SBCC Landscape Analysis   Tanzania’s readiness to accelerate  the implementation of the NationalNutrition Strategy using C...
Contents1. Landscape Objectives2. Salient Background  – NNS  – TFNC/WHO Landscape Analysis3. SBCC Landscape Assessment Pro...
Contents1. Landscape Objectives2. Salient Background  – NNS  – TFNC/WHO Landscape Analysis3. SBCC Landscape Assessment Pro...
1. Landscape Objectives1. Assess:  – Current status of Tanzania’s communication capacity    and efforts to address social ...
Contents1. Landscape Objectives2. Salient Background  – NNS  – TFNC/WHO Landscape Analysis3. SBCC Landscape Assessment Pro...
2. Salient BackgroundThe National Nutrition picture:• Stunting rates indicative of chronic under-nutrition  are high (42% ...
The National Nutrition StrategyNNS Priority Areas1. Infant and young child feeding2. Vitamin and mineral deficiencies3. Ma...
The National Nutrition StrategyNNS Strategies1. Accessing quality nutrition services2. Advocacy and behaviour change commu...
The National Nutrition StrategyOther NNS sub-strategies include important actions forSBCC:• Develop and implement a social...
The National Nutrition StrategyGuidance on SBCC• Focus on action: “Enhance behaviours, customs and traditions of men, wome...
The National Nutrition StrategyGuidance on SBCC cont’d:• Be guided by a BCC strategy, which is informed by formative resea...
The National Nutrition StrategyNNS Strategy 2.1: Behaviour change communicationSTRATEGIC OBJECTIVE        EXPECTED RESULT ...
The National Nutrition StrategyNNS Strategy 5.2: Technical capacity for nutrition      STRATEGIC                      EXPE...
TFNC/WHO Landscape AnalysisFindings relevant to the task of SBCC:• Commitment to accelerate action   – Problem of stunting...
TFNC/WHO Landscape AnalysisFindings relevant to the task of SBCC:• Capacity to accelerate action   – Human resources: nutr...
Therefore…1. Recognition that poor nutrition situation is not a supply or   health services problem only; changed attitude...
Therefore…3. All assessments combined show a need for a robust SBC   Communication program that:     – builds multi-sector...
Contents1. Landscape Objectives2. Salient Background  – NNS  – TFNC/WHO Landscape Analysis3. SBCC Landscape Assessment Pro...
3. SBCC Landscape Assessment Process1. Review of SBCC literature, materials, program evaluations,   lessons learned and be...
3. SBCC Landscape Assessment Process                                                           (continued)    5. Rapid ass...
Contents1. Landscape Objectives2. Salient Background  – NNS  – TFNC/WHO Landscape Analysis3. SBCC Landscape Assessment Pro...
4. Assessment FindingsAssessment findings are presented in three parts:                      Nutrition Communication      ...
Nutrition  Communication                          Institutional SBCC                         communication     climate    ...
TFNC:                Funds for nutrition      2010 SUN                               Established in       programming decr...
Nutrition    Communication                                         Institutional SBCC                               commun...
Nutrition     Communication                                     Institutional SBCC                              communicat...
Nutrition    Communication                          Institutional SBCC                        communication       climate ...
Nutrition    Communication                                  Institutional SBCC                            communication   ...
Nutrition Communication                                     Institutional SBCC                          communication    c...
Therefore, given the current communication                      climate…• TZ’s communication climate rich with lessons and...
NutritionCommunication                                    Institutional SBCC                        communication   climat...
Nutrition     Communication                                            Institutional SBCC                                 ...
Leaflets and Posters in Health Facilities                        Title in Kiswahili                            English Tra...
Nutrition     Communication                                Institutional SBCC                             communication   ...
Nutrition    Communication                                     Institutional SBCC                             communicatio...
Nutrition   Communication                                       Institutional SBCC                              communicat...
NutritionCommunication                                Institutional SBCC                      communication   climate     ...
Nutrition      Communication                                         Institutional SBCC                                 co...
Therefore, given the current status of nutrition          communications materials…1. While some existing materials meet t...
Nutrition  Communication                             Institutional SBCC                       communication     climate   ...
Nutrition  Communication                                      Institutional SBCC                            communication ...
Nutrition  Communication                                       Institutional SBCC                            communication...
Nutrition  Communication                               Institutional SBCC                         communication     climat...
Therefore, given the current institutional SBCC                    capacity…Actions necessary to strengthen Government and...
Contents1. Landscape Objectives2. Salient Background  – NNS  – TFNC/WHO Landscape Analysis3. SBCC Landscape Assessment Pro...
5. Conclusions: SBCC “Readiness”Q: What is the state of readiness of communication tosupport pro-nutrition social change a...
