Community Video for Nutrition Guide

Introduction

Background

This Community Video for Nutrition Guide is a joint product of SPRING and Digital Green (DG), an international nongovernmental organization (NGO) registered in the United States and India. This guide is based on our organizations' combined experience in implementing a proof of concept project between January and October 2013, formally known as the SPRING/DG Collaboration and Feasibility Study. This 10-month project focused on integrating content on high-impact maternal, infant, and young child nutrition (MIYCN) practices, including information on key hygiene-related behaviors, into the existing DG community-led video project, which is predominantly focused on promoting improved agricultural practices among small-scale and marginal women farmers. The target audience was pregnant women and/or mothers with children under the age of two participating in existing self-help groups (SHGs) in 30 villages in two blocks of Keonjhar District of Odisha, India. The SHGs also included a wider representation of female community members, who were targeted as key influencers for the recommended behaviors. Given that the target audience included a large number of influencers that wouldn’t be adopting the practices themselves, the project not only tracked adoptions, but also promotions of MIYCN behaviors.

Intervention villages were chosen from among 130 villages engaged with DG’s agriculture-focused collaboration with the Voluntary Association for Rural Reconstruction and Appropriate Technology (VARRAT), a local development NGO for the previous three years. The proof of concept was successful in validating the feasibility of the approach for promoting MIYCN, and was found to be acceptable to the communities where the project was implemented. The ten MIYCN videos produced during the project were shown to women farmers in more than 3,000 households, and more than 1,000 unique behavioral adoptions/promotions were documented¹—more than double the projected number of households to be reached and the anticipated adoptions for the project. The demand for the videos within the 30 villages grew as the project was more widely introduced, and community leaders negotiated the participation of double the number of VARRAT-led SHGs than originally planned for in the proof of concept. The videos served to inspire the target audiences to adopt behaviors that are globally recommended to improve MIYCN.

Why use community video for maternal, infant, and young child nutrition?

SPRING and DG see this community-led video approach, with videos created by the community for the community, as a revolutionary tool for nutrition and health behavior change which blends innovative, low-cost, accessible technology with the strength of human-mediated interpersonal communication techniques. Although video provides a point of focus in this model, it is people and social dynamics that ultimately ensure its effectiveness. The model leverages people-based extension (community health, agriculture, or other) systems functioning through existing social organizations and other structures, and uses video as a tool for engagement, empowerment, motivation, and connection as community members come together and discuss topics relevant to their everyday lives. The process of producing and disseminating the videos often elevates the role and influence of positive deviants or early adopters, who are the video “stars”. Community-led video has been shown to be highly effective as both a means of conveying information and catalyzing social change and individual behavior change for improved agriculture, livelihoods, and health behaviors. The videos allow community members to observe practices in their own geographical context, demonstrated in their own language and by someone of similar means. Seeing practices promoted by their neighbors, community members realize that they, too, have the means to implement them. At its core, this approach democratizes video, allowing communities to tell their stories while retaining the technical integrity of the information. The approach is feasible even in remote communities with limited Internet connectivity and irregular access to electricity.

This approach functions best when overlaid onto an existing community group infrastructure, extension system and/or support activity and when complemented by other community mobilization or support services, such as a robust community health system to support similar messages and recommendations and provide access to necessary inputs in order to adopt behaviors (e.g., IFA tablets, condoms, health care services). It is possible to develop a system where there is none to roll out this community video approach, however, it will require significant resources to develop and manage.

What is the evidence for this approach?

