Gender Responsive Communication for Development: Mapping and Assessment of UNICEF Initiatives in Afghanistan, Bangladesh, Nepal and Pakistan
UNICEF Regional Office for South Asia February 2018
Gender Responsive Communication for Development: Mapping and Assessment of UNICEF Initiatives in Afghanistan, Bangladesh, Nepal and Pakistan
This report provides in-depth analysis of initiatives from four countries – Afghanistan, Bangladesh, Nepal and Pakistan. These country offices participated in all phases of the assessment by responding to the initial request for information, providing documents for review, completing the survey and reviewing the draft report. The lessons learned, guidelines and recommendations, however, are intended to benefit all countries in the region.
This assessment was undertaken by Ami Sengupta, Consultant with overall guidance and inputs from Sheeba Harma, Regional Gender Adviser UNICEF ROSA. Acknowledging the contribution of C4D and
Gender teams in the country offices for their collaboration and for sharing materials and reviewing
the assessment. Also acknowledging, Diane Summers, Regional Adviser C4D and Kendra Gregson,
Regional Adviser Child Protection for reviewing this assessment and Rui Nomoto, Gender Officer for
supporting the document design and layout. The assessment was undertaken with joint funding
from Gender and Child Protection sections at UNICEF ROSA.
© UNICEF ROSA Cover Photo: © UNICEF/UNI121045/Froutan
2
Table of Contents
List of Tables ...... 4 List of Figures ...... 5 Abbreviations ...... 6 Introduction ...... 9 Overview ...... 9 Definitions and Key Concepts ...... 10 Section 1: Mapping of Current Interventions ...... 14 Methodology...... 14 Trends in UNICEF C4D and Gender Initiatives in South Asia...... 15 Country Snap Shots ...... 23 Afghanistan ...... 24 Bangladesh ...... 32 Nepal...... 43 Pakistan ...... 51 Section 2: Case Studies and Lessons Learned ...... 63 Afghanistan: Golden Villages Initiative ...... 63 Bangladesh: National Multi-Media Campaign Strategy to End Child Marriage ...... 67 Nepal: The Golden 1000 Days Communication Campaign ...... 72 Pakistan: Menstrual Hygiene C4D Strategy ...... 76 Section 3: Gender Responsive C4D ...... 80 Opportunities and Challenges for Integrating Gender in C4D ...... 80 Applying a Gender Lens to C4D Programme Planning ...... 83 Gender Responsive C4D Checklist ...... 85 Integrating Gender in the C4D Planning Process ...... 86 Section 4: C4D and Gender Needs Assessment ...... 95 Methodology...... 95 Findings ...... 95 Section 5: Recommendations ...... 102 Annex 1: Mapping and Needs Assessment Survey ...... 106
3 List of Tables
Table 1: Gender Responsive Assessment Scale ...... 13
Table 2: Criteria for Inclusion ...... 15
Table 3: Summary of C4D Initiatives Across the Focus Areas ...... 18
Table 4: Different Kinds of Beliefs and Collective Practices on Child Marriage ...... 68
Table 5: Sample of Social Change Indicators included in the Strategy ...... 77
Table 6: Phase(s) of the C4D Planning Cycle where Gender Considerations are Integrated ...... 82
Table 7: Phase(s) of the C4D Planning Cycle that are most Challenging to Integrate Gender Considerations ...... 82
Table 8: Gender Responsive C4D Initiatives to Address VAC ...... 84
Table 9: C4D Staffing in Country Offices ...... 95
Table 10: Gender Staffing in Country Offices ...... 96
Table 11: Level of Coordination Between C4D and Gender Sections ...... 97
Table 12: Involvement of Gender Specialist/Focal Point in the C4D Planning Cycle ...... 97
Table 13: Level of Gender Integration in Current C4D Programmes ...... 98
Table 14: Stages of C4D Planning and Gender Integration ...... 100
Table 15: Thematic Areas Requiring Further Investments and Capacity Building ...... 100
4 List of Figures
Figure 1: Mapping Methodology and Report Writing Process ...... 14
Figure 2: Gender Equality Continuum ...... 83
Figure 3: Social Ecological Model ...... 86
Figure 4: Overview of Integrating Gender and C4D ...... 87
Figure 5: Integrating Gender in the C4D Planning Process ...... 88
5 Abbreviations
AATWIN Alliance Against Trafficking In Woman and Children in Nepal ACORAB Association of Community Radio Broadcasters AGE Acute Gastro Enteritis AI Appreciative Inquiry AKRSP Agha Khan Rural Support Programme AMARC World Association of Community Radio Broadcasters (Association Mondiale Des Radiodiffuseurs Communautaires) ANC Ante Natal Care ARLC Adolescent Radio Listener Club AWLI Afghan Women’s Leadership Initiative BCC Behaviour Change Communication C4D Communication for Development CBA Community Based Approaches CBO Community Based Organizations CHW Community Health Worker CLTS Community led Total Sanitation CO Country Office CPD Country Programme Document CTI Comprehensive Targeted Intervention DSMS Directorate of School Management Shuras ECD Early Childhood Development ECMP Ending Child Marriage Programme E-E Entertainment-Education EFM Early Forced Marriage EPI Expanded Programme on Immunization FATA Federally Administered Tribal Area FCHV Female Community Health Volunteer FGD Focus Group Discussion FLW Front Line Workers FT Fixed Term GAP Gender Action Plan GBV Gender Based Violence GESI Gender and Social Inclusion Team GFP Gender Focal Point GRID Gaming Revolution for International Development
6 GVI Golden Village Initiative ICT Information Communication Technology IEC Information Education and Communication IFA Iron and Folic Acid IFC Information Feedback Centres IMCI Integrated Management of Childhood Illness IP Implementing Partner IPC Interpersonal Communication IVR Interactive Voice Response IYCF Infant Young Child Feeding KAPB Knowledge Attitudes Practices and Behaviours KP Khyber Pakhtunkhwa LHW Lady Health Worker M&E Monitoring and Evaluation MIC Microsoft Innovation Centre MIYCN Maternal Infant Young Child Nutrition MCWk Mother and Child Week MHM Menstrual Hygiene Management MOWCA Ministry of Women and Children Affairs MSNP Multi-Sector Nutrition Plan MTR Mid Term Review NHEICC National Health Education Information Communication Centre NGO Non Governmental Organization NMICS Nepal Multiple Indicator Cluster Survey NPC National Planning Commission ORS Oral Rehydration Salts PCA Programme Cooperation Agreements RMNCAH Reproductive Maternal Newborn Child and Adolescent Health RI Routine Immunization ROSA Regional Office for South Asia SBCC Social and Behaviour Change Communication SEM Social Ecological Model SMS School Management Shura TA Temporary Appointment TOC Theory of Change UNICEF United Nations Children’s Fund VAC Violence Against Children
7 VDC Village Development Committee VSC Village Sanitation Committee WASH Water Sanitation and Hygiene WIFS Weekly Iron and Folic Acid Supplementation WHO World Health Organization
8 Introduction
Overview
The United Nations Children’s Fund (UNICEF) Regional Office for South Asia (ROSA) commissioned an assessment of the gender responsiveness of communication and development (C4D) initiatives in the region in order to better understand how to address critical gender norms. The primary objective of the assessment is to examine how gender has been integrated into C4D efforts, collate good practices in addressing gender norms, identify areas for improvement and provide a set of clear recommendations to enhance gender responsiveness in C4D programming in the region.
Recognizing the value of the girl child is a fundamental part of achieving UNICEF’s mission and addressing gender discrimination is an imperative to ensuring the rights of girls and women. Evidence clearly supports that gender-based norms contribute to and perpetuate the marginalization of girls in South Asia. Girls are discriminated against throughout their lifecycle, from birth, in the early years and through adolescence. Girls are disadvantaged in terms of health care and nutrition, access to education and secondary school completion, and are at risk of child marriage and several forms of violence, abuse and exploitation. Data across countries supports the fact that a disproportionate share of gender disadvantage is faced by women and girls.1 Gender is, therefore, a critical determinant of child outcomes and accounting for gender-based differentials in C4D planning, implementation and evaluation can enhance the impact of social and behaviour change efforts.
Assessing how gender is being addressed in C4D interventions enables planners to consider what has been done well and identify potential gaps and opportunities for future investments. A systematic review of ongoing work, garnering insights from UNICEF staff and analysis of relevant literature supports enhanced gender responsive social and behaviour change interventions in the future. In addition to this mapping report and the accompanying needs assessment report, the assignment includes developing practical guidelines and evidence based recommendations to inform forthcoming C4D and gender efforts.
The overall question guiding the assessment was to gain an understanding of how gender is integrated in recent, on going or planned C4D initiatives led by UNICEF offices in South Asia. Specifically, the assignment seeks to shed light on the following questions:
• What types of gender related C4D interventions are currently being carried out or planned by UNICEF offices in South Asia? • How gender aware or responsive are UNICEF’s C4D interventions in South Asia? • Which stages of the C4D planning cycle have integrated gender considerations? Which stages require better integration? • What are some good practices, lessons learned and opportunities to scale up in the region? • What are some gaps, potential opportunities and areas for improvement in further integrating a gender perspective in C4D interventions? • What are some barriers and bottlenecks in integrating gender perspectives in C4D interventions in South Asia? • How can UNICEF staff in South Asia be supported to better integrate gender elements in current C4D programming?
This report comprises of five parts; a mapping of C4D and gender initiatives, case studies and lessons learned, guidance on planning gender responsive C4D, C4D and gender needs assessment, and recommendations for future actions. The mapping presents an overview and gender analysis of C4D efforts based on documents
1 UNICEF Gender Action Plan 2014-2017.
9 shared by Afghanistan, Bangladesh, Nepal and Pakistan Country Offices. The case studies highlight initiatives across countries and programme areas where gender has been well integrated. The section on gender responsive C4D provides practical guidance on better integrating gender in C4D initiatives. This section includes a check-list and a step-by-step guidance. The needs assessment addresses technical needs of UNICEF staff in country offices. Finally, the recommendations put forth specific actions that will support country office teams to ensure more gender responsive C4D interventions in the future. A separate report will cover a review of literature on C4D and gender in South Asia and global good practices.
Definitions and Key Concepts
In order to have a common frame of reference for the assessment, this section provides definitions of key terms and concepts related to both C4D and gender.
❖ Communication for Development
Communication for development is currently defined in UNICEF as a “…systematic, planned and evidence based strategic process to promote positive and measurable behaviour and social change that is intrinsically linked to programme elements; uses consultation and participation of children, families, communities and networks, and privileges local contexts; and relies on a mix of communication tools, channels and approaches.”2 C4D uses a combination of complementary and mutually reinforcing approaches to promote behaviour and social change among targeted participant groups. These approaches include advocacy, social mobilization, social change communication and behaviour change communication. Each approach typically operates at different levels of the Social Ecological Model (SEM). It is important to note that these are broad categorizations; in practice there is often some overlap between these closely related approaches. The following section provides definitions for each approach.3
Advocacy is an organized effort to inform and motivate leadership to create an enabling environment for achieving programme objectives and development goals. The purpose for advocacy is: (1) to promote the development of new policies, change existing governmental or organizational laws, policies or rules, and/or ensure the adequate implementation of existing policies; (2) to redefine public perceptions, social norms and procedures; (3) to support protocols that benefit specific populations affected by existing legislation, norms and procedures, and/or (4) to influence funding decisions and equitable allocation of resources for specific initiatives. Community level advocacy provides a platform for voices of children and women, especially those from marginalized and excluded groups, to be heard.
Social mobilization is a continuous process that engages and motivates various inter-sectoral partners at national and local levels to raise awareness of, and demand for, a particular development objective. These partners may include government policymakers and decision-makers, community opinion leaders, bureaucrats and technocrats, professional groups, religious associations, non-governmental organizations, private sector entities, communities, and individuals. This communication approach focuses on people and communities as agents of their own change, emphasizes community empowerment, and creates an enabling environment for change and helps build the capacity of the groups in the process, so that they are able to mobilize resources and plan, implement and monitor activities with the community. Engagement is usually through interpersonal communication (i.e., face-to-face dialogue) among partners towards changing social norms and accountability structures; providing sustainable, multifaceted solutions to broad social problems,
2 Communication for Development (C4D) Strategic Framework and Plan of Action 2008-2011: Harnessing the Power of Communication to Deliver Results for Children. C4D Section, UNICEF: New York. 3 A Global Communication for Development Strategy Guide for Maternal, Newborn and Child Health and Nutrition Programmes (2015). UNICEF: New York.
10 and creating demand and utilization of quality services.
Social change communication is a purposeful and iterative process of public and private dialogue, debate and negotiation that allows groups of individuals or communities to define their needs, identify their rights, and collaborate to transform the way their social system is organized, including the way power is distributed within social and political institutions. This process is usually participatory and is meant to change behaviours on a large scale, eliminate harmful social and cultural practices, and change social norms and structural inequalities.
Behaviour change communication (BCC) is the strategic use of communication to promote positive health and other outcomes. BCC is a theory-based, research-based, interactive process to develop tailored messages and approaches, using a variety of population-appropriate communication channels to motivate sustained individual- and community-level changes in knowledge, attitudes, and behaviours. Formative research is used to understand current levels of knowledge, attitudes and behaviours among individuals in a specified population in order to develop communication programmes that move those individuals along a continuum of change (or through stages of change) towards the desired positive behaviour(s).
Communication has been used for several decades as a means to improving the situation of children and families by promoting health, nutrition, sanitation, education and numerous other human rights issues. There is abundant evidence demonstrating that communication strategies implemented through a mix of approaches, channels and aimed at different participants and stakeholders can inform, influence, motivate, engage and empower. The UNICEF Global Strategic Plan 2018-2021 highlights the role of C4D in achieving its five goals.4 At the regional level, too, C4D is considered a vital strategy in achieving results for children. C4D can contribute to the following changes:
• Increase knowledge and skills related to child survival, education and protection; • Alter attitudes and perceptions that pose barriers to children’s health, safety and well-being; • Strengthen capacity and confidence to demand and use available services for child survival, nutrition, sanitation, education and protection; • Enhance skills to negotiate choices, voice perspectives and make safer choices, especially for adolescents; • Transform attitudes that normalize and accept gender discrimination linked to child care, access to nutrition, health care, education, sanitation and protection; • Break the silence surrounding violence against children; • Foster community dialogue on the value of the girl child and the importance of protecting children’s rights; • Promote new norms where all children complete secondary school and do not marry before the age of 18; • Transform existing power structures and patterns of discrimination based on gender, ability, ethnicity or background; • Create an enabling environment where homes, schools, and communities are safe spaces for girls and boys; and • Advocate for policy changes and improved service provision related to child rights.
❖ Gender
Gender refers to the social attributes and opportunities associated with being male and female and the
4 The Strategic Plan seeks to contribute to the realization of the rights of all children, especially the most disadvantaged. This envisaged impact will be achieved through five Goal Areas: every child survives and thrives; every child learns; every child is protected from violence and exploitation; every child lives in a safe and clean environment; and every child has an equitable chance in life. The Strategic Plan is available at: https://www.unicef.org/about/execboard/files/2017-17-Rev1-Strategic_Plan_2018-2021-ODS-EN.pdf
11 relationships between women and men and girls and boys, as well as the relations between women and those between men. These attributes, opportunities and relationships are socially constructed and are learned through socialization processes. They are context- and time-specific and subject to change over time. Gender determines, in large measure, what is expected, allowed and valued in a woman or a man in a given context. In most societies there are differences and inequalities between women and men in responsibilities assigned, activities undertaken, access to and control over resources, as well as in decision-making opportunities. Gender is part of the broader socio-cultural context. Other important criteria for socio-cultural analysis include class, race, poverty level, ethnic group and age.5
Given the differences and inequalities that exist between girls and boys during childhood and between women and men through adult years, development and social change programmes aim to further gender equality. UNICEF adopted a policy on gender equality and the empowerment of girls and women in 2010, which continues to guide the organization’s work in the area of gender equality. The policy articulates that UNICEF’s work in gender equality must contribute to the achievement of global development goals through results-oriented and effective action that ensures the protection, survival and development of girls and boys on an equal basis. The policy also stipulates that all UNICEF-assisted programmes, including humanitarian actions, are designed to contribute to gender equality in clearly defined and measurable ways, with evidence-based gender results statements and indicators.6
UNICEF’s Gender Action Plan (GAP) explains that gender equality is realized when women and men and girls and boys enjoy the same rights, resources, opportunities and protections. Because power structures in societies across the world mostly privilege boys and men, advancing gender equality most often requires addressing disadvantages faced by girls and women. At the same time, because gender inequality pervades personal, family and social relationships and institutions, it affects men and boys as well, and requires the engagement of both sexes to make progress towards justice and equality. Shifts in gender equality require not only awareness and behaviour change, but also changes in the fundamental power dynamics that define gender norms and relationships. 7 Achieving gender equality requires levelling the playing field, which necessitates working with girls and women, as well as with boys and men, parents, community leaders, and those with power and influence in the economic, political and social spheres.8
Gender responsive programming refers to programmes where gender norms, roles and inequalities have been considered, and measures have been taken to actively address them. Such programmes go beyond increasing sensitivity and awareness and actually do something to narrow or remove gender inequalities. Gender sensitive programming, on the other hand, refers to programmes where gender norms, roles and inequalities have been considered and awareness of these issues has been raised, although appropriate actions may not necessarily have been taken. Gender sensitive efforts need to be accompanied by gender responsive actions in order to achieve gender equality and transform gender relationships and power structures.9
A gender analysis critically examines how differences in gender roles, activities, needs, opportunities and rights or entitlements affect men, women, girls and boys in certain situation or contexts. Gender analysis examines the relationships between females and males and their access to and control of resources and the constraints they face relative to each other.10 A gender analysis seeks to understand how gender differences,
5 UN Women: Concepts and Definitions. Available at: http://www.un.org/womenwatch/osagi/conceptsandefinitions.htm 6 Working for an Equal Future: UNICEF Policy on Gender Equality and Empowerment of Girls and Women. 7 UNICEF Gender Action Plan 2018 -2021. 8 UNICEF Gender Action Plan 2014 -2017. 9 Integrating Gender into HIV/AIDS Programmes in the Health Sector: Tool to Improve Responsiveness to Women's Needs (2009). World Health Organization: Geneva. 10 UNICEF, UNFPA, UNDP, UN Women. E-Learning course on Gender Equality, UN Coherence and You.
12 roles, power dynamics have been considered in the planning, development, design, implementation and evaluation of the programme. Table 1 provides a gender assessment scale and criteria for assessing programmes and policies, developed by the World Health Organization, which has been used to guide the analysis in this report.
Table 1: Gender Responsive Assessment Scale11
Gender Negative • Perpetuates gender inequality by reinforcing unbalanced norms, roles and relations • Privileges men over women (or vice versa) • Often leads to one sex enjoying more rights or opportunities than the other
Gender Blind • Ignores gender norms, roles and relations • Very often reinforces gender-based discrimination • Ignores differences in opportunities and resource allocations for women and men • Often constructed based on the principle of being “fair” by treating everyone the same
Gender Sensitive • Considers gender norms, roles and relations • Does not address inequality generated by unequal norms, roles or relations • Indicates gender awareness, although often no remedial action is developed
Gender Specific • Considers gender norms, roles and relations for women and men and how they affect access to and control over resources • Considers women’s and men’s specific needs • Intentionally targets and benefits a specific group of women or men to achieve certain policy or programme goals or meet certain needs • Makes it easier for women and men to fulfil duties that are ascribed to them based on their gender roles
Gender Transformative • Considers gender norms, roles and relations for women and men and that these affect access to and control over resources • Considers women’s and men’s specific needs • Addresses the causes of gender-based health [and other] inequities • Includes ways to transform harmful gender norms, roles and relations • The objective is often to promote gender equality • Includes strategies to foster progressive changes in power relationships between women and men
11 Gender Mainstreaming Manual for Health Managers: A Practical Approach, (2011). World Health Organization: Geneva.
13 Section 1: Mapping of Current Interventions
The section presents a mapping of UNICEF’s C4D initiatives implemented or planned between 2010 and 2020. Initiatives addressing five focus areas - Health and Nutrition, Educating Girls and Boys, Ending Child Marriage, Violence against Children and Menstrual Hygiene Management – are reviewed. The focus areas were selected to closely align with the six regional headline results for 2018 -2021, which are:
1. Save newborns: 500,000 additional newborn lives saved by 2021; 2. Stop Stunting: 10 million fewer children with stunted growth and development by 2021; 3. Every Child Learns: 10 million previously out-of-school children are enrolled and learning in pre- primary, primary and secondary by 2021; 4. Eradicate Polio: a) No new polio cases by the end of 2018 b) 3.3 million children fully-immunized by 2021 with focus on the most marginalized; 5. End Child marriage: 500,000 child marriages averted by 2021; 6. Stop Open defecation: 148 million fewer individuals practice and use basic sanitation in South Asia.
Methodology
This regional analysis and mapping relied on information, documents and material shared by UNICEF offices in the region. The country offices included in the South Asia region are: Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka. Following the initial requests for information with all country offices, a brief questionnaire was developed and circulated for inputs. The survey aimed to systematize the mapping and to ensure that the experiences, technical needs and perspectives of both C4D and Gender colleagues in all country offices were included.
The survey was completed by both C4D and Gender staff and focal points, with a section for the Deputy Representatives or Officer in Charge. Out of the eight country offices, four countries – Afghanistan, Bangladesh, Pakistan and Nepal – responded to the request for information, provided documents for review, and also completed the survey questionnaire, therefore, the analysis in this report focuses on these countries. Follow up interviews were held with relevant staff members during the report writing process to cross check data and to garner additional insights for the case studies. The draft report was reviewed by staff from all four country offices prior to finalization. Figure 1 provides an overview of the mapping methodology and report writing process.
Figure 1: Mapping Methodology and Report Writing Process
Initial request for information
Mapping and needs assessment survey
Follow-up interviews
Review of draft report
Finalization of report
14 The documents shared by colleagues included concept notes, partnership agreements, press releases, C4D strategies and research reports. The criteria and inclusion parameters are detailed in Table 2. The mapping included C4D initiatives in the region on the five focus areas, which met the inclusion criteria and for which supporting documents were provided.
Table 2: Criteria for Inclusion
Criteria Inclusion Parameters Type of Intervention Implemented or planned C4D interventions with a gender focus
Timeline Initiatives spanning between 2010-2020
Thematic Focus Areas I. Health and nutrition12 II. Educating girls and boys III. Ending child marriage IV. Ending violence against children V. Menstrual hygiene management
Type of Documents Documentation of initiatives in English (e.g., strategy documents, programme briefs, donor reports, partnership documents, evaluations)
Exceptions Any initiatives that did not fit the above three criteria but are noteworthy and may be exemplars or best practices for C4D and gender in the region
This mapping did not include the actual content of media products and material such as TV soaps, spots or training toolkits, or any documentation that was in national or regional languages. Reviewing media material would have been challenging for several reasons such as the vast amount of C4D material produced in the region, the multiple languages used across countries and the difficulty in accessing the material remotely. Hence, media material and training content were beyond the scope of this assignment.
Since this was a remote assignment, the consultations and follow up were over email and, when necessary, on Skype calls. An inherent bias of the study is that the review included only what was shared by country offices and only initiatives that were documented in some form or another in English. The mapping also relied only on the inputs of current staff members. Some initiatives that could have served as best practices or lesson learned may not have been included for lack of input or available documentation. Another limitation is that the documents reviewed may not fully capture the implementation challenges or complexity of the programming context. Finally the mapping does not aim to present findings on the effectiveness of the C4D initiatives in furthering gender equality or transforming gender relationships, which would require a full-fledged evaluation.
Trends in UNICEF C4D and Gender Initiatives in South Asia
Based on the documents shared and survey responses received from country offices, UNICEF offices in the region are engaged in a wide variety of C4D efforts across all five focus areas. Diverse initiatives are represented, ranging from awareness-raising or health promotion initiatives such as the promotion of Iron
12 In line with the headline result the focus area initially selected was Saving the Newborn, it was later expanded to health and nutrition to include a wider range of initiatives – through the first 28 days to infancy, childhood and adolescence.
15 and Folic Acid (IFA), to those that engaged community based influentials such as male religious leaders to end child marriage and mobilization of school management shuras to promote enrolment of out-of-school children.13 The initiatives presented a range of C4D approaches, including both individual level behaviour change and social change where the emphasis is on community members rather than individuals, as agents responsible for social change and supported with information, actionable advice and communication tools.
Country offices reported multiple initiatives under the five focus areas (see Table 3). The documents received represented a mix of research reports, strategy documents, partnership agreements, concept notes and press releases. Many initiatives addressed a specific issue within a focus area, such as routine immunization or maternal, infant and young child nutrition, while several others took on a cross-sectoral approach and addressed multiple focus areas, such as the Golden Villages Initiative in Afghanistan which encompassed five sectoral results (immunization, attended birth, nutrition, school enrolment and child marriage) and the 1000 Golden Days programme in Nepal. The C4D programme in Bangladesh includes 11 behavioural areas covering key life-saving, care and protective practices. Several countries are also carrying out integrated, cross- sectoral efforts on adolescent issues. Bangladesh, for example, is spearheading a multi-media Entertainment-Education (E-E) initiative focussing on adolescent issues and child marriage. Beyond the five focus areas guiding the study, country offices also shared examples of emergency communication efforts that had a strong emphasis on gender and protection, such as the earthquake related disaster risk reduction C4D initiatives in Nepal and the C4D response to the Rohingya crisis in Bangladesh.
The level of gender integration varies across focus areas, depending on whether it is an initiative specifically targeted to girls and women (e.g., menstrual hygiene management or child marriage) or one aiming to mainstream gender (child survival or violence against children). C4D initiatives targeted towards girls appear to be more gender responsive than those where gender is mainstreamed. Likewise, gender results are integrated at different levels of the results framework. For instance, the Golden Villages Initiative in Afghanistan includes the recognition of women’s role and autonomy at the outcome level and engagement of women in mothers groups and village co-ordination committees at the output level. The Golden 1000 Days campaign in Nepal promotes more equitable distribution of household tasks and childcare as a campaign objective; and changes in spousal communication and workload distribution are tracked through behavioural monitoring. System strengthening and institutional capacity development initiatives with an emphasis on gender have also been carried out, such as a university based initiative for curriculum development and research and a new programme on community participation in relation to local governance for children in Bangladesh.
In terms of strategic planning and design, the initiatives examined aimed to achieve a varied range of communication objectives. All efforts include enhancing knowledge and skills, but some of them went further to include building self-confidence or generating community level dialogue through engaging adolescents or local influentials.