5. Conclusions: SBCC “Readiness” Tipping Pointsfor Pro-Nutrition                            Status                        ...
5. Conclusions: SBCC “Readiness” Tipping Pointsfor Pro-Nutrition                             Status                       ...
5. Conclusions: SBCC “Readiness” Tipping Points for    Pro-Nutrition                                 Status               ...
5. Conclusions: SBCC “Readiness”Tipping Points    for Pro-                                         Status                 ...
5. Conclusions: SBCC “Readiness”Tipping Points   for Pro-                                             Status              ...
5. Conclusions: SBCC “Readiness” Tipping Pointsfor Pro-Nutrition                                                      Stat...
Contents1. Landscape Objectives2. Salient Background  – NNS  – TFNC/WHO Landscape Analysis3. SBCC Landscape Assessment Pro...
6. Recommendations1. Develop a multi-year, multi-sectoral National SBCC   Nutrition Strategy to address nutrition behaviou...
6. Recommendations5. Forge alliances and partnerships with universities, creative   agencies, private sector, media, to en...
Annex A: Social Change Indicators for SBCC Nutrition1      INDICATOR                                                      ...
AcknowledgementsThe 2012 SBCC Landscape Analysis was conducted by the Mwanzo BoraNutrition Program and funded by the Unite...
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Tanzania SBCC Landscape Analysis 2012

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In support of the implementation of Tanzania's National Nutrition Strategy, the Mwanzo Bora Nutrition Program conducted an analysis of the Social and Behavior Change Communication (SBCC) Landscape for Nutrition. This presentation provides an overview of this work.

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Tanzania SBCC Landscape Analysis 2012

  1. 1. SBCC Landscape Analysis Tanzania’s readiness to accelerate the implementation of the NationalNutrition Strategy using Communication for Social and Behavior Change (SBCC) 2012
  2. 2. Contents1. Landscape Objectives2. Salient Background – NNS – TFNC/WHO Landscape Analysis3. SBCC Landscape Assessment Process4. Assessment Findings – Communication Climate – Nutrition Communication Materials – Institutional SBCC Capacity5. Conclusions: SBCC “Readiness”6. Recommendations 2
  3. 3. Contents1. Landscape Objectives2. Salient Background – NNS – TFNC/WHO Landscape Analysis3. SBCC Landscape Assessment Process4. Assessment Findings – Communication Climate – Nutrition Communication Materials – Institutional SBCC Capacity5. Conclusions: SBCC “Readiness”6. Recommendations 3
  4. 4. 1. Landscape Objectives1. Assess: – Current status of Tanzania’s communication capacity and efforts to address social and behavioral barriers to improve the nutrition status – The potential to meet the goals of the NNS for advocacy and communication given present status, including untapped opportunities – National capacity to develop, lead and implement a robust SBCC Nutrition program2. Make recommendations for the development of a National SBCC Nutrition Strategy 4
  5. 5. Contents1. Landscape Objectives2. Salient Background – NNS – TFNC/WHO Landscape Analysis3. SBCC Landscape Assessment Process4. Assessment Findings – Communication Climate – Nutrition Communication Materials – Institutional SBCC Capacity5. Conclusions: SBCC “Readiness”6. Recommendations 5
  6. 6. 2. Salient BackgroundThe National Nutrition picture:• Stunting rates indicative of chronic under-nutrition are high (42% of <5 years) and stagnant• Stunting rates are not always aligned with food insecurity: – high maize and rice producing areas also have high stunting rates• Anemia rates are 53% for pregnant women and 40% for women of reproductive age: indicative of supply and adherence problems:• Optimal nutrition practices not followed: – E.g.: no more than 30% of children in any age group are receiving minimal acceptable diets – E.g. only 4% of pregnant women take 90+ days of IFA 6
  7. 7. The National Nutrition StrategyNNS Priority Areas1. Infant and young child feeding2. Vitamin and mineral deficiencies3. Maternal and child malnutrition4. Nutrition and HIV and AIDS5. Children, women and households in difficult circumstances6. Diet-related non-communicable diseases.7. Household food security8. Nutrition surveillance, surveys and information management 7
  8. 8. The National Nutrition StrategyNNS Strategies1. Accessing quality nutrition services2. Advocacy and behaviour change communication3. Legislation for a supportive environment4. Mainstreaming nutrition into national and sectoral policies, plans and programs5. Institutional and technical capacity for nutrition6. Resource Allocation7. Research, monitoring and evaluation8. Coordination and partnerships 8
  9. 9. The National Nutrition StrategyOther NNS sub-strategies include important actions forSBCC:• Develop and implement a social marketing program for nutritious and fortified foods.• Nutrition incorporated into primary and secondary curricula.• Develop multi-level nutrition advocacy strategy.• National Food and Nutrition Policy.• Staffing and training with appropriate job aids. 9
