The Drum Beat 827 - Responding to the Growing Need for SBC Impact Data

• 1. Counseling, Mobilization, Media - 13.6 Percentage Point Increase in Dietary Diversity
   
• Combining Intensive Counseling by Frontline Workers with a Nationwide Mass Media Campaign Has Large Differential Impacts on Complementary Feeding Practices but Not on Child Growth: Results of a Cluster-Randomized Program Evaluation in Bangladesh
• by Purnima Menon, Phuong Hong Nguyen, Kuntal Kumar Saha, Adiba Khaled, and Tina Sanghvi, et al.
• Alive & Thrive (A&T) used intensified interpersonal counseling (IPC), mass media (MM), and community mobilisation (CM) to deliver interventions addressing the inadequacy of complementary feeding (CF) in Bangladesh. The intensive group received all 3 interventions; the nonintensive group received standard IPC and less-intensive MM and CM. A cluster-randomised, nonblinded impact evaluation found a 13.6 percentage point (pp) increase in minimum dietary diversity in intensive areas, along with minimum meal frequency (14.7 pp), minimum acceptable diet (22 pp), and iron-rich food consumption (24.6 pp). [Aug 2016]
• Full summary is here.
   
• 2. SBC Communication - 14% Difference in Prevalence of Stunting
   
• Effectiveness of Unconditional Cash Transfers Combined with Lipid-based Nutrient Supplement and/or Behavior Change Communication to Prevent Stunting among Children in Pakistan: A Cluster Randomized Controlled Trial
• by Sajid Bashir Soofi, Shabina Ariff, and Gul Nawaz Khan, et al.
• Conducted in district Rahim Yar Khan, Pakistan, this community-based cluster RCT tested whether unconditional cash transfers combined with lipid-based nutrient supplement (LNS) and/or social and behavioural change communication (SBCC) provided to children living in poverty could prevent stunting. As part of the SBCC component, lady health workers, having been trained on SBCC, delivered the SBCC messages during their routine monthly household visits and quarterly community sessions using a picture booklet. There was a 14% difference in the prevalence of stunting in the UCT + LNS + SBCC arm at 24 months of age. [Oct 2021]
• Full summary is here.
   
• 3. Social Protection and BCC - 36% More Correct Knowledge of Child Nutrition
  Nutrition Behaviour Change Communication Causes Sustained Effects on IYCN Knowledge in Two Cluster-Randomised Trials in Bangladesh
• by John Hoddinott, Akhter Ahmed, Naureen I. Karachiwalla, and Shalini Roy
• Two, 2-year, cluster RCTs in rural Bangladesh that included nutrition behaviour change communication (BCC) - e.g., weekly group sessions in villages, along with home visits - in some treatment arms found that BCC improves infant and young child nutrition (IYCN) knowledge substantially in the first year of the intervention; participants correctly answer 3.0-3.2 more questions (36% more) compared to the non-BCC groups. Knowledge persists; there are no significant decreases in IYCN knowledge 6-10 months after nutrition BCC activities ended. [Aug 2017]
• Full summary is here.
   
• 4. Nutrition and Health Behaviour Change Communication, along with Home Visits - 15.9 Percentage Point Reduction in Diarrhoea
   
• A 2-Year Integrated Agriculture and Nutrition and Health Behavior Change Communication Program Targeted to Women in Burkina Faso Reduces Anemia, Wasting, and Diarrhea in Children 3-12.9 Months of Age at Baseline: A Cluster-Randomized Controlled Trial
• by Deanna K Olney, Abdoulaye Pedehombga, Marie T Ruel, and Andrew Dillon
• This study assessed the impact of Helen Keller International (HKI)'s 2-year integrated agriculture [homestead food production (HFP)] and nutrition and health BCC programme, which involved, in part, participating women receiving home visits twice a month from either an older woman leader or a health committee member. The study found statistically significant impacts on diarrhoea (difference-in-difference (DID): -15.9 pp; P = 0.00) among children aged 3-12.9 months and on anaemia (DID: -14.6 pp; P = 0.03) and mean hemoglobin (Hb) (DID: 0.74 grams per decilitre (g/dL); P = 0.03) among children aged 3-5.9 months in intervention communities compared with control villages. It also found marginally significant impacts on mean Hb (DID: 0.51 g/dL; P = 0.07) and wasting (DID: -8.8 pp; P = 0.08). [Apr 2015]
• Full summary is here.
   