Countries also shared some examples of C4D research. The Bangladesh Office was the only country that shared an evaluation of the effectiveness of the C4D Programme. Likewise, initiatives from Nepal and Bangladesh provided examples of robust behavioural monitoring systems to track the effectiveness of various activities and messages. Formative research was more commonly conducted, as in the case of MHM and immunization in Pakistan. A very small number of initiatives explicitly built on SBCC theories or frameworks and no initiative drew on any gender theories. The following section provides an at-a-glance
13 School Management Shura is a council for each school which aims to promote quality education and change community attitudes towards girls’ education. Shuras provide management and supervision to Public Schools supported by the Ministry of Education for ensuring community ownership for the future of their children (Barekzai, 2015).
16 summary of current C4D and Gender initiatives followed by an overview and analysis of documented initiatives, under the country snap shots. Table 3 presents the range of C4D initiatives underway in the four country offices across the five focus areas. The information is compiled from the survey responses received from countries. It is important to note that some of these initiatives are C4D led, while some are programme or sector led efforts, which include a C4D component. For instance, beyond the initiatives listed, behavioural outcomes have been integrated with an estimated 5000 Adolescent Clubs run through the Ministry of Women and Child Affairs in Bangladesh. Supporting documentation was not provided for all the initiatives presented in the table, hence all interventions listed may not necessarily be included under the country snap shots.
17 Table 3: Summary of C4D Initiatives Across the Focus Areas
Focus Areas/Country Afghanistan Bangladesh Nepal Pakistan
Health and • Country-wide promotion • National level media • Print and mass media • Mother and child and Nutrition of Zinc-ORS co-pack campaign on essential products on essential breastfeeding weeks in ‘Salamaty’ newborn care newborn care Pakistan
• KAP formative • Proof of concept for • Promoting facility based • MNCH communication qualitative research on institutional deliveries, delivery through strategy complementary 100% immunization and community engagement feeding adequate growth (engaging men elderly) • Training manual and
through the Golden guidelines on essential • Formative research on Villages initiative newborn care and IMCI • Networking systems at stunting in Sindh,
local levels to facilitate supported also by • RMNCAH • MIYCN communication public debate around life- WASH communication strategy strategy and action plan saving, care and as a part of the multi- • protective behaviours U-report. Survey on RI • Immunization strategy sectoral nutrition plan with fathers and mothers. FGDs with • Community based • Adolescent health and • Golden 1000 days targeted communities
nutrition package nutrition programme communication • with emphasis on ARSH campaign (mass media Messages on immunization • Weekly IFA and adolescent girls and community supplementation in mobilization) schools for adolescent girls
Focus Areas/Country Afghanistan Bangladesh Nepal Pakistan
Educating Girls and • C4D strategy for girls’ • ‘Meena’ communication • Print and audio and • Study on good Boys education (planned for initiative radio phone-in visual materials on practices in the every 2018) programme on girls’ Education child in school initiative
education • Enrolment of out of • Advocacy support for • Gender in education KAP assessment, 2010 school children through • Gender sensitive the schools as a zone of mobilization of SMS communication package peace (focusing on the to promote inclusive school closure due to • Enrolment of out of education, retention and political and social school girls through end corporal punishment events) Golden Villages Initiative • Social and behavioural • Promotion of child change communication friendly schools integrated within national, multi-partner, sectoral primary education development programme (PEDP) 4
19 Focus Areas/Country Afghanistan Bangladesh Nepal Pakistan
Ending Child • Improve adolescents • National level multi- • Mobilization of religious Marriage lives programme and media entertainment- leaders (focussing on Afghan women’s education campaign on male religious leaders) leadership initiative adolescents’ issues with to end child marriage (AWLI) for adolescent a focus on child marriage, girls, includes includes baseline (2017) • Sathi Sanga Man ka Kura community mobilization and endline survey to – weekly radio and cash grants assess impact programme
• Life skills training • Adolescent radio • Print and audio and package on GBV and listening clubs lead by visual material on child adolescent health, Bangladesh Betar for marriage under the IKEA funded adolescent participation project • Community and male • Ensuring no child engagement initiatives to marriages under the motivate parents and Golden Villages Initiative communities to support adolescent participation • TV and radio spots on through peer and ending child marriage community dialogues
• Module on measuring normative dimensions of child marriage embedded
within the UNICEF BCO real time monitoring system
20 Focus Areas/Country Afghanistan Bangladesh Nepal Pakistan
Ending Violence • Child Protection will • Linking up the child help • Strategy to engage men • Stick and stone manual against Children have a gender marker of line (hotline) number and boys to prevent for child protection in all outputs including 1098 with the existing GBV emergencies, with mapping, IEC materials addressing, social norms social mobilisation and community based • Print and AV materials and training. To be delivered in FATA • Prevention of unsafe campaign to prevent VAC on VAC through mobile vans migration using mural and support art as a catalyst for • Launch of the ending dialogue • Linking up child marriage violence campaign and • Social mobilization prevention hotline advocacy events • Positive parenting activities, supporting number 109 supported IEC materials for birth initiative (planned for by the Ministry of • Child labour registration in FATA, 2018) Women, Children Affairs communication strategy Sindh and Punjab with ongoing media for municipalities and (Under Child campaign on Child capacity building of Protection) Marriage partners
• Module on VAC embedded within the • Communication and UNICEF BCO real time social mobilization monitoring system interventions for resilience and recovery among earthquake affected populations focusing on trafficking and safe migration
21 Focus Areas/Country Afghanistan Bangladesh Nepal Pakistan
Sanitation and • National advocacy on • Communication package • Implementation of the • MHM Communication Menstrual Hygiene MHM and the on menstrual hygiene handwashing with soap Strategy Management celebration of management and WASH and water campaign as block in schools for girls • MHM advocacy events Afghanistan’s first a part of public private and boys celebrations “Girls’ Hygiene Day”, partnership on
guidelines and comic handwashing with soap • book for promotion of Community based and water • MHM communication packages including facilities in school and initiatives to improve sanitation and progress teachers/ girls guiding health centres • Development of print booklets and Puberty through the sanitation materials on menstrual ladder (from open book • Handwashing hygiene management defecation to using an promotion through improved sanitation • MHM included in social community dialogues, mobilisation initiatives facility) sex-segregated in schools and
sanitation facilities, and communities as part of • WASH section has a national events Pakistan’s Approach to SANIMART programme Total Sanitation based in adolescent clubs • Support to family health that engages and action groups for • National MHM empowers adolescents in hygiene and CLTS awareness campaigns production and via mainstream/social marketing of low cost media sanitary towels
22 Country Snap Shots
This section provides an overview of C4D and gender initiatives across the focus areas by country, based on documentation received from the four country offices. The aim is to present snap shots rather than in- depth descriptions. The information synthesizes the key aspects of initiatives, such as the focus area, objectives, scope, timeline, type of C4D approach and level of gender responsiveness. Given that C4D approaches often have an element of overlap and most C4D strategies employ multiple approaches, it was difficult to classify by approach, so in several cases multiple approaches have been identified. In the absence of evaluation data, it was not possible to gauge the effectiveness of initiatives in bringing about gender related transformation, however the analysis aims to highlight the different types of initiatives that have been carried out across countries; what level of gender related change the initiative aimed for and how well gender dimensions were integrated in the various components of the intervention. Where possible, suggestions for enhanced gender responsiveness are included.
Afghanistan
This section presents the following initiatives from Afghanistan:
Cross-Sectoral Initiatives
•Golden Villages Initiative
Health and Nutrition
•Promoting Cord Care •Weekly Iron and Folic Acid Supplementation
Educating Girls and Boys
•Enrolment and Retention of Out-of-School Children through Capacity Building of School Management Shuras
Menstrual Hygiene Management
•Girls’ Hygiene Day in Afghanistan
Ending Child Marriage/Adolescent Issues
•Improving Adolescents’ Lives in Afghanistan •Afghan Women’s Leadership Initiative in Support for Adolescent Girls
24 Afghanistan: Cross-Sectoral Initiatives
Golden Villages Initiative 14
Description of Initiative: The Golden Village Initiative was conceptualized as an office wide strategy to bring about social and behavioural change across programme areas. It was designed as an integrated approach to five sectoral results and used an Appreciative Inquiry (AI) based methodology to generate transformational change. The initiative was piloted in one province with the intention to test and refine the approach for subsequent scale-up. The primary communication catalyst for change was the Appreciative Inquiry approach that built on participants’ strengths and focussed on the future. A series of AI workshops were held, each with about 30 villages, with four participants per village, and district and provincial functionaries, managers and authorities. Creating a community – provincial authority / service provider linkage was another key feature facilitating trustful communication between the two groups. Community ownership was encouraged through community led line-listing, data generation and tracking, listening and joint explorations of solutions.
Timeline: April 2016 – December 2017
Focus Areas C4D Approaches
•Health and Nutrition •Social and Behavioural Change •Educating Girls and Boys Communication •Ending Child Marriage •Community Mobilization
Objectives:
1. To inspire and mobilize communities towards attaining a ‘Golden Village’ status by achieving five key results within a mutually defined timeframe, such as a year: i. All children under one year of age are fully immunized ii. All pregnant women deliver with skilled birth attendants iii. All infants under two years of age fall in the green band of the WHO Child Growth Monitoring chart, reflecting adequate nutrition and hygiene standards iv. All girls between 6 - 16 years are enrolled in school v. No marriages occur before age 18.
2. To enhance the capacity of governmental functionaries – provincial outreach functionaries, technical managers and service delivery staff, and Provincial and National Authorities, to support and consolidate ownership and commitment among communities to ensure the five key results.
Scope: 129 villages in two districts of Bamyan Province. This was equivalent to a full district, but spreading across two districts allowed for variations in remoteness and ethnicity.
14 This Initiative is featured under the Case Studies; see Section 2 for additional description and analysis.
25
Gender Responsiveness
The initiative builds on the premise that sectoral issues (e.g., child marriage, girls’ education, maternal mortality) are intrinsically linked to the status of women and girls in the society. The effort addresses the underlying core issues for several child well-being outcomes and has the power to transform deep- rooted norms and practices. The initiative engages both female and male family members in order to foster social change related to gender norms. The sector specific themes such as safe delivery, nutrition,
lactation, immunization, ANC/PNC were envisioned as entry points to discuss gender issues such as the role of women, distribution of responsibilities, women’s mobility, their rights and agency. The gender dimension could be strengthened by a clearer articulation of how gender, rights and equity would be addressed by the initiative. The impact level monitoring includes gender-disaggregated data, but could extend to include gender-disaggregated data on knowledge and attitudes linked to the practices as well as gender related constructs.
Partners: Ministry of Public Health, Ministry of Education, and Ministry of Labour, Social Affairs, Martyrs and Disabled
Sources of Information: Concept Note, 2016 RAM ‘Output’ Reporting under the Social Inclusion Outcome
Afghanistan: Health and Nutrition
Promoting Cord Care
Description of Initiative: Promotes the use of chlorhexidine by building on the Social Ecological Model (SEM) approach and mobilizing health care providers to facilitate participatory discussion with mothers and care givers at the community level. Includes partnering with local media. Uses a mix of communication materials, including leaflets, instructional videos and radio and TV spots. Sensitization sessions will be held for community health workers and health care providers, who in turn will hold awareness-raising and counselling sessions for mothers. Health workers will reach out to mothers on proper cord care during Maternal Newborn and Child Health (MNCH) visits and delivery.
Timeline: 2016 – 2019
Focal Areas C4D Approaches •Health and Nutrition •Social Mobilization •Social and Behaviour Change Communication
Objectives:
1. Increase knowledge and confidence among mothers about the benefits of use of chlorhexidine for umbilical cord care and create demand; 2. Increase knowledge and confidence of health care service providers about the benefits of use of chlorhexidine for umbilical cord and build their interpersonal communication (IPC) skills for quality counselling.
26 C4D Indicators:
1. Percentage of mothers and care givers in 10 priority districts who can re-collect at least three benefits of the use of chlorhexidine for umbilical cord care; and demonstrate three steps on how to apply chlorhexidine gel for cord care.
2. Percentage of health care providers who can explain at least three benefits of the use of chlorhexidine for umbilical cord care in 10 priority provinces; and demonstrate at least four steps on how to apply chlorhexidine gel for cord care.
Scope: 10 UNICEF targeted provinces
Gender Responsiveness
The objectives include mothers and caregivers but the focus of the initiative appears to be only on mothers and female caregivers. The desired behaviour change is for mothers and caregivers to have adequate knowledge and confidence about the importance of chlorhexidine and discusses what, when, and how to use chlorhexidine for cord care. However, the C4D indicators are primarily at the knowledge
level and do not include level of confidence or motivation. Awareness-raising activities and counselling sessions are for mothers only. Likewise, health workers reach out to mothers on proper cord care during MNCH visits and delivery. The initiative would be more gender responsive if the design included outreach or engagement of fathers, as they have an important role to play in maternal health. Male engagement would reduce the burden of childbirth and care on mothers and contribute to more equitable norms. Based on the information provided, this appears to be a health promotion effort and does not transform gender roles and relationships.
Partners: Ministry of Public Health
Source of Information: Concept Note and Work Plan
Weekly Iron and Folic Acid Supplementation
Description of Initiative: The Weekly Iron and Folic Acid Supplementation (WIFS) programme institutionalizes school-based weekly iron and folic acid supplementation for the control of anaemia amongst adolescent girls in classes 5 to 12 from public and private schools.
Timeline: 2015 – 2018
Focal Areas C4D Approaches •Health and Nutrition •Social and Behaviour Change Communication •Social Mobilization
Objective: The programme equips teachers, headmasters and principals with the skills to educate adolescents aged 10-19 years, about anaemia prevention and control, encourage them to take a weekly iron and folic acid tablet for 52 weeks in a year, on a fixed day of the week. Ultimately this will improve their concentration and school performance, increase energy levels and productivity in day-to-day work and play,
27 boost appetite and growth, improve sleep, skin and complexion, regularize menstruation and build pre- pregnancy health, and enhance their overall capacity to work and earn.
Gender Responsiveness
Focused on adolescent girls and specific health behaviour. The initiative engages both parents and male religious leaders as champions to garner family and community level support. The media spots emphasize the link to equality and rights by highlighting that healthier girls means a healthier, more productive nation and future generation. However, the communication component does not address Scope: National confidence building or empowerment among girls and this is an area where the gender dimension could be further enhanced.
Partners: Ministry of Public Health, Health Promotion Department and Ministry of Education
Source of Information: Note on WIFS and Flyer
Afghanistan: Educating Girls and Boys
Enrolment and Retention of Out-of-School Children through Capacity Building of School Management Shuras
Description of Initiative: The initiative builds capacity of School Management Shuras (SMS) in community mobilization and inclusive school governance to promote education of out-of-school children, especially girls. The Directorate of School Management Shuras (DSMS) is expected to provide overall guidance to provincial SMS units who, in turn, will create, strengthen and mobilize School Management Shuras to be agents of community engagement in education. This is expected to entail a range of mobilization activities, from mapping and line-listing families with children who are out-of-school, to creating a supportive social environment for continued education, especially for girls, to local innovative activities to listen, negotiate and facilitate enrolment of children.
Timeline: October 2016 – 2018
Focal Areas C4D Approaches •Educating Girls and Boys •Community Mobilization •Capacity Building
Objective: To generate leadership among the DSMS and Provincial SMS Units to motivate and train School Management Shuras to effectively mobilize and engage communities and schools, to enhance enrolment and retention of out-of-school children, especially girls.
Scope: Conducted in 13 provincial SMS Units from across UNICEF zones.
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Gender Responsiveness This initiative is gender specific in its programme focus as well as in the results framework (e.g., girls are specified at the activity and impact level result statements). The initiative also takes into account the
role of social norms in determining enrolment and retention of girls in school, and attempts to equip the SMS Units to actively support girls’ education. The recognition of social norms allows the initiative to go beyond awareness-raising and to address the social context that poses barriers to children accessing and completing school. A programmatic recommendation would be to include gender training as part of the capacity building and equip Shura Councils with interpersonal and group
communication skills to enable them to lead community discussions around gender equality and education.
Partners: Ministry of Education, DSMS and provincial SMS units, Girls’ Education Department, Ministry of Public Health/Public Nutrition Department, Ministry of Labour, Martyrs and Social Affairs
Source of Information: Conceptual Framework
Afghanistan: Menstrual Hygiene Management
Girls’ Hygiene Day in Afghanistan
Description of Initiative: A campaign to raise national awareness of the importance of menstrual hygiene and the availability of a private and dignified space at school for girls to take care of their hygiene needs, thus helping them to stay in school until 12th grade. A high-level event was held to mark Girls’ Hygiene Day under the slogan “Nothing can stop me from going to school.” The campaign included dissemination of communication material on MHM such as guidelines and comic books.
Timeline: 2017
Focal Areas C4D Approaches •Menstrual Hygiene Management •Advocacy
Objective: To raise national awareness of the importance of menstrual hygiene and the availability of a private and dignified space at school for girls to take care of their hygiene needs to help them to stay in school until 12th grade.
Scope: National
Gender Responsiveness
This advocacy effort targets an issue that is a manifestation of gender inequality. Bringing such a private issue to a public forum can help transform public opinion and lead to both normative and policy changes. However, advocacy efforts need to be sustained and should be linked to a larger C4D effort that specifically addresses and measures norms change around menstrual hygiene and engages multiple actors including adolescent girls and boys, mothers and fathers and male and female community level influentials.
29
Partners: Ministry of Education
Source of Information: Press Release
Afghanistan: Ending Child Marriage
Improving Adolescents’ Lives in Afghanistan
Description of Initiative: An adolescent life skills initiative aiming to increase self-efficacy, especially among girls. The three pillars include 1) adolescents, organized into groups, as change agents, knowledgeable about their rights and entitlements, participating in forums and discussions; 2) families, communities and decision makers knowledgeable protectors about adolescent rights abuses, and 3) public authorities equipped with skills and able to provide services as upholders of adolescents rights.
Timeline: May 2017 - 2020
Focal Areas C4D Approaches •Child Marriage •Social Mobilization •Violence •Community Engagement •Entertainment-Education
Objectives: To increase the self-efficacy of adolescents, particularly girls, to reduce their vulnerability to violence perpetuated through harmful practices and nurture their ability to act as agents of change in their communities.
Scope: 11 Districts in Bamyan and Badghis Province
Gender Responsiveness Addresses a range of issues affecting adolescents, especially girls, and engages families and communities to protect children and their rights. The emphasis on participation goes beyond awareness-raising to focus on self-efficacy and collective change. Gender and equity are well embedded
in the programme, with women serving as primary organizers and community facilitators. The overall objective is gender responsive, aiming for efficacy and agency among girls. Furthermore, gender has also been integrated at the output level (e.g., Programme Output 1.1. Adolescents, especially girls are mobilized to participate in forums, take part in discussions via adolescent groups/shuras and where possible social media). The engagement of religious leaders and elders to promote empowerment and
rights contributes to the enabling environment and supports community level dialogue and acceptance, which are critical for changing gender norms. The performance indicators could be further gender disaggregated (e.g., # of adolescents who gain knowledge in life skills to make informed choices and participate in decisions affecting their lives).
Partners: Aga Khan Foundation Afghanistan
Source of Information: UNICEF Programme Document
30 Afghan Women’s Leadership Initiative in Support for Adolescent Girls
Description of Initiative: Engage key actors, including adolescents, especially girls to enjoy their childhood, stay in school and delay marriage to experience healthier, safer and more empowered life transitions and decision-making about lifestyles, relationships, marriage and child bearing.
Timeline: 2015 – 2018
Focus Areas C4D Approaches
•Child Marriage •Community Engagement •Girls' Education
Objectives:
1. Change perceptions on the acceptability of Early and Forced marriage (EFM) and mobilize communities to delay marriage, by raising awareness of adolescent girls’ rights, the laws in place to protect them, the negative consequences of EFM, and the importance of educating girls; 2. Empower adolescent girls to make informed life choices through educational, vocational and life skills training, and peer support networks; 3. Map and document the status of adolescent girls in Afghanistan
Scope: 20 districts of five provinces - Farah, Ghor, Heart, Nangarhar, Samanghan
Gender Responsiveness
Addresses a gender specific issue and aims to achieve gender equality and social transformation by
educating and empowering adolescents, especially girls. The life skills training includes areas such as decision-making, self-esteem and agency. In addition, the vocational training component can support livelihoods and not just life skills. The goal and objectives are gender transformative and empowering in their vision. Based on the funding proposal, it is not possible to discern how well gender and rights are integrated in the training content, communication material or interpersonal outreach and counselling. It is also unclear, how the initiative will reach out to vulnerable groups of adolescent girls.
Partners: Ministry of Women’s Affairs
Sources of Information: Funding Proposal
31 Bangladesh
This section presents the following initiatives from Bangladesh:
Cross-Sectoral Initiatives
•Monitoring of Communication for Development (C4D) Programme through Knowledge Management Outreach Sites (KMOS) •Programme Evaluation of UNICEF Bangladesh Communication for Development (C4D) Programme 2012-2016 •Community Information Services •Adolescent Radio Listener Clubs
Health and Nutrition
•National Strategy for Adolescent Health
Ending Child Marriage
•National Multi-Media Campaign Strategy to End Child Marriage •Improving the Well-Being of Adolescents with an Emphasis on Ending Child Marriage
32 Bangladesh: Cross-Sectoral Initiatives
Monitoring of Communication for Development (C4D) Programme through Knowledge Management Outreach Sites (KMOS)
Description of Initiative: UNICEF assessed the impact of C4D interventions in the 2012-2016 Country programme by using a randomised control methodology. The goal of this project was to track and assess the relevance and effectiveness of C4D interventions in changing knowledge levels, behaviours and harmful practices detrimental to child survival, development, protection and participation with an equity focus. The evaluation covered 11 priority behavioural areas; health (Antenatal/postnatal care visits, Acute Respiratory Infection /Pneumonia, HIV/AIDS), nutrition (breastfeeding and complementary feeding) handwashing, child protection and violence (birth registration, injury prevention, child labour, child marriage and corporal punishment). The study used a mixed methodology approach, with a quantitative survey conducted in each site followed by a qualitative study using focus group discussions, in-depth interviews and key informant interviews among different target groups. Knowledge, behaviour and practices between the sentinel and control sites were compared. The endline study findings indicate that the knowledge level has increased significantly in the sentinel areas compared to control areas. This difference in improved knowledge among respondents from sentinel sites supports the effectiveness of the C4D programme.
Timeline: September 1, 2014 – March 31, 2016
Focus Areas C4D Approaches
•Health and Nutrition •Impact Assessment •Child Protection •Violence
Objectives: The objective of the study is to capture the progress of overall C4D programme activities, assess the implementation processes, and explain the reasons for any deviation in selected sentinel sites, as well as control sites. Specifically the study aimed to:
1. Capture and measure the trends in individual and community characteristics with regards to key knowledge, attitude and practice variables around selected behavioural themes; 2. Compare the trend in changes between sentinel and comparison sites; 3. Identify the relevance and effect of various C4D approaches and channels with regards to the desired changes including the underlying reasons; 4. Explain the reasons for specific trends (positive or negative); 5. Detect challenges and barriers in programme implementation.
Scope: Study area includes 21 upazillas from the selected 7 sentinel sites and 7 control sites of 20 UNDAF districts - Bandarban, Cox’s Bazar, Sunamgonj, Netrakona, Shatkhira, Rangpur and Bhola.
33
Gender Responsiveness
The assessment aimed to gauge the impact of C4D activities in addressing selected behaviours and harmful social norms – many of which had a gender focus (e.g., maternal health and child marriage). The C4D efforts promoted knowledge and practices across a range of child well-being areas, created opportunities for open dialogue and community action, which can contribute to gender and social change. In terms of methodology, a stratified purposive sampling technique was applied and selection of each target group, and included variables such as age, gender, occupation, role in the community, and role in the program implementation. The survey respondents included mothers of children (under
six months and under five years), adult males (who may have also been fathers but fathers of children under six months and five years were not specifically included), adolescent boys and girls (ages 12- 17). The qualitative component included male and female community members, local business owners, social leaders, teachers, health providers, district information officers, parents of children under five and adolescents. The findings highlighted important gender differences such as boys experiencing
more punishment than girls, mothers being considered to be responsible for protecting children from physical injury than fathers (at the time of the baseline). Likewise, the endline reported that girls were mostly engaged in unpaid household work while boys were engaged in work outside home and helped with farming, fishing, worked in local business (e.g., teashops, mechanical workshops) or as daily labour. The study focused on knowledge and attitudes around the selected behaviours and constructs such as gender roles, equality, socialization, empowerment, self-efficacy were not measured. Notably, males demonstrated lower knowledge across all behaviours compared to
adolescents and young mothers.
Partners: James P Grant School of Public Health, Institute of Global Health, BRAC University
Source of Information: Proposal and Research Report
Programme Evaluation of UNICEF Bangladesh Communication for Development (C4D) Programme 2012-2016
Description of Initiative: This evaluation report describes the scope of and activities for the evaluation of the UNICEF Bangladesh “Engaging Communities for Social and Behavioural Change” programme for the duration of (January) 2012 through (July) 2016. This program focused on engaging communities in bringing about social and behavioural change. The key was to establish networking systems at local levels to facilitate public debate around messages related to life-saving, care and protective behaviours that included health, nutrition, education, water, sanitation and HIV. Therefore, the goal of this programme was to increase knowledge on key life-saving behaviours and create awareness among communities about social basic services; change individual, harmful traditional beliefs and perceptions; influence attitudes and behaviours and consequently social norms and social practices in order to promote the fulfilment of children’s and women’s rights. The C4D efforts followed a social change approach where communities were engaged to assess their situations, in light of the beliefs and values, and social norms that shape their lives. Individuals and communities were not only informed but also empowered to change behaviours and be proactive about improving their lives. Based on the findings, the interventions that appeared to be effective were 1) experiences for stimulating dialogue (i.e., community dialogues/meetings, household visits, and adolescent clubs); (2) building on the social dynamics which have been built within the programme communities; (3) working through a network of C4D Ward Promoters to engage more effectively in interpersonal communications. Timeline: January – May 2017 (covers the three phases of the evaluation – desk, field and production)
34 Focus Areas C4D Approaches •Health and Nutrition •Programme Evaluation •Educating Girls and Boys •Protection and WASH
Objectives: This evaluation covered the period from July 2012 to July 2016 and was designed to support future C4D interventions under the following objectives: • Assess the effectiveness, efficiency, relevance, and sustainability of the C4D programme; • Assess the potential scale-up in areas for selected components of the C4D programme; • Identify enablers, bottlenecks and barriers to the achievement of results; • Assess the appropriateness of results monitoring system put into place; and • Provide recommendations for the design, management, coordination, implementation and measurement of progress of future C4D-related programmatic interventions for the new country programme 2017-2020.
