BCC

G Vaidhegi,
PG-IIND Year Student
Department Of Community Medicine,
VMACON, Salem.
 OUTLINE OF PRESENTATION

INTRODUCTION.

HEALTH EDUCATION

BCC

ROLE OF BCC IN BEHAVIOR

REFERENCES
INTRODUCTION

 The 6th report on world health situation states that health has to
be attained &cannot be imposed.

 thus the 1st requirement for attainment of health is a

commitment by both people and the govt.

 Adequate education in general is essential for the development

of this commitment.
 HEALTH EDUCATION

 The declaration of Alma-Ata(1978) emphasized the

need for individual and community participation. The
dynamic definition is as follows:

“A process aimed at encouraging people to want to be

healthy , to know how to stay healthy , to do what
they can individually and collectively to maintain
health , and to seek help when needed”.
PRINCIPLES OF HEALTH EDUCATION

1. Community involvement in planning health

education is essential. Without community
involvement the chances of any programme
succeeding are slim.

2. The promotion of self esteem should be an integral

component of all health education programmes
PRINCIPLES OF HEALTH EDUCATION

3. Voluntarism is ethical principle on which all health

education program should be built. without it health
education programs become propaganda.

Health education should not seek to coerce but should

rather aim to facilitate informed choice.

4. Health education should respect cultural norms and

take account of the economic and environmental
constraints face by people. It should seek positively to
enhance respect for all.
PRINCIPLES OF HEALTH EDUCATION

5.Good human relations are of utmost importance in

learning.

6.Evaluation needs to be an integral part of health

education.

7.There should be a responsibility for the accuracy of

information and the appropriateness of methods used.

8.Every health campaign needs reinforcement. Repetition

of messages at intervals is useful.
BEHAVIOUR CHANGE
COMMUNICATION(BCC)

 Studies revealed that traditional IEC methods have

stopped giving information and creating awareness
but BCC is characterized by its direct approach
towards changing behavior.
Behavior Change Communication
Definition-1

 BCC is an interactive process with communities

(as integrated with an overall program) to develop
tailored messages and approaches using a
variety of communication channels to develop
positive behaviors; promote and sustain individual,
community and societal behavior change; and
maintain appropriate behaviors.
Behavior Change Communication
Definition-2

• Behavior change communication (BCC) is the

strategic use of communication to promote
positive health outcomes, based on proven
theories and models of behavior change.
• BCC employs a systematic process beginning
with formative research and behavior
analysis, followed by communication planning,
implementation, and monitoring and
evaluation.
• Audiences are carefully segmented, messages and
materials are pre-tested, and both mass media and
interpersonal channels are used to achieve defined
behavioral objectives.
Behavior Change Communication
Definition-3

 Behavior change objectives refer to intended

changes in the audience’s actual behavior.
 BCC must be……
•Research based
•Client centered
•Benefit oriented
•Service linked
•Professionally developed , and
• Linked to behavior change
 Why BCC?
15 The increasing area of interaction
Objectives of BCC
activities
 Major objectives for health are to enable people:
- To define their own problems and needs
- To understand what they can do about these
problems with their own resources combined with
outside support
- To decide on most appropriate action to promote
healthy living and community well being
 Principles of BCC
17
The Educational Spiral
Defining tasks and
educational
objectives

Planning an
Implementin evaluation system
g evaluation

Preparing and implementing

an educational programme
STEPS OF BCC
UNAWARE

INFORMED/AWARE

CONCERNED

KNOWLEDGEABLE
AND SKILLED
MOTIVATED TO
CHANGE
TRIAL CHANGE OF
NEW BEHAVIOUR
MAINTENANCE/
ADOPTION OF NEW
BEHAVIOUR
Informed/ Aware

 Initially a person is unaware that a particular

behavior may be harmful.
 The first step in a behavioural change programme is
therefore to make people aware through various
channels using mass media, group methods and
through interpersonal communication.
Concerned

