Final APR communicaiton strategy master copy (002)

INTEGRATED ADVOCACY, SOCIAL MOBILIZATION AND COMMUNICATION
STRATEGY AND ACTION PLAN FOR ‘A PROMISE RENEWED’
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Integrated Advocacy, Social Mobilization and
Communication Strategy & Action Plan for
‘A Promise Renewed’
Led by - Sheeba Afghani, Communication for Development (C4D) Specialist
Supported by – Miriam Lwanga Communication for Development (C4D) Officer

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Contents
Executive Summary.................................................................................................................................4
List of Acronym .......................................................................................................................................5
Key terms ................................................................................................................................................6
CHAPTER I................................................................................................................................................7
INTRODUCTION, RATIONALE AND PROCESS...............................................................................................7
1.1 Background:..........................................................................................................................................7
1.2. Rationale for Communication framework and structure......................................................................8
1.3. Development process..........................................................................................................................9
CHAPTER II ............................................................................................................................................10
OVERALL FRAMEWORK FOR THE INTEGRATED STRATEGY.....................................................................10
2.1 Communication Framework................................................................................................................10
2.2. The Package:.....................................................................................................................................10
2.3. Communication Goal, objectives (Roadmap Materanal & Neonatal Mortality & Morbidity).............11
2.4. Target audience and behavioral analysis..........................................................................................12
Chapter III..............................................................................................................................................18
STRATEGIC COMMUNICATION INTERVENTIONS.......................................................................................18
3.1. Communication Strategies.................................................................................................................18
3.2. Behavior Change Communication (BCC)..........................................................................................18
3.3. Social mobilization with specific focus on the hard to reach............................................................20
3.4. Advocacy:..........................................................................................................................................22
Chapter IV .............................................................................................................................................24
SPECIAL STRATEGIES - MALE INVOLVEMENT, HEALHT WORKERS MOTIVATION, HARD TO REACH...24
4.1. Male Involvement...............................................................................................................................24
4.2. Health Workers Motivation.................................................................................................................26
4.2. Specific activities for Hard to reach:..................................................................................................27
4.3. Collaboration and Networking: ..........................................................................................................28
CHAPTER V ............................................................................................................................................29

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TRAINING AND CAPACITY BUILDING..........................................................................................................29
5.1. Training and capacity building;.........................................................................................................29
5.2. Training of Trainers (TOT):.................................................................................................................29
5.3. Training of District Health Management Teams (District Health Educator, District Health Inspector
and District Health Visitor):........................................................................................................................29
5.4. VHTs, LC1s, Chiefs, religious leaders, teachers, TBAs and health assistants:................................29
Appendices............................................................................................................................................35
Annex 1: INTEGRATED ACTION PLAN 2014-2015.......................................................................................35
Annex 1: Stages of Behavir change...............................................................................................................42
Annex 2: Social ecological model..................................................................................................................43
Annex 5: Matrix for assessing Demand side barriers (adapted)...................................................................44

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Executive Summary
The integrated Advocacy, Social Mobilization and Communication Plan aims
to support the new priorities highlighted in the ‘A Promise Renewed;
Reproductive Maternal, Newborn and Child Health Sharpened Plan For
Uganda (2013)’ and other priorities outlined in ‘Roadmap for accelerating
the reduction of Maternal and Neonatal Mortality and morbidity in Uganda
(2007-2015)’ and ‘National Child Survival Strategy (2009 -2015).’
The communication strategy takes an integrated approach to maternal and
child health and focuses on the critical time period on the continuum of
care, consistent with the priorities underlined in the Sharpened Plan.
Building on the ‘Stages of Change’ and ‘Social Ecological Model for
Behavioral Change’, the Strategy gives clear strategic direction on achieving
key behavioral objectives. Although formative research has not yet been
conducted, target audiences and barriers have been identified after a
comprehensive research of secondary sources and the best practices
documented in various toolkits developed by partners.
The behavioral analysis and the resulting behavioral objectives are presented
for key target audiences; Primary, Secondary and Tertiary. This analysis gives
a robust way forward on priority strategies, activities and messages to reach
main stakeholder groups for RMNCH.
The ‘Strategy’ also aims to optimize the use of innovations in communication
technologies like mtrac, VRS, edutrac, in support of RMNCH, with specific
focus on real time data collection and utilization for monitoring purposes.
The key strategies include behavior change communication, social
mobilization and Advocacy. The strategy also prioritizes male involvement
and health workers motivation as key strategies to improve RMNCH
outcomes. Gender transformative and gender sensitive communication
approaches are envisaged to improve adoption of key behaviors among the
target audiences.
The roll out of this integrated communication strategy will also entail a robust
capacity building and training component with specific focus on building
capacity at the district and community levels.

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List of Acronym
ANC Antenatal Care
APR
BCC
C4D
A Promised Renewed
Behavior Change Communication
Communication for Development
DHT District Health Team
DMHT District Management Health Team
HMIS Health Management Information System
EPI Expanded Programme on Immunization
FBO Faith Based Organizations
IEC
IMR
Information Education and Communication
Infant Mortality Rate
IPC Interpersonal communication
MDG Millennium Development Goals
MMR Maternal Mortality Ratio
MOH Ministry of Health
M&E Monitoring and Evaluation
MCH Maternal and Child Health
PSA Public Service Announcement
RNMCH
SM
Reproductive New-born Maternal Child Health
Social Mobilization
UDHS Uganda Demographic Health Survey
VHT Village Health Team
WASH Water Sanitation And Hygiene

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Key terms
1.1. Communication for Development: refers to a planned, evidence-based
strategic process for promoting positive and measurable individual behavior
and social change that is an integral part of development programmes,
policy, advocacy and humanitarian work. This process is crucial for social
transformation and operates through three main strategies namely;
advocacy for raising resources, political and social leadership commitment,
social mobilization for wider participation and ownership and programme
communication for bringing about changes in knowledge, attitudes and
practices among specific participants in programmes (UNICEF, 2001).
1.2. Programme Communication/ Behavior Change Communications (BCC):
Is designed to achieve measurable objectives. It shifts the emphasis from
making people aware to bringing about new attitudes and practices. It is a
process that uses various strategies, communication processes, and media to
persuade people to increase their knowledge and change risky behavior
(UNICEF, 1999b). It uses an appropriate mix of interpersonal, group and mass
media channels including participatory methods.
1.3. Community Mobilization: Uses deliberate participatory processes to
involve local institutions, local leaders, community groups, and members of
the community to organize for collective action toward a common purpose
(CEDPA,2000).
1.4. Social Mobilization: Aims to muster national and local support for a
general goal or programme, in order to create an enabling environment and
effect positive behavior and social change (Mckee, 1992). It also refers to a
process of bringing together all feasible intersectoral social partners and allies
to identify needs and raise awareness of, and demand for, a particular
development objective. It involves enlisting the participation of such actors
(including institutions, groups, networks and communities) in identifying,
raising and managing human and material resources, thereby increasing and
strengthening self-reliance and sustainability of achievements made.
(UNICEF, 1992).
1.5. Advocacy: Is a process that involves a series of actions conducted by
organized citizens in order to transform power relations. The purpose of
advocacy is to achieve specific policy changes, or allocation of resources
that benefit the population involved in the process (CEDPA, 2000 ).
1.6. Empowerment: is a process of facilitating and enabling people to acquire
skills, knowledge and confidence to make responsible choices and
implement them.(UNICEF, 1992)

