Designing a Social and Behavior Change Communication Strategy for CROPS: a WASH and Homestead Food Production Intervention in Odisha, India Restricted; Files Only

Abstract

Background: Though there has been significant improvement in nutrition in India in the past few decades, states of lower sociodemographic index, such as Odisha, have a higher burden of malnutrition. Minimum dietary diversity (MDD) is a qualitative diet quality indicator that serves as a proxy for population level micronutrient status. In Odisha, 39% of children ages 6 – 23 months met the MDD. Homestead food production (HFP), a form of nutrition sensitive agriculture (NSA), may provide an opportunity to increase food availability and dietary diversity. Social and behavior change communication (SBCC) plays an important role in promoting behavior and an enabling environment to sustain behavior change at the individual, interpersonal, and community levels.

 

The Project: The Climate Resilient Odisha Produce Study (CROPS) is a HFP intervention in villages in rural areas of Ganjam and Gajapati districts in Odisha, India. The study aims to improve the nutritional status of women and children under five by increasing dietary diversity through HFP in villages with improved sanitation and piped water systems. 

 

Methods: Formative research for CROPS was conducted in Odisha, India during May – June 2022 and again in May – July 2023. Through the formative research, SBCC focus behaviors were identified. The SBCC strategy includes a situation analysis, audience segmentation, and program theory to describe the context. Using the Designing for Behavior Change (DBC) framework the behavioral determinants were used to design SBCC activities including communication objectives, strategic approaches, and messages.

 

SBCC Strategy: The final product of this special studies project is an SBCC strategy for the CROPS intervention. The strategy includes an in-depth analysis of the context of nutrition in rural Odisha, an audience analysis, SBCC activities guided by communication objectives and strategic approaches, and draft key messages.  

 

Conclusion: Nutrition sensitive agriculture, such as HFP can be a sustainable, climate resilient method for increasing the dietary diversity of women and children. The CROPS intervention in Odisha, India aims to improve women's and children’s dietary diversity in villages with improved sanitation and piped water systems. Designing an SBCC strategy promotes targeted behavior change to complement the planned intervention activities.

Table of Contents

Chapter I: Introduction 1

List of Acronyms & Abbreviations 4

Chapter II: Comprehensive Literature Review 6

2.1 Prevalence, Consequences, and Causes of Undernutrition 6

2.1.1 Prevalence of Undernutrition 6

2.1.2 Consequences of Undernutrition 6

2.1.3 Causes of Undernutrition 7

2.1.3.1 Micronutrients and Dietary Diversity7

2.1.3.2 Infectious Disease & WASH 8

2.2 Nutrition Policies and Programs 9

2.2.1 Nutrition Policy in India 9

2.2.2 Nutrition Sensitive Programs 9

2.2.3 Nutrition Sensitive Agriculture 10

2.2.4 Homestead Food Production 11

2.2.5 Climate Resiliency in HFP 12

2.3 The Role of Social and Behavior Change Communication 13

2.3.1 Behavior Change Communication 13

2.3.2 SBCC in Nutrition 14

2.3.3 SBCC in NSA and HFP Programs 16

2.3.4 Challenges and Sustainability in SBCC 17

2.4 Designing a SBCC Strategy for CROPS 18

Chapter III: Methods 19

3.1 Formative Research 19

3.1.1 Barrier Analysis 20

3.1.2 Quantitative Household Survey 21

3.1.3 Focus Group Discussions 21

3.1.4 Seasonal Calendar Participatory Activities 22

3.2 Intervention Development 22

3.3 SBCC Strategy Development 23

Chapter IV: Results 29

4.1 SBCC Activity Plan 29

4.2 SBCC Messaging Plan 42

Chapter V: Discussion, Recommendations, & Conclusion 47

5.1 Discussion 47

5.2 Recommendations and Public Health Implications 51

5.3 Conclusion 51

References 53

Appendix 1: CROPS Social and Behavior Change Communication Strategy 60

 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Nutrition Sensitive Agriculture SBCC Social Behavior Change Communication Homestead Food Production WASH
Committee Chair / Thesis Advisor	Dr. Sheela Sinharoy, Emory University
Committee Members	Allison Salinger, MPH, Emory University
Partnering Agencies	International Non-governmental organization (e.g., CARE, Inc.)

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