Evidence: Compelling Data

Participating organisations in the Global Alliance for Social and Behaviour Change - Building Informed and Engaged Societies were asked to identify, in their opinion, the 5 most compelling research and evaluation studies that demonstrate the direct impact of this field of work on a major development issue.

In support of your advocacy efforts related to the impact of your work, we have compiled below the key extract results from that research evidence. (Please click the extract of interest to access a summary with a link to the full research)

• Globally, nearly seven in 10 respondents among the general population worry about fake news or false information being used as a weapon (Fig. 5). Sixty-three percent agree that the average person does not know how to distinguish good journalism from rumor, and 59 percent say that it is getting harder to tell if a piece of news was produced by a respected media organization. (Executive Summary, In Search of Truth).
• A meta-analysis was performed of studies of mediated health campaigns in the United States in order to examine the effects of the campaigns on behavior change. Mediated health campaigns have small measurable effects in the short-term. Campaign effect sizes varied by the type of behavior:
  r=.15 for seat belt use,
  r=.13 for oral health,
  r=.09 for alcohol use reduction,
  r=.05 for heart disease prevention,
  r=.05 for smoking,
  r=.04 for mammography and cervical cancer screening, and
  r=.04 for sexual behaviors. Campaigns with an enforcement component were more effective than those without. To predict campaign effect sizes for topics other than those listed above, researchers can take into account whether the behavior in a cessation campaign was addictive, and whether the campaign promoted the commencement of a new behavior, versus cessation of an old behavior, or prevention of a new undesirable behavior. Given the small campaign effect sizes, campaign planners should set modest goals for future campaigns. The results can also be useful to evaluators as a benchmark for campaign effects and to help estimate necessary sample size.
• There is growing evidence to suggest that media and communication can support people to become more resilient to short-term shocks and long-term trends. To date, however, systematic research on the role of media and communication projects in helping to build resilience is limited. This report advances this body of work in two ways. First, it shows how research carried out across Asia, and in Bangladesh and Tanzania has been used to build an approach to producing media programming for resilience that is rooted in the needs of people. Second, it shows the impact that media can have when adopting this approach. Specifically, the report shows how using research to understand different people’s needs, as well as the barriers and motivators they face personally and in their wider, socio-political context, is important when designing media and communication projects that facilitate change. Research across multiple countries shows that the main determinants of whether or not people take steps to become more resilient include: • The impacts they are currently feeling or the anticipated risk of those impacts • The extent to which they feel informed about how to take action • How connected they feel to others in their community • How confident they feel to act on their own • How much they believe resources or institutional factors are a barrier to uptake The report draws upon two examples – a national reality television programme in Bangladesh and a local radio programme in Tanzania – to illustrate the power of this approach. The evaluation findings from each of these projects show the impact that media and communication can have on supporting people’s resilience. • Reach: Both programmes reached people at scale. Over the course of the three-year project, BBC Media Action’s resilience programming in Bangladesh (including both the television programme and a PSA) reached an estimated 22.5 million people. In Tanzania, the radio discussion programmes and affiliated debate specials together reached 31% of the population in the two drought affected states. • Knowledge: In both countries, the programmes helped to improve people’s understanding of resilience issues – over two-thirds of audiences reported improved understanding as a result of listening to or watching the output. • Discussion: The programmes also stimulated discussion. In Tanzania, for example, 46% of listeners said that they discussed the topics covered in the programme with others. • Action: Ultimately, the research shows that the programmes have been successful at driving action.In Bangladesh, nearly half (47%) of viewers in Bangladesh could name actions that they had taken as a result of watching the programme. This included making water safe to drink, storing food and raising their houses so they were less at risk of flooding. However, although both programmes contributed to adoption of resilient behaviour, they did so in different ways. The Bangladesh programme worked primarily through the effect of perceived risk and lack of institutional support, whereas in Tanzania, knowledge and confidence appeared to be more important drivers of change.
• Health Marketing's strategies and techniques are based in part on traditional marketing theories. The basic elements of Health Marketing reflect years of evidence-based research that analyse the needs, values and methods of exchange for different market.