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CHAPTER I
INTRODUCTION, RATIONALE AND PROCESS
1.1 Background:
As the global community rolls out action plans to improve maternal,
newborn and child survival, Uganda has developed its own strategy entitled
‘A Promise Renewed; Reproductive Maternal, Newborn and Child Health
Sharpened Plan for Uganda (2013)’. The ‘Sharpened plan’ is not meant to
replace the existing ‘Roadmap for accelerating the reduction of Maternal
and Neonatal Mortality and morbidity in Uganda (2007-2015)’ or the ‘National
Child Survival Strategy (2009 -2015)’ but to catalyze them.
The Sharpened Plan has identified five strategic shifts to avoid business as
usual; 1. Focus Geographically 2. High burden populations 3. High impact
solutions 4. Education Empowerment, Economy, Environment and 5. Mutual
accountability. The Sharpened Plan places a strong emphasis on
accountability and monitoring mechanisms and partnerships for social
mobilization.
Over the past 15 years Uganda has made modest progress in improving
health and development indicators. However, maternal and infant mortality
and morbidity remain unacceptably high and as a result Uganda is not on
track to achieve MGD 4&5. Nationally, maternal mortality is estimated at 438
deaths per 100,000 live births. This MMR translates to 6000 women dying every
year from pregnancy related causes.
Uganda’s under- five mortality also remains high at 90, while it’s infant and
newborn mortality 54 and 27 deaths per 1,000 live births, respectively (UDHS
2011). Therefore, Uganda’s maternal mortality ratio (MMR) and under five
mortality rate still remains well off track the MDG 5 and MDG 4 targets of 131
deaths per 100,000 live births and 56 deaths per 1,000 live births respectively
by 2015.
Key challenges experienced in the health system and barriers to Uganda’s
path to achieving the MDGs include inadequate skilled birth attendants
which leaves many pregnant women dying at home due to lack of access to
health care, prompt decision making, difficulties in transportation and lack of
emergency obstetric care services at the referral level. Other key challenges
in maternal, newborn and child health include lack of health personnel, poor
health service delivery, low VHT (Village Health Team) coverage, as well as
frequent stock out of essential drugs in remote and difficult to reach areas.
On the demand side several barriers exist to the utilization of RMNCH service.
Women often lack knowledge and decision making power to avail critical

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RMNCH services before during and after delivery. Women who may face
complications often are not part of the decision regarding the potential
course of action1.
In addition, several religious and cultural practices exist in many parts of
Uganda that threaten maternal and neonatal survival2; Ingestion of herbs to
quicken labor, refusing caesarian section on the pretext that women need to
deliver normally to prove woman hood and culture of silence/non expression
of pain3.
Evidence based communication strategies to increase knowledge and
change attitude, behavior norms at individual, community and societal level
are essential to eliminate key demand side barriers. However, in the past
communication initiatives have focused on individual and household level
behavior change leading to strategies that provided only short term,
fragmented and limited behavior change.
1.2. Rationale for Communication framework and structure
The rationale for this framework is to;
 Support the new priorities highlighted in the ‘A Promise Renewed;
Reproductive Maternal, Newborn and Child Health Sharpened Plan
For Uganda (2013)’ and other priorites outlined in ‘Roadmap for
accelarating the reduction of Maternla and Neonatal Mortality and
morbiditity in Uganda (2007-2015)’ and ‘National Child Survival
Strategy (2009 -2015)’
 To build strong partnerships in support of RMNCH program across
different levels; national, district and communities and highlight
exisiting resources and structures within and outside the health system
that can be mobilized in support of an integraed RMNCH Program.
 To highlight and address key cultural and socio economic barriers
impacting women’s abiliity to access RMNCH services. Specific focus
1
Roadmap for accelerating the reduction of Maternal and Neonatal Mortality and morbidity in Uganda (2007-2015)’, page 13
2
Roadmap for accelerating the reduction of Maternal and Neonatal Mortality and morbidity in Uganda (2007-2015)’, page 13
3
Kyomuhendo GB 2000, Ndyomugyenyi 1998)

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on the three delay model and involving communities in planning and
management of RMNCH activities.
 To Support the roll out of key innovations in communication
technologies in support of RMNCH program; mtrac, VRS, edutrac and
U Report.
 Show case special strategies for engaging with the male populations
by highlighting gender transformative communication strategies
 To focus on capacity building of community based VHTs in
interpersonal communication in support of RMNCH
 To facilitate resource generation for communication actvities in support
of integarted RMNCH program.
1.3. Development process
The draft strategy has been developed in-house by UNICEF ALIVE section to
guide the communication support for ‘A Promise Renewed; Reproductive
Maternal, Newborn and Child Health Sharpened Plan for Uganda (2013)’ and
the ALIVE Program as a whole. The draft will be shared broadly with partners
for review and revision; MOH, development partners, parliamentarians, district
and sub county stakeholders. A series of consultative workshops from the
national to the district and sub district level are envisaged for the roll out of
this strategy. The feedback will further inform the implementation down to the
community level.

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CHAPTER II
OVERALL FRAMEWORK FOR THE INTEGRATED STRATEGY
2.1 Communication Framework
The communication strategy is based on the theories of ‘Stages of Behavior
Change’ and Social Ecological Model. The Stages of Behavior Change theory
views behavior change as a process rather than an event. The main tenet of
this Model is that an individual (or a stakeholder group) goes through several
stages from non-practice to practicing or adopting a desired behavior. These
stages including Knowledge, Approval, Intention, Practice, and Advocacy
are so strongly associated with the new behavior that he or she becomes an
advocate). This model helps to explain where the individual or a stakeholder
group is in relation to a specific behavior and in relation to other stakeholder
groups and gives direction on the types of strategies to move them along the
ladder to the desired behavior (See Annex 1).
The Social Ecological Models explain the link between the individual behavior
and the enabling environment. In the past, development approaches
focused on individual behavior change. But since then we have learnt that
individuals often do not or cannot change behavior without support from the
environment around them; Parents, spouses, peers, friends, community and
religious leaders etc. Factors such as family pressure, community norms, and
the larger policy and legal environment can affect the health related
behaviors an individual engages in. Thus an individual’s behavioral choices
should be seen in the larger context of his or her environment. Hence,
interventions are needed at different levels of the environment to facilitate
behavior change (See Annex 2).
2.2. The Package:
The communication strategy takes an integrated approach to Reproductive
Maternal, Newborn and Child Health and focuses on the critical time periods
on the continuum of care. The target audience information needs will
include messaging on the following;
Table 1
Life stage priority area for
Programming
Health priority area linked to RMNCH
New born, Infant and Child - New Born Care
- Early initiation of breastfeeding
- Exclusive breastfeeding
- Acute Respiratory Tract infections
- Diarrhea