  10. 10. The National Nutrition StrategyGuidance on SBCC• Focus on action: “Enhance behaviours, customs and traditions of men, women, caregivers, family and community members, and those who influence them- which impacts positively on nutrition.”• Cover the full range of nutrition issues, including: – Breastfeeding and complementary feeding – Dietary diversity – Hygiene and sanitation – Home care of illnesses, and utilization of health services• Ensure that programmes and projects use consistent community messages, tools and materials• Insert nutrition behaviour change counseling and support into all points of contacts between women, caregivers and service providers 10
  11. 11. The National Nutrition StrategyGuidance on SBCC cont’d:• Be guided by a BCC strategy, which is informed by formative research that establishes the key behaviour issues and the barriers to and facilitators of interventions to prevent malnutrition.• Focus not only on the primary target groups, such as women, but also on those who influence the primary target groups at all levels, including family members, employers and health service providers.• Utilize a broad range of channels, including individual and group counseling, informal gatherings at community level, formal sessions through health services, school curricula and mass media.• As individual and group counseling is one of the most effective channels, enhance the capacity of health service providers to counsel women, caregivers and family members on the changes in behaviour needed to prevent malnutrition. 11
  12. 12. The National Nutrition StrategyNNS Strategy 2.1: Behaviour change communicationSTRATEGIC OBJECTIVE EXPECTED RESULT INDICATORS MEANS OF VERIFICATIONSO 2.1: Enhance the Women, caregivers, Proportion of Surveynutrition behaviours family and community caregivers whoof women, caregivers, members practice practice minimumfamily and community behaviours that support set of keymembers, and those improved nutrition behaviours forwho influence them nutrition 12
  13. 13. The National Nutrition StrategyNNS Strategy 5.2: Technical capacity for nutrition STRATEGIC EXPECTED RESULT INDICATORS OBJECTIVESO 5.2: Improve the Pre-service curricula and training Proportion of trainingknowledge and materials for service providers includes institutions using up-to-dateskills of professional appropriate content on nutrition. curricula.and community- In-service training materials, guidelines, Proportion of service providersbased workers at all protocols and job aids are available that have relevant job aidslevels to giveadequate support in Pool of trainers in nutrition for training of Pool of trainers available fornutrition. service providers is developed. training of service providers and community-based workers in nutrition. Follow-up and supportive supervision of Proportion of service providers service providers and community-based and community-based workers workers is improved to sustain their who receive at one least knowledge and skills. supportive supervision contact following training. 13
  14. 14. TFNC/WHO Landscape AnalysisFindings relevant to the task of SBCC:• Commitment to accelerate action – Problem of stunting and micronutrient deficiency not well recognized or understood (lack of recognition that all children have potential to grow adequately) – Nutrition problem seen as one of food availability; not of caring practices or insufficient services – “Nutrition is nobody’s responsibility” – Policy link not made between nutrition and needs of vulnerable groups – Funding not meeting program needs – Programs/action not reaching areas of most nutritional need—scale-up is critical
  15. 15. TFNC/WHO Landscape AnalysisFindings relevant to the task of SBCC:• Capacity to accelerate action – Human resources: nutritionists and nutrition focal people in ministries and districts available for scale-up – Training inadequate: standards, harmonization, scale-up and post- training follow-up lacking – Although HWs report implementing more basic preventive nutrition measures than treatment, their knowledge is higher on treatment / HIVHWs lack confidence and skills to counsel caregivers appropriately – Overall lack of capacity and programming for reaching the community level
  16. 16. Therefore…1. Recognition that poor nutrition situation is not a supply or health services problem only; changed attitudes, practices and social norms are critical to good nutrition outcomes.2. NNS provides general guidance for SBCC Nutrition. 16
  17. 17. Therefore…3. All assessments combined show a need for a robust SBC Communication program that: – builds multi-sectoral commitment – mobilizes and strengthens the capacity of agencies & personnel at all levels in SBCC – blends the power of mass media, traditional media and Tanzanian oral tradition to scale-up pro-nutrition opinions, positive role models, and actions – harmonizes the focus on a core set of behaviors and “tipping points” for positive social change 17
