formative research for assessing exposure and

Formative Research for Assessing Exposure and Effectiveness of IEC/SBCC Interventions

Implemented by IEM Unit of DGFP

Study Conducted byDepartment of Population Sciences

University of Dhaka, Dhaka-1000

Dissemination Seminar of the Study Findingson

29 August 2018, Venue: Multipurpose Hall, BIAM Foundation

Presentation Outline

• Background

• Methodology

• Findings• Exposure of Different Communication Channels

• Effectiveness of the Communication Channels

• Cost-Benefit Analysis of the IEC Activities

• Policy Recommendations

• Bangladesh has achieved considerable progress in reducing fertility throughincreasing contraceptive prevalence, and reducing maternal and child mortality.

• Still there are many areas of family planning, maternal and child health wheregreater attention is needed to achieve the various targets set in the 4th HPNSDP:

• To increase CPR to 75% (62.4/2014)• To increase the contribution of LARC in CPR to 20% (8/2014)• To reduce TFR to 2 per woman (2.3/2014)• To increase ANC (at least 4 visits) to 50% (31.2/2014)• To increase delivery by SBA to 65% (42.1/2014)• To reduce NMR to 18 per thousand (28/2014)• To reduce U5MR to 34 per thousand (against 46/2014)• To reduce MMR to 121 per one hundred thousand (176/2015)• However, achieving these targets are very challenging due to various sociocultural

factors existed in our society.

Background

• Information, education and communication (IEC) programs are beingimplemented to address these sociocultural issues as IEC aims to increaseawareness, change attitudes and bring about a change in specific behaviours.

• IEC means sharing information and ideas in a way that is culturally sensitive andacceptable to the community, using appropriate channels, messages andmethods.

• In the area of family planning, IEC can help us in the following way:(a) creating public awareness about the need for family planning;(b) increasing knowledge about the use and risks of family planning methods, orwhere to obtain contraceptives; and(c)motivating couples and individuals to use family planning services.

• There was time until when it has been proven that IEC programs have playedpivotal role in achieving the health and family planning related targets along withcontinuous political commitment, innovative program approaches, andcommitment of the field-level functionaries.

Background (contd.)

• There is a growing understanding that behaviors are grounded in a particularsocio-ecological context and change usually requires support from multiple levelsof influence which has resulted in an expansion of the communication approachto become Social and Behavior Change Communication (SBCC).

• The GoB has adopted a comprehensive SBCC Strategy in 2016.• SBCC for health and family planning is a research-based, consultative process that

uses communication to promote and facilitate behavior change and support therequisite social change for the purpose of improving outcomes.

• SBCC is guided by a comprehensive ecological theory that incorporates bothindividual level change and change at broader environmental and structurallevels.

• SBCC works at one or more levels: the behavior or action of an individual,collective actions taken by groups, social and cultural structures, and the enablingenvironment.

• SBCC programs include a wide range of interventions that fall into three broadcategories: mass media, interpersonal communication, and communitymobilization

Background (contd.)

Trends of IEC/SBCC Exposure (BDHS)

46.5

42.2 41.544.4

38.4

32.830

42.1

36.3

24.9 24.3

12.5

2.91.4

40.1

32.8

19.7

14.1

19.6

13.7

18.817.2

19.9

28.7

33.831

24.4

19.2

9.4

5.5 6.48.1

9.9

5.5 4.9

5.93.1 2 1.2

3.45.3 5.1 4.6 3.6 3 2.90

5

10

15

20

25

30

35

40

45

50

1993-94 1996-97 1999-2000 2004 2007 2011 2014

Perc

en

tage

of

Res

po

nd

ents

At least one FP message Radio Visits by FP workers Television

Billboard/Poster Community Event Newspaper/Magazines

• This formative research aimed to provide a comprehensive understanding on theexposure and effectiveness of SBCC interventions through exploring the causesand potential remedies of relatively lower exposure of SBCC interventions amongpeople.

