELING andSUGGESTION.Throwtheballtoanyparticipantofyourchoiceandstarttheabove process. As the participants make their statements record them under theappropriateheading.Makesurethateachparticipantcontributesonlyonepoint. Once all the participants have contributed summarise what is written on the board.

16:45 to 17:15 (30 minutes)


Session No. Topic Time Methodology

1 RecallofDayIsessions 10:00 to 10:15 Discussion

2 Introduction to Social Inclusion

10:15 to 11:00 Simulation exercise and discussion

11:00 to 11:15 Tea break (15 minutes)3 Session on Social

Inclusion (continued)11:15 to 12:00 Film ‘I Am a Dalit’ and

discussion4 How to Conduct a Group

Discussion12:00 to 12:45 Use of sociogram and

discussion12:45 to 13:45 Lunch break (60 minutes)

5 UseofaCommunityDialogue Tool

13:45 to 14:45 Pulleyexerciseanddiscussion

6 Understanding Teamwork 14:45 to 15:30 Broken square exercise and discussion

15:30 to 15:45 Tea break (15 minutes)7 Planning and Organising a

VHND15.45 to 16.45 Film ASHA, Ek Din Zindagi

Ka and discussion8 Creating a Village Health

Plan and Developing a Village SBCC Plan

16.45 to 17.45 PPT presentation and discussion

9 ValedictorySession 17.45 to 18.15 Feedback from participants

Session 1No materials requiredSession 2• Six pieces of chart paper

(30 cm x 15 cm)• Markerpens(thick–preferablyof

different colours)Session 3• I am Dalit CD• Laptop and LCD or TV• DVDplayer• White board and marker pensSession 4• Chart paper and marker pensSession 5• Apulleystand• A doll

• String• A plastic bag• 12 thick VIPP cards• Blackboard and chalk or chart

paper and sketch pensSession 6• 12 pieces of the broken square.• Thekeytothebrokensquare• Black board and chalk or chart

paper and sketch pensSession 7• The film ASHA, Ek Din Zindagi Ka

(VHND)• VCD,aVCDplayerandTV• Blackboard and chalk or chart

paper and sketch pensSession 8• SBCC Plan framework (8-10) copies

LIST OF TRAINING MATERIALS:

DAY 2 PROGRAMME SCHEDULE


SESSION 1 RECALL OF DAY I SESSIONS

• Welcometheparticipantstotheseconddayoftheorientation.• Recallbrieflysessionsofday1.• Runthroughtheschedulefortheday.

SESSION 2 UNDERSTANDING SOCIAL INCLUSION AND ITS IMPORTANCE IN SOCIAL AND BEHAVIOUR CHANGE COMMUNICATION

SESSION OUTCOMES

At the end of the session, participants will be able to:• Clearly describe what "exclusion" means and understand the humiliation,

frustration, and sense of helplessness associated with it.• Sharetheir"feelings"afterhavingexperiencedtheimposedsocialrestrictionsand

getfullysensitisedtotheneedforfocussingoninclusionintheircommunicationplans.

MATERIALS REQUIRED

• Six pieces of chart paper (30 cm x 15 cm)• Markerpens(thick–preferablyofdifferentcolours)

METHODOLOGY

Simulation exercise and discussion

PROCESS

1. Divide the participants into six groups and give each group a piece of chart paper; Assign each group a role as given below:

• Group 1 members are SC/STs.• Group 2 members are WOMEN (single mothers, widows & women heading

households).• Group 3 members are DIFFERENTLY ABLED.• Group 4 members are RELIGIOUS MINORITY GROUPS.• Group 5 members are RICH/DOMINANT CASTE.• Group 6 members are HIV or LEPROSY AFFECTED PEOPLE.

Tell the participants that during the exercise, the members of each group are required to feel, think and act as people belonging to the category assigned to them and their actions should reflect the reality in society.

2. Each group is given a piece of chart paper and a marker pen to make a placard. Askthemtowriteboldlyandclearlythenameofthecategorythatisassignedtothem.

10:00 to 10:15 (15 minutes)

10:15 to 11:00 (45 minutes)


3. Linesaredrawn,onthefloorofthetrainingroomandallthegroupsaremadetostand at the starting point in the manner shown in the diagram below.

4. One of the facilitators reads out from a list of statements (given at the end of the session).

STARTING

LINE

GROUP 1

GROUP 2

GROUP 3

GROUP 4

GROUP 5

GROUP 6

5. Theparticipantsare requested to listencarefully toeachstatementand thendiscussamongthemselvesanddecideiftheycanfollowthe‘statements’asina real-life situation.

6. Ifanyofthegroupsfeelthattheycanperformthetaskina real-life situation theyaskamemberofthegrouptoholdtheirplacardandstepforwardsoastostandonthelineimmediatelyinfrontofthestartingpoint.

7. Conversely,ifthegroupsfeelthatitisnotpossibletoperformthetaskinareallifesituationthentheyasktheirrepresentative(holdingtheplacard)toremainwherever She/he is standing.

8. As the statements are read out, each group discusses the statement among themselves and then asks their representative to either remain where She/he is or take a step forward near the next line. This continues on until all the 10 or 12 statements are read out and acted upon.

9. The representative can keep stepping forward even after all six lines have been crossed.

10. Attheendoftheexerciseyouwouldhaveasituationwherethegroupsareindifferentpositions.TheHIV/Leprosyaffectedpeoplewouldhavemovedoneortwo steps forward, the dalits three or four and so on. The rich /dominant caste willbewayahead.


11. Once the exercise is over ask the following questions:

• Whichcategoryadvancedthemost?• Whichcategorywaslast?• What did we see here?• Howmuchdideachcategoryadvance?• Whyarethecategorieswheretheyare?• What stops people from advancing; do the categories have equal status?• Iftheansweris“no”,askwhyitisso.• Whichcategorieswerehappyandwhichwerenot?Allowthemembersofdifferentgroupstosharewhattheyfeltwhiledoingtheexercise.Didtheyfeelasenseof injustice?Tryandbringoutthefrustrations,and feelings of helplessness and sadness that some members would have felt.

Allow sufficient time for participants to reflect and share their feelings andthoughts about each of the questions. Remember we have to bring out the feelingsoftheparticipantssothattheyinternalisewhattheyarespeakingandhearing.

Ask whether this situation exists within our communities. Are people being deprived of their entitlements just because of their social and economic status, gender or health status? Allow time for the participants to share their thoughts.


Aswrapuptothispartofthesessionconveythefollowing:

• Therearemanyinequitiesthatstillremainwithinourcommunities• Large sections of our people remain discriminated against• TheproblemisacuteinthecaseofHIVandleprosypatients,widows,dalits

and tribals; women in general are subjected to discrimination in almost all walks of life.

GROUP 1

GROUP 2

GROUP 3

GROUP 4

GROUP 5

GROUP 6


• The Indian Constitution gives every individual, irrespective of the religion,caste, gender or social status She/he belongs to, equal rights. The Universal Declaration of Human Rights, the Convention on the Elimination of all Forms of Discrimination against Women (CEDAW) and the Convention on the Rights of the Child accepted all over the world recognise that everyone is bornequalandguaranteethefulfilmentofhumanrights(shortnotesonvariousconventions are given at the end of session).

• TheGovernmentofIndia,overthepastseveralyears,hasmadehumanrightscentraltodevelopmentprogramming–therighttofood,therighttolivelihood,the right to education and health care, and the right to information are all directed towardsbringingaboutequityandsocialjusticewithinourcommunities.

• ItisextremelyimportantthatanySBCCinitiativerecognisesthisbasictenetand ensures that we target those who are discriminated against and are most vulnerable. Empowering them and bringing them into the mainstream will help us to achieve our targets.

• We need to focus on inclusion in all the activities that we undertake, including home visits (select houses of the poor and marginalised), group meetings (focusonthediscriminatedandensurethattheyparticipateandsharetheirviews),servicedelivery(ensurethatthepoorandvulnerablearegivenpriorityand are covered) etc.

STATEMENTS TO BE READ OUT

How certain are you that...• Yourchildrenwillbetreatedequallyintheirschool?• Youwillreceiverationsduetoyouinthevillagerationshop?• YouwillreceivethebestofattentionwhenyougotoyourlocalPHC?• The Sarpanch, ANM, doctor, AWW, Gram Sevak etc.willvisityourhousetodiscuss

problems?• Youcanbuyamotorcycleforyoursontoattendcollege?• YoucanattendandfearlesslyparticipateinameetingbeingheldbytheANMand

AWWandthattheywilllistentoyou?• Your daughters can pursue high school studies?• You will get justice at the local Police Station?• Therewillbenoinjusticeagainstyouattheplacewhereyouwork?• Youcancelebratethenextreligiousfestivalthewayyouwant?• Youwillearnequalwagesforthesametypeofworkdonebymen?• Youwillbeableto,ifrequired,getanexpensiveoperationforamemberofyour

family?

NOTES FOR THE FACILITATORUNIVERSAL DECLARATION OF HUMAN RIGHTS (UN)

Providesequality,irrespectiveofcaste,creed,religionandregion.Allhumanbeingsareborn freeandequal indignityand rights.Theyareendowedwith reasonandconscience and should act towards one another in a spirit of brother hood.

Everyoneisentitledtoalltherightsandfreedomssetforthinthisdeclaration,withoutdistinctionofanykind,suchasrace,colour,sex,language,religion,politicalorotheropinion, national or social origin, property, birth or other status. Furthermore, nodistinction shall be made on the basis of the political, jurisdictional or international statusofthecountryorterritorytowhichapersonbelongs,whetheritbeindependent,trust,non-self-governingorunderanyotherlimitationofsovereignty.