  18. 18. Contents1. Landscape Objectives2. Salient Background – NNS – TFNC/WHO Landscape Analysis3. SBCC Landscape Assessment Process4. Assessment Findings – Communication Climate – Nutrition Communication Materials – Institutional SBCC Capacity5. Conclusions: SBCC “Readiness”6. Recommendations 18
  19. 19. 3. SBCC Landscape Assessment Process1. Review of SBCC literature, materials, program evaluations, lessons learned and best practices from other health sector areas in Tanzania and globally2. Review of available nutrition education/IEC/BCC materials in MBNP regions and among stakeholder organizations at national level3. Inventory of cultural resources in MBNP regions4. Review of evidence base, efficiencies and potential for new technologies to support behavior change communication to expand reach and scale 19
  20. 20. 3. SBCC Landscape Assessment Process (continued) 5. Rapid assessment of social change climate based on 10 “tipping points1” or indicators of social change, included: • SBCC/Nutrition institutional capacity assessments of TFNC and COUNSENUTH • Review of TFNC/WHO Nutrition Landscape Analysis findings • Interviews with key informants at different levels, across multiple sectors and from government and NGO sectors • Participant-observation during work sessions and meetings with nutrition stakeholders and stakeholders in other health sector areas (RH/FP, malaria, HIV/AIDS)1The “10 Tipping Points for Pro-Nutrition Social Change Framework” (Clemmons, L; MBNP 2012) is adapted from theories and ideas originating inThe Tipping Point: How Little Things Can Make a Big Difference by Malcolm Gladwell, 2000; and from Womens Funding Networks Making theCase™ Framework for 5 Indicators for Social Change. 20
  21. 21. Contents1. Landscape Objectives2. Salient Background – NNS – TFNC/WHO Landscape Analysis3. SBCC Landscape Assessment Process4. Assessment Findings – Communication Climate – Nutrition Communication Materials – Institutional SBCC Capacity5. Conclusions: SBCC “Readiness”6. Recommendations 21
  22. 22. 4. Assessment FindingsAssessment findings are presented in three parts: Nutrition Communication Institutional SBCC communication climate capacity materials 22
  23. 23. Nutrition Communication Institutional SBCC communication climate capacity materialsHistory of Nutrition Communication• Tanzania has a rich history of nutrition education - Fugelsang, etc.• Integrated programming – 70’s & 80’s recognized as a productive time for community nutrition, although nutrition education not emphasis• Over past 2 decades, nutrition education/BCC languished, efforts were directed to more one-off/single topics: – HIV and nutrition – Breastfeeding• Improvement in nutrition-related practices is recognized as a stubborn problem 23
  24. 24. TFNC: Funds for nutrition 2010 SUN Established in programming decrease movement; 1974 and leads as Family Planning, RH Renewed state of the art and HIV/AIDS programs donor interest in Nutrition IEC receive bulk of donor and fundingTransitions in Communication funds for nutritionState-of-the Art in Tanzania Nutrition HIV/AIDS, RH/FP, Malaria 24
  25. 25. Nutrition Communication Institutional SBCC communication climate capacity materialsMass media• Radio: pervasive; long-running soap operas for HIV/AIDS and FP, nutrition programs; programs for farmers• Television: TV spots for Safe Motherhood as part of the Wazazi Nipendeni Campaign, TV drama serial for FP• Film and video: booming informal sector industry (“Swahiliwood”) – ~10 films made in Dar every week – Over 10,000 video bandas (informal video halls) country-wide in Tanzania; video bandas average 62 customers a day- usually young people and men – Informal sector now producing enter-educate films for malaria 25
  26. 26. Nutrition Communication Institutional SBCC communication climate capacity materialsTelecoms/Cell phones• m-Banking, m-PESA money transfer, purchases, iPhones to watch TV, films, access Internet• Successful SBCC initiatives with new technologies: • MOHSW Tanzania m-Health Partnership and Wazazi Nipendeni National SM Campaign • Radio linked with SMS and IVR (Farm Radio programs)Private sector• Rapid expansion of creative agencies, advertising and marketing firms• Growth of Corporate Social Responsibility 26
  27. 27. Nutrition Communication Institutional SBCC communication climate capacity materialsOther health sectors, primarilyRH/FP, HIV/AIDS and malaria:• Have materials and strategies designed for men• Promote couple communication and positive gender norms• Use wide variety of media and materials; experiment with new technologies• Include advocacy awareness-raising materials for Tanzanian opinion leaders, including religious leaders 27
  28. 28. Nutrition Communication Institutional SBCC communication climate capacity materialsInventory of Cultural Resources forCommunication:• Religious gatherings, elders’ and their groups, and traditional birth attendants• Other venues: – girls’ initiation ceremonies (unyago) – harvest celebrations – celebration @ 40 days after birth (arobaini) – men’s gatherings, such as fishermen (magenge ya wavuvi), sporting events, pubs, coffee and tea houses, bao and draft games – circumcision rites – women’s gatherings: hair plaiting, ufinyanzi / ceramics, kitchen parties 28