• Using a randomised controlled trial, we find that the intervention improved gender attitudes by 0.2 standard deviations, an effect size comparable to that of having parents whose attitudes are one standard deviation more gender-equitable. Programme participants also report more gender-equitable behaviour such as increased interaction with the opposite sex. The change in attitudes is similar for boys and girls, but behaviour change is larger among boys, pointing to the importance of barriers for girls to act in accordance with their own altered attitudes. The underlying theory of change was: • The programme inputs are delivered effectively by Breakthrough and result in increased awareness and understanding of gender equal behaviour and issues. • Increased awareness and understanding of gender issues translates into attitudinal change and higher aspirations for girls, and participants improve communication skills to express their desires regarding gender-related decisions. • Attitudinal change or higher aspirations or better communication skills among the youth lead to intermediate and sustained long term behaviour changes, in spite of entrenched norms and power structures. (Note: This is an important assumption which the evaluation aims to test both in the short run and long run through a variety of evaluation methods). • For example, girls might attend school more because they think it is more acceptable to be more educated than their husband (attitude change resulting in higher aspirations and changed behaviour) or because they can convince their parents to allow them to do it (better communication skills). • Youth and anyone also has constraints on acting in ways they desire. Thus, for attitude and aspirations to translate into behaviour, students must have enough autonomy over decisions or ability to persuade others to accept a behaviour. Thus, family and community attitudes and power serve as mediating factors in how attitude change translates into behaviour change. Key Results: • The results suggest that the intervention increased gender attitude index by 0.2 standard deviations. The intervention also increased the gender behaviour index by 0.14 standard deviations. The change in attitudes is similar for boys and girls, but behaviour change is larger among boys, suggestive of barriers for girls to act in accordance with their own altered attitudes. • The change in attitudes was similar for boys and girls. o In-depth examination of attitudes reveals the following: o The intervention has a significant positive effect on participants’ attitudes towards employment. Results suggest that the intervention led to a 7 percentage point increase in attitude towards women’s paid employment outside the home. o Intervention also increases attitude towards female gender roles by 3.6 percentage points . o Results also found an increase in attitude towards education by 4 percentage points . o However, the effects on attitudes towards gender-equitable fertility behaviour are smaller with an increase of 0.01 percentage points , perhaps because such attitudes are difficult to change, or because school-age participants are too distant from their own child-bearing years to absorb messages on this topic. Programme participants also report more gender-equitable behaviour such as increased interaction with the opposite sex. Results found that the intervention led to a 3-percentage point increase in the gender behaviour index, indicating a more progressive behaviour. The average score of programme participants on the gender behaviour index stood at 79 percent at baseline, where 100 percent stands for fully gender-equitable behaviour. The behaviour change was larger among boys, pointing to the importance of barriers for girls to act in accordance with their own altered attitudes.
• This three-phase study characterized, validated, and applied community capacity domains in a health communication project evaluation in Zambia. Phase I explored community capacity domains from community members’ perspectives (16 focus groups, 14 in-depth interviews, 4 sites. These were validated in Phase II with 720 randomly selected adults. The validated Domains were incorporated into a program evaluation survey (2,462 adult women, 2,354 adult men; October 2009). The results indicated that the intervention had direct effects on community capacity; enhanced capacity as then associated with having taken community action for health. Finally, community capacity mediated by community action and controlling for confounders, had a significant effect on women’s contraceptive use, Children’s bed net use, and HIV testing. The results indicate that building community capacity served as a means to an end—improved health behaviors and reported collective action for health—and an end-in-itself, both of which are essential to overall wellbeing..
• Exposure to FP dialogues was associated with 1.78 (95% CI: 1.20-2.63) times higher odds of using a modern FP method at endline for women, but this association was not significant for men. Women’s use of modern FP was significantly associated with higher spousal communication, control over own cash earnings, and FP self-efficacy. Men who reported high approval of FP were significantly more likely to use modern FP if reporting high approval of FP and more equitable gender beliefs.
• A national integrated polio, measles, and deworming campaign was implemented across Liberia May 8-14, 2015. The community engagement and social mobilization component of the campaign was based on structures that had been invested in during the Ebola response. This article provides an overview of the community engagement and social mobilization activities that were conducted and reports the key findings of a rapid qualitative assessment conducted immediately after the campaign that focused on community perceptions of routine immunization in the post-Ebola context. Focus group discussions and interviews were conducted across four counties in Liberia (Montserrado, Nimba, Bong, and Margibi). Thematic analysis identified the barriers preventing and drivers leading to the utilization of routine immunization. Community members also made recommendations and forwarded community-based solutions to encourage engagement with future health interventions, including uptake in vaccination campaigns. These should be incorporated in the development and implementation of future interventions and programs.
• According to the McKinsey Global Institute, digital flows now represent a larger part of gross domestic product (GDP) growth than centuries-old trade in goods. MDI estimates that 543 terabits of data flow across borders every second, where data accounts for US$2.8 trillion of this impact, which is significant for media organizations.
