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Strategies for Introduction of EC in India : Expert Viewpoints

Role of Communication in the National Program
– Ms Sadhna Shanker, Dy. Secretary (IEC), GOI

First of all, it needs to be clarified that emergency contraception is not yet a part of the National Family Welfare Program. Presented here is a brief overview of the role that IEC has been playing in the national program. The communication media have always played an important role in promoting the Family Welfare Program.

It was during the Fourth Five-Year Plan when communication efforts became truly effective.The now famous ‘Red Triangle’ symbol for family planning was conceived during this period and a national campaign was launched for advocating ‘two or three children-enough’. The campaign for male contraception-the condom under the brand name ‘Nirodh’ as the first social marketing effort undertaken with professional guidance was also initiated about this time.

There was a setback after 1975-76 to the entire programe due to the negative impact of mass sterilization camps, which was offset only in the late eighties, when the Program, renamed as the National Family Welfare Program, began to address not just contraceptive needs, but also child-survival and maternal-health issues. Thereafter, the program encompassed many areas of reproductive and child health and a multi-media approach was used to disseminate information.

In the wake of the country’s acceptance of the global agenda of ICPD (POA)-1994, the Government of India launched the Reproductive and Child Health Program in 1997. This represented a radical shift in the Government’s policy as it moved away from obsession with sterilization targets, to a bottom-up decentralized participatory planning process based on community needs assessment. The program covers an extended range of services for unwanted fertility, maternal health, RTI/STI, child health and adolescent health. The new paradigm embodied in the RCH program generated a strong demand for new initiatives in the IEC campaign. The Ministry of Health and Family Welfare engaged private professional agencies to produce audio-visual software for the program. It was also decided to invite eminent filmmakers to make full-length feature films on RCH issues.

The RCH paradigm shift towards client-centered, demand-driven services needs strategic communication to work as a tool to create demand for quality services. The communication challenge for RCH is one of demand creation and this requires understanding of media opportunities, professional procedures and use of marketing approaches. The focus is no more on awareness generation; the communication campaign has to promote behavioural change. In January 1999, MOHFW started the process of defining a holistic and yet flexible strategy for communication of the country’s RCH program. Starting with a National Workshop in January 1999, followed by three Regional Workshops in the summer of 1999 and a series of deliberations, the National Communication Strategy was adopted through a National Workshop in October 2000. The strategy lays down the goals and suggests an operational framework for communication at Central, State and District levels. It also identifies the major behavioural change objectives that the communication managers have to address and achieve along with the barriers and opportunities that are in place.

A crucial feature of the new strategy is the recognition that, increasingly, IEC work will have to be taken over by the states, districts and community leaders. The central government will continue to play the lead role in national mass media campaign and multi-media campaigns, while the local radio, TV and print media and local specific IEC work through leaflets, posters, traditional entertainment methods, banners, hoardings etc. will be the exclusive responsibility of the state, district and community.

The massive IEC compaign for social mobilization for Pulse Polio Immunization over the last few years has been a significant activity. One of the most important lessons learnt from the polio campaign has been the realization that at the field level, inter-personal communication (IPC) is the key to behavioural change. The mass media creates an enabling environment, it lends credibility to what the health worker is saying, but the crucial factor in getting people to come to the booth for the vaccine is the persuasive skill of the health worker.

The National Population Policy, 2000 stresses that the Family Welfare messages have to be clear, disseminated everywhere and be in local dialects. It emphasizes the need for inter-sectoral convergence for IEC and sensitization of all field–level functionaries. It also encourages advocacy and sensitization of the opinion leaders.

All methods and means of communications are important. What needs to be decided is the right mix and the appropriate levels that will carry out the campaign. Growing partnership with NGOs and with the private sector for social mobilization and IEC are essential for success.

In a country as diverse as ours, area-specific approaches have to be adopted and, therefore, decentralization of communication efforts is the key to address various local and specific needs.

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