Evidence from the SPRING Community Video Experience
SPRING Project, JSI
"In Niger, where the Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) project has worked to improve nutrition since 2015, MIYCN [maternal, infant, and young child nutrition] behaviors are influenced by cultural norms and practices, including polygamy and an emphasis on male decisionmaking."
The SPRING project, supported by the U.S. Agency for International Development (USAID) implemented a facilitated community video project to promote high-impact MIYCN and hygiene behaviours. The project addressed under-5 mortality and stunting in the Sahel region of Niger, influenced by norms and practices including polygamy, male decisionmaking, and low levels of literacy. In collaboration with Digital Green, a pilot video project was implemented in 2014 through partners: Resilience and Economic Growth in the Sahel–Enhanced Resilience Program (REGIS-ER) and two Food for Peace projects: the Livelihoods, Agriculture and Health Interventions in Action (LAHIA) and Sawki projects. The project was applied in 40 villages. "A mixed methods evaluation on the acceptability, effectiveness, and scalability of the approach was conducted in mid-2015, and it determined that the pilot was effective in achieving improvements in MIYCN and hygiene behaviors." In 2016, transferring community video production and dissemination capacity to local partners, the project scaled up to 115 villages in the Maradi and Zinder areas, establishing four production hubs and two technical advisory groups.
"Produced locally, the videos feature community members performing as actors and focus on many key themes, such as dietary diversity, handwashing, exclusive breastfeeding, and complementary feeding practices. Field mediators (or volunteers) share the videos with community groups, lead interactive discussions following the videos, and conduct home visits to address any questions raised by participants. During the home visits, mediators also ensure that group members understand the practice correctly and promote the practice to others in their family or community. Husbands in the community are exposed to video messages when they attend the video disseminations, during home visits, or when they learn about the health messages from their wives."
This study, begun in August of 2016, set out to: understand the influence of community videos on couples dialogue about MIYCN and resulting husband supportive behaviours; explore how to use the community video approach to encourage spousal communication and husband support; and assess perception changes among community members and influencers (like mothers-in-law) on spousal communication and husband support. Five villages studies were conducted using in-depth one-on-one interviews with husbands and their wives and in-depth interviews with mothers-in-law and focus group discussions (FGD). A second round of data collection occurred in January of 2017, seeking greater depth and saturation of the themes.
Interviewers were trained to administer a guided interview in Hausa, using an audio recording device; they then translated and transcribed interviews. Inductive and conceptual codes were developed and applied and information categorised and analysed.
The results include the following:
- Understanding community videos influence -
- Husbands received information from wives who participated in women's groups, from viewing videos, from discussion with neighbors, or from peer educator home visits. They described learning about food and feeding in the first 1,000 days of an infant's life.
- Conversations between husbands and wives occurred early or late in the day, frequently initiated by husbands who viewed the video, and included topics of what children ate, how to finance groceries, using complementary or exclusive breastfeeding, and how to keep their living space clean.
- Couples reported: improved levels of conversation; sometimes, purchases by men of groceries, soap, or medicine.
- How the videos changed male involvement -
- Husbands affirmed that seeing the videos changed behaviours.
- Mothers-in-law recommended that the videos be shown to men. Others confirmed that all community members should see them.
- Seeing benefits at home was a recognised factor in behaviuor change.
- Open dialogue between couples was the third factor.
- How community members perceived changes -
- Mothers-in-law noted more couples communication and shared responsibility.
- Community members confirmed more couples' mutual participation in the health and nutrition of children.
The study concludes that the use of community videos "encourages spousal communication to promote MIYCN behaviors for most couples." Showing supportive fathers and inter-couple communication can stimulate adoption of behaviours through imitation. Men can influence behaviour change in family adoption of positive health and nutrition, as well as offer emotional, physical, and financial support.
SPRING Nutrition website, January 8 2018. Image credit: Marjolein Moreaux, SPRING.