Social/Community MobiliSation Plan to Encourage Health Seeking Behaviour for Acute Encephalitis Syndrome-Muzaffarpur District, Bihar.

1. 1Social/Community Mobilization Plan to Encourage
Health Seeking Behaviour for Acute Encephalitis
Syndrome-Muzaffarpur District, Bihar. Dr Piyush
Kumar, M.B.B.S., E.M.O.C., PGDPHM (student).1
Page
1
D
Dr Piyush Kumar
General Medical Officer
MBBS, EMOC, PGDPHM (STUDENT)
Bihar Health Services
Government of Bihar
Email-drpiyush003@gmail.com
Mob-+919955301119/+917677833752
DR PIYUSH KUMAR,M.B.B.S., E.M.O.C.,P.G.D.P.H.M. (STUDENT)
2021
Social/Community Mobilization Plan to
Encourage Health SeekingBehaviour for
Acute Encephalitis Syndrome-Muzaffarpur
District, Bihar.
Health Promotion and Communication –
Generating Positive Deviance
SAVECHILDREN
SAVENATION
AES control plan in muzaffarpur district, Biharthrough
Community mobilization & facilitatedparticipatory
learning and action cycles.
D R P I Y U S H K U M A R , M B B S , E M O C , P G D P H M ( S T U D E N T )

2. 2
FORWARD: - I am pleasedto present social/ community mobilization plan for
encouraging health seeking behaviour by communities of muzaffarpur district for
recurring outbreaks of AES. The recurring outbreaks have taken lives of so many children
and a sense of fear is prevailing in the district particularly rural areas. The SCMP plan will
be of great help in such situations added with clinical care.
The state government and other concerned authorities have made several program cycle
which are very intensive, and extremely satisfactory. I have built new thinking around
social & community mobilization plan (SCMP) to deal with the situation. This plan can be
useful for many other situations also if prosecuted in proper way. The SCMP plan
application needs integrated approach with community and different sectors involvement
to deal with the issue of AES outbreaks. It also involves community training to enhance
health seeking behaviour of communities to healthcare. This will prevent delay in reaching
at proper time, at proper place for proper care.
The spread of technologies enable us to leverage and design transmedia initiatives to
resonate key message across relevant audience. Knowledge and evidence based facts will
serve as backbone to guide through the principles of SCMP. SCMP knowledge if
disseminated in proper way to communities through seminars, media will prove a
milestone in public health strategy to deal with AES and many other diseases. The drive
and commitment of SCMP programme will definitely have a positive impact on lives and
well being of communities.
Declaration: - This paper has not been previously published and is not currently under
consideration by another journal. The world population is growing every second and it’s
quite difficult to cater the needs of healthcare on individual basis. Hence advocacy for
social and community mobilization should be considered strongly to cater the needs of
community. The whole work is solely done by author.
Dr Piyush Kumar, General Medical Officer
MBBS, EMOC, PGDPHM (STUDENT)
Bihar Health Services
Government of Bihar
Email-drpiyush003@gmail.com
Mob-+919955301119/+917677833752

3. 3
CONTENT:-
COVER PAGE-01
FORWARD-02
CONTENT & ABBREVIATION-03
SYNOPSIS-04
INTRODUCTION, DEFINITION & PRINCIPLE OF SCMP-05
AIM OF SCMP-06
STRATEGIC PILLARS OF SCMP-07 (SMART ART)
OBJECTIVE-08
How to mobilize community-09
ORGANIZATION-10
Plan with the community-11
Recommendations-12 & 13
Acronyms and Abbreviations
AES – Acute Encephalitis Syndrome
SCMP- Social/Community Mobilization Plan
FLW – Front Line Worker
SBCC- social & behaviour change communication
Microsoft word document-1981 words, English-united states