Scope: National and subnational levels
Gender Responsiveness Both the design and analysis of this report are gender responsive. A gender equality lens was applied when creating the sample parameters and 51.9 per cent were female and the remaining 48.1 per cent
were male. Even though a Gender Equality and the Empowerment of Women (GEEW) perspective was not explicitly mentioned in the ToR, this programme was designed with an equity approach to include those communities and families in the hard-to-reach areas. Hence, while the construct of GEEW is not formally framed within the evaluation, these concerns are inherently part of the entire evaluation
process. The C4D programmes focus on the household and community level, inspired critical discussions about the need to practice improved parenting skills and appears to have contributed to enhancing children’s and women’s rights. While most of those surveyed reported knowledge about the eight life-saving care and protective behaviours, the groups within the overall sample who could still benefit from further efforts offered by this programme, are: (1) mothers with children under six months; (2) adult males; and (3) adolescents. One noteworthy finding, is that rights-holder/fathers, men, and adolescent boys did not have adequate knowledge about the lifesaving care and protective
behaviours. While encouraging change in knowledge, attitudes and behaviours among women and girls is necessary, it is also necessary to change the knowledge and attitudes of men and boys as they play an influential role in the household decision-making process. The recommendations from the study make a strong case for engaging men – both adolescent boys and fathers. The findings also support investments in longer-term initiatives, which are needed for social and gender norm change.
Partners: Ministry of Information, Ministry of Women and Children Affairs and NGO Implementer Partners Source of Information: Evaluation Report
Community Information Services
Description of Initiative: Cox’s Bazar is among the low performing districts in almost all child-related indicators and one of the most vulnerable to disasters and climate change in the country. Despite being an economic hotspot for the tourism industry, it is characterized by high levels of poverty, income disparity, weak social services and has witnessed a high influx of displaced people from the border. The condition has worsened since late August 2017, with the heavy influx of the Rohingya community from Myanmar, creating
35 an unprecedented humanitarian situation. An estimated 800,000 refugees of which over 70 per cent are children, women and adolescents are now living in settlements.
Multi Sectoral Rapid Assessments identified that the majority of new arrivals have little knowledge of how to access services or are not aware of available services. This assessment also recognized the gaps in the outreach efforts with the new arrivals and referral services, including creation of information hubs to receive, orientate and refer to relevant services. Considering the growing numbers of Rohingya refugees entering Bangladesh, UNICEF in collaboration with NGO partners established Information Feedback Centres (IFCs) to ensure consistent and coherent dissemination of key life saving messages across Rohingya settlements. The objective is to ensure that feedback is collected, disseminated and meaningful response taken to link the localised response with service referral pathways. IFCs are a major source of information for community members and on an average every week the 10 Information Feedback Centres get approximately 2000 queries, complaints and feedback about services in the camps. Information service providers (based in the IFCs) respond to these right away by providing information and referrals to services.
Timeline: 17 September 2017 – 31 Dec 2018
Focus Areas C4D Approaches
•Health and Nutrition •Social and Behaviour Change •Protection Communication •WASH •Community Engagement •Entertainment-Education
Objective: To improve community access to timely and relevant information and facilitate two-way communication to ensure community feedback is captured and used to influence programmatic decisions targeting 200,000 people in the host community including new spontaneous sites and makeshift communities in Teknaf and Ukhiya. Specifically, the programme outputs are:
1. New influx families have improved knowledge regarding priority behaviours and practices that promote the overall well-being of infants, young children and their mothers in emergency situations; 2. New influx families have access to emergency information on life saving/priority behaviours and services; 3. New influx families and communities, especially women and children, have a safe environment and are protected from sexual exploitation, child marriage, corporal punishment and other harmful social norms.
Scope: Thaingkhali, Moynerchar, Unchiprang, Shamlapur, Balukhali, and Kutupalong
Gender Responsiveness
The programme intends to address community queries, complaints, feedback and service referrals through 12 Information and Feedback Centres (IFCs). Almost 75 per cent of visitors are women, one third were between 18 and 29 years of age, and close to 90 per cent of the queries are related to health issues. The key areas include a range of child well-being issues including the safety of women and girls to ensure they are protected from sexual abuse, child marriage, violence and other harmful
social norms. On ground activities such as home visits, community consultations and engaging
36
(Continued)
communities are facilitated mostly by female community mobilizers and information service providers. The interpersonal communication trainings and engagement of religious leaders, along with the other activities contribute towards creating a safer environment for girls and women, thereby considering their increased vulnerability during emergencies. Peer group discussion with pregnant women, lactating mothers, fathers, adolescent girls, adolescent boys, mothers-in-law are conducted separately by community mobilizers to address gender norms and differences. Radio programmes are scripted and aired emphasizing gender discrimination in families and in accessing
services. Community consultation meetings are organized separately with adolescent boys and girls, as well as men and women to know the service gap and to address gender differences, keeping in mind the norms and practices of the Rohingya. Understanding and addressing the unique and contextual needs and barriers to accessing information or services for girls and women in this particular situation will be important for designing effective and gender responsive interventions.
Partners: People’s Upliftment in Livelihood and Social Empowerment (PULSE-Bangladesh)
Source of Information: Programme Document
Adolescent Radio Listener Clubs
Description of Initiative: The Adolescent Radio Listener Club (ARLC) is a group listening forum where Secondary School students from Grade 7-10 come together to listen to and discuss an adolescent and life skills based radio program. Radio listening clubs provide a safe space for children to learn about, discuss, share and act upon issues that affect them. UNICEF in partnership with Bangladesh Betar – the State owned radio station has been operating radio listener clubs since 2014. The radio programmes include different components such as a phone-in-program, magazine, radio drama serial and quizzes. Under the new Country Programme, UNICEF is supporting school based listener clubs in schools where the Life Skills Based Education package is already being implemented. This provides convergence and strengthens the Life Skills curriculum. The clubs are led or managed by a Teacher or Assistant Teacher and includes a group of 20-25 students in each school. Once set up, each club receives a daylong orientation on how the group listening programme operates. The club members provide feedback and participate actively in the programme content development. ARLCs are also conducted at the community level, where out of school adolescents and school going adolescents meet once a week and listen to a programme and provide feedback to Bangladesh Betar.
Timeline: 2018 – 2020
Focus Areas C4D Approaches •Education •Community Engagement •Child Marriage •Social and Behaviour Change Communication •Violence •Menstrual Hygiene
Objectives:
1. Adolescent boys and girls have the knowledge, skills, and peer group support to act to protect themselves from violence, exploitation and child marriage.
37 2. Promote media participation and civic engagement of adolescents.
Scope: 210 schools to be covered in first phase in 7 divisions and urban areas (22 districts and 46 upazilas)
Gender Responsiveness Adolescents constitute more than one fifth of the population in Bangladesh and are faced with several threats to their safety and wellbeing such as violence, early marriage, school drop out, engaging in risky behaviours and injuries. Many of these threats have gender implications, affecting
both boys and girls. The format and methodology of life skills based discussion groups aims to encourage participation, dialogue and solution seeking and can be both empowering and gender transformational. The fact that the listeners’ clubs converge with the life skills education package already being implemented in schools provides an opportunity to enhance an understanding of adolescent issues and deepen this knowledge through group dialogue. This initiative promotes the
participation of adolescents and allows them to voice their concerns, fears, opinions and ideas while interacting with peers in a safe space. The content of the radio programme enables them to know their rights and develop the skills to negotiate choices and seek support from adults and institutions to protect their rights. By engaging girls in secondary schools, the initiative takes in to consideration the patriarchal cultural context where girls have limited mobility and are not encouraged to speak up or participate in decision-making and provides them a platform to express themselves and develop self and collective efficacy. Listener clubs are also conducted for out of school adolescents. A module
on gender, equality and human rights can be included as a foundational component of the curriculum and introduced in the initial club meetings. The teachers who facilitate the group discussion should also be sensitized on gender and trained on leading discussions on sensitive issues.
Partners: Bangladesh Betar, Ministry of Information, Directorate of Secondary and Higher Education
Source of Information: Concept Note and Presentation
Bangladesh: Health and Nutrition
National Strategy for Adolescent Health
Description of Initiative: The National Adolescent Health Strategy 2017-2030 was developed to address the overall health needs of adolescents and takes on a holistic understanding of health. The overarching goal of the strategy is for all adolescents to lead a healthy and productive life in a socially secure and supportive environment where they have easy access to quality and comprehensive information, education and services. The four priority thematic areas or strategic directions include adolescent sexual and reproductive health, violence against adolescents, adolescent nutrition and mental health of adolescents. In addition, social and behavioural change communication and health systems strengthening are included as cross cutting issues, which need to be addressed for the effective implementation of the strategy.
Social and Behaviour Change Communication (SBCC) programmes, can empower adolescents to participate in decision-making processes and enable them to seek appropriate health information and services. In order to ensure that adolescents are able to participate in decision-making processes, SBCC programmes need to also address the attitudes and behaviours of gatekeepers, including parents, family members, teachers and
38 service providers to respect adolescents' opinions, needs and interests. Key SBCC strategies considered are:
1. Development of messages and materials for communication and advocacy through sound research; 2. Utilize ICT (including call centres) and media to reach adolescents, key community members, parents and guardians; 3. Develop the capacity of respective institutions and systems to design, plan, implement and monitor SBCC interventions.
Timeline: 2017 – 2030
Focus Areas C4D Approaches
•Health and Nutrition •Social and Behaviour Change •Violence Communication
Objectives:
1. To ensure political commitment and adequate resources to support SBCC interventions; 2. To promote social mobilization and ensure wider participation, coalition and ownership of issues which affect adolescents among community members; 3. To use SBCC interventions to bring about changes in knowledge, attitudes and practices among specific audiences.
Scope: National
Gender Responsiveness Gender aspects are covered in the strategy and detailed under the strategic directions. This strategy includes a strong rational to support the gender specific information needs of adolescents including embarrassment, superstition, lack of knowledge and the obstacles posed by older family members
to girls’ wellbeing. The strategy builds on research that points to the need to address shame and stigma associated with being sexually active and the threat of violence, often due to gendered norms and commonly leading to child marriage, inadequate nutrition, adolescent pregnancy, and school dropouts among adolescent girls. The strategy document emphasizes the challenges faced by adolescents such as constraints in making informed life choices, a significant number of adolescents
experience risky or unwanted sexual activity, do not receive prompt or appropriate care and, as a result, experience adverse health outcomes. The analysis addresses the different needs of girls and boys. Adolescent girls face gender-based discrimination, evident in the practice of child marriage, the high rates of adolescent fertility, the high prevalence of domestic violence, the increasing incidence of sexual abuse and higher drop-out rates from secondary education due to the patriarchal social norms of Bangladesh. Adolescent boys also face pressure to comply with prevailing norms of masculinity, which drives them to risky behaviours such as unsafe sex, violence and substance use.
All these factors have a direct as well as indirect influence on the health and well-being of adolescents, and form an essential component of the context within which health issues of adolescents should be understood. The strategy aims to increase access to accurate and reliable information for both girls and boys. While gender is often associated with girls, adolescent boys too face challenges, which are addressed in the strategy.
Partners: Ministry of Health and Family Welfare Government Bangladesh, UNFPA and UNICEF
Source of Information: Strategy Document
39 Bangladesh: Ending Child Marriage
National Multi-Media Campaign Strategy to End Child Marriage15
Description of Initiative: The campaign is designed to make prevention and active rejection of child marriage everyone’s responsibility, and is part of a larger entertainment-education (E-E) based initiative for adolescents. It focuses on positive actions and seeks to promote the idea that when individual actions are added together, they can create a collective movement that ultimately contributes to larger social change. Using the traditional ‘Dhol’ or drum as a symbol of garnering attention, and in voicing protests, the campaign suggests a beat or rhythm for everyone to rally around together in order to raise their voices and report any incidents of child marriage. The aim is to trigger an easy, participatory and highly visible action that reflects increasing public intolerance and actions against child marriage. The Campaign centres around a television drama series and includes radio and TV spots, print and outdoor media components, and a digital and social media presence. Launched in mid 2017, the online campaign elements had already received 25 million views on social media before the end of the year.
Timeline: 2017 – on going
Focus Areas C4D Approaches
•Child Marriage •Social and Behaviour Change •Adolescent Issues Communication •Entertainment-Education
Objectives: The multi-media campaign seeks to expose and expand the information and initiatives on ending child marriage to multiple stakeholders to promote action, support and co-operation. Specifically, the campaign aims to:
1. Translate knowledge into attitude and attitude into practice by inducing an attitudinal shift towards young girls and a change in belief system about child marriage; 2. Accelerate the decline in child marriage through effective targeting, messaging and communication that inspires a social movement.
Scope: National
Gender Responsiveness
This is a gender specific initiative that aims for transformation of roles, relationships and the value of the
girl child. The social norms approach is a strength and is well suited to gender norm change. The campaign promotes a call to action and seeks to emphasize the unacceptability of child marriage. The accompanying community engagement provides ground-based reinforcement to the campaign. Specifically, the community dialogue component brings together men and women and provides a forum to generate discussion around gender equality. For instance, just in the first quarter of 2017,
15 This Initiative is featured under the Case Studies; see Section 2 for additional description and analysis.
40 (continued)
over 900 male and female community leaders and local influentials have been engaged in community dialogue and sensitization meetings to prevent, stop and report on child marriage in their respective communities. These discussions will have clear implications on gender quality and empowerment of girls. Engaging community and religious leaders is also necessary to facilitate a shift on gender and social norms. The campaign notably promotes action by community members to end child marriage. This must
go hand in hand with initiatives such as the life skills enhancement of girls through adolescent clubs to improve their negotiation and decision-making capacities while also engaging parents (both mothers
and fathers) to discuss gender equality and promote new norms. Adolescent clubs additionally provide peer dialogue, mentorship and engage girls and boys to negotiate more equitable futures. Field based reports are indicative of gender-based changes and reduction of child marriage and this will be formally assessed by the endline.
Partners: Government of Bangladesh, Ministry of Women and Children Affairs, Ministry of Information, Government of Canada, UNFPA
Source of Information: Campaign Strategy Document, Campaign Brief, January-March 2017 Progress Report
Improving the Well-Being of Adolescents with to Ending Child Marriage16
Description of Initiative: UNICEF developed the capacity of the NGO partner to deliver context specific community engagement and multi-media campaigns to end child marriage in Jamalpur in the previous country programme. UNICEF has supported two NGOs, Sabalamby Unnayan Samity and Unnayan Sangha to train volunteers who became agents of change. UNICEF will build on the investment it had made to further mobilize the community. This project focuses on interventions for adolescents, their parents, communities and front-line duty bearers to engage and provide them with knowledge and skills to end child marriage. It also promotes abandonment of harmful social norms and uptake of new norms. Change in social norms can be achieved through mobilization and engagement of community level influencers who can sustain change efforts and achieve a critical mass who have changed their beliefs and norms.
Timeline: September 2017 – September 2018 (may be extended)
Focus Areas C4D Approaches •Child Marriage •Community Engagement •Adolescent Issues •Social and Behaviour Change Communication
Objectives: Develop tailored and localised C4D strategies and tools that include community mobilisation, dialogue, local level multi-media campaign and pledging/commitment from the duty bearers against child marriage at the ward and union levels. Ultimately, the initiative seeks to achieve abandonment of harmful norms and practices and change the attitudes of people in the targeted communities.
Scope: Kalmakanda Upazila and Khaliajuri Upazila under Netrakona District, as well as Islampur Upazila and Dewanganj Upazila under Jamalpur District.
16 This is linked to the Multi-Media Campaign Strategy to End Child Marriage and comprises the on-ground social mobilization and community engagement activities to support the campaign.
41
Gender Responsiveness
The project will be inclusive of girls and boys, regardless of age, sexual orientation, gender identity, disability status, religion, and ethnicity. The project will also specifically work on reducing key gender gaps and empowering women and girls and will address issues such as adolescent participation and decision-making. It will act to reduce discriminatory attitudes and practices of duty bearers by engaging men in adolescent and women’s rights related programmes. Adolescent friendly health services and
gender-based violence will also be addressed by the community support system to ensure adolescents’ well-being. The communication activities include community mobilization and dialogue, coupled with mass media and local level events such as pledging/commitment from the duty bearers against child marriage at the ward and union levels. Such multi-layered strategies have resulted in gender and norm based changes in diverse global contexts and it would be worthwhile to ensure a robust evaluation to know what works in achieving gender equality and norm change in South Asia.
Partners: Sabalamby Unnayan Samity and Unnayan Sangha
Source of Information: Program Document
42 Nepal
This section presents the following initiatives from Nepal:
Health and Nutrition
•The Golden 1000 Days Communication Campaign •Communication and Social Mobilization for Acute Gastro Enteritis (AGE) / Cholera Prevention and Response in the Identified Hot Spots for Kathmandu Valley
Ending Child Marriage
•Partnership with Religious Network and Structure to End Child Marriage and other Harmful Practices
Disaster Risk Reduction
•Radio Drama Series on Child Centred Disaster Risk Reduction •Relay Broadcast of Radio Program and Capacity Building of Journalists and Radio Presenters •Communication and Social Mobilization for Promoting Recovery and Resilience among Earthquake Affected Communities
43 Nepal: Health and Nutrition
The Golden 1000 Days Communication Campaign17
Description of Initiative: The Golden 1000 Days Public Awareness Campaign in Nepal is now being implemented after the successful launch in April, 2016. The Golden 1000 Days Campaign seeks to improve child survival and development – from conception to two years of age, through better maternal and young child feeding, improved hygiene and sanitation practices, access to proper health care and social services, as well as delayed marriage and pregnancy. The campaign is an integral part of operationalizing the National Planning Commission’s Multi-sector Nutrition and Food Security Advocacy and Communication Strategy (2015) as well as the Maternal Infant and Young Child Nutrition (MIYCN) Communication Action Plan (2014-2018) of the Ministry of Health and Population. The Golden 1000 Days is being established as a household brand to improve nutrition across the country through very intensive mass media and household level engagement. Paras Khadka, celebrity and Captain of the National Cricket Team has been nominated as the Goodwill Ambassador for the campaign, and three renowned artists- Deepak Raj Giri, Deepashree Niraula and Jitu Nepal are promoting the campaign, lending high level visibility and support.
The campaign builds on the socio-ecological framework and uses various approaches to engage with key stakeholders; advocacy with parliamentarians, relevant government ministries and media at the institutional level; capacity building of Community Based Organizations, Female Community Health Volunteers (FCHVs), teachers and religious leaders and social mobilization at the organizational and community level; mass media, outreach and face-to- face communication at the interpersonal level addressing pregnant and lactating women and their families.
Timeline: April 2016 – January 2019
Focus Areas C4D Approaches
•Health and Nutrition •Advocacy and Capacity Building •Early Childhood Development •Social and Behavior Change Communication
Objectives: The Golden 1000 Days communication campaign aims to increase knowledge, positive attitudes and practices regarding good nutrition and care during the first 1000 days of a child’s life in order to sustain and improve achievements made in the health status of children in Nepal. The campaign also aims to increase demand for required services, ensure favourable policies, encourage sharing of domestic work and childcare between husband and wife and promote child stimulation. The communication objectives are to:
• Increase the level of knowledge on the importance of the Golden 1000 Days in a child’s life among pregnant women, mothers of children under two, husbands and families; • Increase in the percentage of pregnant women, lactating mothers and their families (with a focus on husbands) who are knowledgeable about the importance of the Golden 1000 Days in a child’s life and key messages related with the different phases of the Golden 1000 Days; • Increase in the percentage of pregnant women and lactating mothers and their families (with focus on husbands) who strongly believe that the Golden 1000 Days are very important for the overall development and health of a child. • Increase in the number of health service and community level providers FCHVs, early childhood development (ECD) facilitators, teachers and community groups with the required communication
17 This Initiative is featured under the Case Studies; see Section 2 for additional description and analysis.
44 skills to motivate individuals and families on practicing golden 1000 days behaviours (pregnancy, delivery, postnatal and new born care; early and exclusive breastfeeding, IYCF standards, hygiene practices and child stimulation).
Scope: Intensive in six districts - Jumla, Achham, Kapilvastu, Parsa, Pachthar, Bajura, capacity building in 16 districts and the mass media component is national
Gender Responsiveness
This campaign addresses maternal, infant and young child nutrition through the engagement of mothers and supportive families (husbands and mothers-in law), recognizing the constraints women in Nepal face in accessing resources, food, healthcare and decision-making. Specific behavioural objectives are detailed separately for mothers and fathers across the four phases of the first 1000 days (pregnancy, 0-6 months, 7-12 months and 13-24 months). These include accompanying the expectant
mother for antenatal care visits, supporting her through pregnancy, and helping the mother with infant caregiving and feeding. Relatedly, the behavioural monitoring indicators include workload distribution and spousal communication. Male engagement has been well integrated in the strategy design as well as material production, which emphasizes the role of the father. High profile male celebrities endorse the campaign and promote more equitable relationships within the family. Male engagement can be a broad concept that is difficult to operationalize, but this campaign manages to break down male engagement to specific actions a father must do and follows through with messages, community
engagement, capacity development and behavioural monitoring. Based on the documentation provided it is not possible to discern whether or not women’s empowerment has been specifically included in the message design and if it will be measured. However, the campaign promotes gender equality and transformation of gender roles. Ensuring that aspects such as agency, decision-making, self-efficacy and empowerment are measured will provide demonstrable results on how
communication can contribute to gender transformation.
Partners: Ministry of Health and other line ministries, National Health Education Information and Communication Centre, National Planning Commission and European Union.
Sources of Information: Partnership Proposal, Programme Brief, Communication Action Plan, Campaign Guidelines Communication and Social Mobilization for Acute Gastro Enteritis (AGE) / Cholera Prevention and Response in the Identified Hot Spots for Kathmandu Valley
Description of Initiative: In 2016, to respond to the potential cholera threat, the Epidemiology and Disease Control Division of the Department of Health Services implemented the Comprehensive Targeted Intervention (CTI) of Cholera Control in the Kathmandu Valley. However, there is an imminent need to improve the sanitary practices of people living in urban slums in the Kathmandu valley to ensure that AGE/Cholera outbreaks do not take place every year. The programme is expected to increase the adoption of safe water, sanitary practices and Hygiene among families and communities in Kathmandu valley contributing to the reduction of AGE/cholera.
Timeline: May – November 2017
45 Focus Areas C4D Approaches
•Health and Nutrition •Community Mobilization and Outreach •Water, Sanitation and Hygiene
Objectives: The programme aimed to:
1. Increase collaboration between municipalities, youth clubs and district public health offices to advocate and promote safe water and hygiene behaviours; 2. Increase the percentage of families and communities practicing recommended water, sanitation, hygiene and treatment seeking behaviours during episodes of AGE and cholera.
Scope: Selected hotspots in Kathmandu, Bhaktapur and Lalitpur Districts
Gender Responsiveness
In Nepal, as in many countries, women take on the primary role in household water and sanitation, they therefore, need to be central in this outreach effort. The initiative aims to prioritize women during household and community level outreach, as they need this information the most. In this partnership,
Yuwalaya ensures diversity in terms of recruitment and mobilization of staff by proposing to recruit at least 50 per cent females as staff and volunteers; this will help with outreach activities targeting women. The brief programme document doesn’t provide additional details on how women and girls will be prioritized or what some of their information needs and barriers to access are. It will be essential to propose communication approaches that consider and overcome women’s barriers to
information.
Partners: Yuwalaya
Source of Information: Programme Document
Nepal: Ending Child Marriage
Partnership with Religious Network and Structure to End Child Marriage and other Harmful Practices
Description of Initiative: This initiative brings together inter-faith leaders to advocate against child marriage and other harmful practices. Leveraging the social influence of religious leaders, the initiative sensitizes leaders to raise awareness among adolescents and parents to discourage early child marriage and violence against women. As respected members of society, they are often the first to respond to problems faced in the community. Religious leaders have large networks across the country and represent people from all faiths, including minority groups. Irrespective of location and size, every town, district or village has a network of religious leaders. Training these leaders on gender and children’s rights, situates them as influential agents of change. In a society where practices like child marriage and gender-based violence have long been believed to have religious sanction, the project demystifies these beliefs and promotes children and women’s rights in religious messages. When cases of violence or child marriage occur in villages these leaders take action to prevent it.
46 The group has developed an inter-faith manual, the first of its kind in Nepal, that explains how religions like Buddhism, Christianity, Hinduism and Islam do not advocate child marriage or any form of violence against women. In a country that is prominently faith driven, to have such a manual confirming the rights of women and children is an important sensitization tool. The manual integrates religious teachings about child protection and non-violence with information about laws and health implications.
Timeline: 2014 – 2017
Focus Areas C4D Approaches
•Child Marriage •Community Mobilization •Violence
Objectives: The primary objective of the partnership is to engage and mobilize an interfaith network of religious leaders to advocate against child marriage and other harmful social practices.
Scope: Six districts - Accham, Bajura, Dhanusha, Humla, Mugu and Saptari
Gender Responsiveness
The initiative promotes gender equality and attempts to change gender related norms and practices. The training content covers women’s rights and empowerment. Several inspiring stories of local activism and change are reported. Partnering with norm enforcers such as religious leaders provides a strategic approach to promoting social change and more equitable roles. Beyond gender norms, broader social norms are also impacted through inter-faith dialogue, fostering non-discrimination,
religious tolerance and respect for other people’s religion and places of worship. It would be useful to evaluate this project to understand if engagement of religious leaders is an effective strategy for social change in Nepal and then consider adaptation and scale up to additional districts.
Partners: National Inter-religious Network, Nepal and UNFPA
Source of Information: Leaders for Change Report
Nepal: Disaster Risk Reduction
Radio Drama Series on Child Centred Disaster Risk Reduction
Description of Initiative: This project was envisioned to help families and communities better prepare and respond to natural disasters with a focus on women’s and children’s issues, using a life-cycle based approach. Milan Chowk, a radio drama series has been developed, broadcast, and supplemented by local content produced by community radios from priority districts in local languages. In order to increase the effectiveness of the locally produced content and ensure community participation, the capacity of local radios has also been built through mentoring and training. The drama series covers child survival and well- being and includes episodes on health, nutrition, sanitation, education and protection.
Timeline: October 2016 – March 2018
47 Focus Areas C4D Approaches
•Disaster Risk Reduction •Community Radio •Health and Nutrition •Entertainment-Education •Child Protection and Education
Objective: The overall objective of the project is to help families and communities better prepare and respond to natural disasters with a focus on women’s and children’s issues and positively impact knowledge, attitudes and practices among participant families and communities related to maternal and child well-being in 42 selected districts of Nepal.
