The model on page 164 is important for it allows us to classify and relate a large number of activities, the purposes of which are not well understood outside the information and communication field. In the context of this model, advocacy consists of a large number of what are traditionally known as information and public affairs activities, such as lobbying with decision makers through personal contacts and direct mail; holding seminars, rallies and newsmaking events; ensuring regular newspaper, magazine, television and radio coverage and obtaining endorsements from popular people. The goal of advocacy is to make the innovation a political or national priority that cannot be swept aside with a change in government. Advocacy, in the first instance, may be carried out by key people in international agencies, as well as special ambassadors, but is gradually taken over by people in national and local leadership positions and the print and electronic media.
Advocacy leads directly to social mobilization, a process which involves the addition of more national partners for advocacy and programme communication activities, resource mobilization and service delivery. It is my opinion that the concept of social mobilization within the model given above, helps a great deal in understanding how social mobilization is related to the rest of the communication/information world. It is the glue that binds advocacy activities to more planned and researched programme communication activities.
As the process of social mobilization gathers momentum, advocacy is taken up by a whole new range of partners so that early advocacy is magnified many-fold. A host of allies at the national, regional and community level will join in, influencing a wide spectrum of society. Some of the same allies may join directly in service delivery, mobilizing resources from international, national or community sources; providing new channels for communication; providing training and logistical support for field workers who will implement the programme; and, in some cases, managing field workers directly. Social mobilization, therefore, magnifies advocacy activities and strengthens programme communication, for many more societal partners participate in the programme, such as NGOs, grass-roots organizations which often have the motivation and skills for involving local communities in programmes.
The activities of advocacy, social mobilization and programme communication do not necessarily happen in a consecutive order. However, in general, advocacy begins the process and leads to social mobilization and programme communication. But the "planning continuum" arrow on the circles is two-directional because advocacy is needed at various times in a programme's life, not only at the beginning. For instance, in Epi in Bangladesh advocacy was first geared to gaining political and social commitment to the programme and this facilitated rapid expansion. However, with changes in Government five years into the programme, it was found that specifically- directed, high-level advocacy was needed once more to bring the new leadership "on-board", even though wide-scale, societal ownership in the programme remained strong. Also, as the programme matured, advocacy was used to underline the need to make programme adjustments, such as the need for a new strategy to deal with drop-outs and left-outs.
In terms of analysis and research, the planning continuum is also two-way. Advocacy must remain somewhat opportunistic and therefore less planned and researched. Social mobilization benefits from a thorough analysis of who the best partners are for a particular programme, and what they potentially may contribute, but also should involve some experimentation and lateral thinking since social mobilization is most successful when the chain of command is decentralized, allowing for alliances which may not have been conceived of at the central level. On the other hand, programme communication should be backed by planning research, formative evaluation, programme monitoring, as well as summative and impact evaluation, all research steps involved in the process of social marketing, as outlined in Chapter One, page 11. There should also be an attempt to standardize messages among partners.
The outer circle of this model is necessary but not sufficient, in most circumstances, whether it is called social marketing or programme communication. The lesson which should be learned from the analysis of all the efforts described in this book is that many communication programmes have begun and ended in the outer circle. Careful consumer research may be carried out but there is an absence of strategy for creating a societal ownership and demand. In the original social marketing model, there is no impetus for communities to buy into the idea. It is based on an appeal to the individual, if he or she can be reached. In many developing countries, reaching people with new ideas is the most difficult thing to do. Adding the social mobilization element to this communication model ensures that the product, concept or innovation will be widely diffused through various interpersonal channels.
Even without agenda-setting by the grass-roots community, the social mobilization element within this model, if taken to its fullest, can provide wide-scale participation and ownership. Through social mobilization the programme becomes so widely known and accepted that it is not viewed as an imposition. A vertical programme becomes horizontal. It becomes part and parcel of society. Community leaders throw in their lot and communities become mobilized for the cause. The demand creation brought about by social mobilization ensures an accelerated process of diffusion.
Secondly, the formative research involved in programme communication is not lost in this model. As previously discussed, such research involves the community in defining concepts and how they should be communicated. The programme communicator learns about the beliefs and perceptions of the community and adjusts concepts accordingly. In a later stage of the programme, research may reveal that there is a need to take on new allies or that communities are sufficiently aware of programme goals and services to decrease support for certain activities. In other words, the process of analysis can take place throughout each of the concentric circles at any time. In this way, the activities encompassed within advocacy, social mobilization and programme communication are not linear and do not become stagnant. As realities and communities change, adjustments are made.
Where can the model be applied?