4. 4
SYNOPSIS: - SCMP drives positive social community mobilization added with positive
behaviour and social change to community particularly parents/ guardians of children and
other family members, strengthen dialogue with influencers and stakeholders, and enhance
systemcapacity and local ownership as well as involvement of communities in programmes
to generate sustainable impacts. It partners with government, civil society organizations,
and development agencies to harness the power of communication as a tool for social
transformation to deal with distress together.
The SCMP plan work is based on four strategic pillars that promote and support
social and community mobilization to enhance health seeking behaviour in communities in
time and at proper place. System strengthening, capacity development, media based
initiative and knowledge management is the four pillars added with positive deviance.
The systemstrengthening function will bridge structural capacity
within the programme. Capacity development will advance human resource capacities on
SCMP. Knowledge management drew evidence and insights for programming and
facilitated learning exchange. Media based initiatives to resonate messages around these
learning’s for sharing together.
Programme efficiency, resource mobilization and allocation as well as strategy design will
change as per needs and requirements. The focus is on understanding social norms by
unpacking the individual and community context within which SCMP operates. Through
research and operationalization we can have in-depth knowledge of barriers and drivers of
SCMP to design programme for positive outcome. Through SCMP we will be able to save
lives on one hand at the same time imparting knowledge to communities to enable and
develop health seeking behaviour so that they are able to take proper care in proper time at
proper place.

5. 5
Introduction: - There is recurring outbreaks of Acute Encephalitis Syndrome for past several
years in different parts of Bihar. The disease is particularly more rampant in muzaffarpur district
of Bihar. Despite several measures and guidelines the district is still facing the challenge to
conquer these outbreaks. Several children’s have lost lives and many families are in distress and
fear every year. The health department and Government of Bihar have faced severe irony of
public as well as media due to the prevailing situation. Clinical care added with Public health
approach for AES can be of great help in rectification of problem to a greater extent. Usually
lack of health seeking behaviour is found among most communities due to lack of knowledge
and awareness. Hence I am discussing here about health promotion and communication for
generating positive deviance among the community and people of muzaffarpur for mobilizing
them to encourage health seeking behaviour for managing recurring outbreaks of acute
encephalitis syndrome.
Definition: - In social and community mobilization for encouraging health seeking behaviour the
local community population participates to maximum extent to change the prevailing health
situation problems. The community awareness will help them to seek proper healthcare in proper
time to avoid the distress. There should be proper linkage and network with community,
important stakeholders & various organizations particularly health department for improving
status of AES & overall various different issues related to control of recurring outbreaks.
Principles of SCMP: -
a. We should promote dialogue with the community and within community about the
situation of AES & and discuss with them ways to change the situation.
b. Capacity building among community to enable health seeking behaviour.
c. Social responsibility and morals for everyone to be explained.
d. Transparency and accountability are very important for motivating community.
e. Sustainability of activities for long period for maximum impact.
f. Improve and increase community participation to ensure maximum coverage.

6. 6
Aim of Social & Community mobilization Plan: - The main aims of SCMP is to:-
1. Aware community about their own potential and resources available at home, at
community level and at different levels of healthcare for AES (What they can do? Where
& when to seek healthcare?).
2. Encouraging community to sustainably use their resources and demand services from
accredited institutions such as government hospitals at proper time to avoid delay
(Where/when to seek healthcare?).
3. Capacity building among community for strengthening problem solving ability (how to
do?).
4. Imparting knowledge about AES and common skills to community for improving self
help capacities (ability to act) and capabilities (knowledge – how to act).
5. Bridging gap between community and health service provider (mutual co-operation).
6. Making local community partner instead of only recipients (Give importance).
7. Increasing capacity and skills of service provider through training and working in real
situations (adequate qualities care to demand assurance).
SCMP
COMMUNITY
HEALTH / EDUCATION
/WASH/
NUTRITION/TRAINING
ETC
HEALTH SYSTEM& ALL
INVOLVED
ORGANIZATIONS
TRAININGPACKAGE
WITH DIFFERENT
MODULES/ ETC

7. 7
SCMP
System Strenghtning
Strategic& TechnicalSupport
Multisectoral approach/Funds
Planning
Implementation
Evaluation
Financing
Capacity Development
Skills & capacities -FLW, ASHA,
Community&
Everyone Involved(SBCC)
Enhance Quality &
communication-findvuleranable
family
KnowledgeManagement
Research
Create Platform & Productfor
Learning/sharing
information/Risk communication
Enhance knowledge
generation/dissemination
/application-ADDRESS MYTHS
&BELIEF
Media Based Initiatives
Knowledge/skill/motivation to
practice criticalbeahaviour
Reinforce key message& create
environment
Social/Community Mobilization
Plan to EncourageHealth Seeking
Behaviour for Acute Encephalitis
Syndrome-Muzaffarpur District,
Bihar.
StrategicPillars for :-