  29. 29. Nutrition Communication Institutional SBCC communication climate capacity materialsInventory of Cultural Resources for Communication:• Other media or symbols: – traditional songs and poems – drums, music, dance (ngomas and ngonjera) – traditional clothing (mgolole, khanga) – gourd (vibuyu) – mats and wooden cook spoons – beads – writing on house walls – caps (balaghashia) – khangas 29
  30. 30. Therefore, given the current communication climate…• TZ’s communication climate rich with lessons and best practices in behavior change communications, including the use of new communication strategies and technologies to rapidly expand reach and impact• Abundant cultural communication resources for nutrition, including Tanzanian society’s strong oral tradition• The time to recapture Tanzania’s former leadership in the state- of-the-art nutrition communication is NOW: – Time for a more robust, holistic, and dynamic approach to promote pro- nutrition behavior and social change– under the mandate from the NNS 30
  31. 31. NutritionCommunication Institutional SBCC communication climate capacity materials Strengths: • Factual print materials covering key topics exist: optimal breastfeeding, complementary feeding, dietary diversity, Vitamin A, and HIV/AIDS and nutrition • New materials available on micronutrient powders, blended flours, food fortification, and food processing • Materials target primarily mothers of young children, but also health workers, community health workers and volunteers • Radio scripts for live or pre-recorded nutrition education radio programs have been developed by TFNC and COUNSENUTH • Most or all materials are available in Kiswahili; some are also in English 31
  32. 32. Nutrition Communication Institutional SBCC communication climate capacity materialsGaps:• Limited IEC/BCC nutrition materials in health facilities, communities and households: – TFNC review (2011): 2/3 of facilities lacked IEC materials – MBNP review (3 regions-2012): approx. 80% of facilities had some IEC materials although these were limited in variety and numbers• Advocacy materials to promote a pro-nutrition environment absent for policy makers and public. 32
  33. 33. Leaflets and Posters in Health Facilities Title in Kiswahili English Translation 1 Lishe Wakati wa Ujauzito na Kunyonyesha Nutrition During Pregnancy and Breastfeeding 2 Ulishaji wa Mtoto Baada ya Miezi Sita Feeding a Child After Six Months/ Complementary Feeding after 6 Months 3 Jinsi ya Kumlisha Moto Maziwa Mabichi ya How to Feed your Baby Fresh Cow’s Milk Ngombe 4 Unyonyesahaji Bora Good Breastfeeding Practices 5 Jinsi ya Kunyonyesha Mtoto How to Breastfeed your Baby 6 Zuia Magonjwa na Vifo vya Watoto Wadogo Prevent Illnesses and Deaths among infants and young children 7 Afya Bora kwa Mtoto ni Msingi wa Maendeleo Good Child Health is a Basis for Development 8 Nyongeza ya Vitamin A kwa Watoto Vitamin A Supplementation to children Title in Kiswahili English Translation1 Jinsi ya Kunyonyesha Mtoto How To Breastfeed Your Child2 Ulishaji wa Mtoto Baada ya Miezi Sita Child Nutrition After Six Months3 Mahitaji ya Mama Mjamzito Needs of Pregnant Woman4 Jinsi ya Kunyonyesha How to Breast Feed5 Lishe wakati wa Ujauzito Nutrition During pregnancy6 Chanjo Moja Dhidi ya Magonjwa Sita One Vaccination Against Six Diseases7 Lishe Wakati Wa Ujauzito Na Nutrition During Pregnancy and Lactation Kunyonyesha8 Ulaji Bora Ni Muhimu Kwa Afya Yako Good Nutrition Is Important For Your Health 33
  34. 34. Nutrition Communication Institutional SBCC communication climate capacity materialsNutrition IEC Materials Available in Print Forms(Brochure, Poster, Flipchart/Cue Card) Title Brochure Poster Job Aid 1 How to Provide Fresh Cow’s x x Milk to your Child 2 How to Breastfeed your x x x Child 3 Child Nutrition after Six x x x months 4 Nutrition During Pregnancy x x and Breastfeeding 34
  35. 35. Nutrition Communication Institutional SBCC communication climate capacity materialsGaps:• The majority of materials use a written instruction- based format, require moderate-to-high levels of literacy• Few nutrition materials address behavioural barriers and motivators• Although many are attractive, most are devoid of emotional appeal• Very few maternal anemia materials exist (only 1 poster and 1 leaflet)• The programmatic use of cultural resources for nutrition communication (e.g. music, arts, dance, and drama) is nearly non-existent 35
  36. 36. Nutrition Communication Institutional SBCC communication climate capacity materialsSBCC analysis notes on complementary feeding leaflet:Strengths:• Attractive• Technically sound information• Clear instructions and illustrations• Clear audience: mothers with infantsGaps:• Not linked to audio; requires moderate literacy• Information relayed in print format• Limited emotional appeal• Not based on a behavioral analysis of key barriers to implementing behaviours; focuses primarily on knowledge• No accompany materials for key influencers (e.g. men, mothers-in-law)• No call to action 36
