The USAID-funded MAHEFA project utilizes radio broadcast and organizes community listener groups to promote behavior change around public health issues, such as maternal health and sanitation. MAHEFA's behavior change communications specialist, Elysee Ramamonjisoa, presented on the community listener group program at the 2015 National Conference on Health Communications, Marketing & Media on August 12, 2015.

1. A New Twist for Madagascar:
Community listeners’ groups as an integral part of a
behavior change empowerment strategy to enhance
synergies and boost impact
Elysée RAMAMONJISOA
Behavior Change Strategy Coordinator, MAHEFA
August 12, 2015

2. Learning Objective
Value added of listeners’ groups to an overall behavior change
empowerment approach in mobilizing the community, and in increasing
demand and use of health services in remote areas
Messages:
Radio-Mass Media
Listener groups:
Structure for
engagement and
understanding
Community
Mobilization &
ACTION

3. Presentation Outline
Program Overview: Community-based health in Madagascar
WHAT,WHY, HOW?
Results and Impact
Lessons Learned

4. MAHEFA: Community-based health in remote Madagascar
 Six north/northwest regions of
Madagascar
 Integrated programming:
 Maternal, newborn, and child health
 Family planning and reproductive health
 Water, sanitation, and hygiene
 Prevention and treatment of malaria
 Nutrition
 Programs reach >4 million people
(1/5 of total population)

5. The communities we partner with

9. WHY RADIO: Preferred Channel in Madagascar
Radio assists community health workers (CHWs) in encouraging
communities to seek their own solutions to overcome barriers via
interpersonal communication activities
Radio remains the preferred communication channel for the
majority of Malagasy; helps to enhance and create synergies between
classic channels of message transfer

10. Incites participants to develop an
attitude of mutual assistance
and jointly devise solutions
Listeners’ rates are 54% for
women between 15 and 49
years, and 59% for men
(DHS, 2008/09)

11. WHAT:
Mass media to reach remote areas in Madagascar
 Establishing a community collective
listening structure
 Creating a favorable environment for
community activities
 Using the research to produce
communication materials promoting
behavior change
 Reaching people in remote areas

12. WHY: Health Challenges
High maternal
mortality rate:
498 per100,000 live births
High neonatal
mortality rate:
24 per 1,000 for newborns
Source: Madagascar, DHS, 2008/09

13. HOW: Studies and Formative Research
• Suggest solutions to overcome barriers to practice health
behavior
• Cultural
appropriateness
• Evidence-based
strategy

14. HOW: Creating a community function to enable
messages to be better understood and promote action
• Conduct an inventory of
existing radios and listeners’
groups
• Identify stakeholders and
implementing partners
• Messages must be action-
driven

15. Monitoring and Evaluation
(1) Measuring coverage and functionality of listeners’ groups
(2) Measuring increases in improved practices at the level
of listeners’ groups
Monitoring and evaluation at two levels:

16. Results: Mass Media Reach and Listeners’ Groups
• 608 listeners’ groups have
been established
• 50 radio spots, 6 children’s
tales, and 5 theatrical
programs produced and
regularly broadcast in 3 local
dialects
• 26 local radio stations
regularly broadcast radio
formats in 6 rural areas
In FY2013 &
FY2014, MAHEFA
invested $925,000
in its mass media
program
component, or 47
cents per person
over two years

17. A New Twist, but Common Experiences
1. Do not reinvent the wheel: Choose the preferred communication
channel and transform it into a discussion forum
2. Establish an engaging starting point: appeal to their interests,
whether a health problem or other social issue
3. Give the community an opportunity to discuss and make joint
decisions in order to improve their lives

18. • Establishing a network and creating synergies to facilitate access to
information
– New regions where programs were not previously operating
– Remote areas, hard to access
• Communities become agents of change
• Sustainability: Creating a structure which will be in place even when
mass media program ends
The Importance of Networks

19. This presentation is made possible by the generous support of the American people through the United States Agency for
International Development (USAID).The contents are the responsibility of JSI Research &Training Institute, Inc. and do not
necessarily reflect the views of USAID or the United States Government.
THANKYOU FORYOUR ATTENTION
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