In a controlled, 13-month study conducted by DG in 16 villages and with a total of 1,470 households,² this community video approach produced ,a seven-fold increase in adoptions of certain agricultural practices over a classic Training and Visit-based extension approach. Furthermore, this approach was found to be 10 times more cost-effective compared to traditional agriculture extension services. Our two organizations then collaborated to explore the feasibility of using this community-led video approach to increase uptake of key MIYCN and hygiene practices in India. A mixed methods study using interviews with program personnel, SHG members, mothers-in-law, husbands, agriculture and health workers, and actors in the videos, was conducted by the International Food Policy Research Institute (IFPRI) and the London School of Hygiene and Tropical Medicine. Study findings demonstrated that the use of community videos by agriculture extension workers was feasible in terms of the capacity of partners to produce them and facilitate sessions on nutrition topics, and that the topics were acceptable and appreciated by community members. In fact, demand for the nutrition videos was so high during the proof of concept that the number of SHGs reached doubled from 60 to 120. The videos were reported to be one of the main sources of nutrition information in the communities, stimulating uptake and intra-household promotion of the nutrition and hygiene behaviors. Large majorities of interviewed SHG members retained knowledge on key MIYCN practices, and over two-thirds said they shared information with at least one other person. Based on the favorable study findings on feasibility and acceptability, SPRING has adapted the approach and implemented a similar project in the resilience context of Niger, with an ongoing evaluation component to determine the impact of community video on two specific MIYCN and hygiene behaviors. Preliminary results show widespread acceptability of, and expansive demand for, the videos with high percentages of initial adoptions of handwashing and responsive feeding, the two behaviors being investigated. Final results are expected to be shared in early 2016.

Who is this guide for?

This Community Video for Nutrition Guide is specifically intended to provide organizations, projects, and practitioners interested in using or testing community video for MIYCN with the critical information and tools needed to initiate, produce, and disseminate a participatory community-video approach for MIYCN. This guide is intended to be used in combination with DG standard operating procedures (SOPs), which can be accessed openly on its website linked here. Although focused on promoting MIYCN, the Guide builds on the DG agriculture-focused platform, to which other content can be added or emphasized, such as information promoting sexual and reproductive health and family planning, nutrition-sensitive agricultural practices, community institution building, government schemes, animal husbandry, financial inclusion programs, nonfarm income-generating activities, and a whole range of other topics.

Agricultural extension services and community health programs typically employ traditional social and behavior change communication (SBCC) approaches and tools, with one-on-one or group counseling, where information is shared with communities in lectures, demonstrations, or didactic trainings. Community video provides local agents with a simple and effective medium—a stimulating, innovative, and exciting tool for engaging communities. This approach also helps to ensure quality of content and messages through the video as a technical job aid, as quality of messages is difficult to ensure in group or one-on-one sessions, and especially in cascade approaches. Given the growing affordability of video production equipment and editing software, as well as the increasing availability of battery-operated, mobile pico projectors, the use of community video has become a viable option to catalyze social and behavior change.

The primary audience for this Guide is program planners and managers as well as practitioners from government, nongovernmental, and private sector organizations looking to use low-cost, participatory community video as a tool to effect both social change and individual behavior change around MIYCN. The community-video approach relies heavily on strong community networks or support groups and is intended to be locally owned and rooted in strong community engagement institutionalized within an existing development program or infrastructure. Community videos are neither professional, intensively produced products, nor intended for national or regional dissemination. Their strength and purpose grow out of their local focus.

How to Use this Guide

This Guide is a step-by-step reference to support the design and implementation of a community-led video project focused on MIYCN behaviors. Not a comprehensive programming tool, it is intended to be used in combination with DG’s SOPs and with video production, editing, and monitoring and information system (MIS) training manuals, all available through the DG website. References are provided for the necessary formative research, training, equipment specifications, and other tools outlined in the appendices to this package as well as for the training materials, forms, and sample program-planning documents found in the DG SOPs. These tools are intended to be reviewed and adjusted or adapted to meet a project’s specific needs and local context. To facilitate adaptation, each tool in the appendices is available to be downloaded in editable Word format.

This Guide focuses on the three specific components of the SPRING/DG approach (Initiation, Production, and Diffusion) and goes into detail about the nutrition-specific adaptations of the DG standard model outlined in the DG SOPs. The MIYCN-specific elements that make up the bulk of this Guide are specifically noted in boxes at the beginning of each chapter and bolded in the figures detailing the steps of the approach. Implementation tips are also included in each chapter, along with anecdotes describing specific challenges or experiences encountered while testing the approach.