 Information must be given in such a way that the

audience feel it applies to them.
 The audience becomes concerned and people are
motivated to evaluate their own behavior.
 Targeted communication and interpersonal
approaches are more useful.
Knowledge and Skill

 Once concerned individual may acquire more

knowledge and develop skill by talking to peers,
social worker and health care providers.
 More interpersonal communication needed at this
stage, specially training programmes to build and
develop skills.
Motivated and Ready to
Change
 Individual might now seriously begin to think about
need and importance of new health message and
measures.
 Positive message from peers are particularly
effective.
Trial change of Behaviour

 The individuals decide and try new health

behaviour.
 The result of any trial will be evaluated and if
satisfied than adoption takes place.
Behavior Change Communication
(BCC) for family planning
Flow chart about family planning: Stages of
Behavior change

Stage1:
 Aware: If most of the people are unaware about family planning,
then first of all we have to make awareness among people about
the family planning. We have to explain cause-effect of family
planning.

Stage 2:
 Motivation: Second steps is, we have to motivate them for
taking family planning. And then they will prepare for this.

Stage 3:
 Action: 3rd step is, we have to identify for them how to take an
action about this planning. Then they will start acting on this
family planning.
 Flow chart about family planning: Stages of
Behavior change contd.

Stage 4:
 Maintenance: After staring action many people leave this.
A suitable example for it is that about 62% is contraceptive
use rate in Bangladesh. But 46% of them don’t continue it.
So we have to show for them an effective way how to
maintain family planning program for long time with
benefits.

Stage 5: Final stage

 Termination: Finally, we have to make sure that they won’t
relapse their new practice about family planning.
Five steps of developing BCC
about family planning
 Step 1: Analysis
 Step 2: Strategic Design
 Step 3: Development and Testing
 Step 4: Implementation and Monitoring
 Step 5: Evaluation and Re-planning
Step 1: Analysis

Analysis helps program us to:

1. Identify the issues about family planning to be
addressed;
2. Understand the intended audience.

There are two components of analysis:

2. situation analysis
3. and audience analysis.
Step 1: Analysis contd.

 Situation analysis is gathering information about:

1. The issue (Increase CPR) of family planning
and its severity;
2. Factors that could promote(education) or
hinder change(religion).

 Audience analysis is gathering information about:

1. The knowledge, attitudes, skills, and behaviors
of intended audience; and
2. Communication channels in the area where we
plan to conduct our activity.
Step 2: Strategic Design

Step 2: Strategic Design helps us to:

1. Define our project's objectives;
2. Decide the most effective way to achieve them;
3. Create an implementation plan; and monitoring
and evaluation plan.

 To define our project's objectives, we should make

them SMART:
1. Specific;
2. Measurable;
3. Appropriate;
4. Realistic;
Step 2: Strategic Design contd.

 To prepare ourselves for making an implementation

plan, we need to decide the most effective way to
achieve our project's objectives. We should:
1. Select our approach to behavior change about family
planning;
2. State why and how we expect to affect change in our
intended audience; and
3. Select the partners and communication channels that
provide us the most effective access to our intended
audience, resulting, if possible, in both mobilizing the
community as a whole and reaching individuals
through interpersonal communication.
4. Once we have made these decisions, we can develop
an implementation plan with the following
characteristics outlining our strategy:
Step

3: Development and Testing
Before we are ready to launch our BCC
materials, we need to develop and test them.
This helps us confirm that our product motivates
our audience to change.

 To do so, we can conduct design workshops on

family planning, which:
1. Include key stakeholders, such as field workers, and members of our
intended audience;

2. Use participants input to determine whether our products meet our

audience's needs; and
Step 3: Development and Testing
contd.
3. Test our approach to the project and the
ideas we include in our products. After the
material is designed, we should pre-test it,
noting whether all information is:
a. Clear;
b. Easy to remember
c. Socially appropriate
d. and culturally appropriate

 Based on input from the workshop and pre-

test, we can revise and retest the products.
Step 4: Implementation and
Monitoring
Implementation involves:
1. Participation by all key participants to distribute the materials;

