ExecutiveSummary: Materials RH/FP

Assessment of RH/FP IEC/BCC materials/resources-By MH
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Consultancy: Assessment of RH/FP IEC/BCC
materials/resources_ July 18-Sep. 18 2017
Executive SUMMARY in 55 items
By May Haddad MD.MPH
mayhaddad2013@gmail.com
RHWG meeting Dec. 20 2017

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Introduction
This summary is extracted from the consultancy report: Assessment of RH/FP IEC/BCC
materials /resources that has been submitted earlier to UNFPA. The report, its’ eleven
attachments and 25 E-Guides have been posted on Google Drive (link is valid till the
end of Feb. 2018), and are included in the CD: Assessment of RH/FP IEC/BCC
materials/resources. It can also be shared electronically via e-mail or other digital
means.
In practice, this consultancy has been two folded:
A- On one hand, it entailed the creation of inventories based on the RH/FP materials
and resources that were identified during the consultancy and that address
communities through: Interviews; Electronic questionnaire (Reflect and Improve
survey); On-line search; Visiting offices; and Archives review.
Out-puts: The inventories in RH/FP are presented in 25 E-Guides that can be shared
digitally, printed out and/or posted on-line (Executive Summary: p. 4-9).
UNFPA and partners are encouraged to (1) Make the E-Guides available to producers
and users; (2) Plan for their amendments and updates; (3) Look into developing new E-
Guides in other areas in SRHR (such as GBV, Sexual Abuse, Child Marriage etc.); (4)
Activate the dormant previous inventories; (5) Integrate into skills enhancement efforts
to improve capacities in materials development in SRHR etc.

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B- On the other hand, it collected evidence towards guidelines in developing RH/FP
materials addressed to Syrian refugees based on the compilation/analysis of the E-
Guides; and through a consultative process that entailed Interviews, Electronic
questionnaire (Reflect and Improve surveys), Site visits (Delhamiyeh and Kayed Luz -
Bekaa, Shatila camp-Beirut and several stakeholders premises), Desk review and On-
line search, Discussions with three focus groups from Syrian refugees and one focus
group discussion with a mix of Syrian/Palestinian/Lebanese youth etc.
Outputs: Guidelines in developing RH/FP materials addressed to Syrian refugees in
Lebanon are listed in the second section of this summary (Executive Summary: p. 10-16).
To note that some of the materials that already exist and that have been compiled in this
consultancy can be used as is; other need modifications; and many can be used as a
reference in developing new/modified materials.
Decision makers/Producers are encouraged to: (1) Adopt/adapt these guidelines and
integrate them in their work; (2) Develop unified RH/FP messages, materials and
methods addressed to community members; (3) Engage partners in the process of
production of modified/new materials and resources in RH/FP; (4) Expand the process to
include other areas in SRHR; (5) Integrate findings into skills enhancement of
producers/users in using/developing materials and resources in SRHR.

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I. Best Utilization of the E-Guides (20 items)
Introducing the E-Guides

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1. The E-Guides: During this appraisal 25 E-Guides have been composed based on the findings that
were compiled during the two months consultancy. The E-Guides are introduced in pages 46-76 of
the final appraisal report; and are included in the CD Assessment of RH/FP IEC/BCC
materials/resources and posted on Google Drive links (note that the Google Drive links are valid till
the end of Feb. 2018). Additionally, 25 hints on using the E-Guides are reviewed in the appraisal
report (Main report: p. 79-83).
2. A Wealth of Productions: The E-Guides put in the hands of Producers from the Public Sector,
NGOs, UN system, Academia, etc. a wealth of materials in RH/FP that has been developed in
Lebanon, included are highlights from selected organizations experiences, and inventories of
materials by topics, by logos, by organization, previous inventories and compendiums, social media,
films and you-tube and on-line materials.
3. Themes: The E-Guides are organized under three themes: (1) E-Guides Inventories of
Publications in RH/FP (ten in number), (2) E-Guides Highlights from Organizations (eight in
number), and (3) E-Guides Variant Topics (seven in number).
4. An Introductory Generic Section specific to each of the three themes of the 25 E-Guides and a
reflective note have been integrated in each set of the three themes.

