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

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

Presentation Outline

Program Overview: Community-based health in Madagascar

WHAT, WHY, HOW?

Results and Impact

Lessons Learned

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)

The communities we partner with

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

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)

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

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

HOW: Studies and Formative Research

• Suggest solutions to overcome barriers to practice health

behavior

• Cultural

appropriateness

• Evidence-based

strategy

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

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:

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

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

• 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

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.

THANK YOU FOR YOUR ATTENTION

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