The above model must be tested further with other programmes, concepts and innovations over time. Immunization is one thing that almost everyone wants, once its survival benefits are widely understood. In some societies, the control of diarrhoeal diseases, breastfeeding and other nutrition programmes, family planning and changing Aids-related behaviour may become rallying points for a mobilization process. However, changing hygiene, dietary and sexual behaviour is much more difficult. That does not mean that the model is inappropriate for social programmes which seek change in such areas but it may take longer for change to come about. However, it is unlikely that all programmes are candidates to be starting points or "leading-edge" programmes. For instance, acute respiratory infections (Ari) require a more straightforward programme communication approach. It is likely that Ari would benefit from a system already energized by another main programme but it is unlikely that one would be able to mobilize numerous allies for Ari. At any rate, it may not be necessary or desirable to apply the same level of mobilization for all services which are added to a "leading-edge" programme such as Epi. That is, if a health delivery system has been given a boost by a programme such as Epi, other interventions such as the supply of Ors, vitamin A, iron folate and counselling on breastfeeding and child spacing may be added gradually.
Other likely candidates for social mobilization in most societies are programmes such as universal sanitation and the education goals set by the World Conference on Education for All in 1990. Both programmes appear to be obvious anchors for a grand alliance of partners, such as political, social, and religious leaders; women's groups; service clubs; and Ngo, religious and private schools. These partners can be involved in strengthening service delivery. The process begins with advocacy and moves into social mobilization but also adds the dimension of carefully planned and researched programme communication which will target major problems such as drop-outs and the low enrolment of girls.
In the diagrams on page 137, 169 and 170 I have outlined how these programmes have been conceived in the context of Bangladesh. Not all the partners and channels of communication will apply in all countries but the examples may be instructive in expanding the use of the model in other programmes.
Within all of these programmes it is essential that we establish political will through advocacy and that we mobilize a wider spectrum of allies in order to make a difference. It is equally important that we apply high-quality research methods to such programmes so that the most important channels of communication are identified and improved from the beginning and standard messages are given by all partners concerned.
However, even if the three-part model can be applied to a large number of problems, it may not have universal applicability. For instance, in religiously conservative and male-dominated societies it may be very difficult to find a large number of allies to advocate or mobilize for breastfeeding. Likewise, family planning and Aids education may be taboo. And still more difficult are non-democratic countries where there are strict controls on the media and where governments may consider social programmes to be their business alone. In such countries "mobilization" will likely remain coercive and communication channels strictly controlled. Communication activities will probably remain restricted to the transmission of approved messages via mass media and the field workers of the sector concerned. A pure programme communication method may be feasible through these channels but it would be difficult to broaden the process into a social mobilization through advocacy. In addition, if the people are repressed and moving toward rebellion, positioning the programme with the central government may do damage to its acceptability. It is fortunate for us, and for the application of the ideas contained within the model, that there are fewer and fewer examples of countries where it may not apply as we proceed into the 1990s.
But what about community participation in the sense of agenda setting by beneficiaries? Does this model allow for it? The answer is, where full-scale community participation is possible, there is no conflict within this three-circle model. In the case of the Iringa Nutrition Programme in Tanzania, the programmers advocated at the national, regional and local level for their programme in order to develop a supportive environment for the participatory processes. No one from the Prime Minister to the village council leader was allowed to remain neutral to unacceptable levels of malnutrition and child mortality. The mass media became involved in popularizing the programme's goals. Participation was not seen as a goal in itself. In this sense, the programme was both "top-down" and "bottom-up". 14
Advocacy supported social mobilization, a process which began with problem assessment and analysis at the community level and moved on to action on chosen courses, involving many strategic allies at all levels in a wide range of support activities. Early mobilization created demand. Through continuous assessment, analysis and programme monitoring, the programme of action became more and more refined.14
The programme involved all available media channels including films, interpersonal communication and traditional media14. Thus programme communication, including excellent interactive training strategies for interpersonal communication, was employed to spread knowledge and action to an ever-increasing number of participants and, eventually, to facilitate its expansion to new regions of the country. There were many programme aspects of the Iringa experience which I have not described here. The point of the above analysis is that from a communication perspective, the Iringa Nutrition Improvement Programme involved all of the elements of advocacy, social mobilization and programme communication. The repetition of the three-circle model on the next page, with adjustment for full-scale community participation, should make the above points clear.