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- Immunization
- Vitamin A deficiency
- Growth monitoring
- Infant and young child feeding practices
- Under -utilization of health services
- High reliance on traditional practices
Adolescent - Nutrition
- Health care counselling and services Life skills
- Spacing of children and planning a
manageable family
- STDs/HIV AIDS,
- Complications due to unsafe abortions
-
Pregnant Women;
Delivering;
Postnatal Care
- High fertility Rate
- Low contraceptive prevalence rate
- Early initiation of breastfeeding
- Exclusive breastfeeding
- Birth preparedness
- PPH – Post Partum Hemorrhage
- Under Utilization of RMNCH services during
ANC, Delivery and PNC
- Nutrition and iron for pregnant and lactating
women
- Stop Smoking and tobacco use
- Malaria prevention in endemic areas
(Importance of IPT)
- Sexually transmitted infections/HIV AIDS
- Complications due to unsafe abortions
- Gender based discrimination; work burden,
harmful social norms, limited decision making,
gender based violence
2.3. Communication goal, objectives and overall strategic focus
Goal: To promote, support and ensure adoption of appropriate health
seeking behavior among pregnant and lactating women, their families
and communities4.
Strategic Objective: Create Demand for Quality RMNCH services at the
community level to ensure continuum of care.
Communication Objective:
90% Pregnant & Women of CBA and Men adopt key RMNCH behaviors
(time frame sharpened plan)
4
‘Roadmap for accelerating the reduction of Maternal and Neonatal Mortality and morbidity in Uganda (2007-2015)’, page 7

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Indicators
o % Pregnant & Women of CBA who adopt key RMNCH behaviors
o % of Men who adopt key RMNCH behaviors
Overall Strategic Approach:
Mobilize and Empower key decision makers and communities across
sectors to ensure a continuum of care between the household and heath
facility and create demand for RNMCH services in line with the APR
priorities;
1. Roll out a National advocacy movement for Reproductive, Maternal,
Newborn & Child health across all sectors; Health, education, agriculture,
gender, private, finance, local government), cultural &religious leaders,
development partners, private sector, media
2. Review and harmonize integrated RMNCH IEC tool kit for all health
facilities, community health workers, communities and key stakeholders
4. Build proactive and sustainable partnerships with key stakeholders at
national, district, sub county and parish levels in support of RMNCH
5. Use Gender Transformative communication approaches and messages
to address child marriage, educating girls and women, women’s decision
making with specific focus male involvement in RMNCH
6. Engage mothers and communities to utilize innovative platforms (mTrac,
Mobile VRS, U report, Mother Reminder) for collection and use of real time
data to promote accountabilities at all levels.
2.4. Target audience and behavioral analysis
Although formative research has not yet been conducted, the following
target audiences and barriers have been identified after a comprehensive
research of secondary sources and the best practices documented in various
toolkits developed by the partners.
Generally, the following target audiences were identified:
Primary
 Household level: Women (Caretakers, married/stable relationships,
adolescents, Husbands/Spouses.
 Community Level: LCs, Religious leaders, VHTs, Teachers and TBAs.
Secondary

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 Health facility level: Health Unit Management Committees, Health
workers (Doctors, Nurses and Midwives)
 District level: Politicians such as Resident District Commissioners, LC - V
Chairpersons
 Community level: Chiefs, local councils, VHTs, NGOs/CBOs such as Red
Cross, religious organizations such as (ADRA), Schools, Parents
&Teachers Associations, Community volunteers, community leaders,
Traditional Birth Attendants and extension workers.
Tertiary
National Level:
 Ministry of Health taking the lead and other relevant line ministries
complementing its efforts such as: Ministry of Education, Ministry of
Finance and Planning and Ministry of Local Government;
 Members of Parliament, Religious and Traditional leaders, Media houses
and service organizations such as Rotary and Lions Clubs and NGOs
such as Uganda Red Cross Society.
 Professional bodies such as Uganda Medical and Dental Association,
Uganda Pediatric Association, Uganda Nursing Council, Uganda
Health and Allied Professionals Association; religious organizations,
through their medical Bureau such as Catholic, Protestant, Muslim and
Orthodox Medical Bureau.
 Development partners such as USAID, DFID, KOICA, CIDA, JICA and
others.
Table 2: Target Audience & Behavior/participant analysis
Target Audience Current behavior Barriers to desired
behavior (causes)
Behavioral objectives (2017)
Primary
1. Women of Child
Bearing Age,
Pregnant and
lactating women,
husbands and
caretakers
 Women of
Child bearing
Ages, Pregnant
and Lactating
Women not
practicing Key
RMNCH
Behaviors
 Knowledge Barriers
Inadequate knowledge
on benefits of RMNCH
(ANC, birth preparedness,
emergency readiness,
skilled birth attendance at
delivery, PNC, Early
initiation of Breastfeeding,
maternal nutrition,
immunization, HIV, hand
washing).
 Only 21 % male partners
 80% target women,
husbands and caretakers
understand the
importance, birth
preparedness, ANC,
danger signs and three
delays , institutional
deliveries, PNC and
(annex for detailed
package)

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behavior (causes)
have knowledge on
ANC
 Attitude barriers
- Pregnancy considered a
normal practice in many
communities And women
who deliver at home
without medical
assistance held in high
regard5
- Limited decision making
power of women during
pregnancy, Child Birth
and postpartum period
- Religious and traditional
beliefs; Ingestion of herbs
to quicken labor, refusing
caesarian section on the
pretext that women are
supposed to deliver
normally to prove woman
hood and culture of
silence/non expression of
pain 6
 Practice barriers
 Only 58% of births
attended by skilled birth
attendants (UDHS 2011)
Only 48% women are
having four or more
ANCs visits
80% of mothers, husbands
and caregivers recognize
pregnancy as a special
period requiring special
care and consider women
who deliver in facilities as
positive role models
 80% women involved in
decisions regarding
pregnancy, child birth
and postpartum
 80% of target populations
shun practice of herbs for
quicken labor and
appreciate the
importance of caesarian
in case of obstructed
labor
70% births attended by
skilled birth attendants
70% mothers seek all four
ANC visits
70% women receive
postnatal care in the first
two days after delivery.
5 Kyomuhendo GB 2000, Ndyomugyenyi 1998)

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behavior (causes)
Only 33% women receive
postnatal care in the first
two days after delivery.
Secondary:
2. VHTs VHTs do not
mobilize
communities for
RMNCH services
 Knowledge Barrier
- Inadequate knowledge
on benefits of Key RMNCH
practices
 Attitude Barrier
- Lack of motivation to
promote RMNCH services
 Practice Barrier
- Do not mobilize
communities to avail
RMNCH services
 80% VHTs have
knowledge on key
RMNCH practices
 80 % of functional VHTs
mobilize communities for
availing the RMNCH
services
3. Health unit
management
committee (HUMC)
HUMC members
do not attend
regular quarterly
meetings to
discuss health
issues and support
community
activities
Lack of knowledge on
the importance of
RMNCH service for
maternal and child
survival
Lack of motivation to
attend meetings
concerning health issues
In adequate supervision
monitoring support at
the community level
 80% HUMC are
functional and members
regularly attend
quarterly meetings and
 80% functional HUMC
engaged in monitoring
and supervision at
community level
4. Health workers Health workers do
not counsel
mothers or give
complete
information to
mothers regarding
RMNCH package
Inadequate
interpersonal
communication skills
e.g. counselling skills
 Attitude barrier
In appropriate
treatment of parents
 80% Health workers
trained in counselling
and interpersonal skills
 80% health workers treat
parents with respect
 80% of health workers
counsel women on key