CONVENTION ON THE ELIMINATION OF ALL FORMS OF DISCRIMINATION AGAINST WOMEN (CEDAW) The Convention on the Elimination of all Forms of Discrimination against Women (CEDAW),adopted in1979by theUNGeneralAssembly,defineswhatconstitutesdiscrimination against women and sets up an agenda for national action to end such discrimination.

TheConventiondefinesdiscriminationagainstwomenas"...anydistinction,exclusionor restriction made on the basis of sex which has the effect or purpose of impairing ornullifyingtherecognition,enjoymentorexercisebywomen, irrespectiveoftheirmarital status, on a basis of equality of men and women, of human rights andfundamentalfreedomsinthepolitical,economic,social,cultural,civiloranyotherfield."

NATIONAL COMMISSION FOR WOMEN

NCW is the apex national level organisation of India with the mandate of protecting and promoting the interests of women. Its major responsibilities include:

• Generation of legal awareness among women, thus equipping them with the knowledgeoftheirlegalrightsandwithacapacitytousetheserights.

• Assisting women in redressal of their grievances through pre-litigation services.

• FacilitatingspeedydeliveryofjusticetowomenbyorganisingParivarik Mahila Lok Adalatsindifferentpartsofthecountry.

UNITED NATIONS CONVENTION ON THE RIGHTS OF THE CHILD, 1990

Everychildhasrightswithoutdiscriminationofanykind,irrespectiveofthechild'sorhis or her parent's or legal guardian's race, colour, sex, language, religion, political orotheropinion,national,ethnicorsocialorigin,property,disability,birthorotherstatus.

The rights include protection against all forms of discrimination or punishment on the basis of the status, activities, expressed opinions or beliefs of the child's parents, legalguardiansorfamilymembers.Everychildmustberegisteredimmediatelyafterbirthandshallhavetherightfrombirthtoaname,therighttoacquireanationalityand,asfaraspossible,therighttoknowandbecaredforbyhisorherparents.

Other rights include: To diminish infant and child mortality; necessary medicalassistance and health care to all children with emphasis on the development of primaryhealthcare;tocombatdiseaseandmalnutrition;toensureappropriatepre-natalandpost-natalhealthcareformothers;toensurethatallsegmentsofsociety,in particular parents and children, are informed, have access to education and are supported in the use of basic knowledge of child health and nutrition, the advantages of breast-feeding, hygiene and environmental sanitation and the prevention ofaccidents;andtodeveloppreventivehealthcare,guidanceforparentsandfamilyplanning education and services.

TEA BREAK 11:00 to 11:15 (15 minutes)


SESSION 3 SOCIAL INCLUSION (CONTINUED)

SESSION OUTCOMES

At the end of the session, participants will have:• A deeper understanding of the problems of the dalit and other marginalised

communities. • Aclearerunderstandingoftheneedtofocusonexcludedsectionsofsocietyin

the Social and Behaviour Change Communication initiatives.

MATERIALS REQUIRED

• The“Iama Dalit”CD,laptopandLCDorTVandDVDplayer• Whiteboard and marker pens

METHODOLOGY

Screening of video and discussions

PROCESS

Telltheparticipants:“Wehavejustseenexclusionofgirlsandwomenjustbecausetheybelongtothefemalegender.Wearenowgoingtoseeafilmthatdepictsthepitiable condition of dalitsandthe‘oppressed’castes.Afterseeingthefilmwewilldiscuss it so that we understand the problems better.”

1. Screenthefilm

2. Attheendofthefilm,askthefollowingquestions:• Whatdidyouseeinthefilm?• Whatwerethekeyscenes?• Whatwereyourfeelingsasyouwerewatchingthefilm?• Haveyouhadsimilarpersonalexperiences?• Whicharetheothersectionsofsocietythatsufferduetoexclusion?Generateagooddiscussion.Allowsufficienttimeforparticipantstoreflectandshare their thoughts, experiences and feelings.

3. Once the discussions are over, ask the following questions:• Asdevelopmentworkers,whatmessagesdothefilmandthebottleexercise

give us?• Whatcanwedotoreachouttotheexcludedsothattheybecomepartofall

ouractivitiesandbenefitfromourservices?• List the points emerging from the discussions.

4. Now ask the following questions:• WhatarethewaysinwhichwecanmakeourSBCCstrategiesandinitiatives

more inclusive, so that we reach out to the poorest, excluded and most vulnerable?

• What changes should we bring about in our work to ensure that the excluded get included and are mainstreamed?

• List the points that emerge from the discussion and use these points to conclude the session.

11:15 to 12:00 (45 minutes)


FOR THE FACILITATOR

NOTES ON SOCIAL EXCLUSION

Social exclusion describes a process by which certain groups are systematicallydisadvantagedbecausetheyarediscriminatedagainstonthebasisoftheirethnicity,race,religion,sexualorientation,caste,descent,gender,age,disability,HIVstatus,migrantstatusorwheretheylive.Discriminationoccursinpublicinstitutions,suchasthelegalsystemoreducationandhealthservices,aswellassocialinstitutionslike the household.

Sociallyexcludedgroupssufferfromsomeorallofthesedenials.

Associalexclusionisnotonlyaboutattitudesbutisbuiltintothesocialstructure,changingattitudeswillnotnecessarilychangesocialexclusion.Thesocialstructureof a society contributes to the formation of its attitude, and the attitude in turncontributestothemaintenanceofthesocialstructure.Thereisnoeasywayoutofthishorriblyviciouscycle.

Since social exclusion is about domination, discrimination and deprivation, those who benefit from it do not want to introduce any change, while those who are discriminated against, who are supposed to be ‘inferior’, ‘incapable’, ‘less meritorious’ and ‘lower’, are not in a position to mobilise and organise to alter the existing social system. They do not want to remain in the dehumanising social order but fear that they may be subjected to repression if they resist exclusion and discrimination.

During discussions in workshops on reconstruction of the dalit identityinsixnorthernstatesbytheBiharSocial Institute, itwasfoundthatthenegativeandderogatoryperception of the dominant castes about dalits isthattheyaredirtyandfilthy,thievesandrobbers,lazy,gluttonous(pethu, khau), dishonest and ungrateful. This negates thereality.Forinstance,empiricaldatadoesnotsupporttheperceptionthatdalits aregluttons.Therealityisthatdalits,likeanyoneelse,eattosurvive.

Dalits perceptionsaboutthemselvesisthattheyarecapablebutgetnoopportunities;thattheyarehardworkingbutdonotgetthefruitsoftheirlabour;thattheyareoftenputinasituationwheretheyareforcedtoroborlie;thattheyareculturallytalentedandarenotimmoral,onthecontrarytheyaresensitiveandemotional.Somewouldargue that this perception is unrealistic, even aspirational. However, Dr. Louis argues thatacommunitythatisatthereceivingendalsohasscopeforlookingattherealityof their lives in a positive light.

Tribalsfaceapeculiardilemma.Theyhavebeenorganisingtoensuretheirrights,and protect their culture and natural resources. But whereas formerly they weretotally isolated,now theyare thevictimsofdiscrimination.Non-tribals see tribalsinaderogatorymanner,particularlytheirfoodhabitsandwaysofliving,whichareverydifferent.Thestrongemergingtribal identity,however,seesthemasthefirstinhabitantsof thiscountrywhohavecontributedmuchtotheculture,historyandheritageofIndia,thoughlittlerespectistodayshowntotheirculture,socialsystems,politicalstructuresandeconomy.

Women are the most excluded and discriminated segment of the Indian population. Patriarchy is at the coreof the structural elementdiscriminatingagainstwomen.Controlofwomen’sreproductiveabilitiesandsexualityisinmen’shands.Patriarchylimitswomen’sownershipandcontrolofpropertyandothereconomic resources,including the products of their own labour.


Women’smobility is constrained and their access to education and informationhindered.Overtheyears,ithasbeenrecognisedthattheexperiencesofamajorityofwomenaregroundedinbothpovertyandpatriarchy.Boththesefeedintoeachother and subject women to exclusion and exploitation.

TheMuslimcommunityisanotherexcludedgroupinIndia.TherearemoreMuslimswho live below the poverty line than any other group. They also earnmuch less(on average, Rs. 22,807 per year as against Rs. 25,653 for all others). Only 21percentofMuslimsusethepublicdistributionsystem,whichprovidessubsidisedfood grain, as compared to 33.2 percent of the general population. Enrolment of Muslim children in schools is low (61.6 percent, while it is 71.4 percent for the generalpopulation),andthedropoutrateishigher.NeitheratthepolicylevelnorinprogrammeinterventionsdoMuslimsgettheirdueshareascitizensofthiscountry.

In this environment, Dr. Louis points out, social exclusion is multiple and cumulative. For instance, a dalitortribalgirlsuffersmultipleexclusionsbybeingexcludedduetocasteandethnicreasons,andfurtherexcludedbylocationifshelivesinaruralarea where she cannot avail of facilities available to those in urban areas. If she is adifferently-abledperson,shesuffersfurtherdiscriminationbybeingdeprivedoflife-enhancing mechanisms.

Source:Extractedfromapapertitled“Socialexclusion:Challengesforcivilsocietyorganisations” (DFID)

SESSION 4 HOW TO CONDUCT A GROUP DISCUSSION

SESSION OUTCOME


• Listthedo'sanddon’tsofconductingagroupdiscussionanddefinetheirroleasfacilitators of group discussions.