However, as earlier discussed, this version of the model is the most difficult to apply. Although there were a good number of programmatic factors which made Iringa a success, there were also a host of environmental factors. As previously mentioned, when the programme began, Tanzania had undergone 25 years of grass-roots, social transformation and had implemented national policies, such as universal primary education, which increased the literacy rate to almost 90 percent 14. In addition, the traditional settlement pattern had been totally reorganized from a difficult-to-mobilize, scattered population, to collective villages. Tribalism had nearly disappeared. Local government structures, which had been abolished, were re-established in 1986, allowing for decentralized decision making14. These factors were also important in the noted success of replicating the Iringa programme in other parts of Tanzania.
However, in attempting to transplant the Iringa approach to other countries and continents, programmers may meet with formidable obstacles. In South Asia, for instance, there are many factors inhibiting full-scale participation, such as the caste system in Hindu communities and a top-down concept of governance inherited from colonial times. In Bangladesh, there is strong, pragmatic individualism and poor village-level structures and organizations to support such a programme. There are also strong patron-client relationships derived from the landlord system which was strengthened during colonial times. This strong system of benefactor and beneficiary is reinforced by traditional concepts of charity and the central government establishment. It has been said that, in Bangladesh, even the relationships between NGOs and the people are patron-client oriented rather than social movements.
In such a society, the adoption of full-scale participatory methods in setting priorities for action would be difficult to achieve. It would require a major social revolution which could quickly become politicized, given the multiple political groupings and factions which are struggling for control of resources in the new wave of democracy which has overtaken the world today.
In spite of such constraints in many countries, the social mobilization programmes described in this book have demonstrated that the end result of the process is the participation in programme goals of a wide spectrum of social allies and communities, including the grass-roots. There are lessons to be learned in the management of mobilization, research and training which can help to strengthen the process and increase community participation. I shall now turn to those lessons.
A Summary of Lessons Learned
This book has entailed a survey of a large number of programmes in public health, nutrition and family planning fields which have used, to varying degrees, the methodology of social marketing and social mobilization. There are many lessons in these pages for the management of programmes and institutionalization of skills which ultimately relate to the sustainability and replicability of such programmes. I have summarized a few of the main lessons, below, but have also drawn on other experiences in order to give the reader more substantial information on social mobilization and programme communication.
Managing mobilization
In the context of one household, once one child has received a health service such as immunization, there is a greater likelihood that subsequent children born to the family will be immunized. In other words, the goal is to create a "culture" for an innovation such as immunization 15. Many of the communication programmes undertaken to address health, nutrition, education, population and environmental problems around the world have started and ended in the "outer circle" of social marketing or programme communication without addressing the problem of gaining strong political commitment and without identifying and empowering allies who can create a "culture" for programme goals. When the elements of concerted advocacy, social mobilization and programme communication are successfully combined, the result is a critical force for bringing about fundamental progress in relation to the goals of social programmes.
In creating a "culture" programmers should not create dependency. Although it is excellent that health providers reach out into the community to create demand for services, balance is needed. The strategy of taking health care to the people may encourage a culture of dependency on government outreach 15. Door-to-door service provision is not a good policy under most circumstances. If people provide an outreach post at some cost to them, the programme has a greater chance of being sustained.
It is not possible to continue mobilization efforts at the same level for an extended period of time. Once a population is fully aware of a programme and is demanding its services or product, awareness-building events may be held periodically, while service delivery and reinforcing communication between field worker and client remain constant.
Mobilization of partners must be built on a basis of mutual benefit. They have often been regarded as convenient accomplices whose loyalties can be temporarily purchased. One of the unfortunate consequences is that it may create expectations among partners for material and financial support in exchange for further involvement 16. This should be avoided.
The sustainability of social mobilization is directly and positively related to the degree of control a government or project leader is willing to give up. The social mobilization process encourages the participation of many partners who have their own perceptions and attitudes concerning an innovation, whether they be local government authorities, NGOs or service clubs. However, they should continue to receive strong central guidance and support.
Decentralization should not be seen as an alternative to centralization but as an extension of it16. Day-to-day decision making at the local level takes time to develop and needs to be reinforced and supported over the long-term.
There are a number of other process indicators which can be used to monitor social mobilization to determine if the programme is reaching sustainability (see page 176).
Messages and research
Often there is a rush to produce messages on materials such as posters, flip charts and flashcards before distribution channels and utilization methods are established and before field workers have the skills to use such material properly. These materials may give visibility to a programme but often entail a waste of resources without such synchronization.
Social marketing and social mobilization must work within the mind-set and indigenous knowledge of beneficiaries. There are excellent qualitative research methods available for determining the most important elements of belief systems. Sometimes programme s entail formative research but production of communication materials goes ahead before the research is complete. Communicators often do not know the basic minimum required in the planning and research process.