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behavior (causes)
(often rebuke parents)
 Practice barrier
Health workers do not
counsel women on Key
RMNCH services.
RMNCH services
5. Traditional and
religious leaders
Tradition and
religious leaders
not engaged in
RMNCH promotion
Lack of knowledge on
the importance of and
Existence of traditional
beliefs (Ingestion of herbs
to quicken labor, refusing
caesarian section on the
pretext that women are
supposed to deliver
normally to prove woman
hood and culture of
silence/non expression of
pain 7
Practice barrier
Traditional and religious
leaders do not promote
RMNCH services
 80% of all major religious
association oriented on
RMNCH package and
engaged in social
mobilization for RMNCH
association shun
traditional practices
harmful to maternal,
new born and child
health
association oriented on
RMNCH package and
promote RMNCH
services
6. Media National and
district media do
not adequately
cover RMNCH
activities
- Lack of knowledge and
capacity to present
RMNCH issues and
resulting maternal and
child mortality as a news
worthy
 Attitude barrier
Little interest in
 80% 0f all key national
and district media
oriented on RMNCH
 80% 0f all key national
and district media
oriented on RMNCH
report and cover key
RMNCH activities

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behavior (causes)
comprehensive coverage
of RMNCH
Practice barrier
National and district
media do not adequately
cover RMNCH activities
7. National and district
policy makers/ leaders
• National and
district leaders
not aware their
role in
mobilization
and promotion
of RMNCH
• Knowledge Barrier
Inadequate knowledge
and orientation of policy
makers /influential leaders
on their role in
mobilization and
promotion of RMNCH
National and district
leaders have the
tendency to be donor
dependent and do not
take the lead
Leaders not performing an
oversight function in their
constituencies and districts
 80% National and district
leaders oriented on
RMNCH package and
their role in mobilization
and promotion of
RMNCH
 80% of the oriented
national and district
policy makers and
leaders engage in
oversight functions in
their constituencies and
districts
8. Development
partners
• Uncoordinated
sector support
by donors
• Practice barrier
Uncoordinated sector
investment
 80% donor funds
coordinate through the
sector coordination
committee

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Chapter III
STRATEGIC COMMUNICATION INTERVENTIONS
3.1. Communication Strategies
The development and implementation of this strategy is based on the
recognition that behavior change communication can be effective when
planned and implemented using a combination of communication
approaches with appropriate behavior change models.
Relevant behavior change approaches, models and theories were identified
and applied to analyze the behaviors of primary, secondary and
tertiary/advocacy target audiences. This analysis provided insight into the
behaviors of individuals and factors responsible for the less than optimal
uptake of RMNCH services. This has enabled the identification and design of
relevant interventions and messages to address the problem behaviors.
In order to achieve the communication and behavioral objectives, a three
pronged Communication for Development approach with three main
strategies will be used, namely;
 Behavior Change Communication
 Social mobilization
 Advocacy
3.2. Behavior Change Communication (BCC)
BCC interventions will be implemented at the household level through IPC
involving VHTs, Scouts / Girl guides, LC1s, and through mass media (radio
spots/talkshows. Although mothers are the primary target at household level,
recent research and experiences have shown that there are structural
barriers to women’s decision making. Hence, the household will be further
segmented to include other decision makers; such as mothers,
husbands/fathers, grandparents, aunties, mothers-in-law and fathers-in-law.
Health promotion interventions will target the specific behavioral barriers at
the family/household level and create awareness through the following
interventions:
IPC through IEC materials

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The VHTs will have the main responsibility for IPC using IEC packages
supported by health assistants. The IEC packages will include pictorial cards
and informative leaflets covering important aspects of RMNCH; these will
provide information on birth preparedness, Antenatal care, delivery,
postnatal care, early initiation of breastfeeding, infant and young child
feeing, family planning, pneumonia, malaria and diarrhea prevention,
hygiene, sanitation, nutrition etc. IEC materials in addition to being used in
individual and group counseling can also be used for training purposes.
Information materials will also be developed for promotional activities
conducted by health workers, LCs, Scouts/Girl Guides, religious leaders and
teachers.
Mother to mother education and women’s group
This strategy has been used in many countries with significant results and the
most effective application of peer- to –peer education. Mothers will be
trained to advise other mothers and pregnant women on key RMNCH
practices.
Mass Media:
Mass Media will be used to make Public Service Announcements (PSA) by
government agencies. These are very important in keeping messages in
public eyes. Short spots, talk shows, PSA and jingles to promote RMNCH will be
developed for airing on radio and TV. PSA messages will create awareness
and understanding regarding importance of RMNCH and motivate people to
adopt positive behaviors.
Innovative use of mobile health and related information communication
technologies:
The focus will be in enhancing health literacy and care seeking among
mothers through provision of relevant health information to pregnant women
and new mothers using personalized text or voice messages encouraging
them to visit the local health facility for antenatal care, immunization or
remind them to complete birth plan and go for skilled delivery and post natal
care. Existing mobile health initiatives like mTrac and community
engagement initiatives like U Report will be utilized for real time reporting on
existing gaps and barriers to RMNCH at all levels.
Disease prevention and patient self-management will also be supported
through short messages no more than sixty characters or less to enrolled
mobile phone users. Options will also be explored to use SMS system to
connect remote populations to their health providers.
Involvement of goodwill ambassadors:

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The involvement of goodwill ambassadors for promotion of social causes has
been found to be very effective and bears positive results the world over.
Well-known and popular personalities and media stars possess charisma and
charm that is needed to add visibility and credibility to the cause.
In a bid to make the RMNCH communication more persuasive and relevant
to the target audiences, a panel of goodwill ambassadors belonging to
different walks of life (sports stars, media celebrities, religious leaders and
doctors) will be selected in consultation with partners to promote RMNCH
services.
Programme Communication Activities:
 Mapping of active VHTs nationwide
 Training / Orientation of VHTs on key messages for RMNCH
 Awareness raising through individual/Group counseling sessions
 Awareness raising through Public Service Announcements, TV, talk
shows, Radio spots/jingles, DJ mentions, children’s voices and
testimonies from satisfied users of immunization services.
 Dissemination of messages in newspapers through articles and strip
adverts.
 Development and dissemination of SMS messages
 Sensitization sessions with Goodwill Ambassadors
 Promotional visits by Goodwill Ambassadors to communities
3.3. Social mobilization with specific focus on the hard to reach areas
Social mobilization will operate at the district, sub district and village level. In
addition to parents, it will target local politicians, religious leaders, traditional
leaders, opinion leaders, community groups, and teachers. Social
mobilization is not only crucial for sustainable behavioral change, it is also an
effective strategy for community empowerment and participation. It will
create awareness and seek to change people’s behavior at village level and
will entail the following activities.
Formation of Alliances/Support Groups
The District Health Management Team (DHMT) with the help of local
volunteers (teachers/health-workers) will be responsible for forming support
groups at the community level, to advocate and participate in program
activities. The support groups will include local religious leaders, health
workers, teachers, NGO/CBO representatives. These support groups will
provide an excellent venue for imparting knowledge on RMNCH. These