MATERIALS REQUIRED

• Chart paper and marker pens• Annexure: How to conduct a Group Discussion

METHODOLOGY

Group discussions and plotting discussion on a sociogram

PROCESS

1. Callsixparticipants–twowhoareveryactiveandtendtodominate,twowhoaremoderatelyactiveandtwowhoarethesilent–andaskthemtoformagroupinthe centre of the training room. Call three other participants who are active and have the other facilitator take them out of the classroom.

2. The facilitator who takes the three participants out of the classroom briefs themontheirroleas‘observers’.Tellthemthattheyhavetoobservethegroupcarefullyandthateachofthemhastocreatea‘sociogram’thatwoulddepicthow each of the group members participated in the discussion.

12:00 to 12:45 (45 minutes)


3. Give them clear instructions on how to create the sociogram. Follow the directions listed below:• Ask them to open a fresh page in their notebooks and

mark six dots that create a circle with a diameter of about 3 inches. Each dot represents one of the members who will be participating in a group discussion in the training room. The listing of the names should be in the sequence in which the group members are sitting. Now put the name of a member against each of the dots.

• When the group discussion starts, observe each member of the group. When one starts speaking observe who he/she is speaking, to and draw a straight line between the dots representing the two of them. For example, if D starts the discussion and looks at F while speaking, draw a line with an arrow from D to F as in the chart; then if F speaks looking at B draw a line with an arrow linking F and B. If C speaks next, looking at B link them both with an arrow. Keeprecordingthediscussionsbydrawinganarrowaseachmemberspeakstillattheendthereisawebdepictingthewaythediscussionswent.Incaseamemberspeakswithoutfocussingonanyoneandisspeakingtothegroupdraw an arrow from him/her to each of the others, indicating that he/she is speaking to the group. Tell the participants not to forget to mark the side chats that happen between members.

• Askthemonceagainiftheyhaveunderstoodtheirrolesclearly.Ifthereareanydoubtsclarifythem.

4. Whileonefacilitatorisbriefingthethreeobservers,theothergivesinstructionsto the six members who will be involved in the group discussion as follows:• Tellthesixparticipantsthattheywillhavetocarryonagroupdiscussionon

‘Why is Social andBehaviour Change Communication themost importantpart of our work?’Ask them to select a leader from among them to lead thediscussions.Tell themthattheywillbegiven10minutesforthegroupdiscussionandthattheycandecidehowtoconductthediscussion.

• Tell the other participants to be attentive and to assess how good the discussion was.

• Bring the three observers in and tell the group to start their discussion.• Thetwofacilitatorstooshouldobservetheparticipantscarefullyandcreate

their own sociograms of the group discussion.• Attheendof8minutes,tellthegroupthattheyhave2minutesleftandatthe

end of 10 minutes ask them to stop their discussion.• Askthesixgroupmembershowtheyfoundthegroupdiscussion,whetherall

membersparticipatedeffectively,whethertheleaderhelpedinfacilitatingthediscussion,whetheranyonedominatedetc.Askeachgroupmembertosharewhattheyfeltandhowwelloreffectivelytheycontributedtothediscussion.

• Give sufficient time for the group members to reflect and share theirexperiences.

• Then ask the rest of the participants to comment on the way the groupconducted the discussion and how effectively each member contributed.Give about 7 to 10 minutes for them to give their feedback.

• Next, ask the three observers to share their observations with the help of the sociogram.Askthefirstobservertoexplainwhatthesociogramisandwhatit depicts. In case there are gaps in his/her description, the facilitators join in and explain the sociogram in detail. The observer then explains how the discussion went using the diagram.

• Now ask the other two observers to give their observations.

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5. Next the facilitators make their own comments drawing conclusions from the sociogramspresented.Focusparticularlyonthefollowingpoints:• The role of the leader in facilitating the discussion.• The participation of individual members of the group.• Didanyonedominatethediscussionandevenpreventothersfromsharing

their views?• Wasthereanyonewhowassilentanddidnotspeakorspokeverylittle?• Was the group able to bring out relevant points on the topic given?

6. FinallythefacilitatorsgivetheirownviewsonthequalityofthegroupdiscussionandnarratethestoryoftheKingandtheKheer.

Ĭ The Story of the King and the Kheer

Therewasonceaverybenevolentkingwhoalwaysworkedforthewelfareofhispeople.Thepeoplelovedandworshippedhim.Oneday,thekingwasreflectingonhislifeandhiskingdom.Hewashappythathehadbeenamuchlovedking,always putting the welfare of his people above everything else. But he alsorealisedthatmostofhissubjectshadbecomelazyandweregettingmoreandmoredemanding.Theyhadstartedtoexpecteverythingfromthekingandthissaddenedhim.Sohedecidedtotesthispeopleandteachthemthattheytooneedtoworktoearnalivingandshouldnotbealwaysdependentonhim.

Accordingly,hemadeaplan,andtheroyalannouncers,withtheirdrums,informedthe people that the King wished to eat kheerwithhissubjects.TheyannouncedthattheKinginsistedupononecondition–eachfamilywouldhavetoprovidethemilk for the kheer while the King would provide the rice, sugar and spices.

On theappointedday, thesubjects linedup fromearlymorningwithmilkcansto give milk to the King for his kheer. A huge vessel had been placed in an open area. Each person would walk up to the vessel, climb up the ladder, pour the milk into the vessel and then climb down another ladder. This went on until the last subject had poured his milk into the vessel. The cooking of the kheer started and as promised the other ingredients came from the King. After a long wait, the kheer wasready!EveryoneincludingtheKingsatdowntoeatit.Whentheattendantsstartedserving thedelicacyand thepeople startedeating therewascompletesilence, but not for long. Soon there was a murmur which grew into a loud noise thatrosefromeverycorner,“Thisisnotkheer–thisismeetha bhaat!”

Whatreallyhappened?

7. Distributethehandouton“HowtoConductaGroupDiscussion”attachedherewith.


“Oursessionherewillbelikethekheer. The discussions become richer and more meaningful only when everyone contributes and shares ideas and views. It isimportant that all of us participate so that others get to know about our thoughts and feelings.”

Similarlyagroupdiscussion inthefieldgetsenrichedbyeveryone’sparticipation.Ifonlyfewpeopledominatethediscussionandsomepeoplekeepquiet,thosewhoarenotencouragedtospeakmaynotbeabletocleartheirdoubtsand/orwillnotexpress their concerns about a behaviour change. This will result into incomplete and ineffective communication.

LUNCH BREAK 12:45 to 13:45 (60 minutes)


SESSION 5 USE OF A COMMUNITY DIALOGUE TOOL

SESSION OUTCOMES


• Use the outcomes of the Problem AnalysisProcess in an SBCC session using a communitydialoguetool.

• Understandtheimportanceofhavingtheparticipationofcommunitymembers,especially women, in bringing about behaviour change within families andcommunities.

MATERIALS REQUIRED

• Apulleystand• A doll• String• A plastic bag• 12 thick VIPP cards• Black board and chalk or chart paper and sketch pens.

METHODOLOGY

• Pulleyanddollexercise• Demonstration and discussions

PROCESS

1. Invite the participants to spend a few minutes discussing the low immunisation statusofchildreninoursociety.

2. Write at the centre of the board LOW IMMUNISATION STATUS OF CHILDREN and ask the participants to think of some of the main causes contributing this situation.Askthemtosharetheirthoughtsonebyone,andastheysharelistthepoints below the heading. List 10 to 12 main causes.

3. Once this is done, ask the participants the following questions: How can these problems be addressed? How could the mothers be supported to ensure full RI coverage of their children? How linkages with better earnings (like MNREGA) support full immunisation? What support can come from local governance like village health and sanitation committee for complete RI? What are the factors thatwouldhelpthem?Askthemtoreflectandsharetheirthoughtsonebyone.As they speak, list the points above ‘low immunisation status of children’ asshown in the diagram.

4. Whatweseehereisaninterplayofforcesactingin-favourofImmunisationandagainstit.ThisinterplayofoppositeforcesiscalledForceFieldAnalysis.Inorderto move the equilibrium upwards or downwards we need to alter the forces. The following exercise will show us how the forces can be altered.

(Thediagramshouldbeclearlyvisibletoall).

13:45 to 14:45 (60 minutes)


5. Tell the participants that they will do an exerciseusing the factors listed in the diagram and a community dialoguetool that will highlight these factors and facilitate dialogue with communities, especiallywomen.

6. Ask the participants to stand in a circle. Place the pulleystandinthecentreof the circle. Put the string through the pulleys andhang a bag on one end and a doll in a girl’s attire on the other end. The doll should be lying on thefloor.

• ANM sensitised for social intrusion.• Discussbenefitsandrisks.• Help the parents visualise child’s future.• Motivate and counsel.• Highlightimportanceandurgency.• Clear misconception.• Handle objections.• Explain in terms of changing health conditions and food habits.Th

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Low immunisation status of children

• ANMdoesnot“touch“ourchildren.• No immediate threat.• Inabilityto“see”futureofthechild.• Lack of concern.• Lack of time.• Misconceptions.• Hearsayonaftereffects.

7. Tieastring(preferablyredincolour)horizontallyonefootabovethedoll,parallelto the ground. (You can also ask two participants to hold the string parallel to the ground in a straight line.)


8. Nowasktheparticipants,“Whatdoyouseehere?Whatdoesthedollrepresent?A girl?Why is she on the floor?What does the string parallel to the groundrepresent?”Generate a good discussion.

9. Concludebysayingthatthedoll(girl)isonthefloorbecausesheispoor,helpless,haspoorhealthetc.(Recallthenegativepointsfromtheanalysisdoneabove.)The string parallel to the ground represents the BPL line; the girl is below the healthline(normalbodyweight,nodisease,completeimmunisation).Whatweseenowrepresentsthepoorchildrenwithinourcommunitieswholeadadifficultlife.