2. Flexibility and communication so that problems that arise can be quickly

solved;

3. Training so that all key players have the necessary skills for the project;
 Step 4: Implementation and
Monitoring
Monitoring contd.
is about:
1. Tracking existing statistics related to the targeted behavior;

2. Tracking outputs to ensure that materials are:

a. Utilized as planned; and
b. Have the desired effect;

3. Tracking the reaction of our intended audience to ensure that they are:
a. Motivated by the product; and
b. Change their behavior.
Step 5: Evaluation and Re-planning

Evaluation can:
1. Study whether the materials have assisted in
achieving the desired change in…..
a. knowledge,
b. attitude,
c. and behavior in the targeted
audience;

2. Identify the lessons learned:

a. Where our program is weak and needs
revision;
b. Where our program is strong and should be
replicated;
Step 5: Evaluation and Re-planning contd.

 We should widely distribute our evaluation results

throughout the community, so that everyone involved is
aware of the program's impact. our evaluation results
may indicate that we need to re-plan the design of our
materials.
Re-planning involves:
1. Returning to the analysis stage to properly
address the issues; and
2. Continuing through the five steps with our new
plan and
materials (strategic design, development and
testing,
implementation and monitoring, and evaluation
and re-
Role of BCC in
HIV/AIDS
Role of BCC in HIV/AIDS

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

 Promote essential attitude change : BCC can lead to

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

 Create a demand for information and services:

BCC can spur individuals and communities to
demand information on HIV/AIDS and appropriate
services.
 Reduce stigma and discrimination:
Communication about HIV prevention and AIDS
mitigation should address stigma and discrimination
and attempt to influence social responses to them .
Role of BCC in HIV/AIDS

 Promote services for prevention and care :

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

 BCC has its roots in behavior change theories

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

Presentation 2
BCC GOALS FOR HIV/AIDS

 Program goal: Reduce HIV prevalence among young people in

urban settings in country.
 Behavior change goals:
 Increase condom use
 Increase appropriate STI care-seeking
behavior
 Delay sexual debut
 Reduce number of partners
 Behavior change goals
 Increase perception of risk or change attitudes toward use of
condoms

 Increase demand for services

 Create demand for information on HIV and AIDS

 Behavior change
goals
 Create demand for appropriate STI services
 Interest policymakers in investing in youth-friendly
VCT services (services must be in place)
 Promote acceptance among communities of youth
sexuality and the value of reproductive health
services for youth (services must be in place)
Presentation 2
Role of BCC in RCH
Role of BCC in RCH
Role of BCC in RCH
 Multiple influences & influencers are needed to make BCC
strategies effective.
for eg: mothers-in-law are known to influence the birth spacing
behavior of newly married couples. She will also play a significant
role in pregnancy, delivery and infant nutrition, perhaps
discouraging immediate and exclusive breast feeding. So, they will
be an important target group for BCC for young mothers.
BCC in NHM
IEC-BCC STRATEGY IN HEALTH
CHALLENGES

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

 Political and physical environments. In some countries, geography

and populational diversity can complicate the development of BCC
programs. This is especially the case where vast distances must
be covered, or multiple languages and cultural traditions included,
in a single country program.
CHALLENGES
 Sustainability. To be effective, BCC strategies and components
must evolve constantly to meet the changing needs of target
populations. This requires the continuous input of human and
financial resources.
 Budgets.
 Linkages and coordination. For BCC to be effective, their
messages and information should be coordinated. Building and
maintaining linkages and coordination is an ongoing challenge.
 REFERENCES
 J . Kishore , national health programs of India, 12th
edition
 WHO TRS 690(1983).New Approaches to health
Education in
Primary Health care.
 http://www.hivpolicy.org/Library/HPP000533.pdf


http://en.wikipedia.org/wiki/Behavior_change_communic
ation
WHO, AFMC Text book of Public Health and
Community
Medicine
 Sunderlal , Adarsh , Pankaj ,Text book of community
medicine,
4th edition , chapter 2, P 3-48
THANK

YOU