  37. 37. NutritionCommunication Institutional SBCC communication climate capacity materials Gaps: • Few nutrition materials are designed for men • Few nutrition materials are designed for farmers, or integrate maternal and child nutrition issues into agricultural activities in a way that addresses the needs and interests of farmers • Radio broadcasts of nutrition topics are primarily educational, with limited diversity in style or format, and little interactive programming 37
  38. 38. Nutrition Communication Institutional SBCC communication climate capacity materialsGaps:• No nutrition materials address social norms or promote pro-nutrition social change, particularly positive gender norms: – increased dialogue and joint decision-making among couples – increased spousal support for the role of men as husbands, partners and fathers – grandmothers as influential advisors and supporters – women’s increased empowerment to participate in decision-making and dialogue• Only one nutrition campaign to date has used mobile phone technologies to promote behaviors (Maziwa Campaign; TFNC/MBNP August 2012). 38
  39. 39. Therefore, given the current status of nutrition communications materials…1. While some existing materials meet the need of the NNS mandate, there are few that address the broad social and behavior change vision of the NNS; few materials in use now will close the KAP gap.2. Materials do not address behavioural barriers or resistances nor emotional motivations.3. Disproportionate reliance on print materials in a society with a strong oral tradition and culture.4. New communication technologies and traditional media remain untapped. 39
  40. 40. Nutrition Communication Institutional SBCC communication climate capacity materialsStrengths of the current SBCC capacity of Governmentand NGOs:• Staff comprised of experienced nutrition scientists and other professionals who are key players in the Tanzania nutrition community.• Well connected and respected by nutrition stakeholders: positioned to influence implementation of NNS.• Recognition of the importance of developing staff expertise in state-of-the-art SBCC processes and programming insights; highly motivated staff.• Substantial experience in development and production of nutrition IEC materials in print, radio, film and television.
  41. 41. Nutrition Communication Institutional SBCC communication climate capacity materialsGaps in the current SBCC capacity of Government andNGOs:• Diminished donor funding• Limited exposure to or engagement in shifts leading up to today’s practice of SBCC; materials and activities are out of sync with today’s knowledge base and best practices in SBCC programming• Little to no prior exposure of staff to SBCC theory or practice; lack of training and mentoring to upgrade SBCC capacity• Respect for nutrition expertise; not SBCC expertise/experience• Current institutional mandates and structures not fully aligned with role of developing and managing a national SBCC nutrition strategy and programming• Lack of behavioural or social change indicators and methods to measure progress
  42. 42. Nutrition Communication Institutional SBCC communication climate capacity materialsGaps in the current SBCC capacity of Government andNGOs (continued):• Nutrition counseling not yet fully recognized as a priority professional area of expertise: – Not operationalized in current health systems and structures (e.g. work load, insufficient time with clients). – Training curriculum (workshops, seminars) more aligned to skills building in nutrition education, but not really nutrition counseling (HWs, CHWs). – Peer counseling/peer education for nutrition (e.g. through mothers’ or fathers’ support groups, CHWs, etc.) not yet fully developed or operationalized.
  43. 43. Nutrition Communication Institutional SBCC communication climate capacity materialsOther institutional resources:• Muhimbili University of Allied Health Sciences is initiating a social and behaviour change and communication course of study (graduate and professional development degrees)• Strong private sector capacity for communications – Creative agencies – Production agencies – Media and telecommunications – Marketing, warehousing and distribution companies
  44. 44. Therefore, given the current institutional SBCC capacity…Actions necessary to strengthen Government and NGOSBCC capacity include:• Developing and vetting a strategy for building SBCC capacity within government and among local NGOs• Updating institutional structure, mandates and core functions of technical departments and staff to better align with SBCC capacity development• Prioritizing SBCC training and mentoring using a learning-by- doing approach alongside formal coursework• Building alliances and partnerships with other institutions such as universities, creative agencies, private sector, media, etc.