Scope: National coverage. Focused coverage in 28 Multi-Sectoral Nutrition Plan districts and 14 earthquake affected districts.
Gender Responsiveness
The implementing partner, AMARC has a policy of equal gender representation in all its programme and activities. Over 25 years of experience has shown that it helps to have an affirmative policy towards women candidates during selection processes in order to empower women in radios. The capacity
building aims to ensure equal gender representation. All committees formed during the project also strive for equal gender representation. The radio drama and local content uses gender sensitive language, and gives equal air time to both women and men, ensuring enhanced representation of women. Additionally, this initiative is linked to the gender responsive Golden 1000 Days Campaign and seeks to inform mothers and fathers of children under two. The content includes specific appeals for
fathers and mothers and addresses issues such as the importance of keeping girls in school, delaying marriage and ensuring adequate nutrition to adolescent girls and promotes gender equality and non- discrimination.
Partners: AMARC – Asia Pacific (World Association of Community Radio Broadcasters Asia Pacific), National Health Education Information and Communication Centre, Association of Community Radio Broadcasters of Nepal and Ujyaalo Multimedia Nepal.
Source of Information: Programme Document
Relay Broadcast of Radio Program and Capacity Building of Journalists and Radio Presenters
Description of Initiative: After the April 25th Earthquake, most communication networks were disrupted and there was an urgent need for people to receive critical information. Radio Nepal was the only channel operating 24X7 with uninterrupted service till about six weeks after the earthquake. To respond to peoples’ information needs and provide psycho-social support, UNICEF Nepal partnered with Radio Nepal and launched an innovative interactive radio programme titled Bhandai Sundai (Talking and Listening). The program provided important information on earthquake response and recovery and gave people an opportunity to share their concerns and grievances. In addition, the programme covered content on health, nutrition, water and sanitation, education and child protection.
The local FMs started operating and airing their programs only after the first six weeks. Given the intense penetration of FM stations and the popularity with local communities, UNICEF and Association of Community Radio Broadcasters (ACORAB) proposed a partnership to relay broadcast the national broadcast
48 from Radio Nepal through local FM stations. This proposed radio broadcast through the local FM stations, furthers the reach of the radio programme and gives more people access to life-saving messages as well as psycho-social support to help overcome trauma and anxiety related to the earthquake. The initiative also included capacity building of local journalists and radio program presenters as they are instrumental in producing programs to respond to emergencies and future natural disasters.
Timeline: October 2015 – March 2016
Focus Areas C4D Approaches •Earthquake Response and Recovery •Community Engagement •Disaster Risk Reduction • Community Radio •Child Survival, Education and Protection
Objective: Through this proposal UNICEF and ACORAB plan to carry out relay broadcast of the radio programme Bhandai Sundai through local community FM Stations and build communication capacity of the local journalists and radio presenters on emergency communication and community resilience. Additionally, journalists will be trained in the Golden 1000 Days package in nine districts.
Scope: Relay Broadcast of Radio Program in 11 Districts - Sindhupalchowk, Dhading, Dolakha, Nuwakot, Gorkha, Kavre, Okhaldunga, Sindhuli, Ramechhap, Rasuwa and Makwanpur. Training of journalists and radio presenters in the 61 remaining non-affected districts. Special training of journalists and radio presenters on Golden 1000 Days in nine districts - Saptari, Rautahat, Parsa, Nawalparasi, Kapilvastu, Jumia, Achham, Bajura and Kalikot.
Gender Responsiveness
The radio program with this relay broadcast from local FM stations filled an important information gap and provided women and other disadvantaged groups an opportunity to have access to information. Additionally, the initiative enabled community members to raise their voices and concerns to authorities. The show had different time slots for different audiences, with an afternoon programme specifically for women and an early evening show for children. Morning and evening shows were aimed
for all audiences. Ensuring two-way communication with women and girls was key to enhancing participation. Tracking women’s participation and assessing the changes in their levels of knowledge and efficacy would be useful for future efforts. The initiative emphasized capacity building of local radio producers and presenters and a related next step to consider in the future would be to train women from the community to be producers and presenters.
Partners: Association of Community Radio Broadcasters (ACORAB), Radio Nepal
Source of Information: Programme Document and UNICEF Nepal C4D Response: Earthquake 2015
Communication and Social Mobilization for Promoting Recovery and Resilience among Earthquake Affected Communities
Description of Initiative: The goal of this project was to empower young people aged 19 to 25, their families and communities to make informed choices that enable them to become a resilient community during and after natural disasters, like the recent earthquakes in Nepal. Young people were mobilized for disaster risk communication and planning and sensitized on issues such as human trafficking, migration and gender-
49 based violence that often arise in the aftermath of a natural disaster or displacement. Youth advocates would in turn spread awareness about these issues and conduct risk reduction activities in their communities.
Timeline: April 2016 – December 2017
Focus Areas C4D Approaches
•Disaster Risk Reduction •Social Mobilization •Violence against Children
Objectives:
The overall goal of the partnership is to build the capacities of Civil Society Organisations, community-based groups and networks and young people in select districts to disseminate critical information; track community perceptions and needs; develop community actions plans to address critical issues; create mechanisms for feedback generation and action by duty bearers and prepare communities for future disasters. In order to achieve this goal, the following objectives are proposed:
1. Community-based groups and young people in intervention areas acquire knowledge on disaster preparedness and issues that affect children and young people following disasters like human trafficking, gender-based violence and unsafe migration; 2. Young people in intervention areas are able to identify potential local hazards in their communities and negotiate with existing community organisations to prepare Ward-level Community Action Plan; 3. Capacity of local level mass media built to develop programming on disaster risk reduction, human trafficking, gender-based violence and safe migration; 4. Community mobilisation partners are able to effectively engage with communities to stimulate demand for services and promote positive behaviours; 5. Community feedback mechanisms established with regular reporting at village and district level.
Scope: Select areas of Dhading, Dolakha, Sindhupalchwok, Kavrepalanchowk and Makwanpur
Gender Responsiveness This initiative aimed to use social mobilization activities along with mass media components to reach young people, including girls and women with key messages on DRR and protection. The issues
addressed by the programme included trafficking, migration, and gender-based violence. Since females, especially those from marginalised groups, tend to have lower access to mass media, the social mobilization component of the project focused on reaching these groups. To ensure that girls and women were comfortable talking to the youth mobilizers, at least half of the total youth mobilizers were women, with representation from disadvantaged communities. The documentation
lays out collaboration with the Ministry of Women, Children and Social Welfare at the national level, the Women and Children’s Office at the District level and organizations such as the Gender-based Violence Watch Group at the community level. The results framework and performance indicators however, do not specifically measure gender related indicators and are not gender disaggregated.
Partners: Ministry of Women, Children and Social Welfare, Alliance Against Trafficking In Woman and Children in Nepal (AATWIN)
Source of Information: Proposal and Programme Document
50 Pakistan
This section presents the following initiatives from Pakistan:
Health and Nutrition
•A Study to Identify Drivers of Inequity and Barriers to Access and Utilization of Immunization Services for Improved Immunization Coverage and Outcomes in Pakistan •National Communication Strategy on Routine Immunization (RI) •Formative Research on Behavioural Determinants of Stunting in Ghotki, Khairpur and Nosheroferoze Districts, Sindh Province •Maternal and Child Stunting Reduction Programme Social and Behaviour Change Communication Strategy (Draft)
Menstrual Hygiene Management
•Menstrual Hygiene (C4D) Strategy and Action Plan •UNICEF Gender Innovation Fund – U-Report Pakistan •MoHiM – A Myth Busting Video Game •Advanced Research on Menstrual Hygiene Management Among Girls In Schools Phase-lll •Adolescent Girls Information Needs Regarding Menstrual Hygiene Management: The Sindh Experience
51 Pakistan: Health and Nutrition
A Study to Identify Drivers of Inequity and Barriers to Access and Utilization of Immunization Services for Improved Immunization Coverage and Outcomes in Pakistan
Description of Initiative: A Knowledge, Attitudes, Practices and Behaviours (KAPB) study was conducted to assess the level of understanding of the target population and healthcare providers, as well as their attitudes and perceptions about immunization. The study also looked at communication behaviours and media habits to study correlations in order to guide focused and effective communication interventions. The study will serve as a starting point for future initiatives designed to strengthen routine immunization in Pakistan and will be the basis of the national communication strategy on Routine Immunization (RI).
Timeline: 2014
Focus Areas C4D Approaches
•Health •Formative Research •Routine Immunization •Baseline Study
Objectives:
1. To provide an evidence base of knowledge, attitudes and practices of caregivers, community members, providers and programme managers regarding health service provision and barriers to service utilization; 2. To identify credible information channels and networks for immunization knowledge; 3. To provide a focus for policy planning and interventions, and to set the baseline to monitor progress.
Scope: National study with the qualitative component covering 16 districts and the quantitative survey covering 39 districts.
Gender Responsiveness
The study aims to better understand knowledge and perceptions about immunization. The study included mothers, grandmothers and fathers. Additionally the study included lady health workers who have direct access to women and can share some insights on mothers’ knowledge and attitude. The focus group discussion guides included questions on gender differences. The study could have gained a deeper insight in to the gender differences in vaccination by including additional gender-based questions in the survey and attempting to understand the underlying reasons why girls are falling behind in vaccination coverage.
Partners: Government of Pakistan
Source of Information: Research Report
National Communication Strategy on Routine Immunization (RI)
52 Description of Initiative: This strategy is intended to further communication efforts to support the expanded programme on immunization (EPI) by proposing ways to reduce caregiver reluctance or resistance and increase uptake and demand for immunization services. The strategy seeks to galvanize broad political and social commitment throughout the country to attain the 2018 targets for measles, tetanus and polio vaccination. The strategy positions communication as an important means to achieving a stronger EPI response. The analysis and proposed response build on the findings of the KAPB study presented earlier and suggest that a mix of communication approaches can facilitate adoption of vaccines and overcoming vaccine resistance.
Timeline: 2015 to 2018
Focus Areas C4D Approaches
•Health •Advocacy and Social Mobilization •Routine Immunization •Social and Behaviour Change Communication
Objectives: The overall goal is to engage caregivers and community members to increase demand for and acceptance of routine immunization in Pakistan. The objectives for caregivers include understanding the importance of completing the immunization schedule and overcoming vaccine hesitancy in order to increase the immunization rates of all children, including girls and children with disabilities.
Scope: National
Gender Responsiveness
The strategy acknowledges gender differences in vaccine coverage and the fact that girls are falling behind by their first birthday. The results specify increasing immunization rates among girls and children with disabilities (as immunization of children with disabilities is not currently tracked). Implementation strategies include using couples as health workers so that they can jointly promote health information to male and female family members. The analysis also takes into account the fact
that men are primarily the decision makers in the family when it comes to deciding on vaccinating their children or making other health decisions and recommends special communication materials and careful selection of channels to target fathers. The strategy leverages the role of fathers and grandmothers to increase immunization but doesn’t attempt to empower mothers to make health decisions for their children or to alter gender roles. The analysis looks at the supply and demand side
barriers to full immunization, drawn from the KAPB study and these do not include gender. The barriers are - low awareness level amongst caregivers and healthcare providers; concerns of caregivers about vaccine safety; belief in local remedies; low knowledge and awareness of health workers on vaccine preventable diseases; distance, time and cost of travel to a health facility; unavailability of vaccines and missing vaccination cards. These barriers do not fully explain why fewer girls are immunized than boys. Gender disparities are often shrouded under the category of gender discrimination or norms but deserve a deeper analysis. An analysis of gender differences in the
formative research would have enabled more gender specific activities in the strategy.
Partners: Ministry of National Health Services, Regulations and Coordination, Expanded Programme on Immunization
Sources of Information: Strategy Document, Fact Sheet on Demand Generation for Routine Immunization
53
Detailed Assessment of the Coverage of April 2011 Round of Mother & Child Week and Documentation of the Process, Results, Challenges and Lessons Contributed by MCWk to Guide Future Rounds of MCWk
Description of Initiative: Mother and Child Week (MCWk) is a health intervention conducted by the national programme for Family Planning and Primary Health Care Government of Pakistan in collaboration with UNICEF, since 2007. MCWk has made tremendous progress: launched in three districts as a pilot project in 2007, it expanded to 128 districts by 2010. It is conducted biannually, during April and October, to provide services including immunization among 0-2 year children against five major killer diseases; Tetanus Toxoid among mothers of reproductive age; de-worming of 2-5 year old children; and health education on danger signs of pregnancy and newborns, antenatal care, birth spacing, use of iodized salt, and best newborn care practices, including exclusive breast feeding and vitamin A supplementation.
Mother and Child Week offers a minimum package of high impact, low cost maternal and child health interventions, which is well aligned with the strategic framework for reaching the Millennium Development Goals on mother and child survival. The MCWk, a multi-intervention programme which links social mobilization and service delivery, has been especially devised for and taken up by a wide range of international developing communities and is substantially contributing to improving the mother and child health indicators.
Timeline: 2007 - on going
Focus Areas C4D Approaches
•Health and Nutrition •Social Mobilization •Social and Behaviour Change Communication
Objectives:
1. Service delivery, specifically immunization among children under 2 years of age, against five major killer diseases and Tetanus among mothers of reproductive age group; and de- worming of two to five year old children; 2. Health education to change behaviour on issues related to major killer diseases of children, social mobilization through community awareness on essential newborn care, exclusive breast feeding and complementary feeding, immunization, recognition of danger signs of pneumonia/diarrhoea, basic principles of hygiene, sanitation and deworming, care and psycho-social development.
Scope: Piloted in 2007 in three districts, scaled up to cover all 128 districts of the country by 2010.
Gender Responsiveness
This initiative focuses mostly on mothers and reinforces their role as primary caregivers. The
assessment highlights the fact, that in Pakistan men are the primary decision makers and women have restricted mobility making it important to involve men and boys. The report, therefore, suggests that involvement of male community members can improve coverage significantly and they can be used as agents and activists to create awareness about MCWk.
54
(continued)
They can also influence women to avail health services during MCWk. The report recommends piloting interventions such as establishment of Mohalla (locality) committees and formation of male activists' group to promote male participation and increase the demand for maternal and child health services. Currently, male engagement is a gap in the initiative. The gender responsiveness of the initiative could be strengthened by engaging both parents and motivating fathers to take a more active role in child
rearing. The initiative should, however position men as a means to bringing about higher programme
coverage and address deeper issues of gender roles and relationships within families. Gender equality advocacy events could be integrated in the activities planned for the MCWk and role model fathers could
Partners: Government of Pakistan, Health Services Academy and national and international partners including EPI, WHO, Pakistan Initiative for Mothers and Newborns, Plan International and UNFPA
Source of Information: Research Report
Formative Research on Behavioural Determinants of Stunting in Ghotki, Khairpur and Nosheroferoze Districts, Sindh Province
Description of Initiative: This report presents the process, findings and analysis of qualitative research conducted in three districts – Ghotki, Khairpur and Nosheroferoze - of Sindh Province. The research explored underlying factors that determine nutrition and hygiene behaviours of mothers and caregivers of children under two years of age. Using the Social Ecological Model, this formative research explored psychological, social, and ecological factors that determine behaviours at multiple levels of influence, including mothers and caregivers at individual level, fathers and grandmothers at interpersonal level, and interaction between both male and female frontline workers and their community at the societal level.
Timeline: 2017
Focus Areas C4D Approaches
•Health and Nutrition •Formative Research •Sanitation
Objective: To understand the behavioural determinants of nutrition and sanitation practices among caregivers of infants and young children (under two years of age).
1. Identifying current practices of mothers, other family members and community workers related to six selected behaviours in order to inform an SBCC strategy to address them; 2. Investigating the determinants of current practices and the context within which they occur, in order to understand how social change may be catalysed; 3. Exploring diverse channels through which mothers receive information to identify influencing groups, including the role husbands and grandmothers play as well as women’s/mother’s preferred communication channels
Scope: Sindh Province
55
Gender Responsiveness
This study seeks to understand barriers to women’s care seeking behaviours through an improved understanding of mother’s care practices, the determinants to achieving the recommended feeding and sanitation practices and women’s information seeking preferences. Participants shared that most interactions with Frontline Workers (FLWs) had a pedantic tone and were limited to health-related problems. Their approach did not meet the needs of mothers in the community who aspire not only for
health changes, but also for lifestyle changes. The report highlighted that fathers have a key role to play in deciding the future of their families and should be supported to encourage their wives and other family members to adopt model behaviours, as well as sharing the workload around the house to ease the burden on mothers.
The research revealed interesting and important gender-based insights. Several mothers did not frequently or consistently practice their caregiving behaviours of children under the age of 2 years, despite knowing about them. Their motivation to adopt the target behaviours appeared to be low. Additionally, they were unable to cope with the workload and did not have the skills to negotiate with
their husbands. When they received contrary advice from elders, they did not have the self-efficacy to practice the desired behaviour. This study points to the burden of excessive household chores, lack of awareness coupled with freedom to make their own decisions and limited support from their husband and in-laws as barriers to practicing recommended behaviours and coming in the way of being “model mothers.” The study includes aspects such as self-efficacy, intention, motivation, social pressure and
self-image all of which play a role in changing gender norms. A potential next step would be to use the findings from this qualitative exploratory study to inform a larger scale survey that is representative at the provincial or regional level. Given that a strategy is being drafted, measurable indicators could be developed for the strategy based on the findings of the qualitative study, including behavioural as well as social change indicators (e.g., self-efficacy, motivation, decision-making skills etc.). The quantitative
survey could then serve as a baseline for the strategy.
Partners: UN Maternal and Child Stunting Reduction Programme – a USAID funded initiative
Source of Information: Formative Research Report
Maternal and Child Stunting Reduction Programme Social and Behaviour Change Communication Strategy (Draft)
Description of Initiative: The programme envisioned incorporating an integrated Social and Behaviour Change Communication (SBCC) intervention focused on promoting positive behaviours around exclusive breastfeeding, complimentary feeding, and handwashing with soap among key participant groups and their reference networks. To this end, a Communication firm, WhiteRice Communications, was engaged to design and implement an integrated SBCC strategy. The strategy focuses on key WASH and nutrition behaviours at household and community levels.
Timeline: 2016 – on going
56 Focus Areas C4D Approaches
•Health and Nutrition •Social and Behaviour Change Communication
Objectives: This strategy contributes to UNICEF’s strategic goal of enabling children to survive and thrive. It will help the government of Sindh to achieve its goal of reducing maternal and child stunting in alignment with Pakistan government’s development blueprint, Vision 2025, and its Sustainable Development Goal commitments linked to health, nutrition and WASH.
Scope: Sindh Province
Gender Responsiveness
Following a review of successful integrated stunting reduction interventions in Pakistan, South Asia, and globally, the SBCC intervention is premised on a ‘model mother’ approach that seeks to reward rather than admonish mothers in their caregiving role. It recognizes that mothers are overburdened with multiple responsibilities of which caregiving is a part. Concurrently, it encourages influencer groups such as husbands and grandmothers to support mothers and to allow them sufficient time for
caregiving.
The strategy builds on analysis of women’s child care practices, which highlights, that mothers’ knowledge on the benefits and harmful effects of desired behaviours was high but actual practice was found to be low. Observations found that mothers lacked the skills, and agency to practice the behaviours even when they knew about the practice. Consistent with cultural norms, fathers contributed minimally to caregiving and household chores. These findings necessitate a behaviour and
social change approach that empowers women and promotes redistribution of household work since awareness rising along will not suffice.
The strategy incorporates the Social-ecological model and draws on behaviour change theories including Health Belief Model, Reasoned Action, Stages of Change, Fear Management, Social learning, Diffusion of Innovations and the Social Norms Theory to identify the behaviour determinants - intention, environment, skills to perform the behaviour, belief of the benefits/risks, social pressure, and self-efficacy. In addition to behaviour change theories, applying social theories such as the Theory of Gender and Power, would have provided an appropriate framework to understand the (unequal)
division of labour and power distribution within household. In order to meet the behavioural objectives, the strategy needs to also respond to gender specific needs of women of childbearing age (poor nutrition and burden of child care and household chores) and boys as data shows that in Pakistan, boys under two are more likely to be stunted than girls. Gender, thus needs to be systematically included in the strategy design, material development and outreach and in the M&E
framework.
Partners: UN Maternal and Child Stunting Reduction Programme - a USAID funded initiative
Source of Information: Draft Strategy Document
Pakistan: Menstrual Hygiene Management
UNICEF Gender Innovation Fund – U-Report Pakistan
57 Description of initiative: Pakistan will conduct the following strategy to a) scale-up b) engage youth through polls and c) use poll results to take action. U-Report polls will be conducted to better understand knowledge, attitudes, beliefs and practices surrounding menarche and menstruation. This informs necessary actions and interventions that enable safe MHM. U-Report will launch and host an online/mobile based FAQ on MHM on U-Report that could serve as a helpline all over the country. The helpline will include key MHM related tag words that provide essential information and help explain safe MHM practices while directing people to where they can get more information/assistance on MHM. To achieve this, the ‘MHM Hotline’ will use both text and an Interactive Voice Response (IVR) based 24/7 toll-free helpline, allow anonymity for callers and use a female voiceover to make girls feel comfortable. A comprehensive marketing campaign will also be conducted to support the uptake of the hotline. Pakistan U-Report and WASH team will engage with various women-led groups, media and WASH clubs to conduct U-Report polls, engage and use results for change.
Timeline: 2017 – April 2018
Focus Areas C4D Approaches
•Menstrual Hygiene Management •Community Engagement •New Media and Technology
Objective:
1. Increase the ratio of female U-Reporters to achieve equitable representation (currently the ratio is 23 girls: 77 boys); 2. Address key gender inequities and advance girls’ empowerment opportunities in country programming as aligned with the GAP.
Scope: National
Gender Responsiveness
This gender focused initiative engages a wide range of women’s groups and partners to address a manifestation of gender inequality, while fostering empowerment and gender transformation. Specific steps are taken to promote equitable participation such as anonymity of callers and use of female voice- overs to make girls feel comfortable. The U-Report and WASH team engages with various women-led groups and WASH clubs to conduct U-Report polls and use results for change. One such group is Girls at Dhabas, a collective of feminists who are concerned with the disappearance of women from public spaces. They are an open community and wish to define public space on their own terms by promoting
and archiving women's participation in public spaces and learning from shared experiences. They hold MHM focused discussions in public spaces in Islamabad, Lahore and Karachi on an MHM poll/Helpline. WASH clubs in schools are organized across the country for hygiene promotion and awareness on MHM. WASH and U-Report teams also conduct: • Fun/interactive games around MHM at WASH schools encouraging girls to subscribe to U- Report to receive more information on MHM; • Activities that allow girls privacy and facilities like handwashing stations;
• Conducting awareness sessions promoting MHM in schools; and • Advocating with policymakers and other stakeholders to take actions to improve MHM.
These multi-pronged efforts promote equitable participation and aim to build agency and self-efficacy while breaking the silence about MHM.
Partners: Government, Media and local organizations
58 Source of Information: Note
Menstrual Hygiene C4D Strategy and Action Plan18
Description of Initiative: The strategy aims to increase the adoption of safe MHM practices among 9-18 year old girls by raising awareness and reducing social and political barriers that prevent girls from practicing safe MHM. The strategy will target girls, mothers and teachers as well as men and boys, to contribute to positive social change regarding menstruation. The nationwide campaign utilizes a mix of traditional communication channels along with digital technology and engages a range of actors including families, celebrity champions, religious and community leaders.
Timeline: 2016 – 2020
Focus Areas C4D Approaches
•Menstrual Hygiene Management •Social and Behaviour Change Communication
Objectives: The overall programme goal is increasing the adoption of safe MHM practices among 9-18-year- old girls. In order to achieve this goal, the communication objectives are:
1. Girls are more aware of MH and safe MHM practices; 2. Reduced social barriers, stigma, shame and taboo around MHM and related topics; 3. Increased political support for the inclusion of MHM into Governmental policies.
Scope: National Gender Responsiveness This is a gender-focused initiative that aims to break the silence around a sensitive issue that undermines the health, participation, dignity and confidence of girls. Though the primary aim of the project is to increase awareness and ultimately adoption of safe MHM practices, the holistic approach seeks to build confidence among girls and foster community dialogue and policy changes to support
MHM, including safe, gender friendly WASH facilities in school. Men and boys are included in the strategy design stage and the planning takes in to account the role men and boys can play as siblings, parents and future spouses. Overall, the initiative is designed to be gender responsive and has the potential to be transformative. The objectives and indicators include confidence and self-efficacy among adolescent girls. While the strategy draws on the social-ecological framework, no C4D or gender
theory has been drawn upon explicitly. Building on gender theories and gender assessment scales will strengthen this initiative.
Partners: Government of Pakistan and MHM Working Group
Source of Information: Strategy Document
MoHiM – A Myth Busting Video Game
18 This Initiative is featured under the Case Studies; see Section 2 for additional description and analysis.
59 Description of Initiative: Gaming Revolution For International Development (GRID) leverages video games to educate, engage and empower people to inspire social change. GRID games address social issues such as racial and gender stereotyping, sanitation and hygiene, Science Technology Engineering and Mathematics learning, and women empowerment. In 2016, GRID developed MoHiM, an initiative that raises menstrual health awareness through a fun myth-busting mobile game. The word MoHiM means “an effort” in Urdu and it spells out the acronym for Menstrual Hygiene Management (MHM).
Timeline: 2016 – on going
Focus Areas C4D Approaches
•Menstrual Hygiene Management •Social and Behaviour Change Communication
Objectives: To provide a platform for MHM through an interactive digital game and foster dialogue by educating and creating champions who are eager to eradicate the shame surrounding MHM. The game was adjusted to the Pakistani context, including aligning the content with UNICEF research and puberty book, and translated into Urdu and adding Pakistani design and style.
Gender Responsiveness The initiative responds to a gender specific need and provides girls with an innovative platform to discuss and learn about menstruation. The game provides girls with a tool to come together and can generate dialogue on MHM and beyond.
Partners: GRID
Source of Information: Memorandum of Understanding between UNICEF and GRID
Advanced Research on Menstrual Hygiene Management Among Girls In Schools Phase-lll
Description of Initiative: This research, commissioned by UNCIEF, aims to understand MHM issues and help identify and pilot-test school specific MHM interventions. This research study was conducted from July 2013 to April 2014, in the two provinces of Punjab and Khyber Pakhtunkhawah (KP). The study was carried out in three phases: i) Collection and analysis of the primary data, leading to the development of school specific MHM interventions and a Monitoring Tool; ii) Pilot testing of the proposed interventions by the Implementing Partner (IP); iii) A second round of data collection conducted after implementation of interventions resulting in the revision of the Tool Kit and Monitoring Tool. This report presents findings for phase three of the study.
