Social Mobilisation, Advocacy and Communication for Nutrition

"Social mobilization, advocacy and communications is a growing priority for SUN countries and increasingly seen as an integral part of the national nutrition strategy.  Countries are at very different stages and employing a variety of approaches and techniques. Developing a social mobilisations, advocacy and communication strategy or plan for scaling up nutrition that is well resourced and has clear indicators and benchmarks is critical."

This third briefing from Scaling up Nutrition (SUN) focuses on social mobilisation, advocacy, and communication through lessons from 6 of its affiliated countries: Peru, Cameroon, Uganda, Pakistan, Bangladesh, and Kenya. SUN is an international movement focusing on four strategic processes:
"1. Bringing people together to work effectively through functioning multi-sector, multi-stakeholder platforms;
2. Putting policies and laws in place to establish a coherent policy and legal framework;
3. Implementing and aligning programmes with common objectives and an agreed framework for results; and
4. Mobilizing resources from domestic sources  supplemented by external assistance."

Some of the communication strategies used include:

• In Bangladesh, the Ministry of Health and Family Welfare’s (MoHFW) National Nutrition Services (NNS) is promoting nutrition in print - including comic books - and electronic media including through the well-known "Meena" cartoon (See related summary below.) and folk songs on infant and young child feeding (IYCF), the radio show "Pushtipala", a nutrition quiz show, and TV promotions for nutrition. Campaigning includes: a National Vitamin A Campaign involving around 500,000 volunteers and all health and family planning workers (frontline, supervisors, and managers from grass root to central) and also relevant ministries; NNS’s Growth Monitoring and Promotion campaign, supported by the United Nations Children’s Fund (UNICEF), educating mothers and family members on nutrition surveillance through regular monitoring, ensuring tools are understood and readily available; and a World Breastfeeding Week  campaign.

Training is provided for Community Management Groups (CMG) and Community Support Groups (CSG) that include elected local government representatives, women, and adolescent girls directly engaged in managing 18,000 community clinics. Civil society efforts (trough Civil Society Alliance for SUN), listed on page 9, include: RENEW (Reenergizing Nutrition Expanding Worldwide), a multimedia presentation to advocate for nutrition among leaders; K4Health eToolkit and elearning courses on family planning, maternal, newborn, and child health and nutrition topics, along with interpersonal communication and counselling; a TV talk show series focusing on multi-sectoral approaches to nutrition; and the ‘1000 days Window of Opportunity’, involving community-level activities, such as schoolyard drama, and art and school quiz competitions that use a set of three comic books for adolescents. Media partnership, campaigning of champions, roundtable discussion, and stakeholder involvement are also being incorporated into the strategies used.

• In Uganda, there are radio campaigns, including radio spots/talk shows focused on nutrition best practices, supported by UNICEF. Journalists have been trained on covering nutrition priorities, supported by the United States Agency for International Development (USAID) together with Food and Nutrition Technical Assistance (FANTA) and UNICEF. A community behaviour change communication video initiative is underway as of 2014 to support village health teams to stimulate dialogue on nutrition at the community level. The counselling aides of village health teams are supported by the World Health Organization (WHO) and the Ministry of Health, along with further training and advocacy tools, including capacity building on communication message and materials design for stakeholders.

• In Peru, the Initiative against Child Under-nutrition or Iniciativa contra la Desnutrición Infantil (IDI) was created in 2006 to build political momentum for nutrition during a general election. A commitment document was designed, and all presidential candidates were asked to sign. The elected president endorsed the "National Strategy for Combating Poverty and Chronic Child Malnutrition (CRECER)", which resulted in a strategic framework, budget inclusion, measurement tools, a health security insurance system, and a conditional cash transfer programme for pregnant women and mothers. A radio campaign was created on child nutrition for children under 3 years old. The IDI worked for political commitment again in the 2011 election campaign and got a pledge and then approval of a national strategy from the current (2014) president.

• In Pakistan, a formal advocacy and communication strategy for scaling up nutrition in Pakistan had not been agreed upon at the time of publication (2014). However, awareness-raising at the ministerial level is ongoing, particularly through the launches of: a survey in 2011; a Lancet series specifically on Pakistani health systems and one on maternal and child nutrition (launch covered by national media); an Institute of Development Studies (IDI) Bulletin of May 2013 on "Addressing Malnutrition in Pakistan"; and an Aga Khan University study on the Political Economy of Malnutrition". A SUN civil society alliance (SUN CSA) is also being established through a broad national consultation process and a drive to register CSAs. Roundtables and training workshops for the media are being organised, as are parliamentary briefings. A documentary on nutrition has been produced, which was shown on two national and 18 cable channels across Pakistan. Hosted television talk shows have been aired, with speakers from national and provincial governments, policy makers, and experts. Similarly, a documentary about the situation and importance of breastfeeding has been produced and aired. A national communication strategy for social and behaviour change is in preparation. Mass media work is being done around the 1,000 days, maternal, and child nutrition.

• In Cameroon, media is being engaged through training and field sessions, resulting in articles and radio and television reports. Traditional and religious leaders, local elected officials, and administrative authorities are being sensitised to the issue of malnutrition through information exchange and community visits and through community radio. Televised debates were aired in 2014, and high-level government officials began work on a multi-sectoral platform for nutrition. A business forum was held with the thought of creating a nutrition investment fund. Parliamentarians attended orientation session s of the topic, resulting in a letter of engagement on legislation and strategic planning.

• In Kenya, a Nutrition Advocacy and Communication Committee (NACC) was formed in June 2013; four taskforces were established to guide and implement the work of the committee. An action plan with priorities was adopted, and the advocacy,communication and social mobilization (ACSM) forum was organised. The Lance series on evidence-based interventions for improving maternal and child nutrition was launched in February 2014. "Social mobilization and behaviour change and communication activities include dissemination of infant and young child feeding materials at national and county levels. In addition, a national iron and folic acid supplementation communication strategy, vitamin A supplementation communication strategy, maternal infant and young child nutrition strategy, and food fortification strategy have been developed.' ‘malezi bora’ (good nurturing) weeks are existing national health foci for nutrition advocacy and social mobilisation."

Globally, lessons include:

1. "Having a strategy is the starting point....
2. Nutrition champions can mobilise, advocate and communicate for better nutrition....
3. Mobilizing societies is key for improved nutrition....
4. A common narrative for nutrition leads to effective communication....
5. A variety of tools are available...."