10. Let’s now see how we can help this girl get out of this condition.

11. Spreadthe12thickVIPPcardsonthefloornearthedoll.Askanyoneparticipantto come forward and pick up one card. Ask him/her to write one or two words clearlyonthecardtakenfrompoint#1ofthepositivefactorsfromtheanalysisdone in the earlier part of the session. For example if point #1 is ‘ANM is sensitive towards social inclusion’, he/she should write ‘No social exclusion’ on the card.

12. Now ask him/her to explain how ‘No social exclusion’ could help improve the immunisation status for children in a minute or two. He/she then puts the card into the plastic bag hung on the string.

13. Call a second volunteer and ask him/her to pick a card and write point #2 on the card and explain how this factor will improve the immunisation status of the poor girl.

14. Call10morevolunteersfromamongtheparticipantsonebyoneandrepeattheprocesstillallthecardsonthefloorareusedandputintotheplasticbag.

15. Asthecardsareputintothebag,thegirlwillgraduallystartrisingandbythetime the seventh or eighth card is in; she will be standing and moving above the healthline.Stoptheprocesshereandask,“Whatdoweseehere?”Allowtimefortheparticipantstoreflectandgivetheiranswers.Thencontinuetheprocess.

16. Bythetimethe12th card is put in, the girl will be well above the health line.

17. Stop the exercise.

18. Now move to the second part of the exercise and discuss what happened in the firstpart.

19. Ask the participants:• Whatdidyouobserve?• Wherewasthedoll/girlatthebeginningoftheexerciseandwhy?• What happened to the doll/girl as the cards were being put in?• What position is the doll/girl in now? How did the girl come above the health

line?

20. Givesufficienttimefortheparticipantstoreflectandsharetheirthoughts.Bringout the following points:• The government is providing awide variety of services at the community

level;it isimportantthatfamiliesandcommunitiesarefullyawareoftheirentitlementsandunderstandthebenefitoftheseservicessothattheyandtheirchildrenbenefitfromtheseschemesandservices.


• Theseschemesandservicesareprimarilymeanttoimprovethequalityoflife,especiallythatofthepoor.

• Therearemanythingsthatcommunitiesandfamiliescoulddoontheirownthat could also improve the situation of children and women.

21. Now move on to the next part of the exercise. Remove the cards from the bag; thedollwillonceagaindropdowntothefloor.Removethestringfromthepulleysand put it on the side of the wheel. Now add cards into the plastic bag; the doll will not rise as before. Even putting all the cards will not lift the doll above the healthline.Putthestringbackonthepulleysandthedollgetsliftedagain.

22. Once this is demonstrated ask the following questions:• Didthedollgetliftedupwhenthestringwasoffthepulleys?• Whynot?

Givesufficienttimefortheparticipantstoreflectandsharetheirfeelingsandthoughts.

23. Nowsay,“Weseethatthepulleysplayavery importantrole in liftingthegirlabovethepovertyline”.Thenaskthefollowingquestions:Whatdoesthepulleyrepresent? Does it represent government schemes, the Panchayat? Does it represent functionaries like the ASHAs, AWWs, ANMs, Gram Sevaks etc., who bring communities and services together? Generate a good discussion and highlight the critical role that the functionaries play in creating awarenessamong individuals, families and communities and motivate them to avail of the services that are being provided.


• Asktheparticipantshowtheyfoundthesession.DidtheyfindthelinkbetweentheForceFieldAnalysisandthepulleyexercise?

• Howdidtheyfindtheuseofthepulley,dollandcardsasacommunitydialoguetool? Was it effective?

• Emphasise that it is only throughparticipationand sharing their feelings andthoughts that people internalise messages and get motivated to change.

• A sustained dialogue is essential to bring about behaviour change.

TIPS FOR THE FACILITATORS

• The length of the rope should be such that one end is 2-3 feet above the ground.• Thedollshouldbelyingonthegroundtostartwith.• The weight of six cards should be equal to the weight of the doll so that when six

cards are placed in the plastic bag, the doll and the bag are on the same level.• Do a thorough rehearsal before the actual exercise.• Initiate discussion when each card is being read and put in the bag.• Emphasisethecommunitydialoguetoolwhenwrappingupthesession.


SESSION 6 UNDERSTANDING TEAMWORK

SESSION OUTCOMES

At the end of the session, participants will get a good understanding of:• How teams should work.• What the role of each member of the team is.• Whattypeofleadershipthatwouldbringaboutthebestresults.

MATERIALS REQUIRED

• 12 pieces of the broken square• Thekey(guide)tothebrokensquare• Black board and chalk or chart paper and sketch pens

METHODOLOGY

Thebrokensquareexercisefollowedbydiscussion.

PROCESS

1. Telltheparticipants,“Oursessionnowwillbeonteamwork,whatateammeans,itscharacteristicsandtherolethatthemembersandtheleaderplay.”Askthemwhethertheybelongtoanyteam/s.Ifsomeoftheanswer“yes”,askthemwhichteamtheyaremembersofandwhotheothermembersoftheteamare.Askthemwhethertheyhaveworkedasmembersofateamandif“yes”,asktwoorthreeparticipantstosharetheirexperienceverybriefly.

2. Telltherearetwotypesofteams.Onewithinyourowndepartmentyouareapartofateamwhichcomprisesofyourcolleagues–peerlevel,juniors,andseniors.Theotherteamisoutsideyourdepartmentatthefieldlevelwhereyoucomeincontactwithpeople fromotherdepartmentsandshareacommongoal– likeANM, ASHA and AWW share a common goal of child health and development.

3. In Part A of this session, we will discuss the cross-functional teams. In Part B of this session we will discuss supportive supervision which helps in improving the intra-departmental teams’ performance.

PART A1. Nowaskforfivevolunteersandsendthemoutofthetrainingroom.Askforfive

more volunteers and send them also out of the training room.

2. Telltheotherparticipantsthatthefirstteamthatwentoutisthe‘PlanningTeam’andthesecondteamthe‘ImplementingTeam’.Showthemthesquare(key)asshown in the diagram. Also show them the 12 pieces that when put together will make the square.

3. Now leave the 12 pieces and the Guide on the table. The 12 pieces will be all mixed up and separate.

4. Address the participants inside the training room:

“You are the observers. Your task will be to observe how an individual behaves in both the planning as well as the implementing teams; also note the dynamics among the members as well as between the two teams. You will also observe different leadership styles as well as leadership transferring from one person to the other. Keep a note on each member and her/his behaviour.

14:45 to 15:30 (45 minutes)


At the end of the exercise you will have to share your observations with all theparticipants.

Keep your eyes and ears open; you will have a lot of fun”.

5. Call in Team #1 and tell them the following:“You are the Planning Team and you have an Implementing Team that will carry out the task of making a square under your instructions. Your task is to direct your implementing team to make a square by putting together the 12 pieces kept on the table. You will be given 5 minutes to look at the separate pieces of the square and plan how they can be put together to make a perfect square. The Guide on how the square could be made is also on the table to help you. After five minutes, the Guide will be removed.

Kindlynotethatyouarenotallowedtotouchthepieces;youcanonly lookatthem and plan as a team how the square can be made.

After5minutes,yourImplementingTeamwillbecalledinandyouwillbegivenanother5minutestoinstructandadvisethemhowtheycanmakethesquare.Again,youarenotallowedtotouchthepieceswhileinstructingyourimplementingteam. Your job is complete at the end of 5 minutes.

Your success is when your implementing team completes the square.

6. Now give the Planning Team 5 minutes to plan making the square. After 5 minutes tell them to stop and call in the Implementing Team.

7. Address the Implementing Team members:“A square has been broken into pieces. You have to put these pieces together to complete the square. You have a Planning Team that knows how this can be done and they have been given 5 minutes to give you instructions to complete the task. During these 5 minutes you are not allowed to touch the pieces. Once the Planning Team completes the instructions you will be given 10 minutes to make the square. You will not be allowed to consult any members of the Planning Team while you are making the square.

Your success in completing the square will also be the success of your planning team.

Guide to making the Square The 12 pieces that make the Square


8. AskthePlanningTeamtostartbriefingtheImplementingTeamonhowtomakethesquareusingthe12pieces.Remembertoputawaytheguide.Alsoremindthemthattheyarenotallowedtotouchthepieces.Givethem5minutestodothis.

9. At the end of 5 minutes tell the Planning Team members that their job is over and that theyshouldmoveoutleavingtheImplementingTeammemberstomakethesquare.

10. Give the Implementing Team 10 minutes to make the square. After 10 minutes ask themtostopwork.Inmostcasestheywouldnothavebeenabletocompletethetask.

11. Ask all the participants to go back to their respective seats.

12. Ask the Planning Team members the following questions:• DidyourImplementingTeamsucceedinmakingthesquare?• Areyouhappywiththeoutcome?• Whydidtheyfail?Whatwastheproblem?• WereyouabletoinstructtheImplementingTeamhowtomakethesquare?• Didyouplanwell?

Givetheteammemberssufficienttimetoreflectandrespond.

Now ask the Implementing Team members the following questions:

• Didyousucceedinaccomplishingyourtask?• Whydidyoufail?• What was the problem?• DidyourPlanningTeamgiveyoutherightinstructions?• Howwastheco-ordinationamongyourteammembers?

Givetheteammemberssufficienttimetoreflectandrespond.