Timeline: 2013 – 2014
Focus Areas C4D Approaches
•Menstrual Hygiene Management •Formative Research •Pilot Study
60 Objectives: This MHM study is aimed at understanding the MHM issues within the school context. It will also lay the groundwork for a broad movement meant to mitigate the challenges posed by the MHM interventions among adolescent girls studying in schools. Moreover, this study is intended to help develop a toolkit of MHM interventions for adolescent girls in schools. Some of the specific objectives of this study were to:
1. Carry out an in-depth investigation to understand the range of challenges faced by school girls during menstruation, as well as comprehend the determinants of those challenges across a wide range of settings and cultural contexts within Pakistan. 2. Design and pilot test a set of school-based interventions and a Monitoring Tool that can be implemented and sustained at scale across Pakistan under the Pakistan Approach to Total Sanitation.
Scope: Punjab and Khyber Pakhtunkhwa Provinces
Gender Responsiveness
The study focused on gaining insights from adolescent girls on a gender specific issue and was able to cull out important insights on both the needs and challenges adolescent girls face with MHM in schools. However, the study design did not include voices and perspectives of boys. Only school going adolescent
girls from classes six to eight, female teachers and head teachers were included. Typically, the teachers in girls’ schools are female. Gaining insights from men and boys would have been useful to inform the programme and look at the broader societal ramifications of MHM. Some findings from the study reiterate that MHM is considered a women’s issue, for instance in Swabi, a principal that handed the
MHM booklet to girls and told them not to be shy about discussing menstruation among themselves. However, she also told them to keep the booklet away from male members of the family and not show it to their fathers or brothers. Such deep seated norms will require long term initiatives and understanding the perceptions of men will be a key step to inform future strategies.
Partners: Government of Pakistan
Source of Information: Research Report
Adolescent Girls Information Needs Regarding Menstrual Hygiene Management: The Sindh Experience
Description of Initiative: This research report presents the findings from qualitative research conducted to support the development of the Pakistan puberty book that provides essential, culturally sensitive information on puberty and menstrual hygiene management (MHM) for 10-14 year-old girls. Earlier components of this research were conducted in Punjab and Baluchistan provinces in 2015-2016. To ensure Sindh’s cultural beliefs and values are also represented in this national book, the study was repeated in Sindh in 2016-2017. This report focuses only on the findings from Sindh.
Timeline: 2017
Focus Areas C4D Approaches •Menstrual Hygiene Management •Formative Research
61 Objective: The data includes information on girls’ experiences of menarche, aspects of the cultural values, beliefs and practices surrounding menstruation, and how the available WASH facilities impact girls’ MHM during school.
, Gender Responsiveness
This research responds to the need for menstrual hygiene education among adolescent girls and attempts to fill a gendered gap in information and knowledge around a reproductive and sexual health issue. Cultural norms and religious beliefs in Pakistan limits girls’ access to information on menstruation and typically girls receive information only after menarche. Withholding information about MHM may be related to the desire to ‘raise innocent daughters’ and maintain the gender order
where girls need to be considered pure or innocent. Religious beliefs view blood as a polluting factor, and can lead to seclusion and lack of participation in religious events during menstruation. Within this context, both women and men regard sexuality and reproduction as highly shameful, embarrassing topics, and actively avoid discussing them. This avoidance extends to discussing sex, sexuality and menstruation with daughters and mothers are often reluctant to discuss such topics. Furthermore, mothers themselves often have little experience with conveying menstrual-related information and support, since previous generations also avoided the topic. In that sense, the study opens up
discussion for a taboo topic entrenched in gender norms. While the purpose of the research was to understand girls’ information needs, it would benefit from including male respondents in order to understand how men and boys perceive menstruation and how they see their role in supporting women and girls and in the availability of MHM supplies. Changing gendered norms around MHM need to include men and other influential gatekeepers. Additionally, adolescent boys also need to
understand the changes that they undergo during puberty and this research does not provide us any insights of boys’ reproductive health needs.
Partners: Real Medicine Foundation, University of Alberta, Global Affairs Canada, and Columbia University
Source of Information: Research Report
62 Section 2: Case Studies and Lessons Learned
Afghanistan: Golden Villages Initiative19
Introduction A large number of Afghan children continue to live without access to health, education, nutrition and protection services. Almost half the children under one miss out on immunization, over a third of the children under five are stunted, close to two-third of women currently aged between 30-39 are married before their 18th birthday, and 3.5 million children are out-of-school. Analysis of the socio-cultural determinants of the health, education, child protection and nutrition status of children in Afghanistan reveal that a relatively small and common set of core underlying factors influence various aspects of child rights, and are intrinsically linked to the status of women and girls in the society.20 In 2015, at the start of the country programme, an analysis of programme areas indicated gender-based discrimination and inequality as the predominant underlying issue resulting in seemingly ‘behavioural’ manifestations in areas such as maternal health, girls’ education, child marriage, exposure to both interpersonal family violence and war-related violence, nutritional status and immunization.21
Overview of the Initiative Towards generating a proof of concept for an effective approach to strengthening community and system capacity for addressing social norms and practices, an innovative Golden Villages Initiative was launched in 129 villages in two districts of Bamyan province. The Golden Village Initiative (GVI) responds to the deep- seated gender norms that negatively affect several health and well-being outcomes for children and women. It was conceptualized as a ‘whole-system’ response to support five sectoral results across health (immunization and maternal health), nutrition, sanitation, education and child marriage.
The initiative used an Appreciative Inquiry based methodology, which is a strength and asset based approach for transformational change. The initiative aimed to inspire communities to mobilise themselves towards attaining a ‘Golden Village’ status for their village by achieving five key results within a mutually defined timeframe, while also enhancing the capacity of government functionaries to support and consolidate ownership and commitment among these communities to ensure the following five results:
I. All children under one year of age are fully immunized II. All pregnant women deliver with skilled birth attendants III. All infants under two years of age fall in the green band of the WHO Child Growth Monitoring chart, reflecting adequate nutrition and hygiene standards22 IV. All girls between 6 - 16 years are enrolled in school V. No marriages occur before the age of 18.
Strengths and Innovations GVI promoted an integrated approach to achieve sectoral goals grounded on an analysis of social norms and the underlying gender underpinnings that impact child rights and development outcomes. Such an
19 The Case Study draws on inputs provided by Sharad Agarwal, C4D Manager, UNICEF Afghanistan. 20 Golden Villages Concept Note. 21 Response from the Country Office to the Mapping and Needs Assessment Questionnaire. 22 The nutrition component was later separated out as the Community Health Workers required training before the growth monitoring sessions could take place.
63 integrated response promotes the value of the girl child and can result in multiple sectoral gains. The Theory of Change (TOC) articulates gender related results at the outcome level, including recognition of women’s role, improvements in their autonomy, and critical reflection on traditional practices.23 Incorporating gender transformational results when developing a Theory of Change and clearly articulating these in the programme’s results framework, ensures that gender equality is a key objective of the initiative, and not something that is implied or assumed to be occurring.
Another strength was that the workshops provided a forum where community members and provincial authorities could collaborate to express their shared concerns and commitments. This enabled demand and supply side issues to be addressed collaboratively. The methodology selected was aspirational and empowering, enabling community members to focus on their assets, such as achievements, heroes, and innate capacities to change their futures. Such a transformative approach has the potential to bring about far-reaching change and empower communities to go well beyond sectoral programme results. The use and impact of AI in international development is well documented in several global contexts and issues.24
Gaps and Areas for Improvement The challenging programmatic context of Afghanistan demanded that several operational processes be streamlined before implementation. It was necessary to gain the support of national and provincial government authorities, the community and the local media. This was time intensive and resulted in some components such as the media component not being implemented. Due to capacity constraints, and operational challenges, a behavioural monitoring system could not be established to systematically measure shifts in knowledge, attitudes and practices. However, the intervention tracked all vulnerable children or households through a community led line-listing, which served as the baseline for outcome level indicators. Given that no other SBCC intervention was underway in the programme site and based on tracking data gathered, it is likely that the communication intervention contributed to the change. A formal evaluation is planned for 2018 and will conclusively assess the extent of the change resulting from the intervention.
The initiative could therefore have been strengthened by establishing a sound behavioural monitoring framework with selected sentinel sites prior to the implementation. This would have enabled results to be attributed to the intervention and would have allowed for comparisons between control and intervention sites. Ensuring robust M&E is not always possible, more so in challenging contexts such as Afghanistan. Some feasible options may be to consider leveraging the existing partnership with the Ministry of Public Health, the lead ministry for the DHS survey, to build on their experience in conducting several health-related surveys. Bamyan province was included in both the recent MICS and DHS surveys and could be referred to for baseline comparisons. In addition to surveys, participatory behavioural monitoring tools can integrate data collection as part of the programme and are well suited to the community-centered AI approach. Moreover, in a fragile context, behavioural monitoring allows for communities to measure their own progress without having to bring in outsiders. For instance behavioural monitoring could be integrated with the mothers’ groups sessions using participatory tools such as recording meeting minutes which would provide rich data on changing roles, responsibilities and awareness of rights. Similarly, visual tools such as photo voice or drawings could be used to depict the “before and after.” Such visual tools have been used to engage non- literate Community Health Workers (CHWs) to track changes in nutrition in Afghanistan. 25 The most significant change technique would also fit well with the AI approach and could capture some powerful stories of change. These methods build on the community led self-monitoring that was done and the stories
23 GVI Concept and Approach: Presentation for Stakeholder’s Workshop, 2016. 24 A range of examples are presented in the International Journal of Appreciative Inquiry, Vol 13 (2011). 25 Mayhew, M., Ickx, P., Stanekzai, H., Mashal, T., & Newbrander, W. (2014). Improving nutrition in Afghanistan through a community-based growth monitoring and promotion programme: A pre-post evaluation in five districts. Global Public Health, 9(Suppl 1), S58–S75.
64 and testimonies that have been collected to capture the shifts in attitudes and behaviours at individual, family and community levels.
Partnerships Designed as an integrated cross-sectoral approach to social and behavioural change, the Golden Village Initiative was expected to be implemented in close partnership with three line ministries – Ministry of Public Health, Ministry of Education and Ministry of Labour, Social Affairs, Martyrs and Disabled, as well as four provincial departments – Department of Public Health, Department of Education, Department of Labour, Social Affairs, Martyrs and Disabled, and Department of Rural Rehabilitation and Development. However, the inter-sectoral partnership was best reflected in the sustained efforts of the Provincial Golden Village Coordination Committee representing the four sectoral provincial departments, that met regularly and monitored and provided oversight to the intervention. Within UNICEF, the initiative brought together health, education, nutrition, WASH and child protection. All relevant sections were engaged during the planning phase and activities were included in each of section’s rolling work plans and funded for three consecutive years from 2015-17.
Implications for Women’s Rights and Gender Equality Addressing gender norms is the central core of the Golden Village Initiative as these norms are recognized as a common underlying cause of health, education and protection indicators. Such a cross-sectoral approach has the potential to bring about gender-based transformation while also achieving sectoral results. This approach builds on the multiple deprivations faced by girls and proposed a harmonized response to health, nutrition, education and protection from violence and early marriage. In that sense, the starting point of the analysis and programme was gender and not the other way around, where a programmatic intervention also happens to result in gender related changes. In addition, the methodology aimed to transform and empower community members. The sector specific results all contribute to the realization of children and women’s rights and aim to reduce gender disparities in health and education. Completing secondary education and delaying marriage has far-reaching impacts on girls’ health, livelihood options and economic well-being and yield long term benefits for families and communities. The mothers’ group sessions provides a forum to discuss and reflect on gender issues such as norms, roles, responsibilities, mobility, agency and empowerment and the engagement of community members provides an enabling environment for gender transformation.
The initiative was planned to be rolled out over four years, but the time-frame was cut short, with the programme beginning in 2016, an ending by December 2017. Gender and normative changes typically take time and require sustained efforts. Yet, based on activity monitoring reports and the line-listings conducted, by November 2017, all 129 villages had formed Golden Village Coordination Committees, and Mothers’ Groups, and communities/ volunteers supported vulnerable households in finding solutions to barriers to their health and well-being. Due to the inspirational nature of the intervention, and the interpersonal communication during and after the workshops, a large majority of the villages (118 out of 129) met all four indicators within 15 months of the launch, and another six were expected to do so by December 2017. Sustainability indicators show strengthened communication between communities and services, heightened social cohesion and social capital, and high commitment to sustain actions on child-care and protection. Provincial level tracking data indicates both programmatic and gender related changes:
• 4 of the 477 under-immunized children under 1 year (from a total of 2268), remain to be fully vaccinated, i.e., 99.2 per cent full immunization in the 129 villages. • 785 of the 937 out-of-school girls enrolled in school, i.e., 84 per cent of out-of-school girls enrolled (from a total of 7373 girls between 7-16 years). • 10 deliveries of 1252 pregnancies listed at baseline were at home, i.e., 99.2 per cent were institutional deliveries
65 • No marriages before 18 were reported, and only 1 engagement. • Mothers’ croups and coordination committees were active in all 129 villages, indicating increasing social cohesion.26
By December 2017, all 129 villages had achieved the four indicators and had been verified and declared as Golden Villages.
Lessons Learned and Key Takeaways The positive lesson of the Golden Villages Initiative is that it was a holistic, integrated programming approach, aimed at addressing gender inequities through communication, dialogue and engagement. It was intended to be a strategic approach to programming across sectors and line ministries, and was initiated in one province to test the methodologies, tool and hypothesis, based on which it would have scaled up through the ministries with appropriate mechanisms, possibly such as the Citizen’s Charter.
This was an example of an inspirational, asset based approach that is needed to motivate communities and provincial authorities to achieve change. Community commitment, ownership and endorsement through public declarations are important for sustained changes in norms. Once again, because of the context, the results had to be articulated in terms of programmatic results and gender outcomes had to be kept implicit. This meant that the ToC indicated the sectoral results as the ultimate outcomes, the C4D results, such as self- efficacy or decision- making or commitment not to marry girls before age of 18, were articulated as outputs or intermediate results in the results framework. The country team also shared that due to the prevailing socio-cultural norms, gender had to be approached sensitively to ensure buy-in from partners and community and to avoid resistance to ideas or new norms that are perceived as disrupting the existing social order.27
Key Takeaways
• Gender is central to the initiative and the starting point of the programme analysis and planning. However, the local cultural and political context affects how gender transformation is positioned and promoted;
• Considerable time is required prior to implementation to gain buy in from partners, align all elements of the initiative, build capacities and recruit required personnel;
• Promoting a cross-sectoral response to address the whole child allows for sectoral gains as well as gender norm changes;
• Community ownership and events such as public declarations and commitment from leaders and communities are critical for long term normative shifts;
• Articulating communication and gender specific results should be part of the project design;
• Formalized monitoring and evaluation mechanisms need to be included in pilots to inform scale up and future improvements and be supported by the country office M&E team.
26 Current status and results are taken from the RAM ‘Output’ Reporting on Social Inclusion (Output 6.6) provided by UNICEF Afghanistan. 27 Mapping and Needs Assessment Questionnaire Response from UNICEF Afghanistan.
66 Bangladesh: National Multi-Media Campaign Strategy to End Child Marriage28
Introduction Child Marriage is a widespread global practice, cutting across cultures, religions and socio-economic status. Child marriage violates girls’ right to education, health and protection, limiting future opportunities. Despite legislation that prohibits marriage of minors in many countries, child marriage continues to be rampant, fuelled by various factors including gender inequality, poverty, and fear for girls’ safety.
Bangladesh has one of the highest rates of child marriage in the world, affecting a large number of girls and adversely impacting the well-being of families, communities and the country. The practice remains both socially accepted and expected in many parts of the country. Child marriage in Bangladesh is perpetuated by socio-cultural beliefs and norms that view puberty as a sign of physical maturity and readiness for marriage and the perception that younger girls are “purer.” Additionally, girls are considered a financial burden and investing in their education is not valued. These beliefs operate within a social context that privileges boys over girls, leading to several forms of gender-based discrimination and inequality. Furthermore, girls do not have a say in decisions about marriage, and decisions are primarily made by the father or other family members.
Bangladesh has made considerable progress in reducing child marriage over the past two decades. In 2000, the child marriage prevalence rate was at 68 per cent, affecting two out of every three girls. Recent studies indicate that 52 per cent of girls, roughly one in every two girls is married before her 18th birthday and 18 per cent are married before the age of 15.29 Child marriage is more prevalent in rural areas where 71 per cent of girls are married before the age of 18, compared to 54 per cent in urban areas.30
The Government of Bangladesh along with international and national partners are committed to ending this harmful practice. The Ministry of Women and Children Affairs (MOWCA) has led the development of the national Plan of Action to eliminate child marriage. The plan charts out the role of the various government agencies, NGOs, civil society and international partners, to eliminate child marriage in Bangladesh. Guided by the plan, the Ending Child Marriage Programme (ECMP), with the financial and technical support of UNICEF and UNFPA, is currently underway. Awareness-raising and communication are among the key objectives of the plan, which specifically seeks to: • Create awareness and an enabling environment to eliminate child marriage • Eliminate marriage under 15 and reduce marriage under 18 by a third by 2020 • Eliminate marriage under 18 by 2040 Overview of the Initiative31 The campaign is part of the broader C4D strategy to end child marriage and complements on going ground- based community engagement. The campaign aims to counter the social sanction and acceptance of child marriage to create an overall climate where the practice is considered unacceptable. The campaign is an important part of Bangladesh’s National Plan of Action to accelerate the end of child marriage. The initial phase of the campaign is designed to span 11 months utilizing a range of communication activities. The national level activities include a 26 episode television and radio drama series in conjunction with TV and
28 The Case Study draws on inputs provided by Tania Sultana, C4D Specialist, UNICEF Bangladesh. 29 Bangladesh Multiple Indicator Cluster Survey, 2013. 30 Human Rights Watch, Marry Before Your House is Swept Away, 2015. 31 Campaign Strategy Document and Campaign Brief provided by UNICEF Bangladesh.
67 radio spots and social media. An additional 52 episodes of the television drama are planned for the second phase. The subnational activities include mobile film screenings, and outdoor media such as wall paintings, billboards and posters. The mass media component will be national and the subnational activities are anticipated to reinforce the on-air component.
The campaign call to action is “Report” and the tagline translates to “Stop the wedding music, pick up the phone.” Using the traditional ‘Dhol’ or drum as a symbol of garnering attention to voice protests, the campaign suggests a beat or rhythm for everyone to rally around together in order to raise their voices and report any incidents of child marriage. The aim is to trigger an easy, participatory and highly visible action which reflects increasing public intolerance against child marriage.
Strengths and Innovations High-level political commitment to end child marriage, lends strong support to the effort. The Prime Minister, Sheikh Hasina has publically pledged to end child marriage by 2041 and eliminate marriages under 15. The supportive legal framework is also an enabling factor. The newly adopted Child Marriage Restraint Act (2017) introduces a harsher punishment for those who support or engage in a child marriage. Adults who marry a child can face up to two years of imprisonment and/or a fine of Tk 100,00032. The law does however include a concerning loophole that allows child marriage in “special cases,” without stipulating what those conditions are.33 The existence of these laws and policies and an overall enabling environment are essential for the success of gender focused communication efforts.
Notably, the strategy takes on a social norms approach, recognizing that child marriage is not led by individual behavioural choices or preferences but is instead something that is guided by social and cultural norms. In other words, people are influenced by social expectations and peer or familial pressure. In order to better understand the situation, the analysis for the campaign builds on a social norms diagnostic and assessment which highlighted the normative aspects of child marriage (see Table 4). Child Marriage, when viewed from a social norms perspective calls for a social change communication approach that utilizes both media and community engagement.
Table 4: Different Kinds of Beliefs and Collective Practices on Child Marriage34
Type of Belief Examples Rational response: A rule that people follow Fathers marry off their daughters young because they reason it maximally satisfies their because girls are a financial burden preferences
Factual beliefs: Belief about reality other than An older girl will not find a good husband about people’s behaviour and thought
Custom: A rule that people follow more or less Fathers marry off their daughters young blindly but which would be abandoned if no because it is a tradition and nobody thinks longer in their own interest much about it
Moral value: A rule that people follow because Fathers believe that girls should marry young they believe that it should be followed because girls should be pure and chaste
32 Approximately US$ 1,200. 33 Girls not Brides. Child Marriage Around the World: Bangladesh. 34 Cristina Bicchieri, A Social Norms Perspective on Child Marriage: The General Framework, UNICEF, 2014.
68 Descriptive norm: A rule that people follow Fathers marry off their daughters young because they believe that others follow it because they believe other fathers also marry off their daughters young
Empirical expectations: Beliefs about what All my neighbours marry their daughters as people do soon as they reach puberty
Personal normative beliefs: Beliefs about what I should marry my daughter as soon as she one should do reaches puberty
Social norm: A rule that people follow because Fathers marry off their daughters young they believe that others follow it (empirical because they believe other fathers also marry expectation) and that others think it should be off their daughters young and, moreover, they followed (normative expectation) believe other fathers think that girls should marry young (because girls should be pure and chaste)
According to Bicchieri, these distinctions become important, as different types of belief require different responses. For instance, if child marriage is a rational response, the practice can be abandoned if the incentives are changed. If child marriage is a custom, it is more easily abandoned as people realize the practice is no longer relevant. If child marriage is a descriptive norm or a social norm, abandonment becomes different, as the decision is no longer individual but based on social expectations. Since decisions are based on what other people do and think; a collective approach is required. To change a social norm, it is important to change normative expectations. In the case of child marriage, this might mean that one has to change not only people’s personal normative beliefs that child marriage is good but also their normative expectations that others think that child marriage is good.
The campaign builds on the SEM framework and identifies multiple participant groups including adolescent girls and boys, their families, their immediate and extended community networks and national policy makers. Importantly, the campaign is not a standalone initiative. It is part of the broader C4D strategy, which is in turn part of the national response to end child marriage. Thus, complementing on going ground-based community engagement efforts and strengthening of services and systems (such as health, education and child protection).
Gaps and Areas for Improvement Though the Government partners supported this initiative, the endorsement and approval process for the campaign has been slow. Unlike the Ministry of Health, where there is a long history of health communication and C4D and a dedicated unit for health promotion exists, the Ministry of Women and Children Affairs did not have a unit or committee in place. The ministry has only recently begun engaging in C4D and there isn’t precedence or established protocol to review and endorse material. In hindsight, additional consultations prior to developing the campaign material may have facilitated this process.
The inter-ministerial coordination and overlapping mandates has also at times been complex. For instance, the Child Protection helpline (1098) is under the Ministry of Social Welfare while the MOWCA has a separate hotline number for preventing Child Marriage (109). Since MOWCA was the lead partner, it was decided to use the 109 hotline. Prevalent social and gender norms also impact the programming context and gender transformation has to be handled with sensitivity. This implies that gender inequality cannot be always be addressed directly and requires some negotiation and tact in how interventions, approaches and messages are framed. As in other places, the Government can be resistant to changing the social and gender order. Government partners also tend to be cautious about efforts that are seen as foreign or not suited to Bangladesh’s cultural context. Some of the campaign material has therefore had to be modified.
69 Partnerships The ending child marriage initiative brings together a wide range of partners both within UNICEF and with national and international institutions. The child marriage response in Bangladesh is a priority area and a point of convergence for programmes and national partners. The governmental lead is MOWCA. The inter- ministerial partners include Ministry of Information, Ministry of Health and Family Welfare, Ministry of Education and Ministry of Social Welfare. UNFPA is the technical partner for the ending child marriage programme and the campaign. Within UNICEF, the inter-sectoral collaboration includes education, child protection, gender, C4D, health, nutrition, WASH and social policy, evaluation and research. The internal collaboration has worked effectively. A mechanism was established to hold bi-monthly planning meetings during the strategy formulation and campaign design phase. Sections were also on board for the design workshop. During the scripting stage, relevant sections reviewed programme specific content. Campaign partners are Bangladesh TV, Betar Radio, Asiatic Marketing Communications (for the campaign strategy development), PCI Media impact (for production of the drama series), James P. Grant School of Public Health, BRAC University (for programme evaluation and research).
Implications for Women’s Rights and Gender Equality Child marriage is a violation of human rights and hampers the achievement of several development goals, notably gender equality, poverty, health, and quality education. Ending child marriage on the other hand, can lead to healthier, more empowered and equitable futures for girls. This has been demonstrated in several instances, including in a recent study in Bangladesh, which showed that programs that educate girls, build their skills for modern livelihoods, and engage their communities, can reduce the likelihood of child marriage by one- third, and produce better health, educational, and social outcomes for girls. The study revealed that in communities where girls received educational support, girls were 31 per cent less likely to be married as children than in the control communities. Likewise, in communities where girls received life skills training on gender rights and negotiation, critical thinking, and decision-making, girls were 31 per cent less likely to be married as children than girls in the control communities.35
When C4D addresses root causes of inequity such as the value of the girl child and equal rights of all children, the results are likely to go beyond sectoral gains to include gender equality and empowerment. The harmonization with other programmes such as life skills development through media campaign, adolescent clubs and community engagement (through open community dialogue with local leaders and courtyard meetings for male and female caregivers) provides a multi-pronged and holistic response to child marriage. The office-wide ending child marriage Implementation Plan includes measures of adolescent participation, number of girls supported to stay in school or non-formal education, and the number of service delivery points providing adolescent and girl-friendly health and protection services. The C4D strategy covers the level of participation in dialogues to promote gender equitable norms including delaying child marriage achieved through the community engagement, multi-media campaign and adolescent radio listening clubs. C4D specific results including the contribution to gender equality will be measured in the baseline and the endline. Additionally, monitoring data is regularly collected through the Dashboard.
Lessons Learned and Key Takeaways This initiative provides important lessons for future gender and C4D initiatives. First and foremost, is generating commitment, ownership and buy-in from the Government. National partners need to be part of the planning and strategy development process. High-level political support is important for changing norms that are deep-rooted in cultural practices and religious belief systems. This initiative also makes the case for
35 Amin, S., J. Ahmed, J. Saha, M. Hossain, and E. Haque. 2016. “Delaying child marriage through community-based skills-development programs for girls: Results from a randomized controlled study in rural Bangladesh.” New York and Dhaka, Bangladesh: Population Council.
70 intensive media engagement coupled with ground-based mobilization of caregivers and community leaders. Such intensive media engagement requires heavy investments in the formative research and design of the content. While child marriage is an example of programmatic convergence, the multiple players also pose challenges for the implementation and ownership of the initiative. This campaign is also notable for its social norms approach and paves the way for good practices in social norm change communications. The social norms analysis informs the campaign design and strategic approach.
