This section hosts guidelines, manuals and toolkits to strengthen public health practice.
About the Project
Digital Green’s USAID-supported project Samvad on health and nutrition communication was implemented in the states of Assam, Bihar, Chhattisgarh, Jharkhand, Odisha and Uttarakhand during Sept 2015 - Feb 2022. The project worked with the goal of helping communities to better access government services and entitlements, and maximize impact by linking demand generation with public supply-side interventions. The project used low-cost, community-focused, participatory videos to improve maternal, infant and child health; and increase the adoption of family planning practices. The lessons learnt in the Samvad project were integral as it engaged into structured evaluation and unstructured discourses on the project’s successes and failures with the stakeholders at different levels. The lessons learned are described in the three main realms of the program conception and implementation, monitoring & evaluation, and sustainability.
Program Conception and Implementation
Scope of flexibility in project design for sustainability: Collaboration with the NHM in the implementation states to reach the common objectives was an intrinsic component of sustainability embedded in the Samvad project.
Promote hybrid communication package for optimal outreach and message reinforcements: Initially starting with the community video screening using pico projectors, the project soon introduced alternate dissemination channels like WhatsApp and IVRS due to the COVID-19 restrictions. Though each platform had its challenges, utilizing a hybrid communication package proved more effective in outreach.
Locally produced content for amplifying the impact: Communication content created in local languages/dialects is one of the vital aspects of the success of the project. The local teams were trained in video production. They produced content with which the target audiences were able to relate with ease and internalize the messages.
Robust capacity building system: Capacity building training programs covering a range of topics including video production, content development and dissemination using pico projectors boosted local capacities and, thereby, enhanced the knowledge base and necessary skill sets of frontline workers.
Human mediated video screening for optimal message internalization: Samvad ensured a mechanism of pre or post dialogue with the targeted audiences in relaying messages. ASHAs were engaged to clear the doubts and queries of the target audience and help them understand the subject.
Uniform core messaging for all the states: The content of the videos relayed uniform core messages to the community members through all dissemination channels across all the program states.
Simple and user friendly technology: The use of pico projectors and video screening was appreciated by the frontline workers for its portability, uniformity and high quality covering all the important points in a standardized manner.
Gender empowerment: Concerted efforts by the project team enabled the male frontline workers to discuss subjects like breastfeeding and its significance, and family planning and its methods. This was supported by the targeted women leading to breaking gender-based stereotypes.
Monitoring and Evaluation: The robust M&E tools, including in person monitoring visits, daily reporting systems, and collation of data at the block and district level facilitated tracking of the project progression and aided in initiating appropriate improvisations:
Lean surveys paved the way for evidence based course correction for better outcomes: Conducted in association with the London School of Hygiene & Tropical Medicine (LSHTM), lean surveys used a robust research mechanism to provide quality evidence based findings.
Building appropriate application and dashboard for better reporting and M&E management: Manually managed reporting emerged as a bottleneck due to delays in their completion and sharing at every level. A need for a centralized point for collation of all the data was felt strongly.
Sustainability: The impact of the communication package, enhancement of local capacities and continuous hand-holding paved the way for ascertaining the critical role of improving the sustainability of the project:
Promoting convergence of inter-departmental and intra- departmental and between CSOs and Government for scaling up: The project often faced the bottleneck of delay in decision making at the partner’s level in almost all the states due to the presence of multiple partners. Convergence between departments and organizations enabled prompt decision making and thereby aided in maintaining the momentum and quality of the project.
Promoting dedicated financial resources for hardware components like pico projectors, video cameras and its maintenance: The community-based video approach using pico projectors have been one of the key highlights of Samvad project. The simple and user-friendly technology was embraced by the frontline workers as the portable device aided in sharing their burden.
Promoting dedicated financial resources for capacity building training and motivational honorariums for FLW: The orientation and training of the frontline workers and other stakeholders' team members at different levels provided the key impetus to the project in reaching its goals. The sustainability of the project depends on dedicated financial resources for capacity building and motivational honorariums to the FLWs.
States where the subsidiary or non-NHM partners initiated Samvad performed better in adoption and scaling up: In Chhattisgarh, Jharkhand and Bihar subsidiary departments like the State Health Resource Centre and the State Rural Livelihood Project (Jeevika) embraced the project very promptly and dedicated necessary human and financial resources for its sustainability and scale up.
Popularization of Samvad’s achievements in government portals for enhancing visibility: Consistent visibility of a program helps build the outreach, scope of acceptance and eventually the sustainability of the project. The portals of Departments of Health and Family Welfare, Agriculture, Panchayati Raj, Urban Development etc can be leveraged for the promotion.