Traditions, Poverty and Community Dialogues for Safe Practices

"[E]xcluded communities should be informed and sensitised to change their attitude, behaviours and practices which is necessary for their empowerment and change through innovative communication and social mobilization methods and strategies."

Posted on the United Nations Children's Fund (UNICEF) intranet, this paper explores strategies being developed to address factors responsible for social disparities, especially for hard-to-reach and socially excluded communities in India, and social and cultural conditions and behaviours and traditional practices amongst, for example, dalits (termed "Scheduled Castes" and "Scheduled Tribes" in the Constitution of India) and certain sections of minority communities like the Muslim minority. The paper draws on an equity and inclusion approach.

The introductory section provides context. For example, "excluded communities seek extra attention in the context where they live in different social and cultural milieu. Government Policies do address their need but with inadequate social and cultural sensitivity. This is one of the reasons for excluded communities' apathy towards government policies and programmes. Polio eradication is an example for which Muslim under-served communities, in many places, expressed not only their apathy but often used the programme as a way of expressing their anguish and protest." A text box within this introductory section elaborates: "Due to their social and economic conditions, under-served and excluded communities often lack the level of self-efficacy which is required to fully understand, believe and practise facts like prevention is better than cure. Therefore, good relations, expressed respect and sensitivity on the part of service providers, particularly frontline workers, are crucial because preventive measures, such as vaccination, are hardly any priorities for under-served communities....As a matter of fact, they use 'non-priorities' - the preventive measures, like polio vaccination, as tools for protest and bargaining when these measures are pushed and delivered at their doorsteps (the paradox of cure as priority and prevention as non-priority for the under-served and excluded communities can be verified and validated). Persuasion - therefore, patience and persuasion by frontline workers like ANM (auxiliary nurse and midwife), ASHA (accredited social health activist) etc, can make non-priorities, like immunization, acceptable among excluded and vulnerable communities."

To explain this challenge, the author asserts that evidence shows that "parents and community members of excluded communities behave in such undesirable manners mainly due to the lack of awareness, correct knowledge and appropriate channels/ motivators to internalise and regularly perform correct practices which are essential for child survival and child development at family level. Hence, in addition to the fact that the government agencies and other institutions need to improve services and infrastructures for child survival and child development, parents and communities should also have to get correct knowledge and practice for child survival and child development at family level."

The remaining portions of the report outline strategies for approaching the challenge. Key points include:

• Take into account the socio-cultural context of economically poor and traditional communities - For example, in certain areas of rural Punjab, Haryana, Rajasthan, and Bihar, it has been observed that "even if the households have toilets they are not used by all members of the households. If female members use a toilet then male members of the household don't want to use the same toilet. In those cases, female members quietly give in to the patriarchy - stop using the same toilet, leaving it for the male members to use, and consequently go back to open defecation....In such social and cultural contexts, communication and social mobilisation strategies need to be based on a thorough research and community need assessments. Communication campaigns and community mobilisation initiatives to promote so called 'safe practices', which are not based on proper field studies and communication need assessments with strong component of social anthropology, tend to be ineffective and don't produce desirable results in spite of investing huge resources....Proper social and cultural assessment will be helpful in positioning social and behaviour change initiatives on focussed beneficiaries and stakeholders among excluded communities; proper assessment will also be useful for selecting appropriate channels and motivators who will not feel offended and challenged by communication messages and will become local change agents for long lasting change in unsafe practices."
• "There is need to develop and design communication and social mobilization strategies to demonstrate to excluded communities that unsafe practices are harmful and they have to be replaced by safe practices despite poverty. And those unsafe practices actually make them poorer and more vulnerable....More dialogues around poverty and safe practices should happen around girl child education, routine immunization, exclusive breastfeeding, institutional delivery, iodized salt, etc."
• "There should be focussed communication and social mobilization campaigns which will be helpful in liberating under-served and excluded communities and mainstreaming them to enjoy their due share in local, national and global resources and improving their living conditions, which is impossible in exclusion. Simultaneously, service providers and service providing system should be sensitized to build inclusive attitude and be trained to deliver for the excluded communities with adequate social and cultural sensitivity."

From the author: "The information in this piece includes my personal views and opinions and do not necessarily represent UNICEF’s position."

Click here for the 8-page paper in Word format.