13. Now ask the other participants the following questions:• WhydidtheImplementationTeamfailinitstask?• Did the Planning Team do its job well?• Whatdoyouthinkwentwrong?• Whatwerethedynamicsamongthemembersofboththeteamsandbetween

the teams?• Whoweretheleadersinthetwoteams?Whatwastheirstyleofleadership?• Were there members who were dominating? Were there members who were passive?

14. Generateagooddiscussionaroundthesequestionsandgivesufficienttimeforthe participants to respond.

15. Then ask whether the members worked as a team? What are the important characteristics of a team?

16. Bring out the following characteristics of a good team:Everygoodteamwillhave• Clear goals that all members share and aspire to achieve.• Adetailedplanwheretasksandresponsibilitiesareclearlyspeltout.• A maximum of about 15 members to be effective.• Strong bonding between members with mutual respect and appreciation. • Acodeofconductwithsomerulesandregulationsthatallmembersabideby.• Aleaderwhoisdemocraticandsensitiveandrespectedbymembers.


CONCLUSION PART A

Conclude thediscussionby saying, “Weareallmembersof teams– theASHA,theAWWandhelperand theANMarea team.The teamcouldbeexpandedbyincluding SHG leaders, Panchayat members, Gram Sevaks etc., depending on the tasks to be accomplished. Only when allmembers work as a teamwill weachieveresults.Everyoneshouldhavethesamegoalsandsharethesamevisionand values. Each one should play his/her role well since these roles are inter-dependent. If one member does not perform well, the team does not perform well. Thisissomethingthatallofusshouldrememberalways.

We have many challenges in the field, the greatest being creating awarenessamong families and communities and motivating them to make the right choices/decisions. Only as a team can we succeed. It is important that we strive to create a strong team at the village level consisting of the ASHA, the AWW, the helper, women and youth representatives as well as the Sarpanch and other elected representatives. Each member should have a clear understanding of the goal that needs to be achieved and the work should be delegated so that the team becomes effective and result oriented. We will see how such a team can work effectively in the next session where we will discuss the planning and organisation of the Village Health and Nutrition Day (VHND).

PART BAsk these question to the participants:

Howdoyouwantyoursupervisortobehave?Listfivegoodthingsandfivethingsthatyoudon’tlikeinyoursupervisor.Generateagooddiscussion.

Askthequestion:Whatdoyouthinkyoursubordinateswouldsayaboutyou?Doyouthinktheywillrepeatsomeofwhatyouhavesaid?Generateadiscussion.

Then display the following chart and explain the points linking it with theirobservations.

Supportive supervision is a collaborative effort between the supervisor and the healthfunctionarytohelpthehealthfunctionaryimprovehis/herperformanceandconfidence.

• The Supervisor observes the health functionary’s communication work withmothers/caregivers, and provides constructive feedback.

• TheSupervisorshouldlistentostaffandcommunity.• She/he should be able to empathise with others.• She/he should provide continuous feedback to the staff.• She/he should help each one achieve her/his targets.• She/heshouldreviewstaffperformancesperiodicallyandoffersupportformid-

course correction.

CONCLUSION PART B

Supportive Supervision is different from traditional supervision. Traditional supervision involves more aspects of inspection and control, with a focus on ensuring adherence to policies and procedures. Supportive Supervision involves jointproblem-solving to identifyareasofstrengthandaddressesanydifficulties

TEA BREAK15:30 to 15:45 (15 minutes)


SESSION OUTCOME

At the end of the session, the participants will be able to:• PlanaVillageHealthandNutritionDay(VHND),thedifferentactivitiesthatneed

to be carried out and the responsibilities of different functionaries.• Understand the need to have the Village Health and Nutrition Committee

meetings to review and plan activities for the coming months.

MATERIALS REQUIRED

• Thefilm ASHA, Ek Din Zindagi Ki (VHND)• Laptop or TV and LCD projector• Blackboard and chalk or chart paper and sketch pens

METHODOLOGY

Viewingofthefilmanddiscussions.

PROCESS

1. TelltheparticipantsthattheywillseehowagoodVHNDcanbeorganised.Askthemtowatchthefilmcarefully.

2. Familiarise yourselfwith thequestions thatare raisedduring thefilmatfixedintervalssothatyoucangeneratelivelyandusefuldiscussions.

3. Now start showing the film and stop after the first set of questions appear.Generate a discussion on the questions. Allow participants to share their thoughts. Keep the discussions to the point.

4. Oncethediscussionsareover,restartthefilm.Pauseagainwhenthenextsetofquestions appears. Generate a discussion as before.

5. Continuetheprocesstilltheendofthefilm.6. Once thediscussionon thefilm isoverask, “How isVHNDconducted inyour

villages? Do you follow what was seen in the film? What problems do youencounter?HowimportantishavingaSBCCsessiononVHND?Howdoyouplanfor it?”

7. Allowsufficienttimefortheparticipantstoreflectandrespond.


• ConcludebysayingtheVHNDisprobablythemostimportantdayforanyvillageanditisimportantthatweconductitinthebestwaypossible;theVillageHealth,Nutrition,WaterandSanitationCommitteeshouldberopedintosupporttheday.Frontline functionaries like the ASHA, AWW, helper, ANM etc. should work as a teamandclearlydefinetherolesasshowninthefilm.

• GettingallfamiliesandthecommunitytounderstandthatVHNDiscrucialforthehealthofchildrenandwomenisachallenge.Everychildandwomanshouldtakeadvantage of VHND.

• ItisalsoanimportantdaytoconductanSBCCsessioninaplannedwayusingagoodcommunitydialoguetool.Thesesessionsshouldbeplannedwellinadvanceandwomenshouldbeawareofthesessions.ItcouldbejointlyconductedbytheASHA, AWW and the ANM.

SESSION 7PLANNING AND ORGANISING A VILLAGE HEALTH AND NUTRITION DAY 15:45 to 16:45 (45 minutes)


SESSION 8CREATING A VILLAGE HEALTH PLAN AND DEVELOPING A VILLAGE SBCC PLAN

SESSION OUTCOME

At the end of the session, the participants will be able to:

• Understand the process of developing a village SBCC Plan.

MATERIALS REQUIRED

SBCC Plan templates (8-10) copies

METHODOLOGY

PowerPoint presentation and discussion.

PROCESS

1. TelltheparticipantsthattheywilllookattheprocessofcreatingavillageSBCCPlanthroughgroupwork.Whattheywillbedoingisjustanoverviewoftheprocess.Also inform them that the ASHAs, AWWs, ANMs and other functionaries who will beundergoingthe5-dayModulewillactuallydoeachstepoftheexercise.

2. FormsixgroupsandgiveonecopyofSBCCPlantemplatetoeachofthem.

3. Important: Make sure that you have read through this part of the 5-Day Module and prepare yourself for this presentation.

4. Now explain each column of the template.

5. Request the participants to make an ideal SBCC plan for their group. Give the 30 minutes to prepare this.


Concludebysayingthat:• A communication plan cannot be an event but a process, well planned over the

year.• One challenge is to create a supportive and enabling environment where

behaviour change is induced through social norms and the other challenge is to bring about the desired change in individuals and families.

• Communitydialogue toolsandgroupdiscussionsareeffective for creatinganenabling environment while IPC and counselling are good at the individual and familylevel.Variousaidscanbeusedtohelpincommunication.

• Social,printandelectronicmediacaneffectivelytransmitinformationandcreateawareness;thesealsoreinforcewhatisbeingdiscussedatthecommunityandfamilylevels.

• Aplanshouldlookatagoodmediamix,clearlydefineaudiencegroupsandlist

16:45 to 17:45 (60 minutes)


SESSION 9VALEDICTORY SESSION

PROCESS

• Informtheparticipantsthatday’ssessionshavecometoanendandthateachone of them is welcome to give his/her feedback and comments on the sessions as well as the SBCC module.

• List the points that emerge on the board or on a chart paper.• Conclude by saying that their support and understandingwould be critical in

rolling out such a module.

Thank all the participants for being present despite their busy schedules.

17:45 to 18:15 (30 minutes)


ANNEXURESANNEXURE I : Day1,Session2 – PowerPoint on Development

Paradigm and SBC Theories (given in the CD).

ANNEXURE II : Day1,Session3 – PowerPoint on TARANG SBC Communication Modules (given in the CD)

ANNEXURE III : Day1,Session4 – Thepictureofrailwaycompartment.

ANNEXURE IV : Day1,Session5 – PowerPoint of Shanta’s story (alsogiven in the CD).

ANNEXURE V : Day1,Session5 – PowerPoint of Behaviour Change Process and Roles (also given in the CD).

ANNEXURE VI : Day2,Session5 – SpecificationsforPulleyStand.

ANNEXURE VII : Day2,Session8 – SBCC Plan templates.

ANNEXURE VIII : Pre-PostFormat – SBCCTrainingforMid-levelManagers

"TELL ME, AND I WILL FORGET. SHOW ME, AND I MAY REMEMBER. INVOLVE ME, AND I WILL UNDERSTAND."

Chinese Proverb


Railwaycompartment

THE PICTURE OF A RAILWAY COMPARTMENT

ANNEXURE III Day 1 (Session 4)


SHANTA 'S STORY

Sumitra, the ASHA of village Rampur, was concerned that a few families in the village were not bringing their babies for immunisation. So she decided to visit them in their homes and explain the importance of immunisation to them and the need to get their children immunised.

OneofthehousesshevisitedwasthatofShanta,aladywitha6-month-oldbabywho had never been immunised. When Sumitra discussed the need to immunise herson,Shantasaidthatherfamilydidnotbelieveinimmunisationandthathermother-in-law and husband, Ramlal, would never allow her to immunise the child. Sumitra,inaveryfriendlyandcaringmanner,explainedtoShantawhyimmunisationwasimportantandaskedhertoattendtheVHNDthefollowingWednesdayalongwithherbaby.Shantapromisedtodiscussthiswithherfamily.