8. 8
Objective of SCMP for AES-
To provide a community mobilization plan for recurring outbreaks of AES in
muzaffarpur district of Bihar to mitigate /eliminate the outbreaks.
Target Audience:-
i. The primary audience for this plan is health programme managers, and policy
makers who are responsible for designing AES control programmes, primarily in
low income and rural settings.
ii. The plan is also aimed at health providers and teaching institutions to increase the
knowledge of interventions important for improving children health.
iii. Improving care provided at household level by parents / guardians.
iv. Increasing community support for better outcome.
v. Development programmes and save child activists.
Phases of intervention Plan
i. Identify and prioritize problems
ii. Plan activities
iii. Implement strategies to address the priority problems
iv. Assess the activities and modify plan accordingly if and when required.
The process will include:-
i. Identifying critical questions and critical outcomes
ii. Evidence retrieval
iii. Assessing and synthesizing evidence
iv. Formulating recommendation
v. Planning for dissemination, implementation, evaluation, and
updating guidelines. Technical groups from health department and
SKMCH –district medical college will be formed ideally to
support the development and progress of SCMP for AES.

9. 9
How to mobilize community?
Mobilizing community is a cyclic process so it will keep going. Mobilization
requires Programme manager to:-
a. Assess the resource, linkage and networks at community level.
b. Prepare and upgrade knowledge and skills of all involved.
c. Ensure and develop willingness of community to participate in the programme.
d. Evaluate and understand the socio-cultural norms and beliefs.
Prepareto
mobilize
Organize
community
for action
Explore AES
related issues
& set
priorities
Plan with the
coomunity &
act together
Evaluate
together &
scale
up/down
accordingly

10. 10
Organization requires Programme manager to:-
a. Identify leaders, important stakeholders & influential people.
b. Organize meetings and explain everything to get their support.
c. Advocacy with influential leader will generate momentum for community
action.
Organize
Identify
important
stakeholders
Meetings &
Explanations
Advocacy
Support/
partnership

11. 11
Plan with the community:-
a. Plan strategy and specific activities to address about AES issues.
b. Clearly delineate the role of community and others to avoid conflicts.
Develop positive deviance amongst community members.
c. Decide to arrange resources required available within community and
what to be supplied from outside.
d. Orient community on monitoring the accomplishment of activities and
learn from failures.
e. Finally act & evaluate together, if required scale up/down activities for
better outcome.
Assessment
Prepare
and
upgrade
Ensure &
develop
Evaluate &
understand

12. 12
Recommendations:- Implementation of community mobilization through
facilitated participatory learning’s and action cycles with community groups with
positive deviance (particularly parents/ guardians of children’s) is recommended
to improve the situation of AES, particularly in rural settings with low access to
health services.
Implementation of facilitated participatory learning and action cycles with
community group should focus on creating a space for discussion where
community people are able to identify priority problems and advocate health
seeking behaviour for local solution as well as facility based solutions for AES.
Consideration to be taken into account for implementation of SCMP
a. To have an impact the time period of SCMP intervention should be longer
(few Years-3/4)
b. There needs to be adequate coverage of intervention in terms of density of
population. The success of intervention will largely depend upon greater
participation and positive deviance. The effect may also vary by context
on prior existence, strength and cohesion of local social networks.
c. High quality facilitators are key factor in establishing and maintaining
groups and helping them to be effective; good training and support of
facilitators is therefore essential.
d. Although it will be a community intervention like any intervention at large
scale it must be properly supported by appropriate structures, systems and
processes, resources for effective results.
e. Implementation should also consider potential harm (violence, conflict
with health provider or other community members etc. Potential harms
should be monitored throughout implementation so that they can be
managed.
The political/social context
a. Political support is essential
b. The intervention must be adapted to reflect local community context,
capacities, and constraints.
c. Implementing the intervention with other community health
development plan & structure will enhance coverage and
sustainability.

13. 13
d. No group should work in isolation. To be effective other social group
should act mutually, providing responsive and accountable health
services. Co-operation from non health sector is crucial for
implementing SCMP effectively and properly.
Specific local factors that might be relevant to implementation
a. Knowledge of history of communities, local decision makers, local structures and
processes.
b. Data are needed on local barriers and facilitators of implementation and acceptability of
SCMP intervention.
c. Implementation should consider role of everyone in the community and how and when
they participate.
d. Levels of literacy/numeracy should be considered to design presentations accordingly.-
oral/visual
e. Ethnic group mix, religion, caste and other social categories affecting local group
dynamics need to be considered in developing the approach.
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