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It is Possible…
5. It is Possible: The E-Guides show that many aspects are possible such as: (1) Integrating simple
smart cost saving messages of doable actions that people can do by themselves (examples from
ANERA and partners, materials of the Creative Health Campaigns); (2) Success in coordination
among organizations as reflected in posting several logos on one material; (3) Creating a harmony
between messages/materials and methods (Let’s Talk Campaign); (4) Using spoken Arabic (Marsa
sexual health center’s materials); (5) Making available free download/ online materials (UNFPA,
UNHCR, MOPH, ARC, Abaad, Marsa etc.); (6) Developing simultaneously a print/online material
and video/You Tube in the same subject (Abaad and Marsa); (7) Developing materials for children
(Iron deficiency anemia games, breastfeeding story book); (8) Addressing LGBTQI (Mosaic and
Marsa materials) etc.
Nature of Materials
6. Nature of the Materials: They also reveal the nature of the available materials in RH/FP: (1) Many
tend to be instructional based on a medical model; (2) Minimal pretesting or engaging
users/community people in the process of production doesn’t seem to be the norm; (3) Most of
materials are made to address “normal” situation and not people living in crisis and difficulties; (4)
Some materials are repetitive in contents; (5) Some materials have been reprinted several times
without modifications and presented under different logos and funders without reference to the
original work; (6) Often there are confusion when many logos are presented as who is the
funder/sponsor, who is the implementer etc.; (7) Font used can be artistic but not necessarily
readable; (8) Excessive wordings have been noted in many of the materials; (9) Images used can be
inappropriate or misunderstood or few in numbers; (10) Design and colors can be cluttered with
poor layout that make the contents unreadable; (11) Information is not always accurate and/or
incomplete etc.
Among the Gaps
7. The E-Guides reveal gaps of different kinds, such as: (1) Gaps in the RH topics addressed (for
example lack of materials in the topic of Access, Management plans etc.); (2) Gaps in integrating
principles that stakeholders’ value included are the concept of Rights, Self –reliance etc.; (3) Gaps in
the availability of interactive materials and/or games; (4) Gaps in addressing men, mothers in law
and support people; (5) Gaps in providing credits and/or listing references/or dates/or related
Projects; (6) Gaps in the overall process of developing materials included are gaps in conceptualizing
and budgeting?1
, (7) Gaps in launching/ packaging/ dissemination/ utilization2
etc.
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On several situation, the development of the contents of the materials are done by desk officers
2
On several occasions field people get the materials through national trainings without the availability of a clear
packaging and /or dissemination plans

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Be Creative
8. A Call for Creativity: The effective use of materials is enhanced in the hands of creative
facilitators/educators/users. For examples of how to extract interactive materials/ activities from
reports and/or using posters/images as codes/discussion starters, review the E-Guide Highlights from
UNFPA p. 8-12 and p. 17-26. Similarly, many organizations’ web pages include reports, photos and
posters that can be inspirational in developing other materials and/or integrated into community
education in RH/FP. Several materials inspire creative use where they can easily be transformed into
cards, cutouts, interactive games etc. pending on the creativity of the health front-liners/community
health workers and/or community members themselves.
Other Inventories and Compendiums
9. Other Inventories/ Compendiums: The 25 E-Guides are the fourth inventory/compendium of its
kind that has been developed in Lebanon since 2006. The other three are reviewed in the E-Guide
Inventories and Compendiums (review main report: p. 75) remain useful to producers and users.
Efforts to ensure that people know about their presence and make them available are to be mobilized.
Printed Materials in RH/FP
10. Printed Materials: During this appraisal, a total of 244 printed materials have been identified
and compiled under ten themes to facilitate the utilization by producers and users who are exploring
the available materials in order to choose a useful material, build upon the experiences, avoid
duplications and/or starting from square one.
11. The Model: The E-Guides inventories of publications in RH/FP, build on the model of RH
materials posting in RHWG/HWG Google Drive and Refugee-Lebanon webpage (review E-Guide
On-line publications, p. 73).
12. Titles of the E-Guides inventories of publications in RH/FP are: (1) Family Planning; (2) Ante-
Natal Care ANC; (3) STIs/HIV/AIDS; (4) Cancer; (5) Child Care; (6) Home based records; (7)
Iron Deficiency Anemia; (8) Infant and Young Child Feeding Practices IYCFP; (9) Smart Use of
Medicines; (10) and Youth and RH (review main report: p. 51-63).
13. Form: 66 (37%) of the publication in RH/FP are posted in their PDF form and 178 (63%) in cover
photo form (review main report: p. 55-65).
14. 7.6 X Increase in Number: The number of publications in FP, ANC and STIs/HIV/AIDS that has