ANNEXURE IV Day 1 (Session 5)


OnVHND,SumitranotedthatShantahadnotbroughtherbabyforimmunisationand so, after the session, she took the AWW to Shanta’s house and was fortunate to meet both Ramlal and his mother. She explained to them too the need for immunisation.Aftermuchpersuasion,theyagreedtoimmunisethechild.

AstheANMwasstillinthevillagetheywereabletoadministerthefirstdosesofpolioandDPTaswellasBCG.Sumitrawasveryhappy.ShetoldShantaandherfamily thattheyshouldbringthebabyfortheseconddoseofvaccinesthenextVHND in the following month.


Aweek later,SumitravisitedShanta’shouse tofindouthow thebabywasandalsotoremindthemtobringthebabyfortheseconddose.Shanta’smother-in-law complained that the child was restless after immunisation and had fever all through the night. Sumitra explained that it was normal for some babies to get fever after immunisation and that there was no cause for concern. On the next VHND, Shanta did not come to the PHC.

Sumitra sent the AWW helper to Shanta’s house again, but she refused to come sinceherfamilywasagainstanyfurther immunisationsincethechildhadfevertheprevioustimeandtheyhadalsoheardthatitcouldcripplethechild.Thechild,thus,missedtheseconddose.Sumitrathendecidedthattheonlywaytoensurethat the child got immunised was to convince Ramlal. She spoke to the Sarpanch and also to two of Ramlal’s neighbours who were his friends.


Together theyhada longdiscussionwith the family informing themthatall thechildren in the village were being immunised and that there had been a marked reduction indiseases.Theyalsotoldthefamily that it is therightofeverychildtogetimmunisedandthatparentsshouldnotbeguiltyofnottakingcareofthehealth of the child.

Both Ramlal and his mother were convinced and even accompanied Shanta to the PHC where the child received the second dose of vaccines. Since then the parents have been very careful and have ensured that the child receives allvaccinations, includingagainstmeasles,andVitaminAprophylaxis.Shantanowactivelyadvocatesontheneedtogetbabiesimmunised.


THE BEHAVIOUR CHANGE PROCESS

ANNEXURE V Day 1 (Session 5)

1

2

3

45

6

7


Dropouts

Dropouts

Dropouts

Dropouts

Dropouts

Dropouts

Awareness

Desire

Knowledge Skill

Tries OutRepeats

Maintain

Sustain

An enabling environment consists of

• Supportive relatives and neighbours.• Functionaries and volunteers and other opinion leaders through their

sustained encouragement, through counselling and dialogue and provisionofqualityservices.

• The media through supportive messaging.


THE BEHAVIOUR CHANGE PROCESS AND THE FRONTLINE FUNCTIONARIES ROLE

1

2

3

45

6

7


Dropouts

Dropouts

Dropouts

Dropouts

Dropouts

DropoutsAwareness

Desire

Knowledge Skill

Tries OutRepeats

Maintain

Sustain

Discussbenefits and risks

Project, Request tobecomeyour

advocate

Provide skill and support

Motivate, Create supportive

environment





Motivate, Maintain

supportive environment, Handling of problems


Dimensions: 18 inch/1.5 feet height (to be placed on the table) and14"widthwheel-to-wheel

Material: Wooden (will be polished)

ANNEXURE VI Day 2 (Session 5)

SPECIFICATIONS OF PULLEY


VILLAGE SBCC PLAN

Steps• BeginswithanalysingtheVillageHealthMaptoassessthesituation.• Reference column 2 of Village Health & Nutrition Plan template.• Develop Village Health and Nutrition Plan.• Develop Village SBCC Plan.

SBCC PLAN TEMPLATES

ANNEXURE VII Day 2 (Session 8)


Vill

age

SB

CC

Pla

n

Area

s of

inte

r-ve

ntio

n So

cial

& b

ehav

iour

ch

ange

list

ed

Wha

t are

the

barr

iers

or

trig

gers

to b

ehav

-io

ur c

hang

e?

Who

is to

be

addr

esse

d?

Wha

t ap-

proa

ch

shou

ld I

use?

Wha

t too

ls

or m

ater

ials

sh

ould

I us

e?

Whe

n sh

ould

I d

evel

op th

e pl

an?

Who

will

hel

p m

e?

How

sh

ould

I fo

llow

up?

How

sho

uld

I m

onito

r the

ch

ange

?

Loca

tion

of

gove

rnm

ent

serv

ice

cent

re

Wom

ensafetyshould

beco

me

a so

cial

responsibilityatthe

villa

ge le

vel.

Loca

l nor

ms

on

wom

ensafety

Villageboys,

youngmen

and

wom

en

and

villa

ge

elde

rs

Gro

up d

iscu

s-si

ons

- mixe

d gr

oups

with

ad

oles

cent

s,

men

, wom

en,

elde

rs

Open

dis

cus-

sionsandstory

telli

ng (p

ick

a storyfromthe

new

spap

er)

Orga

nise

a

spec

ial s

es-

sion

Gram

pra

d-ha

n, lo

cal r

eli-

giou

s le

ader

s

Hav

e a

mee

ting

once

in 1

5 daysfor

next

two

mon

ths

Wal

k ar

ound

the

PHC

once

in 1

5 daystoverify

the

surv

eilla

nce

grou

ps; a

sk

wom

eniftheyfeel

safe

rH

ealth

car

e se

ekin

g be

-ha

viou

r

Preg

nant

wom

en

shou

ld b

e as

king

fo

r and

ava

iling

AN

C ch

eck-

ups.

Inac

cess

ible

are

a,

delays,Lowliteracy,

old

tradi

tion,

cus

-to

ms,

dis

cour

teou

s be

havi

our o

f fro

ntlin

e fu

nctio

narie

s

Mot

hers

, hu

sban

ds,

mot

her i

n la

w

Saas

bah

u sa

mm

elan

s;

pati-

patn

i sa

mm

elan

s;

join

t hom

e vi

sit w

ith

VHSC

mem

-be

r

Orga

nise

a

grou

p m

eetin

g w

ith th

e w

omen

of

that

com

mu-

nitytoknowthe

reas

ons

for n

ot

com

ing

for A

NC.

Immediately

afterfinding

that

ther

e ar

e pr

egna

nt

wom

en in

the

community

who

hav

e no

t co

me

for A

NC

A w

oman

fro

m s

ame

grou

p w

ho h

as

com

plet

ed a

ll AN

Cs a

nd c

an

be p

roje

cted

as

a ro

le

mod

el

Every

quar

ter

Obta

in d

ata

for

ANCs

; Hom

e vi

sits

Stat

us o

f: Pr

egna

nt

wom

en &

la

ctat

ing

mot

hers

Mot

her-i

n-la

w a

nd

otherfam

ilymem

bers

supporthealthycare

prac

tices

for p

regn

ant

and

lact

atin

g m

othe

rs

and

new

born

s

Lack

of a

war

enes

s on

dan

ger s

igns

, So

cial

Nor

ms

rela

ted

toearlybathing&

cleansingofbaby&

pre-

lact

eal f

eeds

Fam

ilies

and

m

othe

r in

law

Freq

uent

ho

me

visi

tsFl

ip b

ooks

, pos

t-ers,films

Quarterly,

also

cov

er

all p

regn

ant

wom

en fr

om

thei

r reg

istra

-tio

n on

war

ds

till A

NCs

AWW

/AN

MAt

the

time

of e

ach

ANC

Hom

e vi

sits

Adol

esce

nt

girls

Wom

eninfamilyand

front

line

func

tiona

ries

expl

ain

and

disc

uss

menstrualhygiene

behaviourw

ithyoung

girls

Lack

of a

war

enes

s,

soci

al ta

boo

resu

lt-in

g in

inhi

bitio

ns to

di

scus

s w

ith /

edu-

cate

girl

s

Adol

esce

nt

girls

, mot

hers

Coun

selli

ng

sess

ions

at

scho

ol, a

nd

Anga

nwad

i ce

ntre

Gro

up m

eetin

g w

ith m

othe

rs u

s-ingdoll-pulley

Monthlymeet-

ings

Gram

pra

dhan

(if

a w

oman

) or

Pra

dhan

's w

ife

Monthly

Incr

ease

d us

e of

cle

an c

loth

/sanitarynapkins

obse

rved

thro

ugh

hom

e vi

sits

Child

ren

un-

der 6

yea

rs

RI is

reco

gnis

ed a

s a

prev

entiv

e m

easu

re;

communityrecognises

the

impo

rtan

ce o

f pre

-ve

ntiv

e be

havi

our o

ver

cura

tive

med

icin

e

Lack

of a

war

enes

s,

Trad

ition

al n

egat

ive

valu

es, I

nacc

es-

sibl

e ar

ea, n

egat

ive

attit

ude

of s

ervi

ce

providers,lowpriority

tow

ard

heal

th.

Mot

hers

, hu

sban

ds,

mot

her i

n la

w

Soci

al

dial

ogue

; use

of

relig

ious

le

ader

s

Gro

up m

eetin

g w

ith m

othe

rs u

s-ingdoll-pulley

Monthlyplans

Loca

l rel

i-gi

ous

lead

ers,

sc

hool

teac

h-er

, mot

hers

of

child

ren

with

fu

ll im

mun

isa-

tion

cove

rage

Fort

nigh

t-ly,Ongoing

verification

of 'd

ue-

lists

'

Actu

al n

umbe

r of

imm

unis

atio

ns

done;verification

with

due

list


Vill

age

SB

CC

Pla

n

Area

s of

inte

r-ve

ntio

n So

cial

& b

ehav

iour

ch

ange

list

ed

Wha

t are

the

barr

iers

or

trig

gers

to b

ehav

-io

ur c

hang

e?