• Please do comment on, critique, and engage in discussion about the strategic implications of the data shared. It would be excellent to build a critical dialogue around this data. You can comment without registering. All you need to do is to scroll down to "Add new comment" within any one of the #1-#15 items in this Drum Beat that link to the impact data found on Evidence - SBC Impact to share your thoughts, questions, or strategic insights. We welcome your feedback on any of the entries found here!
   

• 5. Knowledge Translation - Doubled the Odds of Measles Vaccination and Tripled the Odds of Full DPT
   
• Evidence-based Discussion Increases Childhood Vaccination Uptake: A Randomised Cluster Controlled Trial of Knowledge Translation in Pakistan
• by Neil Andersson, Anne Cockcroft, and Noor M Ansari, et al.
• Childhood vaccination rates are low in Lasbela, one of the economically poorest districts in Pakistan's Balochistan province. Where household resources are scarce and little public attention is paid to vaccine-preventable diseases (VPDs), the present costs of vaccinating can eclipse the discounted costs of the possible future disease. This RCT tested a knowledge translation intervention that sought to increase vaccination uptake through evidence-based discussions with men and women on the cost of vaccination versus the costs of treating VPDs. The intervention doubled the odds of measles vaccination in the intervention communities (odds ratio (OR) 2.20, 95% confidence interval (CI) 1.24-3.88). It tripled the odds of full DPT vaccination (OR 3.36, 95% CI 2.03-5.56). The analysis of secondary outcomes shows a significant impact on conscious knowledge and attitudes about vaccination, subjective norms, intention to change, and discussion in the home. [Oct 2009]
• Full summary is here.
   
• 6. Parent Education - Childhood Vaccination up 36% (Relative Increase)
   
• A Systematic Review and Meta-Analysis of the Effects of Educating Parents on the Benefits and Schedules of Childhood Vaccinations in Low and Middle-Income Countries
• by Lungeni Auguy Lukusa, Valantine Ngum Ndze, Nyanyiwe Masingi Mbeye, and Charles Shey Wiysonge
• In light of evidence that active engagement and effective communication between the providers and recipients of vaccination services may be effective in improving vaccination coverage, these researchers conducted a systematic review to assess the effects of interventions for educating parents, compared to standard vaccination practices, on vaccination coverage in low and middle-income countries. Combining the data shows that these interventions led to substantial improvements in childhood vaccination coverage (relative increase 36%, 95% CI 14% to 62%). "Community-based evidence based discussions aimed at knowledge translation to community members may prove to be more effective than conventional health education strategies." [Jun 2018]
• Full summary is here.
   
• 7. Maternal Knowledge - Children 3x More Likely to Be Fully Immunized
   
• Factors Influencing Childhood Immunisation Uptake in Africa: A Systematic Review
• by Abubakar Nasiru Galadima, Nor Afiah Mohd Zulkefli, Salmiah Md Said, and Norliza Ahmad
• The researchers conducted a systematic review of articles on the factors influencing under-5 childhood immunisation uptake in Africa from database(s) inception to 2020. They included 51 studies. Children of mothers with a good knowledge on childhood immunisation were 3 times more likely to be completely immunised; lack of maternal knowledge regarding vaccines accounted for 50% of reasons for non-vaccination. [Jul 2021]
• Full summary is here.
   
• 8. Misinformation Exposure and Misinformation Impacts - Vaccine Intention down 6.2%-6.4%
   
• Measuring the Impact of COVID-19 Vaccine Misinformation on Vaccination Intent in the UK and USA by Sahil Loomba, Alexandre de Figueiredo, Simon J. Piatek, Kristen de Graaf, and Heidi J. Larson
• Conducted in the United Kingdom and the United States, this RCT aimed to inform the design of communication around vaccination campaigns. It found a 6.2%-6.4% reduction in the total number of people who previously answered 'definitely' to taking the vaccine after being exposed to misinformation relating to COVID-19, compared to people who did not receive such misinformation, as well as a 5.7% reduction in those that previously responded 'definitely' to accept the vaccine to protect others. [Feb 2021]
• Full summary is here.
   