21
groups will meet on a regular basis and plan how to provide solutions with
mutual understanding and sharing of experience.
Community Based Participatory Activities: Activities will be organized and
supervised by DHMTs. IPC through the VHTs and partner NGOs supported by
IEC materials will be the main channels of communication for these activities.
Informative/educational materials will be designed and developed for
various members of the support groups. The materials developed for
traditional and religious leaders will be designed to directly address any
cultural constraints and false religious beliefs, and will be in the form of fact
sheets and videos.
Community and school based sports and other info- entertainment activities:
This component will focus on educating and mobilizing communities around
RMNCH through community and school based sports activities. These
activities will entail massive community interest and involvement. The
teachers will be involved in school based interactive/informative activities for
promotion of RMNCH. Focal persons and sports champions will be identified
in each community to support future activities. Drama groups will be trained
in each community and school on key RMNCH messages. Community
screening of relevant documentaries etc. will also be part of this component.
Social Mobilization Activities:
 Community sessions and dialogue/group discussions with various target
groups organized by DHMTs/DHE
 Alliances formed with community leaders, NGOs, religious/cultural
leaders
 Revitalization of Health Unit Management Committees (HUMCs) to
support linking services with communities
 Community based media activities; music, dance and drama
performances as well as puppet shows on RMNCH by DHMTs
 Establishment of community radio listeners’ groups by VHTs to mobilize
the communities, listen and participate in radio discussion programmes
on RMNCH
 Conducting sensitization sessions with religious, traditional and
community leaders
 Conducting sensitization sessions with teachers to create awareness
 School based activities conducted by teachers

22
 Additional activities may include street theatre, community meetings,
sports days, school-based activities, and seminars, celebration of
important health events e.g. World Health Day, Child Days Plus
3.4. Advocacy:
Advocacy will target individuals involved at all levels of policy and decision
making. At the National level it will target ministers, MPs, and other relevant
people in the ministries. At the District level it will target the district councils
and heads of departments. The district level advocacy will entail dialogue
with District Health Officers (DCOs), heads of departments and councilors.
Media agencies and their representatives at national and district levels will
also be targeted.
Newspaper articles, seminars and workshops/meetings will be employed to
make policy makers more aware of the magnitude of risks associated with
low RMNCH service utilization; of the immediate and secondary (including
economic) benefits; and of the potential action to be taken by them such as
supportive legislation and its enforcement. National commitments to
international conventions like the Rights of the Child will be used to legitimize
demand for government support.
The advocacy component will focus on the following:
Policy/Legislation:
Ensure that the government and parliament set up a strong enforcement,
regulatory and monitoring system for RMNCH.
Capacity Building:
Build the capacity of policy makers, parliamentarians at national and district
level for implementing the advocacy strategy. Also, advocacy capacity of
the NGOs and the media will be strengthened to effectively publicize and
promote RMNCH services.
Awareness Raising:
Raise awareness of government officials and affiliated partners about the
consequences of un skilled birth attendance, low antenatal and post natal
visits, lack of early initiation of breastfeeding, low immunization coverage.
Partners will also be given an orientation on means of achieving RMNCH
targets.

23
Advocacy Activities:
 Develop/adapt advocacy kit for political leaders, traditional and
religious leaders at national and district levels.
 Conduct high level advocacy meetings to revive the support and
commitment of political, religious and traditional leaders for
RMNCH/APR.
 Seek endorsement statements from credible authorities in government,
traditional and religious organizations and medical professionals in
support of APR.
 Meetings on key RMNCH concerns with district leaders, heads of
departments, religious and traditional leaders and key partners.
 Launch the Communication strategy by a key figure in government,
either the First Lady or Minister of Health.
 Capacity building of policy makers to develop supportive policy and
implementation
 Sensitization/Capacity Building sessions with media representatives

24
Chapter IV
SPECIAL STRATEGIES - MALE INVOLVEMENT, HEALHT
WORKERS MOTIVATION, HARD TO REACH
4.1. Male Involvement
Men are critical players in decision making regarding major RMNCH
practices; contraceptive use, maternal nutrition, institutional deliveries etc.
However, despite recognition of the urgent need for male involvement, both
globally and at the National level, limited attention has been given to
engagement of this critical target group.8 Hence, at the community level
lack of comprehensive knowledge of key RMNCH practices and low male
involvement leads to poor utilization of the RMNCH services9.
The communication strategy aims to use gender transformative (that
confronts and transforms gender norms) and gender sensitive (that is aware
of the gender norms in a specific context and how these impact gender
relations and decision making) approaches to involvement of men in
RMNCH.
The messages and training tools developed will enable the communities to
explore and understand how gender roles can impact health outcomes and
how male involvement is critical for positive RMNCH outcomes.
Research conducted by WHO - Promundo and UNFPA literature review of
Men’s role in gender equality highlight two main areas that gender
transformative programs could use to increase male involvement in RMNCH;
1. Engaging men as partners in reproductive health.
2. Engaging men as agents of change in RMNCH10.
4.2. Key Strategies
Following key strategies will be used;
8 Engaging men and boys in RMNCH, 2013, Promunoo, UNFPA, WHO
9 ‘A Promise Renewed; Reproductive Maternal, Newborn and Child Health Sharpened Plan for Uganda (2013)’.

25
4.2.1. Group Education
Using traditional approaches like story-telling, dance groups, mimes etc. the
group education sessions will have a high entertainment component. The
three core activities under the group activities will include;
Gender Roles and expectation
The group will jointly examine gender roles, expected gender behavior ‘Act
like a man’, Act like a woman’ and gender relations in their community and
how these impact both male and female reproductive health and RMNCH
outcomes.
Child care: Using role plays and simple games like ‘passing the crying doll’
representing a ‘new born baby’ teach men essential ‘child care’. The focus
should be on educating them on joint child care and showing that although
it seems simple, child care is extremely tiring a woman (mother) needs
support of her partner.
Key Barriers:
Key barriers identified for each region will be further explored; No
communication between couples on pregnancy, pregnancy considered a
normal practice and women delivering at home without medical assistance
held in high regard, Limited decision making power of women during
pregnancy, child birth and postpartum period, religious and traditional
beliefs; Ingestion of herbs to quicken labor, early marriage, girl education etc.
4.2.2. Selection of Male change agents
The use of men as change agents for promotion of RMNCH has proven useful
in different context in increasing male involvement in RMNCH. The male
change agents will be chosen from ordinary fathers, religious cultural leaders,
parliamentarians etc. Tools and materials will be developed for building their
capacity on promoting and mobilizing for RMNCH.
4.2.3. Campaigns and community mobilization
As mentioned earlier the strategy will use gender transformative
communication messaging and approaches. In addition to community level
tools and materials, a mass campaign will be designed around male role in
child caring and raring and in the broader RMNCH programme. The
campaign will move beyond the individual and target how parents, religious
cultural leaders and communities perceive gender norms and roles around
RMNCH.