Who

is to

be

addr

esse

d?

Wha

t ap-

proa

ch

shou

ld I

use?

Wha

t too

ls

or m

ater

ials

sh

ould

I us

e?

Whe

n sh

ould

I d

evel

op th

e pl

an?

Who

will

hel

p m

e?

How

sh

ould

I fo

llow

up?

How

sho

uld

I m

onito

r the

ch

ange

?

VHN

D

Crea

te d

eman

d fo

r and

pa

rtic

ipat

ion

in V

HN

D.

VHN

D is

org

anis

ed a

s a

fest

ival

like

eve

ntFa

mili

es a

nd

care

give

rsCo

nver

genc

e of

all

depa

rt-

men

ts -

espe

-ciallyHealth

and

ICD

S

Wal

l pai

ntin

gs,

child

ren

' pra

b-ha

t phe

ris'

Two

wee

ks

beforeevery

VHND/RIday

MO

I/C,

ICD

S Su

perv

isor

s,

PRI &

VH

SC

Mem

bers

, lo

cal R

MPs

, Re

ligio

us le

ad-

ers

Ongo

ing

activ

-ity,weekly

follo

w u

p w

ith d

ue

list

Num

ber o

f per

-so

ns v

isiti

ng o

n VH

ND

, inc

reas

e in

the

num

ber o

f co

unse

lling

ses

-si

ons

on a

VH

ND

Wat

er &

san

i-ta

tion

Villa

ge w

ater

and

sa

nita

tion

com

mitt

ee

(VW

SC) s

houl

d be

em

-powered;com

munity

inte

rest

in w

ater

and

safetyofw

atersources

is in

crea

sed

Wat

er is

not

see

n as

a

limite

d re

sour

ce;

Pric

e of

wat

er is

not

ac

know

ledg

ed a

s pe

ople

get

it fr

ee;

awar

enes

s on

wat

er

clea

nlin

ess

is p

oor -

w

hat l

ooks

cle

an is

pe

rcei

ved

as c

lean

All c

omm

u-nitymem

bers

-mainlypar-

ents

; VW

SC

mem

bers

Gro

up

disc

ussi

ons

on s

ourc

es

of w

ater

co

ntam

ina-

tion,

pro

per

stor

age

of

wat

er, a

nd

recyclingof

kitc

hen

wat

er

into

kitc

hen

gard

en

Community

dial

ogue

tool

doll-pulley

Quarterly

Scho

ol c

hil-

dren

; wom

enD

urin

g ho

me

visi

ts; a

t th

e vi

llage

ha

ndpu

mp

/wel

l

Hom

e vi

sits

Envi

ronm

en-

tal s

anita

tion

& h

ygie

ne

Communitytakesthe

responsibilityofmak

-in

g th

e vi

llage

OD

F

Old

prac

tices

of O

D;

Health-specially

child

ren

heal

th a

nd

wom

ensafetycanbe

trigg

ers

Men

, Wom

en,

specially

youngwom

-en

; VW

SC

mem

bers

Gro

up d

iscu

s-si

ons;

vill

age

wal

ks th

roug

h OD

site

s in

gr

oup

Wal

l pai

ntin

gs,

grou

p m

eetin

gsQu

arterlyin

cons

ulta

tion

with

Pan

-chayat

Gram

Pra

dhan

Quarterly

Hom

e vi

sits

Any

othe

r is

sue

that

the

grou

p co

mes

up

with


Issu

e

Wh

at n

ee

ds

to b

e a

nal

yse

d

Layo

ut o

f the

vill

age

• Locationofthehouseholds,wheretheverypoor,thescheduledcastes,m

inoritieslive.

How

far t

he p

oor a

re fr

om th

e AW

C, th

e sc

hool

, VH

ND

site

, the

PanchayatBhavan

etc

Loca

tion

of g

over

nmen

t ser

vice

cen

tres

•

Aretheycentrallylocated?

• Doeseveryonehaveeasyaccess?

• Whobenefitsmostfromthelocation?

• W

ho a

re a

t a d

isad

vant

age?

Hea

lth c

are

seek

ing

beha

viou

r •

Whi

ch a

re th

e fa

mili

es th

at d

on’t

com

e fo

r ant

e-na

tal c

heck

up

and

imm

unis

atio

n of

bab

ies,

don

’t co

nsum

e IF

A ta

bs, a

void

gov

ernm

ent s

ervi

ces?

•

Wheredotheyliveinthevillage?Dotheybelongtothepooreranddiscriminatedsections?

• Whomdotheygotoforhealthcare?

VHN

D

• H

ow w

ell i

s th

e VH

ND

org

anis

ed?

• Doesthecommunitycooperateandsupporttheorganisationofthesession?

• Dofamiliescom

evoluntarilyorhavetheytobecalled?Dothefamiliesknowwhenthissessionistobeheld?

• Dotheyknowwhatservicesareoffered?

• H

ow d

ote

ANM

and

ASH

A an

d th

e fa

mili

es/m

othe

rs o

f new

born

s in

tera

ct?

Wat

er &

San

itatio

n •

Wha

t are

the

wat

er s

ourc

es?

• Whatisthequalityofw

ater?

• A

re th

e so

urce

s ch

lorin

ated

at r

egul

ar in

terv

als?

•

How

is w

ater

sto

red

in h

ouse

s? A

nd h

ow is

it h

andl

ed?

• Howmanyhouseshavetoilets?Howmanydefecateintheopen?

• D

o pe

ople

was

h th

eir h

ands

with

soa

p af

ter d

efec

atio

n an

d cl

eani

ng?

• W

here

do

child

ren

defe

cate

? •

Do

mot

hers

was

h th

eir h

ands

with

soa

p af

ter w

ashi

ng c

hild

ren?

• A

re th

ere

a la

rge

num

ber o

f dia

rrho

ea c

ases

?En

viro

nmen

tal S

anita

tion

& H

ygie

ne

• A

re th

e su

rroun

ding

s of

the

tube

wel

ls a

nd o

ther

wat

er s

ourc

es c

lean

? •

Do

scho

ols

and

the

AWC

have

wat

er a

nd to

ilet f

acili

ties?

• A

re th

ere

spac

es u

sed

for o

pen

defe

catio

n?

• H

ow h

arm

ful i

s th

at fo

r hea

lth?

• Dotheyhaveadrainagesystemorsoakpitstohandlewastewater?

• Arecattletiedveryclosetohousesorwithinhouses?

Any

othe

r iss

ue th

at th

e gr

oup

com

es u

p w

ith•

Ambulanceservice,emergencycareetc.

An

alys

ing

the

vill

age

he

alth

map

Villa

ge S

BCC

Plan


Vill

age

He

alth

& N

utr

itio

n P

lan

Are

as o

f in

terv

en

tio

n

Pro

ble

ms

ide

nti

fie

d in

o

rde

r o

f pri

ori

ty

Act

ion

s re

qu

ire

d

So

cial

ch

ang

e th

at s

ho

uld

hap

pe

n w

ith

in

com

mu

nit

ies

"B

eh

avio

ur

chan

ge

that

sh

ou

ld

hap

pe

n w

ith

in fa

mili

es

(W

hat

sh

ou

ld b

e th

e d

esi

red

be

hav

iou

r ch

ang

e

that

sh

ou

ld h

app

en

at t

he

ind

ivid

ual

, fam

ily a

nd

co

mm

un

ity

leve

l so

that

exp

ect

ed

ou

tco

me

s ar

e

ach

ieve

d?)

Loca

tion

of

gove

rnm

ent

heal

th s

ervi

ce

cent

re

PHCislocatedonalonely

patchmakingitdifficult

for t

he w

omen

Sinc

e PH

C ca

n no

t be

shift

ed, t

he

surro

undi

ngs

shou

ld

be m

ade

safe

r thr

ough

su

ppor

tive

envi

ronm

ent

Wom

ensafetyshouldbecom

easocial

responsibilityatthevillagelevel.

Villageboys/youngmen/wom

en

volu

ntee

r to

form

sur

veill

ance

gro

ups

arou

nd th

e PH

C

Hea

lth c

are

seek

ing

beha

viou

r

Wom

en fr

om a

par

ticul

ar

communityarenotcom

ing

for A

NC

Expl

ore

the

caus

esW

omen

sho

uld

be w

illin

g to

talk

abo

ut th

eir

rese

rvat

ions

. Org

anis

e a

grou

p m

eetin

g w

ith

thewom

enofthatcom

munitytoknowthe

reas

ons

for n

ot c

omin

g fo

r AN

C.

Theystartcom

ingforANCsandtake

100

IFA

tabl

ets

VHN

D

Peop

le n

eed

repe

ated

re

min

ders

to c

ome

for t

he

VHN

D

VHN

D s

houl

d be

pe

rcei

ved

as a

maj

or

heal

th e

vent

Invo

lve

mul

tiple

sta

keho

lder

s - P

RI m

embe

rs,

loca

l sch

ool t

each

ers,

ICD

S/H

ealth

, NG

Os to

pu

blic

ise

the

even

t.