When consumer research is applied it is often shoddy, especially focus group discussions. Focus groups are "in vogue" but very few people know how to run them properly. For instance, one rule of focus groups which marketing experts insist upon is that the members of the group should not know one another so that they can speak freely, unhindered by existing relationships. This is often overlooked in development work because it is difficult and expensive to transport people from various villages to a central location. It is also difficult to find a secure place, where comments will not be overheard by curious onlookers and eavesdroppers.
One of the main uses of research in social marketing is for the positioning of products and concepts vis-a-vis complex, traditional belief systems. This is difficult to do well and can become a manipulative endeavour if not carried out by professionals and used ethically. However, when there is a shortage of time or money in programmes, the formative evaluation, feedback and revision phases often suffer or are even dropped entirely. Often, administrators of programmes do not understand the purpose and value of such research and it is seen as an unnecessary step, blocking progress. They prefer that communicators get on with the job of producing posters and videos or anything that is visible and may impress their bosses in turn. Very often, communicators give in to this kind of demand.
Significant progress has been made in bringing about awareness amongst people. But few communication strategies promote understanding of these issues by the people. Messages must go beyond simple slogans to address the "whys". We must carefully examine what people need to know. Too much technical information does not always lead to improved knowledge or practices and can confuse people. Messages should be "actionable".18 There are methods for mobilizing people that do not require their prior knowledge, in the first instance, of the detailed benefits of an innovation. For example, in Epi activities the most salient factors are the physical presence at vaccination sites of a person of high credibility and integrity and the participation of women from the community who previously had their children immunized, to act as change agents and role models in their community15.
Often messages are too complex and aligned with beliefs which cannot easily be changed or with sources that are not credible. The entertainment-education movement has brought new energy and imagination to many population and health programmes around the world and should be expanded. Likewise, traditional folk media should be utilized to convey programme messages where such forms of communication still have wide appeal.
Finally, more effort is needed in the formulation and implementation of research which actually measures behavioural change. Little is known about the extent to which such change actually takes place or how it should be measured. Few programmers build into their plans the necessary longitudinal studies which will document changes over time. Such studies must also be able to measure the influence of various interventions and environmental factors in order to prove the case for communication methods.
Relating research to action
When research is commissioned, it is often carried out in isolation by a professional research group. Unless policy makers are involved in the research from the beginning, they may reject the findings because they do not understand the purpose or need for the research, especially that of a qualitative nature, or may question the methodology and therefore the findings. Programme managers, who often come from a technical field such as medicine, may not be conversant with qualitative methods and may want hard data on which to base decisions. They must be thoroughly briefed beforehand so that the lack of tables and numbers is not a surprise to them.
One method of managing research found to be successful in social mobilization programmes is the convening of a technical committee from various relevant sections of government, NGOs and donor agencies who review the objectives and methodology of the research, follow its progress through periodic briefings and give feedback on the final report. This gives wide-scale ownership to the results and allows people to think about the implications of the research as the results become available. Researchers, in this method, must give up some control and be less protective of preliminary data. Although this may cause problems in some cases, the preliminary nature of the results can be emphasized continually at technical committee meetings to prevent the misuse of data.
However, when the final report is ready it is essential that it not be "shelved". If ownership in the report is wide, there is less likelihood that this will take place. One excellent method of avoiding the disuse or misuse of research is to time the release of results with the beginning of a new planning cycle for the programme. By coding the major findings and recommendations for use by different sections of the programme, such as management, logistics, surveillance, communications and training, it is possible to feed research results directly into problem analysis and strategy formulation. In Bangladesh, the Epi programme has carried out such an exercise successfully, using a methodology called Visualization in Participatory Planning (see panel on page 180-181).
Planning, Training and Partnership Building
Many social mobilization strategies have not put enough emphasis on improving the service provider's willingness and capacity to respond to the needs of the people. The credibility of the service delivery system will be damaged if the people's expectations are raised but fail to be met by service providers15. There is no substitute for the long and sometimes difficult task of training field workers to be effective mobilizers, communicators and counsellors or for assisting the establishment of peer networks amongst people who are the most vulnerable. Even where there is wide-scale social ownership in a programme, this element may be weak.
One of the most overlooked facets of many social marketing and social mobilization programmes, which has a great bearing on institutionalization and sustainability, is the extent and quality of training. Too often, programmes suffer from outmoded training methods in which field workers, mid-level managers and administrators are lectured to for hours.