  45. 45. Contents1. Landscape Objectives2. Salient Background – NNS – TFNC/WHO Landscape Analysis3. SBCC Landscape Assessment Process4. Assessment Findings – Communication Climate – Nutrition Communication Materials – Institutional SBCC Capacity5. Conclusions: SBCC “Readiness”6. Recommendations 45
  46. 46. 5. Conclusions: SBCC “Readiness”Q: What is the state of readiness of communication tosupport pro-nutrition social change and the specificbehavior shifts that will impact nutrition outcomes?A: Within the nutrition community, current readiness ispoor, but momentum and willingness is high and thebroader climate is good for SOTA SBCC/Nutritiondevelopment and implementation. The door is open, we must ensure that opportunities are not missed! 46
  47. 47. 5. Conclusions: SBCC “Readiness” Tipping Pointsfor Pro-Nutrition Status Readiness Social Change 11. Public • Low visibility in the public domainDefinition and • Public concept of nutrition is “food”Visibility of • Level of magnitude and consequences of childhood“Nutrition” stunting and maternal anemia not well recognized or understood; not drivers of action2. Nutrition • High level commitment to champion nutrition at PMOLeadership • Multi-Sectoral Coordination Structures established at national and local levels but not fully mobilized or operational; their SBCC mandate needs to be identified • TFNC identified as lead government agency for National Nutrition Strategy coordination and implementation; TFNC also has SBCC implementation mandate • Areas such as supply chain systems for nutrition commodities (IFA, Vit. A, de-worming, SP) not being sufficiently addressed; hampers behaviour change programming 47
  48. 48. 5. Conclusions: SBCC “Readiness” Tipping Pointsfor Pro-Nutrition Status Readiness Social Change13. Institutional • SBCC Nutrition capacity-strengthening needs assessedCapacity for for lead government and civil society institutions; roadSBCC Nutrition maps in placeprogramming --High capacity / expertise in nutrition subject matterand --Low-to-moderately-low SBCC Nutritionimplementation (communications) expertise: • SBCC Nutrition skill at implementation levels is weak; eg. counseling not yet fully recognized as a priority professional area of expertise; little experience using traditional media • Strong private sector institutions for capacity building and implementation • Guiding SOTA SBCC examples from other sectors 48
  49. 49. 5. Conclusions: SBCC “Readiness” Tipping Points for Pro-Nutrition Status Readiness Social Change14. Nutrition Policy • Nutrition Policy in placeand Strategy • National Nutrition Strategy and Implementation Plan in place; not yet operationalized through the 9 Line Ministries’ plans and strategies • NNS clearly defines mandate for and expectations of communication activities, especially related to achieving pro-nutrition practices5. Social • “Nutrition is nobody’s responsibility”Engagement • No sense of urgency or unity within society(Ownership) in • Private sector not mobilized to support nutritionNutrition • Other sectors (arts, culture, traditional, religious, media) not mobilized 49
  50. 50. 5. Conclusions: SBCC “Readiness”Tipping Points for Pro- Status Readiness NutritionSocial Change16. Pro- • Men’s supportive roles as husbands/fathers notNutrition galvanized; men not “engaged”Gender Norms • Women’s gender roles constrain self-efficacy necessary for adopting nutrition-related behaviors, including accessing nutrition information and services • Limited couple/family dialogue and joint decision- making about nutrition choices; allocation of resources7. Collective • No cohesive strategy or campaigns to mobilize societyActions/Social to focus on key behaviours or social normsmobilization • Local civil society structures not engaged to implementsupporting community nutrition activities, nor SBCC programmingNutrition • Limited guidance provided to help LGAs, CSOs and communities to plan, budget and implement meaningful collective actions to reduce malnutrition 50
  51. 51. 5. Conclusions: SBCC “Readiness”Tipping Points for Pro- Status ReadinessNutrition Social Change18. Resources • Nine Lead Ministries and their respective sectors haveMobilized for been mobilized, but advocacy to support budgeting poorNutrition • Government has mandated a budget line for nutrition, but not a minimum percentage • Donors have increased investments in nutrition through multiple global and national mechanisms • Resources for a robust national multi-year SBCC program lacking; will have to be raised • Human resources: nutritionists and nutrition focal people in ministries and districts available • Local civil society structures in place but not fully mobilized and resourced • Funding not meeting program needs, especially for nutrition commodities and scale-up 51
  52. 52. 5. Conclusions: SBCC “Readiness” Tipping Pointsfor Pro-Nutrition Status Readiness Social Change19. Diffusion of • More cell phones than adults: 26 million cell phoneInnovations & subscriptions in Tanzania; adult population is 24Technologies to millionSupport Pro- • Other health sector areas already using radio,Nutrition Social television, film, and mobile phone platforms andand Behavior technologies (e.g. MOHSW’s mHealth initiative)Change • Innovative approaches to promote social change (e.g. gender) exist in other health sector areas10. Maintaining • Vitamin A supplement supplies not as available in thePast Gains past; weaknesses in government systems for supply chain and disbursement of funds • Recapture community mobilization and collective action efforts for nutrition1 “10Tipping Points for Pro-Nutrition Social Change Framework” (Clemmons, L., MBNP 2012) is adapted from theories and ideas originating in TheTipping Point: How Little Things Can Make a Big Difference by Malcolm Gladwell, 2000; and from Womens Funding Networks Making the Case™Framework for 5 Indicators for Social Change. 52