Key Takeaways
• High-level political will and support has been crucial for the launch and sustainability of the campaign;
• The Prime Minister’s commitment and public pledges to end child marriage endorses the effort and Government buy-in;
• Being cognizant of local cultural contexts and realities is important for gender and social norm change initiatives where partners can be hesitant to upheavals in the status quo;
• Cross-sectoral collaboration and partnerships are vital for long-term holistic change. The fact that the collaboration has worked efficiently has been an enabling factor;
• The combination of ground-based mobilization and on-air media engagement is more likely to lead to impact than stand alone efforts;
• The social norms approach is also an example of a good practice and highlights how social norm analysis can inform programmes.
71 Nepal: The Golden 1000 Days Communication Campaign36
Introduction The Golden 1000 Days Campaign seeks to promote child survival and development during the first thousand days of life - from conception to two years of age. The focus of the campaign is on improving maternal and young child feeding, hygiene and sanitation practices, access to proper health care and social services, as well as delaying marriage and pregnancy, as early marriage and child bearing are closely linked to child nutrition and survival.
Nutrition of mothers and children in Nepal remains an area of concern with a large number of women and children suffering from malnutrition and micro nutrient deficiencies. According to the Nepal Multiple Indicator Cluster Survey (NMICS) 2070/71, approximately 37 per cent of children under 5 years of age are stunted (with chronic malnutrition), 11 per cent are wasted (with acute malnutrition) and 30 per cent are underweight. Nearly 48 per cent of pregnant women and 46 per cent of children under 5 are suffering from anaemia. Furthermore, malnutrition is worse among economically, socially and geographically disadvantaged groups. Newborn and infant feeding practices also need improvement. Roughly half of the newborns are breastfed exclusively (57 per cent) for the first six months and close to three fourth of the children (73 per cent) are introduced to supplementary foods after the first six months. However, the feedings are not timely and the number of children who receive quality, nutritious and diversified food in adequate amount is alarmingly low. Only one-fourth of children are getting the recommended amount of food as per the international Infant and Young Child Feeding (IYCF) guidelines. The limited access to safe drinking water and sanitation adds to under-nutrition.
Therefore, the Golden 1000 days campaign aims to achieve and monitor nutrition-related behavioural outcomes by promoting specific behavioural changes among adolescents, mothers, fathers and other family members. The campaign seeks to increase awareness of maternal and child nutrition while pushing for a normative shift in families by engaging men (husbands and fathers) as well as mothers-in-law. Recognizing that within the patriarchal social context in Nepal most young women are unable to access, negotiate or demand for improved nutrition during pregnancy and lactation, husbands and family members are a central focus of the campaign. Furthermore, the campaign encourages families to understand the importance of the first 1000 days and support women and infants to ensure that they get the required nutrition, adequate rest and care.37
Overview of the Initiative The campaign is closely linked to the Multi-Sector Nutrition Plan (MSNP) which aims to strengthen the capacity of the National Planning Commission (NPC) and the core sectoral ministries responsible for formulating, implementing and monitoring the MSNP in order to improve maternal and infant nutrition in Nepal. Relatedly, a Multi-Sectoral Nutrition and Food Security Advocacy and Communication Strategy (2072- 2076) has been developed to support the MSNP and to ensure accurate information is provided to beneficiaries, as well as adequate mobilization and capacity building of relevant stakeholders is carried out.
This campaign was launched in April 2016 and will be implemented in several districts throughout the country in different formats and levels of intensity. During the initial phase, the campaign is being implemented in six districts combined with intensive behaviour monitoring. Training and capacity building is being conducted
36 The Case Study draws on inputs provided by Sanju Bhattarai, C4D Officer, UNICEF Nepal. 37 The Case Study draws on the Golden 1000 Days Guidelines and Communication Action Plan.
72 in 16 districts and the media component is nationwide. Additional components have been added in earthquake-affected districts. The stakeholders are integrating all the messages, materials and activities developed for the campaign in their existing program and the content will be tailored for the different geographic regions and ethnic communities.
The campaign is being rolled out following a two-pronged approach that combines implementation with behavioural monitoring. Firstly, all Golden 1000 Days families in the implementation districts and VDCs will be reached with specific communication messages and activities. Secondly, Golden 1000 Days family groups will be followed from pregnancy, and their behaviours monitored in 75 VDCs of the six districts with intensive interpersonal and community events. The behavioural monitoring will track 1235 cohort families though the course of campaign, with seven rounds of data collection. A data centre has been established at the Ministry of Health/ National Health Education Information Communication Centre (NHEICC), to send SMSs and IVR based messages to families . The messages build on the life cycle approach, starting from conception up to the first two years of a child's life. The pregnant women/fathers and the family members will be reached with periodic specific interventions and messages, through household visits, community dialogue, and health facility level counselling. A number of actors, such as religious leaders, teachers, Early Childhood Development facilitators, women federations, traditional/faith healers, village development committee (VDC) secretaries, social mobilizers of the Local Governance and Community Development Programme, child and youth clubs, female community health volunteers, adolescent girls groups, local political and social leaders and other service providers, will be mobilized to deliver messages to mothers/caretakers, fathers, mother/ father in laws, and other family members, at different times through the 1000 days. 38
Strengths and Innovations The campaign design reflects a significant shift from typical behaviour change efforts towards a well- integrated social change communication approach. Mothers, fathers, family and community members are reached through multiple mediated and interpersonal communication channels. The community level interventions and special events include engaging communities and networks to influence social norm change and empowering pregnant women/mothers and families (care takers, husbands/fathers) to change the existing social norms and practices around nutrition and service seeking behaviours. Community role models encourage and motivate families and individuals to adopt healthy and more equitable behaviours.
The use of technology and intensive behavioural monitoring are both notable aspects of the campaign. In collaboration with the Microsoft Innovation Centre (MIC), a platform has been established to disseminate phase wise messages through the Internet, IVR and SMS services and social networks (Facebook, Twitter, YouTube, and the campaign website). The web-based central data hub is in the final stages of development and testing and will enable the tracking of message dissemination as well as the effectiveness of messages and interventions.
The Golden 1000 Days initiative aims to gain high visibility and become a familiar household brand. Celebrity endorsement from well-known and popular sports and media personality lends high-level support and brand recognition. Messages on national media endorsed by National Cricket Team Captain, Paras Khadka, are motivational, promoting male support and bringing the campaign to the public agenda. The media messages and PSAs also promote male engagement by showcasing supportive spouses who accompany their wife for ANC visits, help wives with housework and heavy lifting, and participate in early child-care and feeding. As previously highlighted in the mapping section, this campaign demystifies male engagement and spells out key actions a husband or father must do; this way, the campaign ensures that they are included in the communication objectives and media content and their involvement verified by measurable indicators.
38 The Golden 1000 Days Guidelines and Communication Action Plan.
73 Gaps and Areas for Improvement The intervention builds on existing national and subnational structures and networks and the Government’s on going programmes for local development, health and nutrition. The community level activities leverage existing networks such as child clubs, female community volunteers and social mobilizers, all aiding to long- term sustainability. An additional area of investment would be to include a module on gender and human rights within the capacity building of community groups and service providers. This will help to consistently promote gender equality during the campaign and will also be a long-term investment that will reap benefits beyond the campaign.
Though conceptualized as an inter-sectoral initiative, the inter-sectoral collaboration has been difficult to achieve. The Ministry of Health has primarily led the planning and implementation of the campaign, and getting the seven key ministries to coordinate has been challenging. NHEICC is the lead technical agency and the inter-ministerial working group has not worked as efficiently as expected.
Cultural beliefs and practices related to food consumption during pregnancy and lactation are deep-seated and difficult to change in the short term. In spite of Government policies, grants and assistance to support nutrition and health among marginalized communities, the availability and affordability of nutritious foods continue to undermine the behavioural adoption of nutritional choices promoted by the campaign. Many families do not have the means to include a colourful and diversified plate and animal protein sources such as eggs, dairy, fish, meat and poultry, regularly in their diet.
Partnerships This is an inter-sectoral initiative across seven key ministries: Ministry of Agriculture and Development, Ministry of Education, Ministry of Federal Affairs and Local Development, Ministry of Health, Ministry of Lifestock Development, Ministry of Urban Development, Ministry of Women, Children and Social Welfare. The National Planning Commission is the coordinating body and NHEICC (under the Ministry of Health) is the lead technical agency. Overall the campaign’s capacity building and outreach activities are harmonized with the Government’s plans and structures at the national, district, village and community level. The campaign is also aligned with the efforts of other international agencies, NGOs and development partners working on health and nutrition (e.g., World Health Organization, the World Food Programme, USAID/SUAAHARA) and includes private sector partnerships (e.g., Microsoft Innovation Centre).
Implications for Women’s Rights and Gender Equality Malnutrition has serious implications on the survival, growth and development of all children, undermining human rights and the achievement of development goals. Nutrition has significant gender implications, as girls are more likely to suffer from malnutrition than boys. According to the Nepal Demographic Health Survey (2011), adolescent girls are the most malnourished group among women of childbearing age, with almost a fourth of adolescent girls delivering their first child before the age of 18 and half giving birth by the age of 20. The cycle of under nutrition often persists: Women with poor nutrition are likely to give birth to underweight children and under nourished children and these children tend to remain malnourished through childhood and adolescence. While poverty and food insecurity remain key underlying factors, women’s lower socio-economic status, lack of access to resources, inequitable distribution of food in households and cultural practices such as child marriage and early child bearing, exacerbate the situation. The strategy aims to improve maternal and child nutrition and promotes more equitable distribution of food, domestic chores and child care between spouses, consequently promoting women’s rights and gender equality.
The Golden 1000 days communication initiative aims to influence individual and family behaviour and community practices in order to promote improved nutrition and health of mothers and their infants. The social change agenda is to promote pregnancy and the postpartum periods as a special time: strengthening adolescents and women’s self-esteem and negotiation skills; fostering more equitable distribution of food
74 resources in households and sharing of domestic work and childcare between husbands and wives. During this process, shifting gender norms and increasing demand for required services and policies is expected.39
Lessons Learned and Key Takeaways The Golden 1000 days communication initiative promotes nutrition ‘specific’ and nutrition ‘sensitive' behaviours and practices at individual, family and community level to improve the nutrition and health of mothers and children under two. The C4D approach builds on the SEM framework and engages mothers, fathers, mothers-in-law and other family members. Communication objectives and activities are well defined and the results framework includes communication specific changes at the outcome level that will demonstrate the impact of communication on behaviour and social change. The community engagement component includes female community health volunteers and social mobilizers, as well as local networks such as the ward citizen forum, citizen awareness centres (these groups include women and men) and child clubs (which include girls and boys). Communication channels include mass media, interpersonal communication, mobile technology and community dialogue. Such a multi-layered approach is well suited to fostering social change and normative shifts. Notably, performance indicators include standard measures of change in knowledge, attitudes and practices for health and nutrition related behaviours (such as pregnant women consuming the recommended diet and children fed with appropriate IYCF practices), but also include social change indicators (such as fathers taking part in child care and feeding, community members discussing the key messages with families and valuing the importance of the first 1000 days).
Key Takeaways
• The Campaign design builds on and responds to gender based norms and differences in access to nutrition and health services;
• There is strong government buy-in for the campaign as Maternal and Child Nutrition are priority areas for the government given the fact that Nepal is among the countries with the highest prevalence of childhood stunting;
• Male engagement is operationalized right from the communication objectives, to media content and measurable indicators;
• Existing structures and networks at the community level are leveraged, contributing to long term sustainable change;
• A robust behavioural monitoring framework supports the campaign and tracks the effectiveness of the intervention and baseline and endline evaluations to assess the impact of the intervention are included;
• Overall the campaign, promotes renegotiation of gender roles, responsibilities and power structures within families and households.
39 Golden 1000 Days PCA Proposal and Programme Document with Social Development Promotion Centre.
75 Pakistan: Menstrual Hygiene C4D Strategy40
Introduction The Pakistan Menstrual Hygiene Management (MHM) C4D Strategy41 serves as the overarching framework for all MHM C4D activities up until 2020. Various activities have been underway since 2015 and the strategy provides a cohesive framework to tie together the various activities. Ongoing MHM initiatives include research to understand existing knowledge, attitudes and practices about menstruation, promoting access to school based facilities including construction of bathrooms and provision of supplies such as buckets and MHM kits containing sanitary pads and other supplies. In addition, advocacy events such as MHM day are celebrated and a working group of UN agencies, NGOs and CSOs has been established.
In Pakistan, puberty and menstruation are shrouded in a culture of silence and marked by incomplete information, false perceptions and myths. As a result, most girls start their periods uninformed and unprepared. Studies show that girls’ knowledge around menstruation and hygiene practices is inadequate. This lack of awareness of changes in the body coupled with the stigma attached to discussing anything related to female sexuality or reproductive health, prevents girls and women from practicing optimum MHM. Teachers are often reluctant to discuss the subject leaving mothers and elder sisters as the primary source of information for girls. Unfortunately this information is only shared after the girls have had their first period. MHM practices are a key gender inequality issue that undermines girls’ health and sense of confidence and are closely linked to limited mobility and school dropout. Attitudes and practices related to menstruation impact the health, education, safety, self-confidence and dignity of girls, thus making it an important issue for adolescent well-being.
Overview of the Initiative The strategy comprises a national campaign to increase awareness on MHM that includes: a nationwide MHM innovation challenge that promotes innovative ideas and tools to improve MHM developed by young people; leveraging technology such as UNICEF’s U-Report real-time SMS platforms and mobile apps to increase reach on MHM messaging among adolescent girls; using culturally sensitive communication products to reach diverse groups, including mothers and teachers (who are the primary source of information for girls), fathers and boys (to cultivate empathy and support girls), as well as religious and community leaders in order to communicate appropriate messages. In addition, the effort continues to engage leading female athletes as champions of change for MHM by sharing their inspiring stories through different platforms.42
The primary audience for this strategy is girls between the age of 9-18. Acknowledging the importance of interpersonal communications in the socio-ecological landscape, the secondary audience for the strategy comprises families (mothers, fathers, and brothers) and immediate influencers such as teachers. The tertiary audience are indirect influencers and the enabling environment – government, international and local organizations and media. Given the decision-making role fathers play in families and the importance of discussion between both sexes to reduce stigma, their role is well spelled out in the strategy. The strategy also recognizes that males lack knowledge on MHM; therefore, it proposes to involve younger boys to foster understanding and acceptance to reduce stigma.
40 The Case Study draws on inputs provided by Gloria Lihemo, Knowledge Management and C4D Specialist, UNICEF Pakistan. 41 C4D Strategy and Action Plan of Menstruation Hygiene, (2016 – 2020). 42 Brief on Enhanced Well-being and Empowerment of Adolescent Girls through Improved Access to Knowledge, Tools and Facilities to Support Menstrual Hygiene Management.
76 Strengths and Innovations The strategy builds on a robust analysis of the social context and the negative norms associated with menstruation that affect girls in multiple ways. This includes stigma attached to menstruation, traditional beliefs and patriarchal norms that mystify female reproductive health, restrictions on girls behaviour and mobility, as well as lack of social support that girls receive during menstruation to help them cope with shame, fear and discomfort. The gender analysis highlights how MHM perceptions and practices, negatively impact girls’ education and school attendance.
The indicators include aspects of social change critical for fostering gender equality such as confidence, attitude towards MHM, dialogue and public events (see Table 5). The indicators, could however be gender disaggregated as it is important to gauge knowledge and awareness of men and boys too. Ultimately, during the impact evaluation stage, it will be important to utilize appropriate gender scales to measure the gender related changes such as equity, empowerment, negotiation and decision-making.
Table 5: Sample of Social Change Indicators included in the Strategy
Level Indicators Individual/Awareness • % of girls who state they are able to independently practice good MHM. • % of girls who express confidence in overcoming the stigma associated with menarche. Interpersonal/Social • % of girls who feel that MHM is not a shameful topic and feel more confident as a result. • % of girls who feel able to initiate conversations about MHM pre- menarche. • % of girls who feel like they have safe spaces in which they can discuss MHM and have access to the information they need. Social/Political • % of politicians who consider MHM a topic of importance. • # of government led advocacy events on MHM
The use of technology and digital media has been an innovative part of the strategy. The polls and live chat tied up with U-report has solicited a large number of responses from across the country. The digital media component has provided an open platform where both girls and boys can participate and are encouraged to send pictures and inputs under the hash tag “no chutti” which translates to “no holiday.” Another innovative element has been the digital gaming component. In partnership with GRID, a myth busting game MoHim has been created and is being used interactively in WASH clubs in schools. A community outreach worker comes to schools and organizes a club where children play together.
Advocacy events such as Menstrual Hygiene Day celebrations provide a platform to give high-level visibility to this issue and also break the silence in public forums. Another commendable aspect of this initiative is the selection and engagement of the MHM Champions. The Champions, Sana Mahmood - Captain of the National Women’s Basketball Team, Kiran Khan – Olympic Swimmer, and Hajra Khan – Captain of the National Women’s Football team are strong spokeswomen for the Campaign and play an inspirational role that goes well beyond MHM to encompass equality, women’s rights and the ability to follow one’s dreams and
77 passions. The “Be bold, be free” campaign has a strong message, promoting confidence, freedom and equality.
Gaps and Areas for Improvement Operationalizing the male engagement component has been challenging and remains a significant short coming in the strategy implementation. A gap in the research design is that it did not involve boys or men, focusing only on girls and female teachers. Understanding perceptions and perspectives of brothers, fathers and male elders would have added valuable information to the analysis. To attempt to make up for this gap, the live chat was designed as an open platform where both girls and boys could call in. Several boys called in and expressed their curiosity about menstruation and puberty. As part of the gender innovation initiative, the U-report component specifically aimed to increase the ratio of female U-Reporters to achieve equitable representation (currently the ratio is 23 girls: 77 boys).
There is an effort to find male role models or champions and also to engage with male religious leaders. Menstruation is mentioned in the Quran and religious leaders could build on the Quranic teachings and discuss MHM in their sermons. It is important for these community influentials to dispel myths about menstruation. Mobilizing religious leaders for MHM has been used in similar contexts such as Afghanistan and Indonesia and has potential to be used in Pakistan.
The challenge remains in targeting boys and men in the programme. A comic book is under development for boys, although a challenge in dissemination is anticipated given the belief that MHM should not be discussed among boys. Likewise, the puberty book developed for girls has also not been approved. Several road blocks have been faced while advocating MHM with partners, including with government officials who are mostly male, the advertising agency, media partners and at times, even UNICEF staff and colleagues. Overall, while there is a general consensus on the need to promote MHM articulated by even the federal Education minister, there is still reluctance to publicly advocate for the issue.
Partnerships MHM falls under the purview of several ministries such as health, education, women’s affairs and climate change (the official line minister for WASH). While most government partners are on board and realise the importance of the issue, there is a lack of ownership. Since no single ministry is responsible for MHM, there is a lack of accountability and no concerted push for policy change. The exception has been in Punjab where MHM has become part of the curriculum for both Lady Health Workers and Teachers Assistant.
Implications for Women’s Rights and Gender Equality MHM is an important issue affecting the human rights and dignity of girls; more so, the taboos and myths associated with menstruation can negatively impact gender equality and affect the health, education, mobility and self-confidence of girls. Programmes on MHM can serve as an entry point to address equality and rights. MHM can also be linked to reproductive health and human rights and can provide a platform to promote gender equality and empowerment of girls. There are instances of Village Sanitation Committees (VSCs) where MHM has been the gateway to addressing other rights-based issues and members have made action plans to address local development, including livelihood matters. A noteworthy positive consequence of the initiative was observed in Upper Chitral, a hard to reach district of Khyber Pakhtunkhwa (KP) Province. As part of the interventions planned with the Agha Khan Rural Support Program (AKRSP), local women, including hygiene promoters, community activists and entrepreneurs were trained to spread awareness on MHM. AKRSP also supported a small group of MHM trained women entrepreneurs to produce low cost sanitary pads. These women are now conducting orientation sessions in the community and also successfully
78 running a small-scale business producing and selling sanitary pads in their catchment area.43
Lessons Learned and Key Takeaways Looking back at some components of the initiative, it becomes apparent that advocacy and coordination with the government in the early stages of the programme, including formative research, would have been helpful in getting their buy-in and ownership. For instance, there was a lot of resistance to the fact that the puberty book was presented as a finished product ready for dissemination. The government still has not approved dissemination. The ideal process would have been to collaborate more closely through the planning and research stages. Likewise, given the cultural sensitivity surrounding the topic, male engagement should have been done from the very beginning; even though it is included in the strategy, actual integration during implementation did not happen.
Another area to learn from would be from the communication and marketing strategies of the private sector. For instance, Procter and Gamble in Pakistan has their own BCC strategy to promote the Always brand of sanitary pads. Tie up and partnerships with them is something to consider as they have a large national reach in both urban and rural areas. Strategic partnerships is another area that needs further work, for instance the office is trying to tie up with young women parliamentarians and organizations like the girl guides.
Key Takeaways
• Government buy-in is central for gender transformative efforts. The ownership and buy-in needs to be part of the planning process and cannot wait till during implementation;
• The strategy is informed by extensive research of girls’ needs, though a significant gap is the exclusion of boys from the formative research;
• Male engagement needs to be thought through and included in the research, planning and implementation of the programme;
• Innovative tools and information technology are well suited to reaching out to youth and provide a platform to engage on sensitive topics that may not have been possible in a face-to- face setting;
• Demonstrating results is important, hence an endline evaluation is planned and MHM indicators have been included in the Randomized Control Trial being conducted by the Child Protection Section.
43 Inputs from Dr. Wassaf Syed Water, Sanitation & Hygiene Officer, UNICEF Peshawar Office.
79 Section 3: Gender Responsive C4D
The previous two sections reviewed a wide range of C4D initiative across the five focus areas. The varied efforts present differing levels of gender focus and responsiveness as summarized in the snap shots of individual initiatives and highlighted in the case studies. In this section, attempt is made to identify opportunities and challenges for integrating gender in C4D initiatives based on the findings from the mapping. Subsequently, the section provides a framework and guidance on applying a gender lens to C4D and highlights key criteria that are essential for planning gender responsive C4D efforts.
Opportunities and Challenges for Integrating Gender in C4D
Overall the mapping highlighted that all the initiatives reviewed reflected some level of gender awareness. The review did not identify any initiatives that were gender blind or gender negative. The level of gender responsiveness in the initiatives reviewed ranged from being gender specific, to gender sensitive and some could be classified as potentially gender transformative. As the mapping did not focus on impact level data, it is not possible to discern whether or not the initiatives led to gender transformation. It is however possible to ascertain whether or not the vision, objectives, indicators, approaches, activities, participant groups, implementation modalities and monitoring and evaluation are gender responsive.
Several of the health related initiatives (e.g., IFA supplementation, cord care, mother child week) appear to be gender sensitive and could be designed to be more gender responsive. They address a specific health aspect and focus primarily on knowledge and practice level changes. In that sense, they are mostly behaviour change focused and do not lend themselves to social change as the focus is on awareness-raising and less on skill enhancement or confidence building. Furthermore, they target women, in contexts where health and nutrition decision-making is generally controlled by men. In such scenarios, improved knowledge may not result in changed behaviours due to limited access to resources and lower-decision making among women. Focusing only on mothers, also reinforces the caregiving role of women and adds to their burden of responsibility. Some strategies have engaged men to improve uptake of health related practices, but this has been limited to leveraging the role of men as decision-makers in the family and do not adequately address power structures within the household. These initiatives could be further gender transformative by engaging fathers to take on a more active role in child rearing and by promoting decision-making among women as in the case of the Golden 1000 Days Campaign.
This finding is corroborated in the insights gleaned from the mapping survey, where a UNICEF staff member expressed that current C4D efforts are not adequately gender responsive and many efforts fall short of being gender transformative. For instance the emphasis of the mother child week in Pakistan is on mothers as primary caregivers. Likewise, the survey response from Afghanistan aptly stated that “there is often pressure to design C4D interventions as ‘educational’ strategies to inform and educate relevant communities on expected behaviours, based on the assumption that they result from a lack of awareness as opposed to a lack of political will to change a status quo that favours men’s well-being and prosperity. In Afghanistan, the gender dimension of the underlying causes of social inequality and exclusion is so powerful, and the impacts on the well-being of children and their mothers is so devastating, that any and all programming must necessarily be undertaken from a deeply nuanced gender analysis. Greater sensitization is required for stakeholders in all interventions.”
Cross-sectoral efforts such as those addressing adolescent issues (e.g., child marriage, school completion and menstrual hygiene management) appear to score better in terms of the gender responsiveness scale. The strategic planning includes indicators for confidence building and the approaches include dialogue either among peers or at the community level. Self-efficacy, decision-making and dialogue are important aspects in social and norm change communication efforts and are linked with transforming existing norms, values, perceptions, roles and responsibilities. Adolescent initiatives in Afghanistan, Bangladesh and Nepal, all
80 address a range of issues and include gender equality constructs. The objectives include building self- efficacy and agency. It is important to note, that these life skills once developed can be exercised for multiple rights and protection issues and can therefore, contribute to empowerment of girls and women. The Adolescent radio listeners’ group initiative in Bangladesh is an example of an initiative that promotes participation, peer dialogue and decision-making.
The findings from the mapping are consistent with the insights gleaned from the survey with country offices. When asked to rate the current level of gender integration in C4D efforts, all country teams rated the current level of gender integration or responsiveness as “moderate.” This provides clear direction on the need to enhance the level of gender responsiveness in C4D efforts.
There was also a recommendation that gender needs to be better integrated across sectors with convergent programmes. For instance, a key point of convergence could be Girls’ education or MHM in schools. Engagement of high profile celebrities was also proposed as a means of advocacy and leveraging the influence of respected celebrities and champions. An example of this is the use of leading female sports figures as MHM champions in Pakistan. The champions are captains of national sports teams advocating for MHM, but also going beyond this specific issue to inspire girls to follow their dreams, be confident and break away from traditional gender roles. Likewise the Golden 1000 Days campaign in Nepal promoted male engagement in child care through well known male celebrities.
C4D requires a systematic and planned process that follows specific steps of the programme planning cycle and it is important that gender aspects are taken into consideration in all steps of this process, as well as material development, implementation, monitoring and evaluation. It may be easier to integrate gender in certain steps than others. For instance, in some contexts it might be relatively easy to include gender considerations in the situation assessment or formative research, but maybe more challenging to integrate gender dimensions in the programme roll-out and implementation due to women’s limited mobility or access to media, which can curtail attending community events. On the other hand, if the formative research misses out on an in-depth gender analysis, the subsequent strategy too will not be able to address gender specific barriers or manifestations.