26
4.2.4. Health Workers attitude
Health workers attitude has been highlighted as a key factor in impacting
male participation in RMNCH and PMTCT.11 A checklist will be developed
to assess health facility friendliness to male and female clients. Specific
focus will be training health workers in dealing with the needs of male
clients and engaging them in RMNCH. Some of the areas of focus will
include; health workers behavior towards male clients;12 harsh behavior
from skilled health workers a big barrier for male clients returning
(especially PMTCT). Quality of care; Health workers are often burdened
and taking care of participating male members is considered an
additional burden. Hence, need to build their knowledge on the
importance of male involvement. Lack of space and resources; Clinics
often have limited space to accommodate male partners who may be
discouraged from accompanying women to clinics.
4.3. Health Workers Motivation
Health workers motivation is a critical factor impacting the quality of services.
The health care workforce, the foundation of the health system, is under
increasing pressure to perform higher quality of work with limited resources.
Under the current circumstances, a focus on knowledge and skill base alone
cannot remove many of the bottlenecks faced in the delivery of quality care.
Simple, low cost catalytic interventions focusing on putting in place incentive
mechanisms for staff motivation need to be explored as the MOH and
partners prepare for the national scale critical RMNCH services. This is
especially crucial with promotion of institutional deliveries. Recent research
shows that although distance is a key factor inhibiting institutional deliveries,
mothers and caregivers are willing to travel longer distance if the facility is
perceived to provide good quality service13.
Activities
 Creating a non-monetary incentive mechanism for health workers to
Incentivize Implementation of the RMNCH package based on the
RMNCH score card. An in-depth study conducted recently in Uganda
‘Our side of the story’ clearly identifies motivators and bottlenecks to
health facility staff performance. Majority of the motivators are
13 Assessing access to barriers to maternal health care; measuring bypassing to identify health center needs in rural Uganda, Justin O Parkhurst and Freddie Ssnegooba, 20 April 2009

27
unrelated to financial incentives (pride, prestige, trust,
acknowledgement etc.). A second study, ‘non-financial incentives for
health workers retention in Uganda’ will also inform this component.
 Improve the quality of service by putting in place a ‘Certification
Mechanism’ for health facilities. A major factor impacting RMNCH
services is the variation in services between facilities and no
differentiation between well performing and poor performing health
facilities. A district based certification component will ensure
recognition of compliant facilities and will also regulate the huge
variation in quality of service across various districts and health facilities.
This will greatly enhance staff motivation
 Leader boards will be set up in each district highlighting the top
performing health facilities based on the score card. The leader boards
will be updated quarterly. The leader board data will be shared widely
and will be published quarterly in newspapers. The feedback to the
health facilities will ensure a health competition within health facilities.
This data will also be shared on the LCD screens in the health ministry
and on a public website.
 Using mTrac a SMS based disease surveillance, medicines tracking
system for removing ‘Supply Side Bottlenecks' to health workers’
motivation. Stock out of medicines and other essential commodities
has been identified as a huge de- motivator for the health facility staff.
mTrac data is now fully incorporated into the MoH’s Surveillance Unit’s
weekly news bulletin and reports of drug stock-outs, and is being
integrated into the national DHIS2 database. The system will build
accountabilities on all sides.
4.2. Specific activities for Hard to reach:
In line with the Sharpened Plan the communication strategy focuses on high
burden districts and within these districts on the underserved and hard to
reach communities. The districts are being supported by MOH and partners to
map hard to reach populations in their social maps and micro plans. These
populations usually require additional resources extra planning to be
reached. Some additional activities are listed below.
 Identify the hard to reach and underserved populations and their
locations
 Rapid assessment on the reasons why particular special groups do not
believe in and utilize RMNCH services

28
 Identification of grassroots NGOs and FBOs and engage them to
mobilize the hard to reach communities in coordination with DHMTs
 Intensive use of mass media and community radio with emphasis on
interactive radio discussion programmes especially on local FM and
community radio stations
 Intensive community mobilization using film vans, street bashes/road
shows/market days to mobilize and sensitize communities on
RMNCH/APR
 Establish outreaches and or mobile service teams to cover hard to
access populations
 Formation of District Communication Committee
 Identification of focal person within the District Health Management
Team (Health Education Officer/other)
 Identification of local volunteers (teacher/health-worker) and
formation of support groups at community level to advocate and
participate in program activities
4.3. Collaboration and Networking:
Collaboration and networking is an important component of the
communication strategy as it will strengthen alliances and partnerships
among duty bearers and partners so they can implement advocacy, social
mobilization and communication interventions that promote RMNCH services.
Activities:
 Revise Terms of reference for the social mobilization subcommittee to
address issues on mobilization for RMNCH.
 Conduct monthly social mobilization sub-committee meetings to
review progress on action items and plan for continuity in mobilizing for
RMNCH. Hold joint planning meetings to develop the annual
communication implementation plan.
 Conduct joint workshop to develop M&E communication indicators
 Conduct joint monitoring and support supervision of communication
and advocacy activities.
 Conduct behavioral research to guide monitoring and evaluation of
communication interventions

29
CHAPTER V
TRAINING AND CAPACITY BUILDING
5.1. Training and capacity building;
The implementation of the communication strategy requires strengthening
communication capacity in immunization at all levels.
5.2. Training of Trainers (TOT):
A pool of Master trainers will be trained at the national level in social
mobilization/advocacy, design and implementation of the strategy. Further
cascade training conducted at the district level. The Master Trainers will be
nominated by the Ministry of health at the national level.
5.3. Training of District Health Management Teams (District Health
Educator, District Health Inspector and District Health Visitor):
Capacity building of the district health management teams in
communication is crucial for the implementation of the RMNCH social
mobilization strategy at the district/implementation level. This will not be a
one- time activity but a series of participatory workshops will be conducted to
equip them with the necessary communication and mobilization skills for
RMNCH.
5.4. VHTs, LC1s, Chiefs, religious leaders, teachers, TBAs and health
assistants:
For sustained behavior change at community and household level,
interpersonal communication and counseling skills of the service providers at
community level such as VHTs and LC1s are extremely important. They will be
trained to enhance their interpersonal communication and counseling skills,
and in the use of IEC materials related to RMNCH. They will also receive basic
training in community mobilization to form local alliances/support groups.
Activities:
 Develop/update training manual/guidelines on communication for
RMNCH services
 Conduct training/orientation of service providers on communication,
counselling and mobilization skills for promotion of RMNCH
 Facilitate the development of action plans on mobilization of
communities for RMNCH

30
 Conduct follow-up and provide support supervision to the trained
service providers to monitor implementation of community mobilization
activities.
 Conduct meetings with Health Unit Management Committees and the
community to provide feedback on challenges and success stories on
mobilization for RMNCH services.
 Conduct quarterly review meetings with DHMTs to share experiences
and update plans for timely implementation