  53. 53. Contents1. Landscape Objectives2. Salient Background – NNS – TFNC/WHO Landscape Analysis3. SBCC Landscape Assessment Process4. Assessment Findings – Communication Climate – Nutrition Communication Materials – Institutional SBCC Capacity5. Conclusions: SBCC “Readiness”6. Recommendations 53
  54. 54. 6. Recommendations1. Develop a multi-year, multi-sectoral National SBCC Nutrition Strategy to address nutrition behaviours and “tipping points” for pro-nutrition social change2. Update structures, mandates and core functions of technical departments and staff of lead government and civil society agencies to better align with state-of-the-art (needed) SBCC Nutrition program implementation3. Establish a high level SBCC Task Force / Communication Board that can support strategic decision-making and resource mobilization for the implementation of the National SBCC Nutrition Strategy 54
  55. 55. 6. Recommendations5. Forge alliances and partnerships with universities, creative agencies, private sector, media, to ensure reach, appeal and long term capacity development6. Prioritize SBCC Nutrition on-the-job training and mentoring using a learning-by-doing approach7. Establish an implementing partners group that will ensure harmonization of SBCC efforts, support SBCC monitoring and encourage innovation to overcome implementation bottle- necks8. Establish SBCC fora at the regional or district levels to ensure that approaches are relevant, understood and localized 55
  56. 56. Annex A: Social Change Indicators for SBCC Nutrition1 INDICATOR DEFINITIONS1. Shift in Definition and An issue or idea is given new meaning. Society sees the issue differently as a result of SBCC for nutrition. “Nutrition” , minimum acceptable diet and diet diversity, anemia, childhood stunting and other forms and consequences ofPerception malnutrition, are defined and perceived differently in the community or larger society.2. Shift in Leadership Opinion Leaders, Decision-makers and Policy-makers, including government, Parliament, civil society, private sector, religious leaders are participating in creating a Vision, supporting a Vision, setting direction, championing and motivating, and holding people, organizations and systems accountable for achieving the goals and objectives of the National Nutrition Strategy.3. Strengthened Individual staff have technical capacity to understand and apply SBCC-related theories and best practices, designInstitutional Capacity for evidence-based strategies, develop effective messages and materials, and manage, implement and evaluateSBCC Nutrition SBCC/Nutrition programs. Institutions have structures and systems aligned to support each major phase of SBCC programming.4. Shift in Engagement A greater number and a more diverse array of people, organizations and stakeholders in Tanzanian society are engaged in nutrition as a result of advocacy and SBCC. Ideally, enough people get involved that they are noticed, voices are heard, i.e.(Ownership) a critical mass is reached . More and more individuals and multi-sector stakeholders, including private sector buy into “Nutrition is MY Responsibility”.5. Shift in Gender Norms Men and women are behaving and interacting differently as they support pro-nutrition actions. New or enhanced gender roles supportive of nutrition are considered “normal”, appropriate, and positive in the community and wider society.6. Increase in Collective Community groups, peer support groups, social support networks, communities, neighborhoods act or work together for a common cause and collective action to support nutrition.Actions7. Shift in Policy An institutional, organizational, or legislative policy or practice has changed. Organizational, local, regional, state, national or international policy or practices have changed to better serve social change ideals (e.g. specific laws change and/or institutional systems change or practices change).8. Shift in Resources Greater resources (human, financial, logistical, etc.) are mobilized from a wider and more diverse array of sectors of society, including government, civil society, religious, entertainment, private, for-profit, etc.Mobilized9. Diffusion of Innovations New or improved technologies from different sectors (e.g. agriculture, water, livestock, telecommunications/ICT, etc.) are used to support pro-nutrition interventions, behaviors and social norms.& Technologies10. Maintaining Past Past gains have been maintained ; funding for nutrition is saved from budget cuts; gains made in addressing one nutrition priority, such as Vitamin A, are not sacrificed for other nutrition priorities such as maternalGains 56 anemia.
  57. 57. AcknowledgementsThe 2012 SBCC Landscape Analysis was conducted by the Mwanzo BoraNutrition Program and funded by the United States Agency for InternationalDevelopment with support from the American people.This report would not have been possible without the support andcollaboration of many institutions and individuals in sharing their informationand materials with us, including: the Ministry of Health and Social Welfare, TheTanzania Food and Nutrition Centre, Centre for Counselling, Nutrition andHealth Care (COUNSENUTH), Media for Development International, Feed theFuture/Tuboreshe Chakula program, Johns Hopkins University Center forCommunication Programs/Communication and Malaria Initiative (COMMIT)project, the EngenderHealth/CHAMPION Project, and the District teams inMorogoro, Manyara and Dodoma regions.The SBCC Landscape analysis was conducted by Lydia Clemmons, Tuzie Edwin,Peter Riwa, Lunna Kyungu, and Restituta Shirima. This report was compiled andwritten by Lydia Clemmons and Marcia Griffiths with support from Neha Shah. 57

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