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been identified during this appraisal, has risen by 7.6 times, compared to the number the publications
listed on both HWG Google Drive and Refugees-Lebanon site prior to the appraisal (an increase
from 16 to 121 publications)/ Data retrieved on 12 9 2017 (review main report: p. 73-73).
15. The Logos of eighteen organizations stood out during this appraisal as key producers/publishers
of the materials in RH/FP that are posted in the 10 E-Guides (review also the E-Guide: Publications
by logos). They are (alphabetically): Abaad, Amel Association International, ARC, ANERA, IMC,
IOCC, LAECD, LFPADE, Marsa sexual health center, MSF, MOPH, MOSA, NAP, SIDC, UNFPA,
UNHCR, UNRWA, and UOB.
16. Sharing the E-Guides: Towards the end of the consultation, three E-Guides on Family Planning,
STIs/AIDS/HIV, Youth and RH were circulated to original publishers informing them of the
compilation and seeking their agreement to use their materials. Majority responded positively (while
very few did not respond).
Social Media
17. Social Media is reviewed in the E-Guide Social Media (p. 75) that includes: Samples of face book
pages and groups (UNFPA, Amel International, Marsa, Abaad, Peer Education Reproductive Health
-BAS, and Sob7ye Sa7aweye), Titles and description of several useful you tube films and videos that
have been reviewed during this consultancy (Publishers are: UNHCR, UNFPA, UN Web TV, Amel
International, SIDC, Abaad and Marsa sexual health center).
Users of the E-Guides
18. Producers who are looking for available materials/resources in RH/FP and/or interested in
developing new ones are encouraged to review the E-Guides of inventories of publications in
RH/FP. Users (educators/ trainers, health cadres/ activists) who are interested in specific topics
and/or developing an educational intervention may find the compilation useful to extract materials
and inspire ideas.
Applying a similar process to other topics in Sexual and Reproductive Health and Rights (including
GBV, Child Marriage, Sexuality, LGBT etc.) can also be considered.
19. Producers/users of materials/resources in RH/FP who are interested in reviewing the
achievements and innovations of selected organizations (Abaad, Amel Association International,
IMC, Marsa, MSF, UNFPA and UNRWA) that have been encountered during the appraisal (focus on
organization’s publications, social media, films, campaigns etc.) are encouraged to review the E-
Guides Highlights from Organizations.

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Other organizations are invited to construct a similar E-Guide as a tool to share about their
experiences and best practices.
20. Producers/users who are interested in reviewing selected aspects of: (1) Materials by logos, (2)
On-line publications, (3) Social media, (4) Inventories and compendiums, (5) Self help chapters, (6)
Let’s Talk Campaign and (7) Peer Education (BAS); will find interest in the contents of the E-Guides
Variant Titles.
Experiences other than Let’s Talk Campaign and Peer Education (BAS) can also be documented and
added…

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II. Developing RH/FP Materials
Addressed to Syrian Refugees (35 items)
The following are guidelines in developing RH/FP materials addressed to Syrian refugees based on
the findings from this appraisal (review also the following sections of the main appraisal report:
“Improved Standards”, p. 41-44, “Top 20 good practices” p. 84-85 and “Rethink” p. 87-92).
Unified Messages
1. Unified3
well-developed messages in RH/FP have the advantage of ensuring that the sound and
accurate messages addressed to Syrian refugees are constructed and made available. BCC messages
assume that they are based on an overall BCC/health communication strategy with measurable
behavioral objectives4
.
2. Such messages are protective against potential misconceptions that health coordinators and/or
health front-liners may propagate un-intentionally5
.
Food for thought: does unified messages imply unified materials and methods? Not necessarily. Different
stakeholders are to have flexibilities in customizing their own…
Via Electronics and Printouts
3. Seek the development of materials that can be used via both media: electronics and printouts.
Though some decision makers can be inclined to omit the printouts, there is no strong evidence
against using printouts (unless they are very poorly developed and not user friendly) and the evidence
3
The need for unified messages has been voiced during interviews, Reflect and Improve Survey and during the RHWG
meeting of July 2017
4
Decision makers in RH/FP in Lebanon are encouraged to state a BCC strategy with measurable objectives. The unified
messages would be elements of the strategy
5
Few incidents of misconceptions by health coordinators and front-liners were observed