31
Chapter VI
Strategy Implementation
6.1. Implementation Modalities
The implementation of this strategy will be executed at different levels to
promote advocacy, social mobilisation and behaviour change
communication interventions. At national level, the strategy will be used as a
resource mobilisation tool and implementation guide at various levels. As a
resource mobilisation tool, it will be presented to government and
development partners to mobilise financial resources to support
implementation of RMNCH activities.
A phased approach to implementation will be applied based on the
understanding that it is not possible to do everything in this strategy at once.
Activities will be implemented in a phased manner in consideration of what
priority activities should precede others and build momentum for subsequent
activities over the period of five years. Special emphasis will be laid on high
burden districts in line with the priorities of the Sharpened Plan.
The phasing of implementation will provide a balanced approach towards
addressing issues in a gradual process while building on the achievements of
the previous phases and strengthening the effectiveness of each phase.
Some preparatory activities will be implemented during the first year of the
strategy such as development of IEC materials/messages and training
guidelines, putting in place the M&E framework as well as training service
providers. These will build a foundation that will support implementation of
subsequent activities. It is important to point out that the phasing of
implementation will mean giving some activities more focus/intensity and
others low focus /intensity depending on the period of implementation during
the five year period.
For example, during the first year, in addition to preparatory activities, other
activities such as advocacy with key partners national and district, mass
media campaigns, mapping of community resources will be undertaken with
high intensity to build momentum, while community based activities will take
time to build momentum. In the second year to third and fourth years of
implementation, activities of the first year will have built momentum and
community level implementation will be of high intensity. During the fifth year,
there will be greater focus to gear up for evaluation of communication and

32
advocacy interventions. The table below illustrates how key activities in the
communication strategy will be implemented in phases with varying degrees
of intensity in a period of five years.
Table 3: A Phased Approach to implementation of the RMNCH
Strategy
TIMELINE AND LEVEL OF FOCUS FOR IMPLEMENTATION
Communication
Approach
Major Activities Year 1 Year 2
Year 3 Year 4 Year 5
Programme
Communication
Conduct formative research
Develop IEC materials and
messages
Conduct mass media activities
Conduct community outreach
activities
Social Mobilisation
Develop/update
communication training
guidelines
Train service providers (VHTs,
Health Educators)
Develop M & E communication
indicators
Conduct support supervision
Conduct monitoring and
evaluation
Conduct quarterly review
meetings
Advocacy
Develop advocacy kit
Conduct advocacy meetings
for national and district level,
political leaders and other
leaders
Launch Communication
Strategy
Low Intensity Monitoring and Evaluation
High Intensity Monitoring

33
The communication strategy will be implemented as follows:
3.1Dissemination of strategy to partners and stakeholders
Once the communication strategy is approved by MOH, UNICEF, UNFPA,
WHO and other partners, it will be launched by a high level profile leader in
government to relevant key partners and stakeholders who include policy
makers at the highest level in the relevant ministries and development
partners. This will be done to solicit their support and buy-in for support to
RMNCH programme by advocating for allocation of adequate financial
resources. This will be done at national and district levels.
3.2 Development of annual communication plan
The HP&E Division will develop an annual implementation plan that provides
a framework for operationalising implementation of the communication
strategy for RMNCH at different levels. The plan will highlight communication,
social mobilisation and advocacy activities to be implemented at national
and district levels.
3.3 Development and production of training and IEC materials/messages
Effective communication and advocacy outcomes will be achieved with
support of well-targeted and focused IEC materials, messages and training
guidelines/manuals which will enhance knowledge and understanding of
RMNCH among parents, caretakers and service providers. The training
materials will be used to equip service providers with knowledge and skills in
mobilization, communication and counselling for RMNCH while IEC materials
and messages will be used to create/increase awareness and knowledge on
RMNCH among parents, caretakers and members of the community. Once
the training guidelines have been developed/adapted, training of service
providers will commence at regional level in preparation for countrywide
mobilization for RMNCH services.
3.4 Coordination and management of the strategy
Implementation of communication and advocacy activities needs to be
managed and coordinated to ensure stakeholders execute their roles more
effectively through partner complementation. The implementation of the
communication strategy will be managed by HP&E Division and coordinated

34
through the Social mobilisation sub-committee. This committee will advise on
technical issues related to communication and advocacy for RMNCH.

INTEGRATED ADVOCACY, SOCIAL MOBILIZATION AND COMMUNICATION STRATEGY AND ACTION PLAN FOR ‘A
PROMISE RENEWED’
35
Appendices
Annex 1: INTEGRATED ACTION PLAN 2014-2015
EXPECTED RESULTS OF C4D INTERVENTIONS FOR APR IN UGANDA
High impact behaviors
 Pregnant women go for at least 4 antenatal check-ups (ANC+) and 4 post natal visits (PNC)
 Pregnant mothers and Families accept skilled birth attendance and referral for institutional deliveries
 Lactating mother breastfeed within one hour (feed colostrums) and exclusively breastfeed for the first 6
months
 Child care givers provide infants appropriate complementary feeding from 6 months
 Family members practice hand washing with soap/ash at four critical times and stop open defecation
 Child care givers manage diarrhea at home through correct use of ORT and recognize early signs of
dehydration
 Family members practice appropriate care seeking behavior for pneumonia and neonatal conditions
 Families have their children immunized against preventable diseases
 Families use iodized salt, iron folate, and vitamin a supplementation to protect mothers and children against
micronutrient deficiencies

PROMISE RENEWED’
36
Strategic Objective C4D
Approach
Activities Participant Group Time
frame
Communication
Materials
Responsible
Agency
201
4
201
5
NATIONAL LEVEL
Launch a
national
sensitization
and advocacy
campaign for
maternal and
newborn
health to
ensure high
level
commitment
by
government,
political and
religious
leaders.
Advocacy 1.1. National launch ceremony to
introduce and sensitize decision
makers and policy makers at
national level on APR
Parliamentarians,
GoU officials, key
stakeholders,
development
partners, national
other opinion leaders
Done2013
Speeches/Talking points
Advocacy package
- 1 File folder,
- Brochure
- Media kit: FAQs,
stories/ articles written
by UNICEF
UNICEF/MOH
1.2. Orientation session with
parliamentarians on integrated
maternal and child survival
package
Parliamentarians Talking points
Media Kits:
FAQs
Feature stories
Speeches
1.3. Orientation session with
faith based leaders on integrated
maternal and child survival
package; Specific focus on skilled
birth attendance
Religious leaders
from all faiths
Presentations
Briefing Kits.
FAQs
1.4. Orientation sessions with
National traditional herbalist and
healers association; their role in
support of RMNCH
Traditional healers
and herbalists
Presentations
Briefing Kits.
FAQs
1.5. Media engagement and
regular interaction - Partner with
Daily monitor; other
print media;
Invitations in advocacy,
social mobilization

PROMISE RENEWED’
37
Approach
frame
Communication
Materials
Responsible
Agency
national daily newspaper, national
radio to cover nutrition and EPI
Medical Review
NTV-TV/radio
events; Q&A’s;
interviews;
1.7. Private sector engagement
with Private not for profit (PNFP)
organizations implementing
RMNCH.
Private not for profit
(PNFP)
Draft MoA, Briefing
materials
(flyer/brochure)
1.8. Advocacy meetings with
corporate groups for sharing
corporate social responsibility as
part of public-private partnership
Corporate groups:
petroleum
companies;
Draft MoA, Briefing
materials
(flyer/brochure),
backdrop, banners
Q&A’s RMNCH
1.9. Negotiation meetings with
mobile telephone corporation
managers. Partnership with mobile
telecom companies in RMNCH
program for rapid info
dissemination during the
FHDs/CHDs and rapid monitoring.
CSR
Telecommunications
Company
Invitation letter
Memo of agreement
with mobile phone
company
1.9. Develop and implement a
health workers motivation
strategy; Design incentive package,
integrated quality assurance
elements, client/mothers
satisfaction surveys to rate facilities
UNEPI,
WHO,UNICEF &
technical partners
MOH
Incentive package,
leader boards, brochure
District Level
Advocacy Develop integrated
communication micro plans for
APR focused districts Update
existing micro pans for Polio,
FHDs/ CHDS to develop
integrated micro for the RMNCH
Template