• The Tchova Tchova community dialogue program, a theory-based intervention implemented in 2009–2010 in the provinces of Zambezia and Sofala, Mozambique, aimed to change gender and sexual norms for HIV prevention. Through facilitated sessions (Tchova Tchova Histórias de Vida: Diálogos Comunitários (TTHV), which translates as Push Forward Life Stories: Community Dialogues), the program sparked critical thinking and open dialogue among participants. The program had two main components: (1) facilitated community dialogues (TTHV sessions) based on the African Transformation gender tool (Underwood, Brown, Sherard, & Abdur-Rahman, 2011) but adapted to HIV/AIDS prevention (Pinho & Poppe, 2009) and (2) a Tchova Tchova radio magazine. The HIV/AIDS prevention gender tool used principles of adult education proposed by Freire’s empowerment education (Freire & Ramos, 1974), which emphasizes that knowledge comes not from experts but rather from collective dialogue and from within. The tool included nine video and written profiles of real Mozambican trendsetters, known in the literature as positive deviants (Sternin & Choo, 2000; Tuhus-Dubrow, 2009). In the profiles, the men, women, and couples tell their stories of how they overcame gender, cultural, and social barriers, such as domestic violence, alcohol abuse, and the subordination of women, to make positive changes in their lives that impacted HIV treatment and prevention. This article measures the program’s effectiveness based on a sample of 462 participants and 453 nonparticipants, 51% of whom were women and 49% of whom were men. As a result of the TTHV sessions, participants were statistically more likely than non-participants to have positive gender attitudes (64% vs 35%), positive non-stigmatizing attitudes about HIV (52% vs. 30%), were more likely to report discussion with their partner about HIV (88% vs. 72%), and were less likely to report have multiple sexual partners (2% vs. 7%), all of which are known to predict lower HIV transmission rates.
• Researchers found an overall effect size of 0.29. This translates into an 11.6 percentile gain (in terms of education). That is, an average child who does not watch Sesame Street is at the 50th percentile, whereas a child who watches is at the 62nd percentile.
• FLIP determined that, in Colombia, 37% of the population does not have access to locally produced news in their municipality.
• Background: UNICEFs Facts for Life (FFL) Communication Initiative utilizes convergent strategies for engendering behavior and social change by providing parents and other caregivers with the information they need to save and improve children’s and mother’s lives. FFL’s flagship activity from 2008 to 2011 was an entertainment-education television drama serial titled Kyunki… Jeena Issi Ka Naam Hai (Because… That’s What Life Is). This case study describes and analyzes findings from an evaluation of Kyunki. Methods: The research design for Kyunki consisted of 3 cross-sectional evaluation assessments: a baseline (conducted before the show aired in 2008), midline (after approximately 260 episodes in 2009), and an endline (after the conclusion of the serial and 501 episodes in 2011), all utilizing the same sampling design. The primary objectives were to: 1) compare exposed and unexposed respondents at midline and endline, and 2) compare knowledge, beliefs, attitudes, self-efficacy, social norms, interpersonal communication, practices, and behaviors related to FFL topics over time among the baseline, midline, and endline responses. Results: Results indicated that Kyunki elicited high levels of exposure, message, and story recall. Positive results were found at endline on many variables within each of the outcomes assessed (knowledge, attitudes, self-efficacy, perceived importance, social norms, and behaviors). The program appears to have had an impact over time among those exposed with results making the case that longer exposure (ie, endline) was associated with more positive results than shorter exposure (ie, midline). Conclusions: In the future, entertainment-education should move beyond the awareness-generation model and design programs and evaluations from the beginning that target not only changes in knowledge, but also attitudes, efficacy perceptions, and social norms. In addition, an enabling environment is needed that nurtures program messages and translates them into reality.
• After controlling for 17 socioeconomic variables, awareness of HIV communication programs had a positive, dose-response relationship with self-reported condom use at sexual debut. Those who used condoms at sexual debut were 1.38 times more likely to have remained uninfected. HIV-negative status was 3.6 percentage points higher among those who used condoms at sexual debut, corresponding to an estimated 139,835 infections averted among sexually active adults by 2005.