• 9. Mobile-based Conditional Cash Transfers - 62.3% vs. 58.4% Full Immunisation
   
• Small Mobile Conditional Cash Transfers (mCCTs) of Different Amounts, Schedules and Design to Improve Routine Childhood Immunization Coverage and Timeliness of Children Aged 0-23 Months in Pakistan: An Open Label Multi-arm Randomized Controlled Trial
• by Subhash Chandir, Danya Arif Siddiqi, Sara Abdullah, and Esther Duflo, et al.
• Evidence indicates that the majority of Pakistani households can access vaccines, are not deeply opposed to vaccinations, and might therefore respond to demand-side interventions designed to act as nudges to increase uptake and address small barriers to immunisation. This multi-arm RCT measured the relative effectiveness of different types of small mobile-based conditional cash transfers (mCCTs), as well as the impact of SMS (short messaging service) reminders (with and without mCCTs), on immunisation coverage and timeliness in Karachi, Pakistan. Full immunisation coverage was 62.3% (4,980/7,998) for participants receiving any mCCT, compared to 58.4% (934/1,600) for the SMS arm (adjusted OR: 1.18, 95% CI: 1.05-1.33, p = 0.005). [Jun 2022]
• Full summary is here.
   

• Are you a researcher who has conducted an RCT or systematic review, focused on SBC communication (especially issues related to children) that has been published in a peer-reviewed journal since 2010? If so, we'd love to hear from you! Send a note to wfeek@comminit.com with a link to your article(s) so we can assess them for possible inclusion on The CI platform. We can help you get the word out about your research.
   

• 10. Mobile-phone-based Communication - 3.7% Higher Use of Modern Reversible Contraceptives
   
• The Impact of a Direct to Beneficiary Mobile Communication Program on Reproductive and Child Health Outcomes: A Randomised Controlled Trial in India
• by Amnesty Elizabeth LeFevre, Neha Shah, Kerry Scott, Sara Chamberlain, Osama Ummer, Jean Juste Harrisson Bashingwa, Arpita Chakraborty, and Anna Godfrey, et al.
• Kilkari is an outbound service that makes weekly, stage-based, prerecorded calls about reproductive, maternal, neonatal, and child health (RMNCH) directly to families' mobile phones, reaching over 10 million women and their families across 13 states in India. An RCT conducted in 4 districts of Madhya Pradesh found that Kilkari was associated with a 3.7% higher use of modern reversible contraceptives in the treatment group, rising to 7.3% among those who heard 50% or more of Kilkari content, compared to non-listeners. Effects were even larger for certain families - e.g., those in disadvantaged castes (12.0% increase). The evaluation also found higher rates of immunisation among infants at 10 weeks (2.8%). [Jul 2022]
• Full summary is here.
   
• 11. Changing Norms Related to Early Childbearing - 3.8x More Likely to Use Contraceptives
   
• The Effect of Community-Based Reproductive Health Communication Interventions on Contraceptive Use Among Married Couples in Bihar, India
• by Elkan E. Daniel, Rekha Masilamani, and Mizanur Rahman
• The Promoting Change in Reproductive Behavior in Bihar (PRACHAR) project in Bihar, India, involved preventing early marriage and delaying first childbirth within marriage through: involvement of community leaders, parents, and in-laws; training of unmarried adolescents, newlywed couples, and health service providers; group meetings and counselling for young people; and general messaging through street theatre and wall paintings. The increase in demand for contraception between surveys in the intervention area was 1.5 times that in the comparison area, and the increase in contraceptive use was even more pronounced (odds ratio, 3.8). Demand for contraception increased from 25% at baseline to 40% at follow-up in intervention areas but remained virtually unchanged in comparison areas. Similarly, among women with one child, contraceptive use increased fourfold, from 6% to 25% (p<.001) in the intervention areas, but the change in the comparison areas (from 4% to 7%) was not statistically significant. Following the intervention, 39% of women knew about fertile days in the cycle, compared with only 18% at baseline. The intervention group also showed a higher rate of agreeing that early childbirth can be harmful, and that contraceptive use is necessary and safe for delaying first births (odds ratios, 1.6-3.0). [Dec 2008]
• Full summary is here.
   