Fam

ilies

com

e fo

r the

VH

ND

and

di

scus

s th

eir i

ssue

s w

ith A

NM

/AW

W

Stat

us o

f:

Preg

nant

w

omen

&

lact

atin

g m

othe

rs

Wom

en d

o no

t rec

ogni

se

dang

er s

igns

just

afte

r deliveryanditprevents

seek

ing

med

ical

car

e in

tim

e

Impr

oved

HBP

NC

Mother-in-lawandotherfamilymem

bersget

invo

lved

with

chi

ld's

hea

lthMother-in-lawandotherfamily

mem

bers

reco

gnis

e da

nger

sig

ns


Are

as o

f in

terv

en

tio

n

Pro

ble

ms

ide

nti

fie

d in

o

rde

r o

f pri

ori

ty

Act

ion

s re

qu

ire

d

So

cial

ch

ang

e th

at s

ho

uld

hap

pe

n w

ith

in

com

mu

nit

ies

"B

eh

avio

ur

chan

ge

that

sh

ou

ld

hap

pe

n w

ith

in fa

mili

es

(W

hat

sh

ou

ld b

e th

e d

esi

red

be

hav

iou

r ch

ang

e

that

sh

ou

ld h

app

en

at t

he

ind

ivid

ual

, fam

ily a

nd

co

mm

un

ity

leve

l so

that

exp

ect

ed

ou

tco

me

s ar

e

ach

ieve

d?)

Adol

esce

nt

girls

Men

stru

al h

ealth

is n

ot a

priority

Men

stru

al h

ealth

re

late

d is

sues

are

di

scus

sed

and

expl

aine

d to

the

girls

Villageelderlywom

endiscusstheissuewith

younggirls

Girl

s us

e a

clea

n su

n-dr

ied

clot

h/sanitarynapkin

Child

ren

unde

r 6

year

s

Not

all

child

ren

com

plet

e RI

and

chi

ldre

n dr

op-o

ut in

be

twee

n a

RI s

ched

ule

Identifybarriersand

faci

litat

ors

for c

ompl

ete

RI fo

r all

child

ren

RI is

reco

gnis

ed a

s a

prev

entiv

e m

easu

re;

communityrecognisestheimportanceof

prev

entiv

e m

edic

ine

over

cur

ativ

e m

edic

ine

ParentsgiveprioritytoRI

Wat

er &

Sa

nita

tion

Waterisnotstoredsafely

and

is w

aste

dW

ater

sto

rage

to

impr

ove

and

it sh

ould

be

chl

orin

ated

Villa

ge W

ater

and

San

itatio

n Co

mm

ittee

shouldbeem

powered;com

munityinterest

inwaterandsafetyofwatersourcesis

incr

ease

d

Sour

ces

of w

ater

are

saf

e an

d w

ater

is

usedjudiciously

Envi

ronm

enta

l Sa

nita

tion

&

Hyg

iene

Open

def

ecat

ion

exis

tsCo

nstru

ct to

ilets

at

hom

e an

d m

ake

exis

ting

toile

ts fu

nctio

nal

Communitytakestheresponsibilityofmaking

the

villa

ge O

DF

Fam

ilies

use

toile

t at h

ome;

chi

ld

faecesaredisposedsafelyand

properly

Any

othe

r is

sue

that

the

grou

p co

mes

up

with


Co

lum

n

Wh

at to

fill

up

Soci

al &

beh

avio

ur c

hang

e ne

eded

as

liste

d in

the

prev

ious

ses

sion

This

is ta

ken

from

the

grou

p w

ork

done

in th

e pr

evio

us s

essi

on.

List

it u

nder

eac

h ar

ea o

f int

erve

ntio

n.

Wha

t are

the

barr

iers

to

beha

viou

r cha

nge?

List

the

barr

iers

to b

ringi

ng a

bout

the

chan

ge (a

ttitu

des,

cus

tom

s, la

ck o

f aw

aren

ess

etc.

) Remem

bertheProblem

Analysisexercise.

Who

are

the

stak

ehol

ders

? Defineatw

hatlevel–individual,fam

ilyorcom

munity–youwishtobringaboutthechange.

In s

ome

case

s it

coul

d be

at a

ll th

ree

leve

ls, i

n so

me

it co

uld

be a

t tw

o le

vels

and

in s

ome,

just

one

. It

coul

d ev

en b

e a

few

indi

vidu

als

or a

few

fam

ilies

.

Wha

t app

roac

hes

shou

ld I

use?

Shou

ld it

be

IPC/

coun

selli

ng th

roug

h ho

me

visi

ts, o

r gro

up s

essi

ons?

Shoulditbeatthelevelofcom

munityleadersorshoulditbeatthecom

munitylevelusingmedia?

Insom

ecases,youmightdecidetousemultipleapproaches.

Wha

t too

ls o

r mat

eria

ls

shou

ld I

use?

ShouldIusecounselling,discussionsusingflipcharts,filmsorotherAVmaterialincludingthecommunitydialoguetools?

Agai

n, it

cou

ld a

gain

be

a m

ix o

f som

e of

the

abov

e.

Whe

n sh

ould

I de

velo

p th

e co

mm

unic

atio

n pl

an?

Shou

ld I

do it

whe

n th

e pr

oble

m o

ccur

s?

Shou

ld I

do it

at t

he c

hang

e of

sea

son?

Sh

ould

I do

it a

t the

VH

ND

or s

houl

d I o

rgan

ise

spec

ial s

essi

ons?

Howmanytim

esshouldIdoit,whatfrequencyshouldIfollow?

Who

will

hel

p m

e ?

ShouldItakethehelpofothercolleagues(ASH

A,AWW,ANMetc.),PRImem

bers,SHGleaders,youthvolunteersetc.?

Ifyouneedthem

thenyouhavetoplanthesessionwiththem

andeachofyourteammem

bersshouldhaveclearroles.

How

do

I fol

low

up?

HowfrequentlyshouldIfollowup?

Shou

ld I

do a

noth

er s

essi

on u

sing

ano

ther

tool

? W

hen

shou

ld I

cond

uct t

he fo

llow

-up

hom

e vi

sits

etc

.?

How

do

I mon

itor t

he

chan

ge?

Shou

ld it

be

thro

ugh

fam

ilies

acc

essi

ng s

ervi

ces,

com

mun

ities

brin

ging

abo

ut c

hang

es a

t the

vill

age

leve

l thr

ough

variousactivities,orbytrackingindividualsandfamilies?

Vill

age

SB

CC

Pla

n


Vill

age

SB

CC

Pla

n T

em

pla

te

Are

as o

f in

terv

en

tio

n

So

cial

&

be

hav

iou

r ch

ang

e

liste

d

Wh

at

are

the

b

arri

ers

to

be

hav

iou

r ch

ang

e?

Wh

at

are

the

tr

igg

ers

to

Wh

o is

to b

e

add

ress

ed

?W

hat

ap

pro

ach

sh

ou

ld I

use

?

Wh

at

too

ls o

r m

ate

rial

s sh

ou

ld i

use

?

Wh

en

sh

ou

ld i

de

velo

p

the

pla

n?

Wh

o w

ill

he

lp m

e?

Ho

w

sho

uld

i fo

llow

up

?

Ho

w

sho

uld

i m

on

ito

r th

e

chan

ge

?

Loca

tion

of

gove

rnm

ent

heal

th s

ervi

ce

cent

re

Hea

lth c

are

seek

ing

beha

viou

r

VHN

D

Stat

us o

f:•

Pre

gnan

t w

omen

&

lact

atin

g m

othe

rs•

Ado

lesc

ent

girls

• C

hild

ren

unde

r 6 y

ears

Wat

er &

Sa

nita

tion

Envi

ronm

enta

l Sa

nita

tion

&

Hyg

iene

Any

othe

r iss

ue

that

the

grou

p co

mes

up

with


PRE-POST FORMAT –SBCC TRAINING FOR MID-LEVEL MANAGERS

THE PICTURE OF A RAILWAY COMPARTMENTANNEXURE VIII

Pre-Test Post-Test

Participant’s Name: Date:

A.Describeyourroleinfield-levelSBCCinterventionsin3-4sentences.

B. If you agree with the statements given below, please mark Y, else N

1 There is not much difference between IEC and BCC Y N2 It is not possible to change the behaviour of a person Y N3 Generallyallfamiliesinthevillageareatthesamelevelof

understanding.Y N

4 All people have equal rights, therefore there is no need to provide specialprovisionsforagrouporcommunity

Y N

5 Process of communication becomes easier with the participation of all stakeholders

Y N

6 There are seven steps in the behaviour change process Y N7 VillageHealth&SanitationCommitteescanplayanimportantrolein

creating a supportive environment for behaviour changeY N

8 BCC approaches like counselling and IPC constitute a complete and comprehensive medium for effective communication at the village level

Y N

9 Asking questions can be counter-productive in ‘Muskurahat/GATHER’ - IPC

Y N

10 Nature has divided the tasks and roles between men and women. Y N11 Convergence of various services would create confusion at a VHND Y N12 Ifapersoninterpretsamessageinawrongway,itisthatperson’s

mistakeY N

13 There is a need to run special programmes for the disadvantaged sectionsofthesociety

Y N

14 Radio and TV are media through which we can reach all people and we can change their behaviour

Y N

15 Onlyapersonwithgoodcommandonlanguagecanbeagoodcommunicator

Y N

TheCDcontainssession-wisetrainingaids–Pictures, PowerPoint Presentations, Films.

For more copies contact:Communication for Development SectionUnited Nations Children's Fund73 Lodi Estate, New Delhi, IndiaE-mail: [email protected]: www.unicef.org www.unicefiec.org www.unicef.org/india/Telephone: +91-11-24690401

FOR MID-LEVEL MANAGERS - newconceptinfosys.net

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