• Over the past 20 years, communication programs in South Africa have educated the public about AIDS, emphasizing use of condoms. A systematic review of HIV/AIDS mass communication campaigns has shown that they have increased condom use (Noar SM, Palmgreen P, Chabot M, et al. 2009) Secondary analysis of the 2008 Human Sciences Research Council survey found a positive association between exposure to HIV communication programs and condom use at last sex (Peltzer K, Parker W, Maboso M, et al., 2012). Yet doubts remain that this change can be attributed to condom use, primarily because, at the individual level of measurement in population surveys, the correlation between condom use at sexual debut and HIV-positive status can be positive rather than negative. Many may already be infected before they start using condoms consistently or because condoms are used inconsistently and/or incorrectly. The role of condom use at sexual debut has been overlooked. Two interrelated hypotheses are tested: that HIV communication programs have an indirect effect on HIV status through their direct effect on condom use at sexual debut and that condom use at sexual debut assists in the prevention of HIV infection. Results: After controlling for 17 socioeconomic variables, awareness of HIV communication programs had a positive, dose–response relationship with self-reported condom use at sexual debut. Those who used condoms at sexual debut were 1.38 times more likely to have remained uninfected. HIV-negative status was 3.6 percentage points higher among those who used condoms at sexual debut, corresponding to an estimated 139,835 infections averted among sexually active adults by 2005. Never using injectable drugs and having one trusted partner also predicted HIV-negative status.
• Which of the democratic checks and balances—opposition parties, the judiciary, a free press—is the most forceful? Peru has the full set of democratic institutions. In the 1990s, the secret-police chief Montesinos systematically undermined them all with bribes. We quantify the checks using the bribe prices. Montesinos paid a television-channel owner about 100 times what he paid a judge or a politician. One single television channel’s bribe was five times larger than the total of the opposition politicians’ bribes. By revealed preference, the strongest check on the government’s power was the news media.
• The Radio Communication Project (RCP) in Nepal consisted of two entertainment­ education radio serials (a soap opera for the general public and a dramatized distance education serial for health workers), additional radio spot advertisements and community-based promotions, and complementary print materials. This paper examines impact data from a variety of sources, including a pre- and post-intervention panel survey (1994 & 1997) of currently married women (n=1905), three waves of clinic-based observations of client­ provider interactions (n=240 per wave, in November 1995 before the radio serials went on the air and before any IPC/C workshops had been conducted, in early April 1996 about midway through the distance education serial and after three of the four IPC/C workshops had been conducted, and in October 1996 about six months after the distance education serial ended) and client exit interviews (n=240 per wave), and 2 years of clinic service statistics, in order to draw inferences about the separate and combined effects of the RCP components. The study found increased health worker interpersonal interaction skills and improved quality of client­ provider interactions associated with exposure of health workers to the distance education serial, increased client self-efficacy in dealing with health workers, improved client attitudes toward health services and toward the practice of family planning, increased adoption of family planning, and increased family planning service utilization, all attributable to the radio serioal for the general public. The panel data allowed statistical control of the influence of predisposing factors before the campaign on postcampaign ideation and behavior. The e€ffect of the RCP on contraceptive behavior was largely indirect through its influence on ideation..
• At-scale interventions combining intensive Interpersonal Communication (IPC) with Mass Media (MM), Community Mobilization (CM), and Policy Advocacy (PA) had greater positive impacts on breastfeeding practices in Bangladesh and Viet Nam than standard counseling with less intensive MM, CM, and PA. To our knowledge, this study is the first to document implementation and impacts of breastfeeding promotion at scale using rigorous evaluation designs. Strategies to design and deliver similar programs could improve breastfeeding practices in other contexts.
• Communication for Development (C4D) is a strategy promoted by the United Nations Children’s Fund to foster positive and measurable changes at the individual, family, community, social, and policy levels of society. In western China, C4D activities have previously been conducted as part of province-level immunization programs. In this study, we evaluated the association of C4D with changes in parental knowledge of immunization services, measles disease, and measles vaccine, and changes in their children's measles vaccine coverage.