• However, the specific objectives of this formative research are:

• To revisit and identify what SBCC interventions including channels/medium didwork well and what did not, and why?

• To carry out cost-benefit analysis revealing to what extent the SBCC interventionscontribute to increasing CPR and lowering TFR.

Objectives of the Formative Research

• Formative research is such kind of research which is used as the basis fordeveloping effective strategies, including communication channels, forinfluencing behavior change. It helps researchers identify and understand thecharacteristics - interests, behaviors and needs - of target populations thatinfluence their decisions and actions. Formative research is integral in developingprograms as well as improving existing and ongoing programs.

• Formative research is research that occurs before a program is designed andimplemented, or while a program is being implemented to help “form” ormodify a program.

• Formative research should be an integral part of developing programs oradapting programs, and should be used to help refine and improve programactivities.

What is Formative Research?

• A cross-sectional research design with mixed methods approach was used in this study.

• Both primary and secondary data were used.• Both qualitative and quantitative data has been collected as part of primary data. • The secondary data has been collected from the Bangladesh Demographic and

Health Surveys (BDHS).• The cost related to SBCC activities has been collected from the relevant OP

documents for cost-benefit analysis.

Methodology: Study Design & Data Sources

Methodology: Study AreaDivision Category District Upazilla Union

Sylhet

Rural Habiganj Madhabpur Adair, Bahara

Urban Moulvibazar Sadar Ward No. 1, 7

Slum Sylhet City Corporation Ward No. 10, 21

HTR Sunamganj Derai Karimpur, Rajanagar

Khulna

Rural Jhenidah Kaliganj Bara Bazar, Niamatpur

Urban Jessore Sadar Ward No. 2, 5

Slum Khulna City Corporation Ward No. 21, 24

HTR Bagerhat Sharonkhola Dhansagar, Royenda

Brahmanbaria

Rural Sarail Noagaon, Shahbazpur

Urban Sadar Ward No 3, 7

HTR Nabinagar Sreerampur, Paschim Nabinagar

• The quantitative data has been collected from newlywed women or women withone or more children aged 15-24 years and their husbands through face-to-faceinterview using structured questionnaire.

• Focus Group Discussion was conducted among the newlywed women or womenwith one or more children aged 15-24 years; husbands of the newlywed womenor women with one or more children aged 15-24 years; adolescent girls aged 13-19 years; and adolescent boys aged 13-19 years.

• In-depth interviews were conducted among:• program managers (divisional director, deputy director-FP, UFPO & MO-MCH-FP);• service providers (FWVs, FPI, and FWA);• elected representatives (UP Chairman, and women members);• community and religious leaders; and• school and madrasah teachers.

• KIIs were conducted at national level among policy makers, developmentpartners working in HPN sector, media people, and NGO representatives.

Methodology: Study Population & Methods for Data Collection

• 𝑛 =(1.96)2× 𝑝 1−𝑝 ×(𝑑𝑒𝑓𝑓)

𝑒2 ×𝑟𝑟

• n= total sample size

• p= the proportion of women who are exposed to any SBCC related activities inthe last month (p=0.30)

• e2 = Margin of error (.05)

• rr = Response rate (95%)

• deff= Design effect (1.75)

• Total sample 594

Methodology: Sample Size

Methodology: Distribution of Sample Size for Quantitative Study

Division Category District Upazilla

Sample Size

Wife Husband Total Division

Sylhet

Rural Habiganj Madhabpur 100 50 150

600Urban Moulvibazar Sadar 100 50 150

Slum Sylhet City Corporation 100 50 150

HTR Sunamganj Derai 100 50 150

Khulna

Rural Jhenidah Kaliganj 100 50 150

600Urban Jessore Sadar 100 50 150

Slum Khulna City Corporation 100 50 150

HTR Bagerhat Sharonkhola 100 50 150

Brahmanbaria

Rural Sarail 100 50 150

450Urban Sadar 100 50 150

HTR Nabinagar 100 50 150

Total 1100 550 1650

Methodology: Distribution of Sample Size for Qualitative Study

Division/District District/Upazila Type of Study Area KII FGD

Khulna Bagerhat Hard to reach 9 5

Khulna Slum 4 2

Jhenaidah Rural 11 4

Jessore Urban 9 4

Brahmanbaria Nabinagar Hard to reach 8 3

Sarail Rural 15 5

Brahmanbaria Sadar Urban 17 6

Sylhet Moulovibazar Urban 7 2

Sunamgonj Hard to reach 14 4

Habiganj Rural 12 4

Sylhet Slum 10 3

Total 116 42

• The data entry process of the quantitative data started soon after collecting thedata.