• 12. Home Visits - Reduced Problems in Pregnancy and Postpartum
   
• The Impact of Universal Home Visits with Pregnant Women and Their Spouses on Maternal Outcomes: A Cluster Randomised Controlled Trial in Bauchi State, Nigeria
• by Anne Cockcroft, Khalid Omer, Yagana Gidado, Muhammad Chadi Baba, Amar Aziz, Umaira Ansari, Adamu Ibrahim Gamawa, Yahaya Yarima, and Neil Andersson
• Conducted in Nigeria's north-eastern Bauchi State, this cluster RCT tested the impact of universal home visits that discussed risk factors with pregnant women and their spouses to precipitate household actions protecting pregnant women. The study reported significant results, with a 12% relative risk reduction (RRR) for raised blood pressure, 27.1% RRR for the swelling of face or hands, and 39.9% RRR for postpartum sepsis. [Feb 2019]
• Full summary is here.
   

• * The Drum Beat 822 - Meeting the Need for SBC Impact Data for data on SBC impact on: child health, education, adolescent sexual health, gender dynamics, and violence.
   
• * Evidence - SBC Impact for much more data on many more development issues, using various strategies, in various geographies.
   

• 13. Community Mobilisation - 19.8% vs. 14.3% Virally Suppressed
   
• A Community Mobilisation Intervention to Improve Engagement in HIV Testing, Linkage to Care, and Retention in Care in South Africa: A Cluster-Randomised Controlled Trial
• by Sheri A Lippman, Audrey Pettifor, and Mi-Suk Kang Dufour, et al.
• South Africa's Community Mobilisation for Treatment as Prevention trial, also called Tsima ra rihanyu ("working together to plough the fields for health"), sought to increase HIV testing uptake, thereby decreasing undiagnosed infections, and to improve HIV care engagement among adults aged 18-49 years, with the goal of reducing new infections and improving health outcomes among those living with HIV. As compared with men in the control villages, men in the intervention villages were more likely to know their status (44.9% vs 36.9%), be on antiretroviral therapy, or ART (26.1% vs 20.4%), and be virally suppressed (19.8% vs 14.3%). Similar differences were observed between intervention and control village women in known status (68.3% vs 64.0%), being on treatment (44.1% vs 39.2%), and viral suppression (33.6% vs 30.7%). [Sep 2022]
• Full summary is here.
   
• 14. Cash Transfer for HIV Prevention - 90% of Studies Measuring Change in Sexual Behaviours Found a Positive Impact
   
• Can Money Prevent the Spread of HIV? A Review of Cash Payments for HIV Prevention
• by Audrey Pettifor, Catherine MacPhail, Nadia Nguyen, and Molly Rosenberg Studies hypothesise that improving the socio-economic situation of vulnerable populations or providing cash payments conditioned on social goods, such as school attendance, will reduce HIV risk (category 1 interventions). Other studies hypothesise that providing cash for specific outcomes like a negative STI [sexually transmitted infection] test will serve as an incentive for individuals not to engage in high-risk behavior (category 2 interventions). The majority of studies in this systematic review that have measured a change in sexual behaviours found a positive impact (9/10). [Jul 2012]
• Full summary is here.
   
• 15. Participatory Learning - 33% Reduction in the Incidence of HSV-2
   
• Impact of Stepping Stones on Incidence of HIV and HSV-2 and Sexual Behaviour in Rural South Africa: Cluster Randomised Controlled Trial
• by Rachel Jewkes, Mzikazi Nduna, and Jonathan Levin, et al.
• A cluster RCT of Stepping Stones, which uses participatory learning approaches to stimulate critical reflection on issues related to sexual health and behaviour, on incidence of HIV and herpes simplex type 2 (HSV-2) in South Africa. Although there was no evidence that Stepping Stones lowered the incidence of HIV, the programme was associated with a reduction of about 33% in the incidence of HSV-2; meta-analysis indicates that people infected with HSV-2 have 3 times the risk of HIV infection. Stepping Stones also significantly improved a number of reported risk behaviours in men, with a lower proportion of men reporting perpetration of intimate partner violence across 2 years of follow-up and less transactional sex and problem drinking at 12 months. [Aug 2008]
• Full summary is here.
   

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