PROMISE RENEWED’
38
Approach
frame
Communication
Materials
Responsible
Agency
Include RMNCH in the agenda
of all regular monthly meetings
to be held at district level (e.g.
DHMTs, Health Unit Management
Committees meeting, Health
Sector Working groups)
Letter from DG; DHOs
on prioritization of
RMNCH.
Orientation with DHMTs on
health workers motivation strategy
package and indicators for
tracking progress.
Presentation
District Level
Mobilize and
sensitize
communities,
particularly at
sub county
level, on
maternal and
newborn
health.
Social
Mobilization
Revitalization of HUMCs to link
services with communities;
community sessions, defaulter
tracking etc.
DHMTs, Health
facility in charges
Posters
Cascading National Coalition on
RMNCH to sub national level
and development of a work plan
for the alliance in focused districts
Representation from religious
leaders, CSOs/NGOs health
professionals, media, school
teachers
Religious leaders,
NGOs/CSOs,
teachers, health
professionals
public/private,
media/cable
operators
Infor Kit; rationale,
FAQs, actions to be
taken by each group
DHMT/NGO
partner
Quarterly review of the alliances
to update on the work plan In
line with the work plan alliance
members to hold meetings in their
respective sectors
Religious leaders,
NGOs/CSOs,
teachers, health
professionals
public/private,
media/cable
Presentations,
Mobilize schools and use NGO/UJL, DHMT, Flyers, Banners

PROMISE RENEWED’
39
Approach
frame
Communication
Materials
Responsible
Agency
school children and sports
based activities for social
mobilization to communicate with
mothers and caregivers on
important RMNCH issues
Teachers
Use of mobile technology (e.g.
mtrac) for reaching mothers and
fathers with a full package of
RMNCH messages. Including
development of voice content and
delivery mechanism
Mothers, fathers, Short messages
Establishment of community
radio listeners’ groups by VHTs:
to mobilize the communities, listen
and participate in radio discussion
programmes on immunization.
Mothers, fathers, faith
based leaders
Script for Radio program
Household/Community
Review,
develop and
disseminate
health
promotion
materials on
birth
preparedness,
danger signs,
emergency
preparedness
including
emergency
transportation
Behavior
Change
Communica
tion (BCC)/
Community
engagement
Review and revise materials on
RMNCH to prepare new
interactive materials; pictoral
cards, videos, SMS messaging on
birth preparedness, danger signs,
emergency preparedness,
MOH,UNICEF,
UNFPA,WHO,USAID
/MCHIP
Presentations,
Communication material
for review
Developing and airing radio
messages on key RMNCH
practices with specific focus on
ANC/PNC and skilled birth
attendance
MOH,UNICEF,
UNFPA,WHO,USAID
/MCHIP
Radio script
Public announcements and
messages on mass media and
endorsement by good will
Mothers, father,
caretakers
Script

PROMISE RENEWED’
40
Approach
frame
Communication
Materials
Responsible
Agency
and
communication
system at the
community
level.
ambassadress
One day refresher training on
IPC. Community dialogue and
social mobilization for RMNCH
for frontline workers at district and
community level
VHTs,LC1s, Scouts,
vaccinators
NGO/CBOs,
Training Manual
One day training for peer to
peer education mothers trained
on advising mothers and pregnant
women on key RMNCH practices
Mothers Training Manual
Mobilization for community
mapping to identify, include and
support underserved poor families
and disadvantaged pregnant
women, lactating mothers, un-
immunized/ defaulting children
Community, families,
health facility staff
Mapping Template
Register families/caregivers
with U5 children and pregnant
mothers and use SMS/ other
mobile telephony solutions to
remind mothers of RI+ , antenatal
schedule and to give educational
tips messages on NBC, RI/PCV,
EBF, WASH, IYCF.
Families/ husbands/
mothers/ caregivers
With mobile phones
20
13-
20
15
Prepared messaging for
transmission as
scheduled (long term)
TBD

PROMISE RENEWED’
41
Approach
frame
Communication
Materials
Responsible
Agency
Group and individual
counselling sessions with
mothers, fathers and other care
givers by VHTs/LC1s, Scouts to
motivate mothers, caregivers on
RMNCH, reinforcing mass media
messages and addressing queries
Mothers, caregivers VHT manual
Integrated flip chart
One page leaflet on key
RMNCH
Scripts and lyrics for folk
song for community
meetings,
Completion of Birth
preparedness plan for each
pregnant mother; Delivery date,
ANC visits, transportation, cash,
name of health worker etc. (Health
facility midwives with family
support groups)
Mothers, husbands,
family, community
Birth plan
Mobilization through churches
and mosques; Sunday and
Friday sermons
Community
Families
Brochure for Imam
Masjid
Enhancing health literacy and
care seeking among mothers
through SMS. Provision of
relevant health information to
pregnant women and new
mothers using personalized text or
voice messages
Mothers, pregnant
women
Script

PROMISE RENEWED’
42
Annex 1: Stages of Behavir change
The Stages of Behavior Change theory explains the various steps an
individual or stakeholder group goes in order to change behavior.
Individuals and organizations start at different steps and they may not go
through each of step of the process or in the same order or at the same
speed. They can leap up or move down several steps at a time.
Once they have moved up there is no guarantee that they will not move
back.
Hence, sustained effort is needed to keep y target audiences on an
upward path.
Different strategies will help stakeholders move up the ladder; knowledge
through media, friends, trusted cultural and religious leaders etc.
Therefore it is extremely important to know what stage the majority of a
particular target groups is at in order to employ the right strategy. For
example if majority of mother lack knowledge on key RMNCH practices
the first important strategy to reach this group may be mass media for
fast dissemination of information. However, as people move up the ladder
they may have more questions regarding the new behavior and in this
case more interpersonal strategies will be effective.

PROMISE RENEWED’
43
The social ecological models explain the link
between the individual behavior and the
enabling environment. In the past development
approaches focused on individual behavior
change. But since then we have learnt that
individuals often do not or cannot change
behavior without support from the environment
around them; Parents, spouses, peers, friends,
community and religious leaders etc. Factors
like such as family pressure, community norms,
and the larger policy and legal environment can
affect the health related behaviors an individual
engages in. Thus and individuals behavioral
choices should be seen in the larger context of
his and her environment. Hence, interventions
are needed at different levels of the environment
to facilitate behavior change.
Annex 2: Social ecological model

PROMISE RENEWED’
44
Annex 5: Matrix for assessing Demand side barriers (adapted14
)
14

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