PSP-One Leads WHO ORS & Complete Home Diarrhea Management in India
The behavior change communication efforts of the ‘Saathi Bachpan Ke’ (Partners for Childhood) WHO ORS and Complete Home Diarrhea Management (CHDM) Program employ innovative approaches to create the impetus, desire and tools for effective adaptation of health-seeking practices in impoverished areas.
The Urban Poor are at high risk of severe health complications or even death from diarrhea. Children are defenseless against the poor sanitary conditions in urban slums while those responsible for the health and safety are equipped with few resources. Also, most caregivers (primarily mothers) do not have correct and adequate knowledge of home diarrhea management. Consequently, each year in India nearly 500,000 children aged five and under die of dehydration related to preventable and treatable diarrheal infections. Behavior change communication efforts must employ innovative and comprehensive approaches to create the impetus, desire and tools for effective adaptation of health seeking practices, and build the capacity of family and community resources in impoverished areas.
The communication tools of the ‘Saathi Bachpan Ke’ WHO ORS & CHDM Program, funded by USAID and managed by PSP-One in India, do just that. The Program encourages both promotive and preventive behaviors for home diarrhea management. The promotive behaviors include WHO ORS and appropriate home available fluids, continued feeding and additional energy dense food after the diarrheal episode, recognition of critical signs of illness and taking the child to a doctor. Amongst the preventive behaviors are exclusive breast feeding up to six months, continued breast feeding during diarrhea and hand washing with soap.
As a part of the program outreach plan, an innovative approach was adopted to reach out to urban slum dwellers and use edutainment as a means to communicate key messages about home diarrhea management. PSP-One rolled out eight hundred nukkad natak (Street Theatre) shows in the slums of 27 major cities and towns across the states of Uttar Pradesh, Uttaranchal, Jharkhand, Bihar and Rajasthan in the months of August to October this year.
Street theatre is a proven medium to reach those with reduced access to mainstream media. Street theater is interactive, and allows communities to interface with those delivering CHDM messages through real-life situations. This fosters learning and understanding with the aim to adopt positive behavior.
Each performance was followed by a small quiz for the audience to gauge the level of understanding of the messages communicated through the performance. Those giving the right answers were given instant prizes. The Health cards were distributed after each show entitling caregivers of children below five years of age to get a free health check-up at a health camp on the same day. The health camps were located a short distance from the performance venue and PSP-One trained local ISMP doctors (Indian System of Medicine Practitioner) in diarrhea management and overall growth monitoring of children to undertake these camps. No fee was given to the ISMP doctors and they volunteered for the activity as it gave them credibility and increased their patient base. This approach links the campaign to local resources! Since this approach utilizes an intuitive and popular communication channel its potential for success is limitless. Current behaviors and practices amongst communities and other learnings from the formative research were carefully analyzed and woven into the script for these performances. The renowned Banglanatak Street Theatre troupe – specialists in social sector communication and community development - carried out the performances. McCann Outreach was entrusted with the overall management of this huge outreach exercise. The private sector also provided resources, donating ORS samples from program manufacturing partners and demonstrating the correct procedure for mixing ORS.
The public sector was represented by cadets from the National Cadet Corps (NCC), a voluntary youth organization. The Ministry of Defense, Government of India agreed to allow participation of NCC Cadets to help manage crowds at the shows.
The activity was very successful in that the program could directly reach out and communicate messages to 141,000 people overall and to 38,065 caregivers with children below five years of age residing in urban slums. Nearly 25,000 children below the age of five attended the free health check-up camps.
This approach proves that building community resources around health strengthens communities overall. This innovative channel used to inform vulnerable populations about Complete Home Diarrhea Management should make considerable impact and save lives.