• Quantitative data were entered by using CSPro program and analysed by usingSPSS version 21.

• Descriptive statistics have been used to analyze the quantitative data.• Qualitative data were in audio-taped.• Audio-taped were transcribed.• Thematic analysis have been performed for qualitative data analysis.• Data have been presented in the context of study area: urban, rural, slum and

hard-to-reach areas

Methodology: Data Entry, Data Processing, and Data Analysis

Findings

94 93 91 96 9489

96 99 100

63

89

73

49

75

62

30

5344

81 2

55

1811

29 6 1 4 51 2 3 1 2 4

Rural (N=450) Urban (N=450) Slum (N=300) Hard to Reach(N=450)

Total (N=1650) BDHS 2014(N=17863)

Mobile phone Electricity Television Solar panel Computer/Laptop Radio/Betar

Household Possessions of the Respondents

Exposure to BTV and FP Related Messages through BTV

99 99 99 97 99

5766

58 58 6046 50

44 42 46

9 8 13 7 98 6 10 7 72 2 4 1 25 2 5 4 4

Rural Urban Slum Hard to Reach Total

Ever watched BTV

Heard that FP program is broadcasted by BTV

Have ever watched any FP program broadcasted by BTV

Have watched FP program broadcasted by BTV within last 30 days

Know 'Shukhi Paribar' as FP program broadcasted by BTV within 30 days

Know exact broadcasting day of 'Shukhi Paribar'

Know exact broadcasting time of 'Shukhi Paribar'

Differential Distribution of Watching FP Programs in BTV in Last 30 Days

6

15

9

8

13

7

5

7

15

5

8

10

11 11

9

Wife Husband Rural Urban Slum Hard toReach

15-19 20-24 24+ Poorest Poorer Middle Richer Richest Total

Exposure to Private TV Channel in Last 30 days

48

56

48

23

43

36

46

38

14

33

12 14 14

8

12

710

15

810

12 1210

3

98 8

14

587

1310

3

8811

6 68

6 7

11

57

5 4

11

25

36

9

24

3 3 2 2 324

2 1 3


Star Jalsa Jee Bangla (ZEE) Jalsa Movie ATN Bangla Sony 8

Samay TV Channel I NTV RTV ATN News

Sony Max Ten Sports Star Plus

Distribution of Respondents by Their Daily Mostly Watched Private TV (National & International) Channels (First Choice)

3840

31

18

32

67

12

3

6

3

6 6

0

42 3

6

3 32 3 2

3 323

1 2 232 1

2 212 2 1 2


Star Jalsa Star Plus Duranta TV Islamic TV SA TV Channel 24 My TV Banglavision

Distribution of Respondents by Their Daily Mostly Watched Private TV (National & International) Channels (Second Choice)

25

29

21

8

21

6

911

4

75

4 4 4 44 4

12 32 3 3

2 223 3

122 3 3

02

02

4

2 22 1

4

121 2 2 2 2


Jee Bangla (ZEE) Star Jalsa Jalsa Movie NTV ATN Bangla Sony 8 Samay TV RTV ATN News Channel I

Distribution of Respondents by Their Daily Mostly Watched Private TV (National & International) Channels (Third Choice)