• Funded by the Department for International Development (DFID), under the Global Grant project,iii BBC Media Action’s flagship output was the TV drama series Ujan Ganger Naiya (Sailing Against the Tide). Over the course of three series, the drama charted the lives of several rural families in Bangladesh. The drama was accompanied by a TV panel discussion programme, Natoker Pore (After the Drama), TV public service announcements (PSAs), a radio discussion programme (in the first year only) and community outreach activities. To support lasting change, the project also involved capacity-strengthening activities with health workers. The overarching objective was to help to improve maternal and newborn health in Bangladesh. The key behavioural aims of the project, identified as critical in the fight against neonatal and maternal mortality by the World Health Organization (WHO),iv were in the areas of antenatal care (ANC), birth preparedness, safer delivery, and essential newborn care (ENC). Research was used throughout the project to inform programme development and evaluate its impact. This report summarises findings from evaluation research to assess and understand the project’s impact. Quantitative analysis including exposed and unexposed comparison at endline using statistical analysis to control for known influences on health, supplemented by a smallscale randomised control trial (RCT) and an interrogation of the projects theory of change using structural equation modelling (SEM). Qualitative methods, including focus groups and interviews, were also used to enrich and triangulate quantitative findings. Research findings from the Global Grant health project in Bangladesh mean that, for the first time, BBC Media Action has causal evidence that well designed, engaging and research led TV programmes can increase people’s health-focused knowledge and behavioural intent. A randomised control trial (RCT) showed that improvements can be causally attributed to exposure to BBC Media Action’s TV programming, at least over the short term in an experimental setting. This study also showed that exposure to a supporting factual discussion programme in addition to the drama led to additional gains. This experimental study supports insights from cross-sectional survey data, which showed that exposure to multiple formats (in this case the drama, discussion programme and PSAs) was associated with higher levels of knowledge than exposure to the drama only. New mothers who watched BBC Media Action’s programmes were more likely than nonviewers to do things to ensure a safe pregnancy and birth, compared with those who did not watch, even after accounting for differences between these groups (e.g. age, income, and education). This includes going for ANC check-ups, making plans to give birth in a health facility, delivering their last infant in a health facility and/or with the help of a skilled attendant, delaying bathing the newborn, practising skin-to-skin care and avoiding pre-lacteal feeds (feeding the child anything other than breast milk) in the first days of a baby’s life. Programme exposure was associated with more positive outcomes around the uptake of ANC – the topic most covered by the programmes – followed by birth preparation. Some significant positive results were also found for safer delivery of babies and ENC, albeit less consistently.
• KEY FINDINGS: THE GOOD NEWS Journalist safety training has a positive impact. Many journalists report implementing changes in behavior (such as carrying first aid kits and undertaking other preparations for assignments) as a result of training. ● Many journalists reported changes in their overall attitudes toward safety as a function of training. ● Two-thirds of journalists reported using safety training skills either occasionally or frequently. ● Journalists expressed high satisfaction with safety training content overall, as well as for the expertise of trainers. KEY FINDINGS: GAPS AND CHALLENGES Many journalists’ safety training is not current. ● Only 27% of journalists surveyed reported trainings completed within the last year; 36% completed one to three years ago; 16% completed three to five years ago; and 21% completed safety training more than five years ago. ● Fewer than half (43%) of the journalists surveyed reported having ever taken a refresher course, even though general industry standards recommend refreshers every three years. ● Thus, at least one-third of the journalists surveyed are in need of either refresher courses or updating of skills to current knowledge, technology and threats. Training content remains military-and-battlefield centered, despite journalists describing a far broader range of crisis reporting/hostile environment assignments. Lack of training on gender-based violence as well as other gender- and culture-related topics are major gaps, as is gender equity among trainers. Trauma-awareness and digital security trainings also remain significantly limited. • The most commonly taught topics included first aid (96%); personal safety including ballistic threats and equipment (86%); hostage survival (80%); vehicle/travel safety (77%) medical knowledge (75%); and risk assessment and management (71%). • First aid was overwhelmingly rated as one of the most useful of available training topics (79%). Medical knowledge (55%), personal safety (49%), risk and assessment management (38%), vehicle security/travel safety (37%), hostage survival (37%), and digital security (37%) were the next most highly ranked among those who received training on these topics. • The least commonly taught topics included cultural awareness and gender specific considerations (26%), eliciting information (12%), responding to sexual harassment/gender-based violence (8%), crime scene management (7%), and responding to online harassment (3%). • Only 8% of journalists reported receiving sexual harassment/gender-based violence training and only 3% reported receiving online harassment training. Even when taught, integration of gender and diversity topics received the lowest satisfaction rating. • Approximately half (46%) of journalists reported receiving some form of psychological trauma training. However, several journalists explicitly described the available training as cursory, dismissive or stigmatizing. • Barely more than one-third of journalists (35%) reported receiving digital security training, but among those who did receive such training, it was highly valued. • Journalists consistently expressed a need and desire for: o gender-based; o regionally relevant; o and psychological trauma components. These three topics were consistently rated as gaps in available training. The use of kidnap or hostage scenarios in HEFAT trainings proved a divisive topic. ● Approximately one-third of journalists (37%) rated the value of hostage or kidnap simulations very highly. ● However, a vocal minority questioned the value of advice given and/or the possible deleterious psychological impact on trainees. Cost remains a significant barrier to access. • 57% of journalists surveyed reported their safety trainings was paid by their employers. • Only 9% paid for training out of their own pocket. • The remaining 33% relied on charitable organizations, NGOs, or a mix of funding sources. • Cost also seems to be a barrier in accessing refresher courses and other training updates.
