Acceptability, Comprehensibility and Reported Influence - BRAC ...

information garnered from various sources and apply what they have learned from
their own lives. Increasingly we understand the role not only of mothers but also
husbands and other important kin in the family. In Bangladesh, husbands, mothersin-law
and elder brothers of the women play a major role in decision making
especially in the case of health problems (19, 20).
Targeting behaviour change strategies, that address specific barriers and target
segmented audiences, can play a significant role in increasing safe motherhood. In
order to provide quality care at the community level and promote appropriate use of
referral facilities, BRAC has initiated MNCH programme in rural Bangladesh in 2006.
The aim was to reduce maternal, neonatal and child mortality and morbidity with
especial focus on the poor and deprived people (21).
Effective communication involves transmission of health knowledges through
messages that can be readily understood, accepted and practiced by the audience.
The communication strategy of MNCH programme uses existing social and cultural
norms and traditions that offer culturally appropriate ways of enhancing the
communication strategies in a comprehensible and credible form.
Major BCC initiatives of BRAC MNCH programme
The project currently covers four districts (Nilphamari, Gaibandha, Rangpur and
Mymensingh) and has planned to scale up in six more districts (Kurigram,
Lalmonirhat, Faridpur, Magura, Madaripur and Rajbari). In order to achieve improved
maternal and neonatal health, the programme gives importance to not only pregnant
and lactating women but also to others intimately involved in decisions about their
well-being. These include mothers-in-law, husbands of primary target audience,
community health workers (CHW), BRAC staff, government staff at union health
centre (UHC), Upazila Health and Family Welfare Centre (UHFWC), district hospital
(DH), and Maternal and Child Welfare Centre (MCWC). In addition, the MNCH
communication strategy seeks to reach other local government bodies, village elites,
school teachers, village organization (VO) members and other community ‘movers
and shakers’, and local representatives of non government organizations (NGO) and
national and international agencies concerned with improvement of MNCH.
BRAC seeks to increase communication between community members and
healthcare providers with the medium-term objective of increasing the accountability
of local health system for better and wider access of disadvantaged women and
children to quality health services at community and facility levels (21).
The communication component of the MNCH programme involves grassroot level
healthcare providers like Shasthya Shebika (SS), Shasthya Kormi (SK) and newborn
health worker (NHW). These health cadres provide a wide range of services at
household levels encompassing: early identification of pregnancy and antenatal care
(ANC), attendance at delivery, newborn care, post-natal care for mothers and
neonates, under-five care, detection, management and referral of MNCH
complications to hospitals and family planning centres. They provide both information
2 RED Working Paper No. 21