Likewise even when material is specifically designed for men, it may be challenging for outreach workers to meet with them during the day if they are at work. They may not want to either come forward or attend community sessions pertaining to issues such as child rearing or menstrual hygiene management, as these issues are seen as typically women’s issues. Even when gender is well integrated in the planning process there is a need to closely monitor how it is integrated in the programme implementation and roll-out process. Some important steps are to review all media and training content, track the participation of girls and women and assess the capacity of partners and frontline workers. In similar vein, one staff member from the Bangladesh country office shared that the opportunity to integrate gender during programme implementation is often missed and there are gaps in understanding and training capacity of implementing partners. When asked in which stages of the C4D planning cycle sections integrate gender considerations, country team responses reflected a range of answers as shown in Table 6.
81 Table 6: Phase(s) of the C4D Planning Cycle where Gender Considerations are Integrated
C4D Planning Afghanistan Bangladesh Nepal Pakistan Step/Country Situation Analysis X X X Strategy Design X X X X Material X X X X Development Programme X X X Implementation Monitoring X Evaluation X
Country teams also shared that integrating gender into certain steps of the C4D planning cycle was more challenging than others. However, there was no clear pattern in the responses and different offices found different steps challenging, as shown in Table 7 below.
Table 7: Phase(s) of the C4D Planning Cycle that are most Challenging to Integrate Gender Considerations
C4D Planning Afghanistan Bangladesh Nepal Pakistan Step/Country Situation Analysis X Strategy Design X X Material X Development Programme X X X X Implementation Monitoring X X Evaluation X X
Countries also shared some strategies they had used to ensure gender responsive programming. For instance in Afghanistan, community led total sanitation (CLTS) is conducted by male and female teams who are able to achieve community-wide understanding of, and growing compliance with, the open-defecation free concept. The first ODF district was announced in October 2017, at a widely-publicised ceremony attended by both male and female villagers, Deputy Ministers of Ministry of Public Health and Ministry of Rural Rehabilitation and Development, the provincial Governor, the Ambassador and the First Secretary of South Korea, a woman Member of Parliament and female Provincial Councillor, and UNICEF’s Deputy Representative. In Pakistan, SBCC efforts in health and immunization include using innovations such as couple health workers for health education to promote change in male and female family members. In Nepal, male religious leaders have been mobilized to end child marriage, thereby combining involving men and engaging community influentials.
Another staff member pointed out that the overall programming context in the region is strongly gendered and patriarchy is deeply rooted. This has implications on the mind-set of staff, implementing partners, government officials and lawmakers, as they too can have traditional values and norms. Disrupting the status quo or approaching a very sensitive issue in a bold and or unconventional manner may not be encouraged at times by national partners. An example is the puberty book in Pakistan which has been developed based on formative research but is yet to be approved for distribution by the Government. Hence the challenge is to remain culturally sensitive while breaking the silence on taboo issues that affect the rights and dignity of girls and women.
82 There was also a suggestion for documentation and knowledge sharing of best practices with UNICEF offices, globally and within the region. Given the shared cultural context of the region, there is opportunity to learn from experiences within the region. Knowledge sharing opportunities and learning visits could also be a way to understand and learn from good practices in country offices. Another suggestion was to conduct a gender review of C4D strategies and materials by a gender expert for better integration of gender issues. It is worth mentioning that country teams reported on the need for further training on gender and C4D, not only for UNICEF staff but also for implementing partners. Recommendations for capacity development, as well as suggestions to better integrate gender in C4D efforts are further detailed in the needs assessment section.
Applying a Gender Lens to C4D Programme Planning44
The level of gender integration in C4D initiatives can be gauged on a gender equality continuum as reflected in Figure 2. Gender responsive C4D programmes can range from gender sensitive, specific or transformative and this will vary based on the focus area and issues. While all C4D initiatives cannot aim to be gender transformative, at a bare minimum, initiatives should not be gender negative or blind. For instance, typically, a C4D immunization campaign, may not attempt to promote gender equality but it must consider the opportunities, roles and needs of female and male caregivers to effectively reduce the gender disparity in vaccine coverage. On the other hand, a gender transformative C4D effort to promote girls’ education should aim to increase not only school enrolment but also girls’ self-efficacy and empowerment, to enable them to stay in school.
Figure 2: Gender Equality Continuum45
Gender Transformative Gender Specific Gender Sensitive Gender Blind Gender Negative
To illustrate how C4D initiatives can gender responsive or negative, Table 8 presents some examples of how a communication effort to end Violence Against Children (VAC), an issue that affects both girls and boys, may integrate varying levels of gender responsiveness in its programme design and delivery.
44 This section draws on the Gender and SBCC Implementation Kit, Health Communication Capacity Collaborative. Johns Hopkins University. 45 Adapted from the Integrating Gender Into Social and Behavior Change Communication Continuum, Health Communication Capacity Collaborative (HC3), Johns Hopkins Center for Communication Programs (CCP).
83 Table 8: Gender Responsive C4D Initiatives to Address VAC46
Gender Negative A VAC campaign that promotes the idea of girls being in need to be protected by their fathers and brothers and portrays male family members as guardians. This builds on negative gender norms where women are expected to stay at home and men control their movement in public spaces. Likewise, portrayals of a father beating his children, reinforces gender stereotypes and promotes aggressive or violent forms of masculinity.
Gender Blind A VAC campaign that addresses children as a single group and doesn’t include an understanding of gender differences in the prevalence of violence in the research phase. The interventions and messages are designed to target children as a general category and gender needs of girls and boys are not specifically addressed. Such efforts may still meet their objectives but they fail to acknowledge the role of gender and may continue to leave one sex group behind.
Gender Sensitive A VAC campaign that builds on the gender differences in how girls and boys experience violence and incorporates these differences in the intervention design. For instance, data may indicate that boys tend to face harsher forms of physical abuse, while girls may be more vulnerable to sexual abuse. This could mean planning for separate school based activities – one focusing on responding to corporal punishment for boys and another one ensuring that teachers can support girls in school to prevent abuse. This will require different messages, material and programmes for girls and boys. Such efforts take into account gender-based differences but don’t attempt to change relationships or power structures.
Gender Specific A VAC campaign that includes a robust gender analysis in the programme and planning phase. As a result, the intervention is specifically designed to meet the needs of girls and boys. For instance, girls may not have equal access to media so additional steps are required to ensure they can listen to or view media messages and that they can provide feedback through sms or email. This could mean free sms for girls or a dedicated call in line for girls with a female responder. Likewise, community sessions for fathers may need to be organized in a place and time that works for men in the community (e.g., evening sessions at a tea shop).
Gender An integrated VAC campaign that addresses different levels of socio-ecology and Transformative supports commitment from community leaders to end VAC; promotes knowledge of the harmful impacts of violence among parents and builds capacity among adolescent girls and boys to develop self efficacy, decision-making skills and report violence when it occurs. Such an effort, engages girls, boys, women and men to address agency, power structures and relationships. By combining knowledge of the harmful impacts of violence along with the skills to negotiate choices, the effort can be transformative. These interventions will likely reduce violence but also explicitly promote gender equality and non-discrimination.
46 Draws on the WHO Gender Responsive Assessment Scale.
84 Gender Responsive C4D Checklist
Below are some broad criteria to assess how gender responsive C4D initiatives are. The checklist is for the overall gender assessment of a C4D programme or initiative. Specific considerations for a step-by step inclusion of gender in the C4D planning process are explained in the more comprehensive guidance provided in the next section.
Do your communication programmes, materials and messages perpetuate gender inequality by privileging one sex over the other?
Do your communication programmes, materials and messages promote gender stereotypes, inequitable gender norms, roles and relationships (e.g., communication materials that show only the mother responsible for childcare)?
Do your communication programmes, materials and messages take into consideration the prevailing gender differences, opportunities and access to information and resources (e.g., an immunization campaign that targets full coverage without considering the differences in access to services for women or information and communication needs of women and men)?
Do your communication programmes, materials and messages take into consideration gender- based norms, roles and relationships that may affect how your intervention is received, understood, and acted upon (e.g., complex material may be difficult to understand for women with low levels of literacy)?
Do your communication programmes, materials and messages take into consideration gender- based differences in access to resources (e.g., communication interventions that help mothers know about locally available and inexpensive nutritious foods to consume during pregnancy and lactation)?
Do your communication programmes, materials and messages respond to the specific needs of girls, boys, women and men (e.g., school based interventions that inform girls about menstrual hygiene and empower them to practice these behaviours)?
Do your communication programmes, materials and messages attempt to reduce gender disparities by responding to barriers and bottlenecks that prevent a certain group from meeting their needs or fulfilling their rights (e.g., School-based radio listeners groups for girls in a safe space that is culturally accepted)?
Do your communication programmes, materials and messages address underlying root causes of certain issues (e.g., a campaign on valuing girls/daughters)?
Do your communication programmes, materials and messages aim to promote more equitable gender norms, roles and relationships and transform existing power structures (e.g., an early childhood development C4D effort that promotes the role of the father in childcare, nurturing and early bonding)?
Do your communication programmes, materials and messages specifically aim to promote gender equality (e.g., a life skills initiative for adolescent girls that addresses multiple rights and promotes empowerment and gender equality)?
85 Integrating Gender in the C4D Planning Process
Analysis using a social ecological model (SEM) helps us understand how individual, familial and collective beliefs, attitudes, norms, power-dynamics and institutional structures and policies could facilitate the behaviour and social change necessary to achieve programmatic outcomes. This model posits that individual, community, organizational and broader environmental/policy contexts shape how people and societies behave (see Figure 3). All C4D interventions need to consider this inter-related social-ecology when designing communication programmes.
Figure 3: Social Ecological Model
Policy
Institutional
Community
Interpersonal
Individual
SEM helps identify the multiple communication and programmatic interventions needed to engage different participant groups to influence positive change. In addition, to applying the SEM framework to a programme, a 5-step C4D planning process is commonly used. There are several planning models that have been employed over the years such as the P Process47, the C Planning (which adapts several existing planning models), 48 or UNICEF’s ACADA framework (articulated through a cycle of assessment, communication analysis, design and action). Selecting the most effective model for a particular situation depends on the context, issue, resources and preference. All these models approach C4D planning as cyclical or iterative process that follows sequential steps and integrates research across all stages. Building on the common elements of these different models, a 5 Step process (see Figure 5) that delineates the essential steps required to plan, design, implement, monitor and evaluate a C4D intervention or strategy is presented below.49 In each of these five steps, specific questions around what, why and how gender needs, norms, roles and relationships are being addressed need to be considered as illustrated in the outer layer of the C4D planning cycle in Figure 4. To summarize, integrating gender in C4D efforts requires gender specific considerations to guide the overall C4D planning process as illustrated in Figure 4.
47 Johns Hopkins University Center for Communication Programs. 48 C-Change (Communication for Change) 49 The 5 step process is taken from the Global Communication for Development Strategy Guide for Maternal, Newborn and Child Health and Nutrition Programmes (2015). UNICEF: New York. The gender specific considerations in each step have been developed by Ami Sengupta (2017).
86 Figure 4: Overview of Integrating Gender and C4D
Including perspectives of women, men, girls and boys in the situation assessment and planning of the programme
Ensuring that the design of materials, messages and interventions considers and challenges negative gender norms and the approaches facilitate discussion and public dialogue that promote more equitable norms
Taking into account differences in access (related to education, mobility, work load or social practices) to products and services during planning and implementation
Assessing the differential impact based on gender through sex-disaggregated or gender sensitive data, and specifically examining gender transformation resulting from the intervention through constructs such as self-efficacy, agency, decision-making, attitudes towards equality etc.
87 Figure 5: Integrating Gender in the C4D Planning Process
88 Step 1: Data Collection and Analysis
The purpose of this step is to understand the nature and extent of the issue, to identify who is the most affected group and what you are trying to change. In this step it is particularly important to understand why people behave in a particular way, why they do not adopt the desired practice and what can motivate them to change behaviours, practices and norms. Applying a gender analysis lens at this step will allow you generate sex disaggregated data and understand the barriers and motivators and how they may be different for girls and boys, men and women.
Remember if you don’t ask the right questions at this stage you will not be able to get the answers to some of the “why” questions you need when developing your strategy. Examples of research questions include:
• Why are girls falling behind in vaccination coverage? • Why are boys in a certain region more likely to be stunted? • What can motivate girls and boys to complete secondary schooling? • How are girls and boys experience of physical violence different?
In this step, your intervention needs to consider the following questions:
Step1: Gender Responsive C4D Analysis Yes No Comments
Does your situation analysis include gender-disaggregated data?
Does your situation analysis include an analysis of gender norms, roles and relationships?
Does your situation analysis consider gender specific communication channels and sources of information?
Does your analysis seek to identify the barriers to information, participation or adoption of practices by gender?
Does your analysis seek to identify the facilitators who can influence gender norm changes?
Were girls, boys, women and men consulted during the analysis?
What are the existing laws and policies and how are they different for girls, boys, women and men?
89 Step 2: Strategic Design
In this step you design your intervention. You need to build on the evidence and insights garnered in Step 1 and design interventions that respond to the problem as well as the barriers and motivators. It is also important to consult with both experts and programme participants to ensure you are in the right path and what you are suggesting based on the evidence will be accepted in the local context.
Similarly, it is critical to validate your strategy and involve partners in the planning process. This becomes even more essential when dealing with sensitive issues or promoting non-traditional responses that Government and policy makers may or may not accept. The plan should outline what you want to achieve (i.e., your goals and objectives), how you will go about achieving them (i.e., your channels, strategic approaches and activities) and how you expect to measure success or progress on the key objectives of your strategy. Applying a gender analysis in this stage will allow you to understand how gender related factors may enable or hinder certain groups from accessing information, participating in community based activities, demanding for or utilizing services, and act on it. Some questions to ask at this stage are:
• What are the preferred communication channels for girls, boys, women and men? • What are some factors that may prevent certain groups from seeking information or participating in community level activities and what can you do to overcome these barriers? • Who are the people that can support change in prevalent gender norms, relationships and power structures? • What theories can inform the intervention?
In this step, your intervention needs to consider the following questions:
Step 2: Gender Responsive C4D Strategic Yes No Comments Design
Does your strategy draw on gender theories or frameworks? Does your strategy consider gender-related norms, attitudes and practices that influence the desired behaviour and social change?
Do your strategy goals, objectives and indicators include measures for gender equality, empowerment, self-efficacy, decision-making and agency?
Do your communication objectives specifically address gender dimensions and women’s rights?
Do your proposed channels and approaches consider gender-based preferences, access to and control of resources?
Does your strategy include specific measures to overcome gender-based barriers to accessing information or participating in activities?
90 Does your strategy include specific measures to engage influentials who can support gender norm changes?
Were girls, boys, women and men from the community consulted as part of planning or during vetting of the C4D strategy? Were national counterparts and implementing partners consulted during the C4D and Gender responsive strategy development process? Are they supportive?
Step 3: Development and Testing of Messages and Materials
This is the step where you create, test and re-refine C4D products, materials and tools for dissemination and on going engagement of key audience groups. It is important to understand that girls, boys, women and men have different information needs and preferences. What works for one group may not work for the other. Furthermore, lower literacy rates or less access to media channels affect how messages are received, understood and acted upon. Likewise, community based activities may or may not be suited to both sexes and may limit participation of one group. It is important to avoid promoting negative gender portrayals or reinforcing inequitable gender norm50. For this reason, testing communication materials is a pre-requisite. . You need to ensure these messages are vetted by both the target groups, partners, and gender experts in your group. Government partners may be hesitant to approve messages on issues that are culturally accepted and part of the local tradition such as early marriage or menstrual seclusion practices. Questions to consider at this stage are:
• How do girls, boys, women and men respond to the proposed activities? • How can the products be more accessible to different groups? • Are there any unintended interpretations of messages? • Do your products convey positive, doable actions and aspirational messages? • Are social norms and stereotypes challenged or reinforced through these messages?
In this step, your intervention needs to consider the following questions:
Step 3: Gender Responsive C4D Yes No Comments Materials
Do your materials, messages and products respond to the needs of girls, boys, women and men?
Do your materials, messages and products challenge negative gender norms and promote gender equality?
50 Additional information on gender responsive media content is available in the BBC Media Action Gender and Media Toolkit. Available at: http://genderandmedia.bbcmediaaction.org/making-a-programme/
91 Do your materials, messages and products convey the intended message in a simple and culturally sensitive manner?
Were the materials, messages and products pre-tested with different groups of girls, boys, women and men?
Do the materials, messages and products have different acceptance and appeal with girls, boys, women and men?
Do you have gender specific materials such as flip charts, PSAs, training tools, when needed?
Have you taken appropriate measures to promote equitable access to the materials, messages, products and activities?
Step 4: Implementation and Monitoring
This stage is when the planning the science/art behind your strategy is put in to action. Your products, messages, partnerships and capacity building efforts are rolled out. You need to track that your intervention is being implemented as planned and make adjustments when it is not. The key gender considerations in this stage are if the materials are reaching different groups of girls, boys, women and men as intended, and that gender norms and roles are not impeding any group from participating in the activities that are being rolled out. Some questions to consider are:
• How are gender-based norms and roles affecting how people access information and participate in communication activities? • Is the intervention going as planned? Are their any unintended consequences for any group and how can they be overcome?
In this step, your intervention needs to consider the following questions:
Step 4: Gender Responsive C4D Yes No Comments Implementation and Monitoring
Does the coordination and partnerships for C4D implementation include multiple- sectors working on gender?
Does the implementation plan address gender specific issues related to reach, access, literacy, feedback mechanisms and participation?
Does your capacity building efforts include gender training for partners, 92 frontline works and influential community members?
Does the implementation plan consider gendered roles and norms to ensure the programme does not contribute to gender disparities or promote gender stereotypes?
Does the monitoring plan track gender specific issues related to reach, access, literacy, feedback mechanisms and participation?
Do the monitoring tools include collecting gender specific data?
Are their any unintended consequences of the intervention on any group such as added household burden or conflict in the home or community?
Step 5: Evaluation and Re-planning
In this stage you assess whether the programme was effective and whether or not the goals and objectives were met. Evaluation gives you the opportunity to assess the impact of your intervention, as well as to learn from what worked well and what did not. Applying a gender lens in this step will enable you to understand how the intervention affected different groups of girls, boys, women and men, and if the gender specific objectives are being met. The evaluation should use appropriate gender scales and measures51 to determine whether or not the intervention contributed to gender equality. The questions to ask are:
• How did the intervention impact girls, boys, women and men? • How did the intervention impact gender norms, relationships and power structures? • How did the intervention contribute to gender equality and women’s rights?
In this step, your intervention needs to consider the following questions:
Step 5: Gender Responsive C4D Yes No Comments Evaluation
Does the evaluation design include girls, boys, women and men?
Does the study design and data collection take into account gender differentials such as access, mobility, workload and educational or literacy levels?
51 Refer to the C-Change Compendium of Gender Scales to learn more about measuring Gender empowerment, norms, beliefs, equity and power. Available at: https://www.c-changeprogram.org/content/gender-scales- compendium/about.html 93 Does the evaluation capture gender disaggregated data?
Does the evaluation design measure the behavioural and gender equality related results?
Does the evaluation measure changes in gender roles and relationships?
Does the evaluation assess any unintended (positive or negative) consequences related to gender norms or roles?
Does the evaluation provide lessons learned to improve programmes for gender equality?
94 Section 4: C4D and Gender Needs Assessment
A needs assessment was conducted for UNICEF Country Offices in South Asia to better understand the C4D and gender specific technical needs among countries. The overarching objective of the assessment was to understand how UNICEF offices and staff in South Asia can be supported to better integrate gender elements in C4D programming. The assessment attempts to identify current strengths, opportunities, gaps and challenges for further integrating a gender perspective in C4D interventions.
Methodology A brief needs assessment questionnaire was developed and sent to all eight country offices in the region (see Annex 1). The questionnaire included sections to be answered by the Deputy Representative, the C4D Specialist/Chief and the Gender Specialist/Focal Point. All Country teams were given two weeks to submit a consolidated response. Since the size of C4D and Gender teams in the countries varies, one response per country was requested to prevent the findings from being skewed or biased towards offices with larger teams. Out of the eight country offices, four – Afghanistan, Bangladesh, Pakistan and Nepal – completed the questionnaire and submitted responses. Follow up interviews will be held with relevant staff members prior to finalizing the report, to cross check data and to garner additional insights.
Findings UNICEF Country Offices in South Asia present varied organizational structures and C4D and gender staffing arrangements, which are largely dependent on the programming context and the country programme budget. Some countries have international C4D Sections Chiefs with national teams overseeing various focus areas (e.g., Bangladesh, India and Nepal), while others have an international C4D Specialists working with national teams (e.g., Afghanistan and Pakistan). Bhutan and Maldives have national C4D Officers and Sri Lanka does not currently have a C4D Specialist/Officer. Table 9 provides a complete list of C4D Staff – both fixed term (FT) and temporary appointments (TA) - in the country offices.
Table 9: C4D Staffing in Country Offices
Country Title Level Afghanistan International C4D Manager P4
6 National C4D Officers (Kabul) NOB (4 FT and 1 TA approved for FT under the PBR, 1 TA C4D Officer Immunization) 5 National C4D Officers (FT Field Offices) NOB Bangladesh52 International Chief C4D (FT) P4 International C4D Specialist (TA Cox’s Bazar) P3 National C4D Specialist (FT Dhaka) NOD 3 National C4D Specialists (FT Dhaka and Cox’s NOC Bazar) 6 National C4D Officers (FT Field Offices) NOB 2 National C4D Officers (TA Cox’s Bazar) NOA Bhutan National C4D Specialist NOC India53 International C4D Chief P5 International C4D Specialist P4 17 Nationals C4D Specialists (10 FT in State Offices NOC and 5 FT and 2 TAs in Delhi)
52There are five full time consultants (NOC and NOB levels) and three surge staff in Cox’s Bazar. 53 All FTs will be filled under the new CP. TAs to continue only till end of 2018/January 2019. Abolished post (FT NOB) to be phased out in July 2018. 95 9 National C4D Officers (8 in State Offices – 6 FT NOB and 2 TAs and 1 TA in Delhi) Maldives National C4D Officer NOB Nepal International Chief C4D P4 National C4D Specialist NOC 3 National C4D Officers NOB Junior Programme Officer P2 Pakistan54 International C4D Chief P4 (Under recruitment) International Knowledge Management and C4D P3 Specialist (WASH) National C4D Specialist (Health) NOC National C4D Specialist (Polio) NOC 2 National C4D Officers (Education, Child NOB Protection) 4 Provincial C4D Officers (Polio) NOB Sri Lanka National C4D Officer NOB (Recruitment planned for Q3/Q4 2018)
In terms of gender staffing, once again the structure varies between offices. Afghanistan, Bangladesh, and Pakistan have international Gender Specialists, while Bhutan has an international Gender Focal Point (GFP). India has a national Gender Specialist, whereas Nepal, Maldives and Sri Lanka have national Gender Focal Points (see Table 10). Across all countries, there is only one Gender Specialist or Focal Point per country office.
Table 10: Gender Staffing in Country Offices
Country Title Level International Gender Specialist P3 Afghanistan
Bangladesh International Gender Specialist P4 International Gender Focal Point and Child P3 Bhutan Protection Specialist India National Gender Specialist NOD National Gender Focal Point and Child Protection NOC Maldives Specialist National Gender Focal Point and Programme and NOD Nepal Planning Specialist International Gender Specialist P4 Pakistan
Sri Lanka National Gender Focal Point NOB
Coordination Levels Between C4D and Gender C4D and Gender are both positioned as cross-cutting areas within UNICEF offices and the assessment indicates the two sections coordinate and work together at different levels depending on the country. When asked to rate the level of coordination between the C4D and Gender sections in Country Offices, three country offices reported the level of coordination as good and one as moderate (see Table 11). No country rated coordination levels as either poor or extremely poor, which suggests a relatively positive perception
54 There are four Provincial C4D Consultants (one pending for KP Province), two area C4D Consultants for AJK and GB supported by UNICEF and one Advocacy and Communication Consultant (under recruitment) for Federal EPI. 96 and acceptance of coordination efforts between the two sections. However, the fact that only one office considered the current level of coordination as excellent highlights that there is still room for improvement.
Table 11: Level of Coordination Between C4D and Gender Sections
Rate the level of coordination between the C4D and Gender Afghanistan Bangladesh Nepal Pakistan sections in your office Excellent X Good X X Moderate X Poor Extremely poor
Findings from the assessment highlight the need to coordinate more closely throughout the C4D programme planning cycle. The Bangladesh office was the only country office where the Gender Specialist reported being involved in all the stages of the C4D planning, implementation and evaluation process. Afghanistan reported involvement only during implementation, the Nepal team reported involvement during material development and implementation, and the Pakistan team reported involvement during strategy design, material development and implementation (see Table 12). There was no involvement of the Gender Specialist/Focal Point in situation assessment, monitoring and evaluation in three out of the four countries who responded to the questionnaire. This absence points to an important gap in gender responsive assessment, evidence generation and data collection, all of them critical aspects in informing programme development and gender-related social change.
Table 12: Involvement of Gender Specialist/Focal Point in the C4D Planning Cycle
What stages of the C4D planning cycle were you Afghanistan Bangladesh Nepal Pakistan involved in? Situation Analysis X Strategy Design X X Material Development X X X Programme Implementation X X X X Monitoring X Evaluation X
Country offices provided additional inputs on what they think is working well and which areas require improvement. For instance, the Pakistan team shared that spatial arrangements such as co-location of the C4D and gender sections, as well as attendance of C4D Specialist to all meetings of Gender Focal Points and vice versa, positively impact coordination efforts. They also noted that the Gender Specialist is invited to review the majority of C4D strategies, proposals in development and reports, and recommended that it would be beneficial to formalize this process to ensure maximum coordination. The Bangladesh office team also reported good levels of coordination, but stated that further participation of the gender unit members in the C4D programme design process would be a potential area of improvement. In the case of Nepal, the CO team shared that the current coordination through the Gender and Social Inclusion Team (GESI) was a positive mechanism in place in the office. However, they noted that the GESI team were not all gender specialists and highlighted the need to systematically review all C4D strategies and communication materials through a gender lens.
The Afghanistan country office team rated the current level of coordination as moderate and emphasized that overall the office required a more synergized approach to C4D, both across sections and with Gender. They noted the need for a more cohesive approach to C4D interventions such as the Golden Village Approach
97 and the Community Led Total Sanitation (CLTS), followed by broader countrywide approaches to C4D and gender for the remaining two years of the Country Programme.