• We developed a measure of campaign dosage to explore dose-response, based on reported participation in campaign activities and recall of campaign materials. The intervention provided direction on future facility and community level strategies that are effective in addressing behavioral and social norms that negatively affect care and survival of preterm and low-birth weight babies. The evaluation showed that the campaign contributed to changes in injunctive norms around care of newborns, increasing value for LBW and preterm babies, and encouraging social support.
• Complementary feeding (CF) contributes to child growth and development, but few CF programs are delivered at scale. To offer compelling evidence that such interventions can be implemented at scale to deliver impact on improving children's diets, this study evaluate the impact of providing intensified interpersonal counseling (IPC), mass media (MM), and community mobilization (CM) compared with standard nutrition counseling + less intensive MM + CM (non-intensive) on CF practices and anthropometric measurements. The intensive program substantially improved CF practices compared with the non-intensive program. Groups were similar at baseline. CF improvements were significantly greater in the intensive than in the non-intensive group [difference-in-difference impact estimate: 16.3, 14.7, 22.0, and 24.6 percentage points (pp) for minimum dietary diversity, minimum meal frequency, minimum acceptable diet, and consumption of iron-rich foods, respectively]. In the intensive group, CF practices were high: 50.4% for minimum acceptable diet, 63.8% for minimum diet diversity, 75.1% for minimum meal frequency, and 78.5% for consumption of iron-rich foods. Timely introduction of foods improved. Significant, nondifferential stunting declines occurred in intensive (6.2 pp) and non-intensive (5.2 pp) groups in children 24–47.9 months. This study establishes proof of concept for large-scale behavior change interventions to improve child feeding..
• The global polio community is committed to ensuring that all countries currently using oral polio vaccination (OPV) add at least one dose of inactivated polio vaccination (IPV) to their immunization schedules. Globally, communication efforts have been at the forefront of polio eradication programs for more than 25 years. This article combines research from secondary and primary sources of information on country experiences in polio vaccination and from the polio vaccination program in Rwanda. Secondary data included a review of 20 global articles that describe and analyze communication efforts for polio eradication and highlight best practices in communication approaches to address polio. The primary research consisted of qualitative and participatory data gathered from various stakeholders in two rural sites in Rwanda regarding approaches that could be used to develop culturally sound communication strategies to introduce IPV into the current routine expanded program on immunization schedule. Findings from this research highlighted the importance of identifying multichannel and multiaudience approaches to polio eradication that cut across different levels of the social ecological model. Findings further emphasize the importance of evidence-based and audience-centered communication programming to build and sustain the next big programmatic push for strengthening global routine immunization systems and replacing OPV with IPV. This article provides insights into the critical role that communication efforts have played and will continue to play in polio eradication worldwide.
• BBC Media Action’s governance programmes use media and communication to foster political participation. They do this by providing access to information, stimulating discussion and enabling people to interact directly with decision-makers. The organisation works with TV, radio, online and mobile platforms and produces a range of factual and entertainment formats including drama, debate programmes, magazine formats and public service announcements. This research report examines the relationship between BBC Media Action’s debate and discussion programmes and political participation, as well as with the variables that contribute to this participation: political knowledge, discussion, and efficacy. To do this, the report draws on quantitative data collected from more than 23,000 respondents across seven African and Asian countries where BBC Media Action works. The findings are clear and consistent across all seven countries: BBC Media Action’s audiences participate more than people who do not listen to and/or watch its programmes, even when taking other influencing factors – such as age, income and interest in politics - into account. There is also a strong, positive association between exposure to BBC Media Action programmes and political knowledge and discussion. But political participation plays out differently amongst different groups in this dataset. Exposure to BBC Media Action governance programmes is positively related to higher political participation among younger and less educated audiences. However, this interaction effect is reversed for gender: BBC Media Action’s female audience members participate in politics more than women who are not exposed to its programmes. But the increase in political participation demonstrated by BBC Media Action’s male audience is greater. These findings have important implications for the relationship between media and governance. If those who tend to participate less overall in politics – such as younger and less educated groups - gain more by watching or listening to BBC Media Action media outputs, then this suggests that discussion and debate formats can potentially be a powerful tool for social inclusion. Indeed, there may be an argument for targeting this sort of programme specifically at such marginalised groups in order to make their voices heard. But these results also suggest that media programming can reinforce gender imbalances in the way in which men and women participate in politics.