7

4

4

1

4

33

2

2

3

1

3

4

2

2

2

4

2

1

2

11

4

1

2


Sony 8 Jee Bangla (ZEE) Star Jalsa Jalsa Movie ATN Bangla

Exposure to FP Related Messages through Private TV Channel

5

14

19

7

11

2

78

2

4


Have ever watched any FP program broadcasted by Private TV

Have watched any FP program rbroadcasted in Private TV in last 30 days

Distribution of Private TV Channels where Respondents Have Watched FP Programs in Last 30 Days

0.2

1.6

1.3

0.4

0.8

0.2

0.9

2.3

0.2

0.8

0.2

2.0

1.0

0.8

0.2

1.6

0.3

0.5


Channel I ATN Bangla Jamuna TV RTV

Differential Distribution of Watching FP Related Programs in Private TV in Last 30 Days

1

10

2

7

8

22

10

1

2

5

7 7

4



Exposure to Bangladesh Betar and FP Related Messages through Betar

63

75 7672 71

2830

27

3430

2123 22

2523

3 51 2


Ever Listened Bangladesh Betar Know that Bangladesh Betar have FP programs

Ever Listened FP programs in Bangladesh Betar Listened FP programs in Bangladesh Betar in last 30 days

Differential Distribution of Listening FP Related Programs in Bangladesh Betar in Last 30 Days

1

4

3

5

1

1

2

3

2

1

2 2

3

2



Exposure to FM Radio and FP Related Messages through FM

29

20

14

2423

9

21

31

1719

1

4

7

23


Don't Listen FM Radio Ever Listened Any FP Programs in FM Radio

Listened Any FP Programs in FM Radio Within 30 Days

Distribution of FM Radio Channels where Respondents Have Listened FP Programs in Last 30 Days

11

4

0

2

0

1

1

0

1

0

0

1

11


Radio Furti BBC Bangla ABC Radio

Differential Distribution of Listening FP Related Programs in FM Radio in Last 30 Days

1

7

1

4

7

2

1

2

6

2

2

4 44

3



Exposure to Newspapers/Magazines and FP Related Messages through Newspaper

49

60

51

42

51

18

28

22

13

20

9

18 18

913

2 4 52


Ever read any Newspaer/Magazines

Know that Newspaer/Magazines publish any FP related information

Ever read any FP related information in Newspaer/Magazines

Read any FP related information in Newspaer/Magazines in last 30 days

Differential Distribution of Reading FP Related Information in Newspapers/Magazines in Last 30 Days

1

5

2

4

5

11

5

0

21

2

7

2



Exposure to Poster and FP Related Messages through Poster

8478

89

7781

1822

45

24 26


Ever seen any Poster related to family palnning Seen any Poster related to family palnning in last 30 days

Differential Distribution of Reading FP Related Information in Poster in Last 30 Days

22

33

18

22

45

24

2123

33

2220

28 27

30

26



Exposure to Billboard and FP Related Messages through Billboard

7168

83

63

70

22

28

43

2629


Ever seen any billboard related Family Planning Seen any billboard related Family Planning in last 30 days

Differential Distribution of Reading FP Related Programs in Billboard in Last 30 Days

16

54

22

28

43

26

1618

56

28

22

26

31

37

29



Exposure to FP Related Messages through AV Van

26

9

4

9

13

1 1 1


Ever seen any AV Van on family planning

Seen any AV Van on family planning in last 30 days

• Awareness creation about the advantages of small family and changes of perspectives on ideal number of children

• Knowledge on PPFP/realizing importance of birth spacing

• Creation of knowledge regarding different methods

• Awareness about the suitability of methods

• Awareness about the symptoms of side effects

• Capability of decision making regarding method change

• Practice of discussion regarding family planning with spouse

• Adoption/acceptance of contraceptive methods

Contraception Related Behaviour Change after being Exposed to Different SBCC Channels

Effectiveness of Communication Channels for Delivering FP Related Information

• The effectiveness of the communication channels were categorized inthe following way:

• ≤5% respondents reported as effective were considered as leasteffective;

• >5% but ≤ 40% respondents reported as effective were considered asmoderately effective; and

• >40% respondents reported as effective were considered mosteffective.