Table 13: Level of Gender Integration in Current C4D Programmes
Rank the level of gender integration in current C4D Afghanistan Bangladesh Nepal Pakistan programmes Excellent Good X Moderate X X X Poor Extremely poor
Office teams provided some useful suggestions to better integrate gender in forthcoming C4D initiatives. Programmatic recommendations included a close review of C4D research, strategies, materials and projects from a gender lens, as well as development of joint programmes by gender and C4D teams. There was also a suggestion for further collaboration between the C4D and gender teams at the regional level to cascade down to the country level. Recommendations in relation to knowledge management and sharing included documentation of best practices, as well as generation of opportunities for exposure visits, learning and exchange at country and regional levels. Management level responses highlighted the need to invest in capacity building of C4D staff to mainstream gender in C4D research, strategy, material development, monitoring and reporting, and identifying gender-based priority areas that allow for sectoral convergence such as Girls’ education. Another suggestion was to engage high profile figures and celebrities to advocate for human rights and equality. These points are further detailed in the recommendations section.
Coordination Mechanisms Between C4D and Gender Offices shared different coordination mechanisms and work-flow processes used to integrate gender in C4D programming. The responses ranged from having no formal mechanism, to having some amount of review and collaboration based on working relationships and having formalized and well-established mechanisms in place. Among the four responses received, the Bangladesh office provided the most detailed account of both formal and informal mechanisms in place to systematically integrate gender in C4D efforts.
The Bangladesh C4D team has a designated C4D Specialist at the NOC level who has been assigned as the Gender Focal Point for all gender considerations within C4D at the country and field office level. Additionally, the Gender Specialist is part of the cross-sectoral C4D working group. All key programme plans and interventions are shared with the programme chiefs’ group, which includes the Gender Specialist. When working with external partners, a section on gender considerations has been included in all Programme Cooperation Agreements (PCA) to be completed for all partnerships. All research initiatives consider gender and are required to breakdown both methodologies and findings by sex. Likewise, all programmatic interventions have a clear focus on male and female participants, whether as main audience or service providers.
In the case of the Nepal Office, they currently have a Gender and Social Inclusion Committee (GESI) that reviews all gender related initiatives, including C4D. It is expected that the forthcoming country programme will include an Inter-sectoral Task team, as well as the Gender Team in charge of early childhood development, adolescents, disability, disaster risk reduction and gender.
Afghanistan, noted the absence of an existing coordination mechanism to integrate gender and C4D. Stating that gender is an important determinant in Afghanistan and that the C4D team continues to incorporate gender aspects as an integral dimension of its analytical work, the team highlighted the need to establish a formal mechanism, possibly the adolescent task force. 98 Strengths and Opportunities Various factors serve as enablers or opportunities to further the integration of gender in C4D efforts. Both Pakistan and Afghanistan teams highlighted gender as a critical determinant and underlying factor affecting almost all of the sectors and country programme outcomes. The Pakistan team expressed that while gender is an overarching factor across sectors, the main challenge is to prioritize areas where UNICEF could achieve maximum impact. The Afghanistan team shared that the C4D unit recognizes gender as being a critical aspect affecting both social and behaviour change, and emphasized that gender inequality lies at the heart of exclusion in the country. There is a clear understanding that changing behaviours and social norms in Afghanistan requires changing gender-based norms. This calls for joint strategizing on how the challenges of addressing gender in C4D partnerships and how operational plans can be achieved.
The presence of a dedicated gender team in the office combined with a C4D team with strong experience in working with gender-based issues is noted as a positive factor in Bangladesh. This is further augmented by the commitment from senior management to promote gender equality. As previously noted, Nepal does not have a dedicated Gender Specialist, but the presence of the GESI Team (soon to become the Gender Team under the new CPD) is a current strength.
Gaps and Challenges Countries also provided insights on some challenges that need to be overcome to achieve more gender responsive C4D programming. Afghanistan noted the absence of a formal mechanism to coordinate or integrate gender in C4D. Similarly, the Pakistan team noted that gender was not yet in the C4D workflow process. Current collaborations are based on quality of working relationships, implying a gap that could be addressed by establishing more formal collaboration mechanisms. C4D in Pakistan is viewed as a part of a programme section’s efforts and not adequately recognized as a cross-cutting area of work.
Bangladesh and Nepal offices pointed toward the paucity of quality sex disaggregated and gender sensitive data guiding C4D initiatives. Evidence is often limited to number of males and females included in research or reached by a programme, which falls short in understanding deeper aspects of gender differentials. Staff members also emphasized the overall socio-cultural context as a limiting factor. At times, the traditional mindset of partners, stakeholders and UNICEF staff poses a challenge to fully integrating gender in C4D or moving towards more transformative approaches.
The Pakistan team noted that several of the C4D initiatives promoted by UNICEF are not gender-responsive, as they reinforce the role of mothers as primary care givers and do not promote the role of fathers in caregiving and child rearing. Country offices pointed towards the challenge of operationalizing a more gender transformative approach during the programme implementation phase. The response from the Afghanistan office highlighted that even when strategies or programmes have integrated a strong gender dimension in the analysis and planning phase, the may fall short during the actual implementation and roll out phase. Likewise, the Bangladesh office shared that the opportunity to integrate gender responsive interventions is often missed during the programme implementation phase. This gap occurs because of a range of contextual reasons, including lack of understanding of gender and social norms, traditional mindsets, and a tendency to produce material that portrays existing power structures and roles rather than aspirational realities where gender norms and relations are more equitable.
Capacity Building Needs Country teams noted that although training opportunities focused on gender are available for staff as face- to-face and online workshops and orientations, there is still a need for additional capacity building. Responses clearly pointed towards the need of building knowledge and skills to better integrate gender into C4D efforts. When asked in which specific stages of the C4D programme planning cycle staff members found most challenging to integrate gender perspectives a range of responses were received. Across three offices,
99 the Monitoring and Evaluation stages were noted as areas where integration was difficult. Offices also included strategy development and programme implementation as challenging areas (see Table 14).
Table 14: Stages of C4D Planning and Gender Integration
Which phase(s) of the C4D Planning cycle do you find it most challenging to Afghanistan Bangladesh Nepal Pakistan integrate gender considerations? Situation Analysis X Strategy Development X X Material Development Programme Implementation X X Monitoring X X X Evaluation X X X
The Afghanistan office emphasized the need to build capacities to undertake gender analysis in a complex and deeply patriarchal context beyond sensitization; deeper understanding of the linkages between sectoral programmes and reducing gender inequality is needed. They also stressed the need to provide concrete practical tools to government counterparts at both national and provincial levels that are culturally and contextually specific to the drivers of inequality in the country. The Nepal office expressed the need for sector specific gender training in order to enable understanding of gender within the context of C4D.
The Pakistan office pointed that beyond technical skills, there was also a need to change the internal work culture and move beyond sectoral silos. Suggestions from the Bangladesh team included training on gender- sensitive C4D package development and production, as well as gender-sensitive community engagement and interpersonal communication training. Table 15 reflects needs for technical capacity with respect to specific areas of gender and C4D identified by the respondents. In addition to the provided categories, qualitative tools for gender sensitive behavioural monitoring was also listed a thematic area requiring further investment.
Table 15: Thematic Areas Requiring Further Investments and Capacity Building
Thematic Areas/Countries Afghanistan Bangladesh Nepal Pakistan Equity focused C4D X X Social norms and social change X X communication Gender responsive programming X X Gender responsive analysis X X X Gender responsive C4D planning and X X X programme design Gender responsive media and material X development Gender responsive C4D programming and X X X implementation Gender responsive C4D research, X X X X monitoring and evaluation Responses covered a range of beneficiaries of future C4D and gender capacity building efforts. Broadly, these groups can be categorized as internal trainings for UNICEF Staff, and external trainings for government and implementing partners. UNICEF CO teams listed potential capacity building participants that included C4D teams, Gender Specialist/Focal Points, Sector Chiefs and Specialists, staff working in cross cutting areas such as Planning, Monitoring and Evaluation and Knowledge Management, as well as all relevant Field Office
100 Staff. External participants would include government line ministries and implementing partners. Media, civil society, frontline workers and local level implementing partners were not mentioned, although they are important actors to include in planned capacity building efforts.
C4D and Gender within the Country Programme and Results Framework Much like the staffing and organizational structure across offices, Gender and C4D results are reflected differently in the Country Programme Results Framework. The recent Medium Term Review (MTR) process of the current UNICEF Country Programme in Afghanistan (2015-2019) included a review of the impact of gender inequality across all programme components and results. Outputs and indicators were revised to further gender equality. The findings of the MTR highlighted the on going challenges of addressing gender inequality. These include insufficient targeting of girls and weak review of programs’ constraints on contributions to gender equality. A gender dimension is not adequately and routinely included in data collection, reports, studies, evaluations and advocacy presentations, and the country does not have a separate Theory of Change (TOC) for C4D, as C4D is situated within Communications and not as a stand- alone section. Post MTR, the reporting lines will change with the C4D unit reporting directly to the Deputy Representative. Additionally, a shared output on gender and C4D, under programme effectiveness will be included in the programming structure.
Bangladesh reported that the current UNICEF CPD (2017 -2020) for UNICEF Bangladesh is designed on the lifecycle approach to child development. C4D is included as a cross-sectoral implementation strategy under the Partnership and Participation components to support the results for child wellbeing. Gender dimensions are included in the programme’s strategy notes, and well embedded in the results framework for the office wide country programme outcomes and the section’s outputs. The C4D section has developed a Theory of Change where gender is reflected in the key results.
Similarly, in Nepal gender is positioned as an inter-sectoral issue mainstreamed in all sectoral programmes. C4D is one of the enablers in the country programme’s outcomes. The C4D section supports social norms and behavioural change across all sections, including gender-based norms. The Nepal office shared that they have developed a Theory of Change for C4D, but it is not part of the country programme results framework because C4D is positioned as part of the programme effectiveness component of the Country Programme Document (CPD). In Pakistan C4D is integrated within the work of sections in the CPD, as well as in the Strategic Notes for all sections. At the point when the questionnaire was submitted, an exercise was underway to develop a TOC and position the section’s results in line with the GAP. Gender has been mainstreamed throughout the CPD and the accompanying Strategic Notes.
101 Section 5: Recommendations
Gender inequalities exist in all societies and are a critical determinant in realizing children’s rights and well- being globally. Gender considerations become even more significant in the context of South Asia where gender-based norms are deeply entrenched, resulting in patterns of discrimination and inequalities across health, nutrition, survival, education and protection. Addressing the value of the girl child and integrating gender-based norm changes must be a part of all programmatic efforts to ensure gender quality and equitable developmental outcomes for girls and boys. Social and behaviour change communication can play a catalytic role in transforming existing power structures that reinforce gender inequalities, challenging gender discriminatory social practices, and endorsing more equitable gender norms and relationships. Mediated messages, interpersonal dialogue, community engagement and public debate are all important means of bringing about gender related social and behaviour change.
Moreover, social change must also include change in discriminatory gender norms. Accounting for gender- based differentials in C4D planning, implementation and evaluation processes can further the impact of social and behaviour change efforts. Based on inputs received from country office teams and an analysis of the findings from this assessment, the following recommendations are proposed to enable a shift towards more gender transformative C4D programming. The recommendations include:
• Establishing Coordination Mechanisms • Ensuring Quality Assurance • Investing in Gender Responsive Research • Building Capacity of UNICEF Staff • Building Capacity of National Partners • Enhancing Knowledge Management and Regional Learning • Developing Regional Tools and Guidance • Embracing Human Rights and the Whole Child
Establishing Coordination Mechanisms There appears a clear need to establish and formalize coordination and collaboration mechanisms to ensure that all C4D work adequately incorporates gender dimensions. The fact that in several offices both the C4D and Gender teams report to the Deputy Representative may also be a factor that can bring about more cohesive planning and implementation between the two areas and, importantly, across all sectors. Coordination mechanisms can be established through several methods, including:
• Creating a cross-sectoral C4D working group formed by gender and sector chiefs and other cross cutting areas such as Planning, Monitoring and Evaluation. • Guaranteeing that both C4D and gender teams are part of country programming planning processes, developing work plans and quarterly reporting. • Ensuring all C4D strategy and planning documents, partnership agreements, donor reports, monitoring and evaluation reports include a well-developed section on gender responsiveness.
Ensuring Quality Assurance Similarly, it is important to institutionalize a gender review process for all C4D products including research, programme and partnership documents and media and training material commissioned by the office. This will not only ensure that gender is integrated in all stages of the C4D planning cycle, but will also assess how well the intervention has identified, analysed, planned for and addressed gender considerations, and provide guidance on strengthening the level of gender integration. Timely gender reviews can attempt to move initiatives along the gender equality continuum, a critical point to enhance the gender responsiveness of C4D initiatives.
102 Regular gender reviews and quality assurance can only take place when there is adequate staffing and a Gender Specialist in place. There is a need to have a dedicated gender team within Country offices. Without the human resources, close coordination and on going technical support will not be possible. Also the difference in size of scope of the C4D and gender CO teams makes it unfeasible for one specialist or focal point to provide oversight to all stages of C4D interventions. It will be challenging if not impossible for Gender Focal Points who have other responsibilities and leadership roles (as in the case of Nepal and Bhutan), to provide this level of technical support and oversight. The fact that ROSA now has a Regional Adviser for both C4D and Gender is a positive factor; their support and technical expertise will be important for offices without dedicated gender staff.
Investing in Gender Responsive Research Research is the backbone of effective C4D interventions. As it is the case with other aspects of programme planning, research is not gender neutral: Gender has important ramifications in research design, methodological perspectives, respondents’ selection, data analysis and findings. There is a need for gender responsive research in C4D interventions, right from situation assessments and formative research, to process monitoring during implementation and impact assessments. The mapping and needs assessment clearly highlights the need to ensure gender responsive indicators and generate gender disaggregated impact data.
M&E frameworks need to account for differences in how girls, boys, men and women participate in and are impacted by interventions. Including male and female respondents and generating disaggregated data does not suffice to account for gender transformative interventions. Gender responsive indicators are required at the output, outcome and impact levels.
Based on the sample of documents shared by COs, there is a gap in evaluating the effectiveness of C4D initiatives in contributing to gender transformation. Evaluations must include findings on what level and type of gender related transformation has resulted from the initiative. It is not enough to only measure programmatic changes in knowledge, attitudes and behaviours. Changes in gender related attitudes and norms must also be measured (e.g., belief that girls and boys should be treated as equals, valuing the importance of educating girls, sharing of household chores between spouses, mothers making health related decisions for their children). Additionally, gender-focused research must include a deeper understanding of the root causes and drivers of gender discriminatory behaviours and norms. This calls for a blend of quantitative large-scale data that is representative of prevalent behaviours and norms, and robust qualitative data that provides a more nuanced understanding of why some behaviours and norms persist in order to motivate change. This will necessitate a move from traditional survey data to more innovative, grounded and participatory ethnographic methods.
Building Capacity of UNICEF Staff The responses from country offices made a strong case for building capacities on C4D and gender. Office teams highlighted specific areas within the C4D planning cycle where additional training is required and also identified stages of this process where they find it hard to integrate gender considerations. Thus, capacity building efforts must include step-by-step guidance on integrating gender in C4D programming. While offices mentioned a range of areas where capacity building is required (see Table 15), Gender responsive C4D research, monitoring and evaluation was identified as an area requiring further training by all four offices who responded to the questionnaire. Likewise, gender responsive C4D planning and programme design and implementation were also identified as important areas requiring additional training. Several offices have already planned for national level C4D capacity development in the new CP, which provides an opportunity for gender to be integrated into C4D training and capacity building efforts.
Capacity development of programme staff and external partners in C4D and gender for country offices through either the Regional Office or Country Offices is recommended. This can be an opportunity to integrate C4D and gender training and also give country offices the opportunity to share lessons learned and 103 experiences. This Country level training should include programme staff from national and zonal levels, as well as government and other partners. While capacity building on gender for C4D staff is necessary, it should be noted that this cannot replace gender expertise and C4D staff cannot become gender experts through short trainings. The integration of gender through a systems-based approach of capacity building, recruitment, programme design, monitoring and evaluation and gender-based indicators is necessary for enhanced office wide gender responsive interventions.
Building Capacity of National Partners Partnerships are central to taking forward and sustaining UNICEF’s efforts. The capacity gap among partners and the challenge of implementing well-developed strategies is evident in the responses from country offices. Building capacity of national counterparts and implementing partners will be an important element to really moving forward the C4D and gender agenda. Building national capacities will also contribute towards changing prevalent attitudes and gendered norms in the overall programming context, thereby creating a more enabling environment for change. This should include capacity building of service providers, health and frontline workers.
One aspect that was not explicitly mentioned in the responses is the need to invest in media partners, including those producing mainstream commercial media. The current communication context is rapidly changing and highly saturated. This means that people are constantly surrounded by different media and there is considerable choice in what people decide to view, listen to, or participate in. The reality is also that mainstream media is at most times more engaging and attractive than media products produced by development agencies, and for every media message or product produced for development or social change, there are numerous mainstream or commercial media choices. The impact of media on perceptions, behaviours and norms is well documented and investing in the broader media sector can have long-term benefits on how individuals and societies perceive gender roles and norms.
Training partners on production of gender responsive media and materials is another important area to consider. The communication material is ultimately what reaches intended audiences; therefore, it is important to develop capacities to produce material that lean towards gender transformation and do not reinforce negative gender roles and relationships. For example, material on child survival often portrays the mother as the primary caregiver. As mentioned previously, this will require setting systems in place for review and vetting of all material from a gender lens. In some cases, as shared by the Afghanistan team, there is pressure to portray “reality” and a life like representation of existing norms, rather than promoting an aspirational alternative or a modified reality to propose new norms. This tension is commonly experienced when producing materials portraying new norms, for instance, when showcasing a role model husband or father who is helping his pregnant wife with household chores or involved in caring for his children. Some of this can be ameliorated by showing characters such as a mother who is informed, empowered and promotes gender equality in the home or young female characters who are bright, proactive, going to school, asking intelligent questions and displaying change agent qualities, even in a traditional portrayal of child rearing. Likewise boys can be portrayed as questioning gender discrimination and supporting equal rights for their friends and sisters.
Enhancing Knowledge Management and Regional Learning Given that the region has several forms of gender-based discrimination that are common across countries and that the overall programming context has many similarities, there is tremendous opportunity for regional learning and knowledge sharing. The regional office can play an important role in enhancing knowledge sharing by documenting best practices, developing guidance notes and facilitating learning visits and experience sharing workshops. Webinars and web-based resources are a time and cost effective way of sharing best practices, and lessons learned on topics of common relevance.
A regional online knowledge management platform C4D and gender resources such as tools, manuals, and reference literature has been created. This will be helpful for offices with large C4D teams and will be a handy 104 resource for the smaller offices who have limited staff and budgets for this area. Offices can add to this repository with additional tools, templates or samples of on going work. Since C4D interventions on issues such as child marriage, menstrual hygiene management, child health and nutrition, and violence against children are being developed or implemented by multiple offices, sharing resources can eliminate duplication and foster effectiveness through peer review and experiential learning. For instance, approaches, indicators or material developed for a child marriage focused C4D strategy in one country, can inform strategies and interventions in another country.
Developing Regional Tools and Guidance The Regional Office can also support COs by developing regional tools and guidance on C4D and Gender. Easy to use tools, templates and manuals are useful to staff as they help simplify complex issues and broad principles into actionable steps. For instance, a manual on engaging fathers in early childhood development can be used across offices. Similarly, a step-by-step guide on how to develop gender responsive C4D strategies can help staff understand what specific considerations need to be included in each step of the C4D planning process. Another useful tool would be an adaptable facilitation module for religious leaders to use for community engagement sessions on changing social norms around child marriage, violence against children, and girls’ education. Toolkits and training manuals on working with men and boys is another valuable resource that can be used across offices and across issues.
Embracing Human Rights and the Whole Child Sector specific C4D interventions often focus on programme related behavioural objectives and miss out on promoting human rights and equity. Integrated initiatives, on the other hand, allow convergence across sectors and provide a good platform to include equity-focused change to enable empowerment and transform gender norms. Importantly, C4D interventions need to look beyond sectors to address underlying factors such as valuing the girl child, non-discrimination between girls and boys, equitable power relations between adolescent girls and boys, and ending violence against girls and women.
Some examples where empowerment of girls can be easily integrated are initiatives addressing adolescent issues, initiatives such as the 1000 Golden Days in Nepal, or health and well-being efforts such as the Golden Village Approach in Afghanistan. Efforts to end child marriage and keep girls in school can also be integrated across programmatic areas. It is important to promote a child-centred approach that looks at the whole child rather than specific aspects of a child’s wellbeing (e.g., education, nutrition, or sanitation). Ultimately, it is the same child and same parents that C4D interventions are focusing on, and packaging several or closely linked issues provides the opportunity to integrate a gender and rights dimension. This will also enable programme participants to build confidence, self-efficacy, respect and dignity, not just knowledge and adoption of practices. This is a concrete step to move from designing and delivering C4D initiatives focused on information provision, to those that truly engage and empower intended populations.
105 Annex 1: Mapping and Needs Assessment Survey
The Regional Office is currently conducting an assessment of the gender responsiveness of UNICEF led C4D initiatives in South Asia. The Regional Office Team and the consultant for this Assignment, Ami Sengupta have already reached out to you and requested for relevant documents. Thank you to the colleagues and country office teams who have already shared C4D and Gender related documents. In order to systematize the mapping and to ensure that we include the experiences, technical needs and perspectives of both C4D and Gender colleagues in all country offices we will be following up our initial request for information with a short survey. The survey will include a mapping of C4D and Gender initiatives across specific focus areas and a needs assessment to better understand gaps and opportunities to enhance gender responsiveness in forthcoming C4D initiatives in the region.
The survey is intended for both C4D and Gender staff and focal points across the region. Since the staffing of C4D and gender sections in the different countries varies, we request the office to consolidate responses and send us one completed response per office. The survey should take no more than 1-2 hours of your time. Please make sure to include links to any relevant documentation or send as attachments. All completed responses should be sent to Sheeba Harma at [email protected] and Ami Sengupta ([email protected]) by November 3, 2017.
Section 1: Country Office Information
To be completed by the Deputy Representative/OiC
1. Name of country office
2. How are C4D and Gender results reflected in your current or forthcoming CPD?
3. In your opinion, how would you rate the level of coordination between the C4D and Gender sections in your office? Excellent Good Moderate Poor Extremely Poor
4. How would you describe the level of coordination between the C4D and Gender sections in your office? What is working well and what can be improved?
5. Do you have any suggestions to better integrate gender considerations in C4D initiatives?
Section 2: C4D and Gender Mapping
To be completed by C4D Section Chiefs/Specialists/Staff Members
6. Please list all C4D and Gender Initiatives related to the following focus areas that you are currently implementing or have implemented since 2010 in your office. Please fill all boxes relevant to your office. Saving Newborns
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Educating Girls and Boys
Ending Child Marriage
Ending Violence against Children
Water and Sanitation and Menstrual Hygiene Management
7. If your section has a Theory of Change, how are C4D and Gender results reflected in it?
8. Are there any C4D initiatives where you feel gender considerations have been particularly well integrated?
9. Are there any C4D initiatives where you feel further gender integration is required?
10. Are there any examples of gender focused C4D initiatives your office has led that may serve as a best practice, innovation or exemplar? You may include on going or past efforts. Please provide a brief description and share relevant documentation if you have not already done so.
11. Are there any examples of gender focused C4D initiatives in your country led by any other organization or agency that you consider a best practice, innovation or exemplar? Please provide us with any relevant references, links or contact information?
12. In which phase(s) of the C4D Planning cycle do you feel your section/you have integrated gender considerations? Check all that apply. Situation Analysis Strategy Design Material Development Programme Implementation Monitoring Evaluation None of the above
13. In which phase(s) of the C4D Planning cycle do you find it most challenging to integrate gender considerations? Check all that apply. 107 Situation Analysis Strategy Design Material Development Programme Implementation Monitoring Evaluation None of the above
14. Please rank according to your opinion, the level of gender integration in current C4D programmes.
Excellent Good Moderate Poor Extremely Poor
15. Please explain your answer for the above question. Provide examples to illustrate your choice.
To be completed by Gender Specialists/Focal Points
16. Could you list any C4D initiatives in the following focus areas that you have been part of: Saving Newborns
Educating Girls and Boys
Ending Child Marriage
Ending Violence against Children
Water and Sanitation or Menstrual Hygiene Management
17. What stages of the C4D planning cycle were you involved in? Check all that apply. Situation Analysis Strategy Design Material Development Programme implementation Monitoring 108 Evaluation None of the above
18. Please rank according to your opinion, the level of gender integration in current C4D programmes.
Excellent Good Moderate Poor Extremely Poor
19. Are there any examples of C4D initiatives in your office that you consider gender transformative or gender positive? If yes, please describe.
20. Are there any examples of C4D initiatives in your office that you consider gender sensitive? If yes, please describe.
21. Are there any examples of C4D initiatives in your office that you consider gender negative? If yes, please describe.
22. Do you have any suggestions to better integrate gender in C4D initiatives in your office?
23. Are there any examples of gender focused C4D initiatives in your country led by any other organization or agency that you consider a best practice, innovation or exemplar that we should include in this assessment? Please provide us with any relevant references, links or contact information.
24. Are you aware of any gender and communication best practices, frameworks or resources that you think would be useful for this assessment? If yes, please provide us with any relevant references, links or contact information
Section 3: C4D and Gender Needs Assessment
To be completed by C4D Chiefs/Specialists/Staff and Gender Specialists/Focal Points
1. Are there any existing mechanisms to ensure gender integration in C4D research, planning, programme implementation or evaluation? (e.g., task forces, coordination groups or committees)
2. What are the strengths/opportunities in your Country Office to integrate gender in C4D initiatives? Please list up to 3 strengths/opportunities and provide brief explanations.
3. What are the gaps/challenges in your Country Office to integrate gender in C4D initiatives? Please list up to 3 gaps/challenges and provide brief explanations.
4. In your opinion, what can enhance gender integration in C4D initiatives? Please consider factors such as human and financial resources, technical capacity, existing and future partnerships, knowledge management etc.
5. What capacity strengthening opportunities currently exist in your office for gender and C4D integration?
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6. In your opinion, what additional training, tools or resources are required to build the capacity of UNICEF staff and national partners to better integrate gender and C4D? Please specify what is required for whom.
7. In your opinion, who would benefit from a training on gender integration in C4D assessments, planning, design, implementation, monitoring and evaluation? Please include both UNICEF staff and external partners.
8. Which specific areas do you think require further investments and capacity building? Please check all that apply and list any other relevant areas.
a. Equity focused C4D b. Social norms and social change communication c. Gender-based programming d. Gender sensitive analysis e. Gender-based C4D planning and programme design f. Gender responsive media and material development g. Gender responsive C4D programming and implementation h. Gender responsive C4D research, monitoring and evaluation i. Others (Please specify) ______
9. Is there anything else you would like to share on C4D and gender programming and initiatives?
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