• Settlements at higher risk of refusing OPV have systematically lower levels of community-level activity (households reporting participation in community meetings)." Approximately 31% of women in very-high-risk (VHR) settlements had attended a religious meeting; in contrast, approximately 55% of women in very-low-risk (VLR) settlements had done so. Women in VHR settlements who had attended those religious meetings had a 0.261 propensity to refuse oral polio vaccine (OPV); in contrast, those in VLR settlements who had attended those meetings had a 0.699 propensity to refuse. This corresponds to -15.66 t-stat. Approximately 18% of women in VHR settlements had attended a village development meeting; in contrast, approximately 39% of women in VLR settlements had done so. Women in VHR settlements who had attended those village development meetings had a 0.157 propensity to refuse OPV; in contrast, those in VLR settlements who had attended those meetings had a 0.581 propensity to refuse. This corresponds to -16.64 t-stat. Approximately 18% of women in VHR settlements had attended a health committee meeting; in contrast, approximately 35% of women in VLR settlements had done so. Women in VHR settlements who had attended those health committee meetings had a 0.142 propensity to refuse OPV; in contrast, those in VLR settlements who had attended those meetings had a 0.519 propensity to refuse. This corresponds to -14.94 t-stat. Approximately 12% of women in VHR settlements had attended a non-governmental organisation (NGO) meeting; in contrast, approximately 22% of women in VLR settlements had done so. Women in VHR settlements who had attended those NGO meetings had a 0.102 propensity to refuse OPV; in contrast, those in VLR settlements who had attended those meetings had a 0.332 propensity to refuse. This corresponds to -10.28 t-stat.
• Can the media reduce intergroup prejudice and conflict? Despite the high stakes of this question, understanding of the mass media's role in shaping prejudiced beliefs, norms, and behavior is limited. A year long field experiment in Rwanda tested the impact of a radio soap opera featuring messages about reducing intergroup prejudice, violence, and trauma in 2 fictional Rwandan communities. Compared with a control group who listened to a health radio soap opera, listeners' perceptions of social norms and their behaviors changed with respect to intermarriage, open dissent, trust, empathy, cooperation, and trauma healing. However, the radio program did little to change listeners’ personal beliefs. Group discussion and emotion were implicated in the process of media influence. Taken together, the results point to an integrated model of behavioral prejudice and conflict reduction that prioritizes the communication of social norms over changes in personal beliefs.
• The decline in the homicide rate was 66% greater in intervention neighborhoods than in control neighborhoods (rate ratio = 0.33, 95% confidence interval: 0.18, 0.61), and resident reports of violence decreased 75% more in intervention neighborhoods (odds ratio = 0.25, 95% confidence interval 0.11, 0.67).
• Identifying early adolescence as a “gateway” moment, the Saloni study is a randomized control trial (RCT) to improve nutrition, hygiene and reproductive health behaviors in 30 schools in rural Uttar Pradesh (UP), India. A prevention model that includes Sadharanikaran, an ancient Indian theory of communication, guided the development of the intervention. The Saloni strategy includes a 10 session in-school intervention based on compassion, self efficacy, emotional well being, peer and parental support, packaged in the form of short, easy-to-use instructional modules. A diary designed to engage adolescent girls is provided to each girl. The intervention promoted 19 behaviors that included five health seeking, six nutrition, three reproductive health and five hygiene behaviors. A structured teacher's manual included 10 one-hour sessions that were conducted monthly. Systematic pretesting of the teacher's manual and the Saloni diary was conducted from February to April 2010. The strategy of using diaries to promote empowerment has been used effectively by women's self help groups in rural India (Noponen, 2003), but the approach has not been used with adolescent girls. Intergenerational communication was included in every session and role-plays were conducted with the girls on how to initiate dialogue with their parents on Saloni topics. AV support materials in the form of nine posters reinforced the Saloni behaviors and promoted intergenerational communication. The cluster RCT was conducted from January 2010 to October 2011 with adolescent girls (11-14 years of age) in Hardoi district. The trial is a two-level, nested RCT with the unit of randomization being the block with 15 schools in the intervention arm and 15 schools in the control arm. A sample of 1200 girls was randomly selected. The intervention had a significant impact on more than 13 preventive health behaviors. About 65% of girls in the intervention group had adopted 13 or more health behaviors at end line compared to only 4.5% of the control group. Behavioral impact was demonstrated in all three areas of nutrition, hygiene and reproductive health. The study provides evidence that early adolescence is indeed a “gateway moment” to build nutritional and health reserves.
• Access Now's Keep It On initiative tracks Internet shutdowns globally. In the first half of 2018, 81 shutdowns were recorded, which is about 30 less than the total amount of Internet shutdowns in all of 2017 - indicating that they are growing in frequency.