76

53

6066 64


Total (N=1650)

Most Effective Channels of Communication for Getting FP Related Information: Family Planning/Health Field Worker

Why Family Planning/Health Field Worker Are Most Effective Communication Channel?

• Easier accessibility to family planning/health field workers as their services(contraceptive methods, information, referrals, suggestions etc.) can be renderedat the doorsteps of the couples.

• Follow up visits of family planning workers.

• Fruitful discussion sessions regarding their needs of services in their ownhousehold.

• Better ecology for both service providers and receivers than health care servicecentres.

• A wide range of topics can be discussed rather than only being confined to thefamily planning methods’ discussion.

2523

24 24

16

10

4

38

33 3432

19

108

34

27

36

29

25

2

6

31

38

24

17

21

4 4

3231

29

25

20

76

NGO Workers Bangladesh Television Billboard Private TV Channels Poster/Leaflette ThroughMobile/Message

Newspaper/Magazines

Rural (N=450) Urban (N=450) Slum (N=300) Hard to Reach (N=450) Total (N=1650)

Moderately Effective Channels of Communication for Getting FP Related Information

• Infrequent visits of NGO workers.

• Payment for receiving services especially from poor and rural people.

• Perceived lower quality of services where unskilled workers are providingservices.

• Over commercial attitude resulting into less acceptance of NGO workers as asource of information and as service providers,

• Lack of NGO workers in different areas resulting into lack of service provisions,

• Perceived unimportance of NGO health workers because of the presence offamily planning/ health field workers in particular areas

NGO Workers: Reasons for Being Moderately Effective Communication Channel

• Reasons for being Moderately Effective Communication Channel:

• Inappropriate timing of the program.

• Household engagements at the time of programs being telecasted.

• Tendency of viewers of not watching BTV now a day after the huge availability of

dish channels.

• Unattractive and traditional pattern of the programs.

• Lack of advertisements of the programs on health and family planning issues

resulting people not knowing about the timing and content of the programs and

not watching those.

• Religious constraint resulting not watching television at all.

• Viewers’ reluctance to watch health and family planning related programs in BTV

leaving sports, movies, and serials in other channels.

Bangladesh Television

• Scopes for Development:• Changing the current broadcasting timing of the health and family planning

related programs preferably at night time.• Increasing health and family planning related advertisements.• Reducing the number of other advertisements while telecasting health and family

planning related programs.• Diversifying the programs:

• Creation of different magazine programs to be telecasted about health andfamily planning related issues.

• Increasing the amount of drama on family planning and telecasting it at leasttwice in a week.

• Inclusion of celebrity (famous actor-actress, political figures, sportsman, etc.)in the programs related to family planning and health issues.

• Creating live discussion programs with the involvement of married couple.• Creation of programs on especially the popular contraceptive methods etc.

• Increasing the telecasting time.• Use of better audio-visual tools.

Bangladesh Television


• People’s lack of interest to watch contents of billboards resulting into thecontents not being noticed.

• Billboards being situated mostly in urban areas and very few in rural areasresulting rural people’s less access to the contents of billboards.

• Women especially in rural areas not being exposed to the billboards as they don’tspend time much in public places are the reasons.

• Torn condition of posters.

• Re-sticking other posters on the posters related to health and family planninginformation.

• Hazy and unclear printing of the posters, concentration of maximum posters inhospital and other health care centres and not in usual public places.

• People not paying attention to the small posters especially to those which arecontaining health and family planning related information (mostly in rural areasaccording to the respondents).

Billboards/Posters

• Scopes for Development:

• Increasing the number of posters and billboards and placing these posters and

billboards mainly in the places where people gather on a daily basis (for example

local markets, bus stations, railway stations, union Parishad office, schools etc.).

• Providing more pictorial presentation on health and family planning issues.

• Providing easier and interesting messages regarding family planning aspects.

• Using celebrity people as model in posters/billboards so that people can be more

influenced.

• Enlarging the size of posters so that people can understand the message clearly.