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for using electronics (and that has been collated during the appraisal) is still sporadic6
(main report:
p. 45).
4. Develop the materials that can be shared via different channels: Printed matter, WhatsApp, Face
Book, Instagram, On-line etc.
5. Post the materials developed on-line and via partners’ electronic channels (Webpages/Facebook
/Blogs/You Tube etc.), making it accessible for view and download.
Food for thought: Should there be a new on-line site and related social media where materials are
posted? Should an interactive on-line mechanism be energized to accommodate the dynamism of the
process of materials development?
Values and Principles
6. Ensure that stakeholders’ values, particularly the concept of Rights, are reflected in the messages.
Only one out of 244 publications compiled in RH/FP was on rights (IOCC’s poster/flyer My right to
breastfeed).
7. Adopt messages that focus more on what people can do by themselves instead of instructions of
what they must do (following a “medical model”). Materials developed during the Creative Health
Campaigns 2006-2011 that have been energized by ANERA and partners (UNRWA, MAP-UK,
ARCPA/Al-JANA, Women Humanitarian Organization, Amel Association International and dozens
of community based organizations etc.) provide several examples.
Food for thought: The above two examples tackle the values of rights and self-reliance. What about
other values? (Review the E-Guide: Values, Principles and Mandates).
Smart Messages/ Out of Pocket Savings
8. Ensure that the messages are Smart, Scientific, Simple, and Doable-promoting actions that people
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Sporadic utilization of WhatsApp and tablets have been noted during the appraisal, included are IOCC experience in
developing pregnant women WhatsApp group and IMC introducing Samsung tablets for information control. Note:
MOPH i-message re vaccination, and UNHCR’s has e-communicated videos on injuries.

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can perform by themselves.
9. Highlight the messages about out of pocket savings (for example the savings of breastfeeding vs.
the cost of infant formula). High costs are of great concern as demonstrated during the consultant’s
focus group meetings with Syrian refugees (organized by Medair, Kayed Luz, 14 8 2017) and with
youth participating in the Janana summer encounter in Brumana (organized by Al-JANA/ Arab
Resource Center for Popular Arts, 28 8 2017). Additionally, findings from the “Reflect and Improve”
survey correlated an increase in RH services utilization with free services.
To Sustain…
10. Sustain the development of materials that communicate to beneficiaries where to get free or
sponsored RH/FP services7
, and how much they need to pay (if not free)/ build on UNHCR
experience. Sustain references to hot line and contact phone numbers8
.
11. Sustain and develop further appropriate messages in family spacing (such as “I decide to delay
pregnancy during these difficult times” or “It is my right to access family spacing methods”, “family
spacing protects us from the need for abortions” etc.), STIs (possibly use the analogy with a plant pot as
implemented by MSF in Bekaa) and other key ANC topics that are being addressed. Encourage the
integration of using audio-visuals (include using the family planning methods themselves) and 3D
demonstrations together with the messages/materials.
Food for thought: What else?
To Avoid…
12. Avoid messages and materials that pour all responsibilities on women themselves; as example
messages/materials that instruct women with STIs to treat themselves without addressing the need to
treat her partner; or those that specify family spacing to women without addressing husbands and/or
mothers in law; or those that make breastfeeding a sole responsibility of mothers without addressing
the support people and/or the aggressive role of marketing and promotion of mother milk substitutes
by the medical system etc.
13. Avoid printing huge numbers9
(in case of printed materials) and integrate the packaging,
7
Voiced by stakeholders, Syrian refugees and youth
8
Integrating hot-lines and phone contacts was among the key findings from the focus discussion with youth
9
As an example and unacceptable number of handouts and posters were printed in 2016 as follows: One MILLION & A
HALF COPIES of a breastfeeding promotional handout were printed for the national breastfeeding campaign in 2016
(source of information: interviews during the appraisal).

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dissemination and utilization of the materials into your plans of materials development.
Food for thought: What else?
Enhance Positive Role of Men…
14. Integrate the positive role of men in standing by their wives particularly in asking for family
planning. Anecdotes collected during the appraisal (interviews, focus group with Syrian men and
results from Reflect and Improve survey) are summarized on p. 90 of the main report.
15. Address men and mothers in law (who are key decision makers) in your productions as noted
during the appraisal.
“Access, Danger signs & Management plans”
Are among Top Priority Topics
16. Address the topics of Access to Reproductive Health Care services and Safe Birth particularly
that messages/materials are not developed yet (review priority topics, p. 32 of the main report).
17. Develop materials that help women (and her support people) learn to identify the Danger Signs
that may occur to them while pregnant, at delivery or postpartum, as well as the danger signs that
may affect their newborns, infants and children; and prepare a management plan. Women and their
support people must learn about signs of delivery ensuring that they have a management plan and act
accordingly.
Food for thought: Abortion? Home deliveries? Iron deficiency Anemia? Rational use of medicines? Etc.
Message + Material + Method
18. Think simultaneously Message, Material and Method: the triad of Message + Material + Method
are bonded. A weakness in one element weakens the other. As example, the impact of the best
message can be lost, if it is framed in a poorly designed material and/or delivered by a person who
does not show respects to people etc.
Food for thought: Money is a fourth “m”. Ensure that you budget for programming /development of
materials and resources in RH/FP. Don’t underestimate; and include costs in your planning process.