• Rapid review question: - To assess the socio-normative values, beliefs and practices of the Rohingya around health, wellbeing and nutrition, and around the protection of children, adolescents and women (including gender norms) in a humanitarian context. - existence of social classes/ caste or social structure that might become invisible barriers for accessing services (e.g. child-friendly spaces)?
• The review included 135 articles representing 77 interventions. Two interventions incorporated all eight benchmark criteria, but the majority included fewer than four. Each intervention included behaviour and methods mix criteria, and more than half identified audience segments. Only one‐third of interventions incorporated customer orientation, theory, exchange and insight. Only six interventions addressed competing behaviours. We did not find statistical significance for the effectiveness of interventions on child‐level diet, physical activity or anthropometric outcomes based on the number of benchmark criteria used.
• Behaviors such as handwashing, and products such as those for oral rehydration treatment (ORT), can be marketed like commercial products in developing countries. Although social marketing in these areas is growing, there has been no systematic review of the current state of practice, research and evaluation. We searched the literature for published peer-reviewed studies available through major online publication databases. We identified manuscripts in the health, social science, and business literature on social marketing that used at least one of the 4 Ps of marketing and had a behavioral objective targeting the behaviors or products related to improving water and sanitation. We developed formalized decision rules and applied them in identifying articles for review. We initially identified 117 articles and reviewed a final set of 32 that met our criteria. Social marketing is a widespread strategy. Marketing efforts have created high levels of awareness of health threats and solutions, including behavior change and socially marketed products. There is widespread use of the 4 Ps of marketing, with price interventions being the least common. Evaluations show consistent improvements in behavioral mediators but mixed results in behavior change. Interventions have successfully used social marketing following widely recommended strategies.
• After excluding those new articles that did not meet full-text inclusion criteria, we reviewed 69 in total...Branded health campaigns cover most major domains of public health and appear worldwide. Since 2008, we observed improvement in evaluation, application of theory, and description of campaign strategies in published work. We recommend enhanced education of public health practitioners and researchers on the use and evaluation of branding.
• 97 studies reported on changes in behaviour. Statistically significant findings were more likely to apply when audience insights and other social marketing approaches were used.
• The empirical results can be accounted for by a simple theoretical model where politicians have an eye on their election chances. The role of the media enhances their incentives to do so by more closely tying their actions to voting outcomes. Columns (2) and (5) look at whether newspaper circulation explains responsiveness. They reveal a positive correlation between newspaper circulation levels and our two measures of large enough to influence chronic poverty the system has an important role to play in protecting citizens from short-term food crises (see Dreze [1991] and Radhakrishna and Subbarao [19971). The effects are large and significant - a 1 percent increase in newspaper circulation is associated with a 2.4 percent increase in public food distribution and a 5.5 percent increase in calamity relief expenditures. Moreover, the result is robust to controlling for the political variables introduced in columns (3) and (6). States with higher levels of media development are thus more active in protecting vulnerable citizens. This is consistent with the theoretical idea that this is due to improvements in political accountability..
• In the late 1990s, the Ugandan government initiated a newspaper campaign to boost schools' and parents' ability to monitor local officials' handling of a large school-grant program. The results were striking: capture was reduced from 80 percent in 1995 to less than 20 percent in 2001.
• Exposure to women's groups was associated with a 23% non-significant reduction in maternal mortality and a 20% significant reduction in neonatal mortality. Results of meta-regression analyses indicated that the proportion of pregnant women participating in groups was linearly associated with reduction of both maternal and neonatal mortality. In high-coverage studies (≥30% of pregnant women participating in women's groups), exposure to women's groups was associated with a 49% reduction in maternal mortality and a 33% reduction in neonatal mortality. No effects were noted in the low coverage studies (<30% participation) for any of the birth outcomes. In three of four south Asian trials in which the behavioural mechanisms were reported, women's groups showed strong (including significant and non-significant) effects on clean delivery practices for home deliveries (especially handwashing and use of clean delivery kits), and noticeable effects on breastfeeding (early initiation and EBF). The intervention was cost effective by WHO standards and could save an estimated 283 000 newborn infants and 36 600 mothers per year if implemented in rural areas of 74 Countdown countries.
• This is a summary of results from another brief describing the same program evaluation which this study built on: "Results from the combined arm’s implementation indicated a 72% average increase in proportion of girls having savings of their own (compared to a 12% increase in control groups) and a 15% increase in use of modern family planning methods among participants (compared to a 5% increase in control groups)".