• Using quality papers for the posters and build quality billboards so that those

cannot be damaged quickly.

Billboards/Posters

• Reasons for being Moderately Effective Communication Channel: • Less programs on health and family planning related information telecasted in

private TV channels. • Very little advertisements on family planning methods. • Preference of viewers to certain kind of programs such as daily serials, news,

sports rather than watching family planning or health related programs in dish channels,

• Preference of watching foreign channels (especially Indian channels where daily soaps are very popular) due to low quality programs of the local channels.

• Not having television.• Absence of dish connections especially in rural areas, • Dissemination problems (such as very tiny letters of scrolls where information

regarding health and family planning issues are being shown. • Too fast running of scroll. • Lack of permission from family.• Not having electricity at the time of telecasting.

Private TV Channels

• Scopes for Development: • Inclusion of popular figures in disseminating health and family planning related

information. • Increasing the amount of programs for telecasting.• Producing daily soaps on health and family related issues and advertising about

this soap operas in other programs. • Increasing informative scrolls with a slower pace while showing. • Making more advertisements on health and family planning issues. • Providing family planning related advertisement in between popular programs

such as sports tournaments and reality shows, • Decreasing the amount of other advertisements during telecasting family

planning related programs. • Creating different talk shows regarding health and family planning issues.

Private TV Channels


• Lack of people’s perception about audio visual vans due to absence ofadvertisements.

• Infrequent visits of Audio visual vans/ Absence of audio visual vans’ program inmany rural and hard to reach areas.

• Inappropriate timing of the show when male is busy in their professional worksand female are involved in daily household activities.

• Preference of TV channels over these types of show even in rural areas.

• These vans not having a fixed and proper time schedule.

• Low quality of the video.

• Use of AV Vans for personal and official purposes.

AV Vans

AV Vans

• Scopes for Development:• Increasing the number of vans and associated human resources, provision of at

least one van for each district.• Ensuring regular visits of audio visual vans especially in rural and hard to reach

areas (after every three or six months preferably),• Providing a proper fixed schedule of shows to the people so that people can

manage their time for these shows.• Arranging different shows for each time and not showing similar content again

and again.• Separate provision for female to provide them greater accessibility to these

shows.

Messages Through Mobile Phone


• A large number of people’s inability to open messages and read especially incases of rural women and women of hard to reach area.

• Perceived unimportance of the received messages regarding health or familyplanning issues/avoiding tendency to read SMS.

• Not getting any messages regarding contraceptive methods’ information andinformation about where to get them.

• Messages bearing no meaning to the illiterate people.

• Language barriers (in cases of messages which are sent in English language).

Newspapers/Magazines


• Lack of accessibility of illiterate people to the news and information providedregarding health and family planning related issues.

• Less availability of newspaper in households of rural and hard to reach areas.

• Existence of a portion of people both in urban and rural areas without the habitof reading newspaper,

• Tendency of people to read only main news and to avoid advertisementsregarding family planning methods and other related news.

• Avoiding tendency/reader’s shyness to read family planning methods and otherrelated news in presence of others.

• Household engagements of female participants and other work-related engagements of male participants.

Newspapers/Magazines

• Scopes for Development:• Wider coverage of the newspapers on a continuous basis especially in rural and

hard to reach areas,

• Providing news regarding health and family planning issues in easier and moreunderstandable way.

• Publishing family planning related advertisements and news on the first and lastpage of newspaper so that people can easily see those.

• Providing detailed discussion on a weekly basis on every contraceptive methodsavailable in market for both male and female.

• Publishing special supplements featuring different advertisements andinformation on family planning products.

• Involving popular models in health and family planning related advertisementpublished in newspapers.

• Providing family planning related news in the local newspapers of every area sothat mass people can have greater access to the information and news provided.