Trainers need to be trained to employ participatory methods such as visualization, role play, observation, small group discussion, interactive video, practical demonstrations and field observation. Supervisors and managers should be exposed to the same. Unless there is a change in training culture we cannot expect a change in the culture of communication between field worker and client.
Once a core group of communication trainers has been established, training success will benefit from decentralization. Trainers who are given the tools and the opportunity to construct their own syllabus and determine the best methods to apply in a given area will take ownership in their programme and put more effort into motivating field staff to become good communicators.
Visualization in Participatory Planning (Vipp)
The Vipp method is a useful methodology in training and orientation of field workers, as well as planning with partners. Vipp counters the "seminar culture" which is predominant in most workshops, training and orientation sessions as well as so-called planning meetings in many developing countries. These are usually formal affairs where participants are required to listen to a large number of speeches from a dias, set rigidly before rows of chairs or a boardroom-style table. Hierarchical relationships are strictly adhered to. Speakers come with fixed positions on various subjects and attempt to pass on information in lectures, relying on their wit and charm to keep audiences receptive. Very often discussion sessions consist of another series of formal speeches with little or no feedback. Much of the content of speeches is lost to audiences.
Although there are many methods for participatory group interaction, the Vipp method is different. It relies on the preparation of a large number standard-size cards of different colours on which participants express their main ideas in large enough letters or diagrams to be seen by the whole group. Private note taking is not allowed. Participants are asked to stick to the rule of one idea per card. They are asked to synthesize their thoughts, or the thoughts of others, on these cards and to display the cards on moveable boards.
By this method, everyone takes part in the process of arriving at a consensus. Less talkative participants find a means of expression and those who might normally dominate a group lose control and are forced to let others have their say. By visualizing the group's main proceedings, repetition and circularity in argument are reduced. If there is a record of the group's progress, visible to everyone, it is easier to point out such repetition.
The rule of one idea per card is important. Flip charts with long lists of ideas allow only part of the group process to be visible at one time. Some of the ideas are flipped out of sight. It is possible to pin or tape flip chart paper to a wall or board. However, it is difficult to separate individual ideas, move ideas to other groupings or categories or to collapse the ideas of two sub-groups, ruling out redundancy. If there is one idea per card, all of this is possible. Individuals and sub-groups can identify their own work and see how it fits in with the thoughts of the group as a whole.
The Vipp method also may involve a good number of warm-up exercises and presentation through role play, a method of gaining group attention and involvement in the issues. With techniques such as role play, the proceedings of the workshop become alive to all. The additional level of visibility through the card system makes recording the proceedings easy for the cards can be photographed and a report written from them, or the information can be transferred directly to computer at the workshop site.
In Bangladesh, this methodology has proven extremely useful in galvanizing a whole number of partners for various social programmes such as Epi, breastfeeding, sanitation, control of diarrhoeal diseases, basic education, urban planning and child rights.
Conclusion
In this book I have shown that major social marketing initiatives around the world have relied very much on community-based activities. In this chapter, I have attempted to demonstrate how the researched communication activities of social marketing can be incorporated into a new model for broader and potentially more successful development communication. This new model was arrived at by analyzing a large number of social marketing/social mobilization endeavours around the world.
I have concluded that there is a great amount of rhetoric and confusion, as well as a large number of questions involved in the concepts of social marketing, social mobilization and community participation. In the latter field, some successes have been achieved, but it has not yet been demonstrated how true agenda-setting by individual communities on a massive scale, if it were possible, could mesh with the plans of governments, bilateral and multilateral agencies.
With programme communication, incorporating the research tools of social marketing, the alliance-building process of social mobilization and the extra element of advocacy, I have constructed a model which is useful in conceptualizing concerted national action around a particular social problem or sector such as sanitation and the control of diarrheal disease, nutritional problems, basic education, environmental problems and in some societies, family planning and control of sexually transmitted diseases such as Aids.
The model should help implementing and donor agencies understand how all the various elements of communication and information fit together in the development process. The terms used by development communicators are incorporated and redefined, according to their place in the circles. With the use of such a model, the functions of various occupations in the communication and information world are brought together for focused action in a particular social programme. Some people are involved in advocacy, some with social mobilization and others are more involved in programme communication. As previously discussed, the borders between advocacy, social mobilization and programme communication are not exact. The activities might better be described on a continuum. They need not take place in a linear order either. There is a need for new kinds of advocacy, social mobilization and programme communication as a programme matures. Strategies must be adjusted according to the programme needs of the day.
I hope that this synthesis of advocacy, social mobilization and programme communication offers new possibilities to the success and expansion of social programmes which face enormous challenges in this decade and beyond. |