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Engage/Pretest/Participatory Process
19. Engage the active participation of community members and health front-liners/community
health workers in all stages of materials development: as you develop the messages, the materials and
the methods.
20. Pretest, Pretest and Pretest10
as you go along. Check for accuracy, clarity, attractiveness,
appropriateness, cultural acceptance, accuracy of contents, smart messages, emphasis on what people
can do by themselves, cost savings etc. and modify accordingly.
Build Partnerships-Actions
21. Use the process of materials development, as an opportunity to build partnerships-actions;
exchange and develop ideas towards best dissemination and utilization; enhance skills in materials
development; and build momentum towards improved practices.
22. Seek the development of materials that invite dialogue, creativity and different ways of utilization.
Visuals/Language/Style
23. Use visuals11
that people identify with. Photographs if acceptable, or realistic line drawings. Let
people dress in both rural and urban appearances (possibly develop more than one set addressing the
rural/tribal and the urban/contemporary ambiances).
24. Use Syrian and/or Lebanese dialects12
or both, use words and expressions that people identify with
more than the classical language or medical expressions.
25. Integrate proverbs, slogans, headlines, songs and music etc. that people appreciate and capture
their attention.
10
Little evidence that the materials developed so far is composed in partnership with communities themselves. Pretesting
is often translated as a limited FGD exercise when more or less the product is ready.
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Almost all parties consulted requested using more images
12
Success in integrating spoken Lebanese into Marsa sexual health center materials, Youth recommended using Syrian
dialects that will make the materials more acceptable to Syrian refugees

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26. Avoid many pieces of information in one material and focus on one important theme13
.
27. Choose a user-friendly and simple layout and design staying focused on what is most essential.
Our Reservations can be Unrealistic
28. Address your own reservations: People can make reservations that are not realistic. We need to
address our own reservations, and this is how we can make a breakthrough (dialogue with
Cecilia/LFPDE and Geneneve/MSF).
Trust People’s Wisdom
29. People know what is good for them. They take good care after the MCH booklets; pregnancy
cards and they value UNHCR publications on health centers contacts. They will keep a material if
they think it has value for them even if they can’t read and write.
Apply Adult Education Principles
30. IEC/BCC materials and resources in RH/FP are to be utilized within the broader context of adult
education principles and methodology. Effective materials are codes that help people reflect on their
own realities and take action towards change. Remember that adults learn through respect and
human dignity; immediacy; life experiences; and from peers. We remember 20% when we hear, 40%
when we hear and see, 80% when we hear, see and do; and more when we discover for ourselves.
Credits/References/Dates
31. Credit those who developed the work (authors, artists, lay-out, designers, contributors etc.), Mark
the date the material was developed/ modified/ re-published, Clarify if the material is part of a
project/ campaign/ initiative, Include references used, Add useful links and hot-lines, Ensure that
there is a contact name/organization.
32. Include logos of all partners differentiating those that are producers, implementers and funders.
33. In case of prints, decide on reasonable number of copies in line of your needs and abilities to
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Despite the efforts that went into the MOPH/UNFPA/UNHCR brochure on ANC and FP, several people and youth
who were consulted, found the materials very cluttered, difficult to read and not user friendly

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disseminate and utilize.
Improved Standards of IEC/BCC
Materials and Resources in RH/FP
34. Proposed recommendations in improved standards have been summarized on p. 41-44 of the
main report. Included are: Lessons learnt, Enhancing effectiveness, Enhancing relevance, Ensuring
quality of the messages, Unified materials, and Access to the materials.
Responsibility and Accountability
35. Partners are responsible and accountable to see the best launching, packaging, dissemination,
utilization and collating feedback on the materials; reflection and improvement, planning for
updates/ modifications/ follow up etc. Developing MOU between partners is a practice to be
encouraged.
Make the process enjoyable-
Celebrate Achievements

ExecutiveSummary: Materials RH/FP

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