Least Effective Channels of Communication for Getting FP Related Information

8

5

3 3

5

1

4 4

7

4

0

3

6

43


Total (N=1650)

Workshop/Seminar Bangladesh Radio FM Radio/Community Radio

Respondents Opinion Regarding the Preferred Channels of Communication for Getting FP Related Information

62

36

45

5650

7 5

138 8

3

14

6 7 83

93 3 53 5 6

3 43 4 3 1 36

1 2 2 317

1 1 22 1 1 3 21 25

21 2 1 3 2

Rural (N=450) Urban (N=450) Slum (N=300) Hard to Reach (N=450) Total (N=1650)

Family Planning/Health Worker BTV (Advertisement/Scroll)

NGO Field Worker Private TV Channel (Advertisement/Scroll)

Billboard Pharmacy/Medicine Shop

Upazilla Health Complex District Hospital

Satelite Clinic/EPI Outreach Friends/Relatives

Do not know

Cost Benefit AnalysisRow No. Cost Benefit Analysis Data Source/Calculation/Estimation

2011 20141 Total Married Women 31460385 31496402 Census 2011 and ASMR (BDHS )2 CPR 61.20% 62.40% BDHS3 CPR User 19253756 19653755 Calculated (1*2)4 Effect of SBCC on CPR 4.93% 3.643% Logistic Regression (Estimated)5 CPR User due to SBCC 948877 715929 Calculated (3*4)6 Pregnancy Rate (who are not using

contraception)16.56% 14.57% BDHS

7 Number of Pregnancy Averted 157105 104311 Calculated (5*6)8 MMR Averted 305 204 Calculated (7*MMRatio)9 Infant Mortality Averted 6756 3964 Calculated (7*IMR)

10 Child Mortality Averted 1728 834 Calculated (7*CMR)11 C-section Averted 26708 23887 Calculated (7*C Section Rate)

DALYs13 YLLs lost due to maternal death 15940 10958 Calculated (8*(e0- Mean Age of Motherhood))

14 YLLs lost due to Infant death 459510 276278 Calculated (9*(e0- 1))

15 YLLs lost due to child death 115821 57329 Calculated (10*(e0- 2))

16 Years Saved from Hospitalization 679 615 Calculated (7*Mean days of hospitalization due to delivery)

17 Total DALYs 591950 345180 Calculated (13+14+15+16)Economic Benefits

19 DALYs*GDP per capita 39579639563 28751878856 Calculated (17*GDP)20 Cost of Delivery Averted (in BDT) 809470026 656336204 Calculated (7*Cost of Delivery (BDHS))21 Total Benefit 403089109859 29408215060 Calculated (19+20)22 Total Cost (Expenditure) in BDT 166463000 215652000 DGFP (IEM Unit)23 Cost to Benefit Ratio 243 136 Calculated (21/22)

Policy Recommendations• Family planning workers or health workers were appeared as most effective channels of SBCC

intervention. Therefore, more emphasize should be given on the coverage of family planning workers.This can be done through:• Filling up the vacant positions• Reducing the workload of the FWA through creating/recruiting more FWAs• Providing refreshment trainings on various aspects of family planning issues including inter-

personal communication and counselling• Strengthening the monitoring system of the field level activities of the FWAs

• The current broadcasting timing of Bangladesh Television for telecasting health and family planningrelated programs must be changed.

• The Government should introduce a condition in the terrestrial license agreement so that privatetelevision channels are telecasting health and family planning related programs compulsorily as part oftheir CSR commitment.

• The coverage of AV Van should be increased and vehicle tracking system should be introduced andused for proper monitoring of AV Vans.

• Numbers and visibility of posters and billboards should be increased through placing the posters andbillboards mainly in the places where people gather on a daily basis (for example schools, colleges,local markets, bus stands, railway stations, Union Parishad office, etc.).

• Health and family planning related programs communicated through workshop/seminar, BangladeshBetar, and FM Radio should be reconsidered.

• Audience segmentation must be considered in developing effective communication strategy for allchannels.

Thanks!!

• Research Team• Mohammad Bellal Hossain• Dr Mohammad Mainul Islam• Sanjit Roy• Shafayat Sultan• Md Zakiul Alam

formative research for assessing exposure and

Documents