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Albania example of an SBCC strategy
Here is an example of a completed communication strategy and its components.
Communication Strategy
1. Summary of Your Analysis
Problem
Statement
Research Needs
Changes the
Problem Calls
For
Theory of
Change
Albanian couples’ use of modern contraceptives is the lowest in the European region, with high reliance on
traditional means of family planning, such as withdrawal, and on abortion in the event of unwanted
pregnancies. Recent estimates (DHS 2002 and PRO Shëndetit 2005) indicate that the use of modern
contraceptive methods has increased from approximately 8 percent in 2002 to approximately 15 percent in
2008. In 2009 DHS shows a slight increase of contraceptive use at 11 percent. The use of withdrawal as a
Family Planning (FP) method among young men and women in Albania is contributing to unwanted pregnancy
and abortion rates among young women and to high health care costs in general. Mass media is contributing
to general misinformation, and pharmacists don’t know how to deal with young people. As a result, young
people lack the motivation and skills to switch to safer FP methods. Deep gender and power relations are
contributing to the lack of motivation to stop using withdrawal as an FP method.
2008: Why are the majority of the Albanians still using traditional methods as contraception? Are they really
satisfied about using withdrawal?
People most affected: Young men and women (15-29) in Albania need to be motivated to use safer FP
methods, while addressing power relations and peer pressure
People directly influencing them: Pharmacists need to learn how to offer services to young people so that
they become a trusted source
People indirectly influencing them: Mass media need to be trained for better reporting
One could argue that a tipping point for change may arise from combining increased individual self-efficacy
among couples to use and negotiate FP methods, increase ease of access to methods through better provider
(pharmacist) training, and setting the agenda by increasing the frequency of and correct reporting about FP in
the media. It is proposed that this would provide a better enabling environment for norm change with regard
to FP use. These concepts are based on assumptions of the Health Belief Model, Social Learning Theory,
Consumerist Model for service providers, and Agenda Setting Media Theory.
2. Communication Strategy
Female students at Universities
Final Audience
Pharmacists whose services were used by University students
Segmentation
Journalists who produced print or radio pieces on health issues at national level
Reduce fears and misconception as a barrier to the use of modern contraceptives among women of
reproductive age.
Desired
Increase the use of modern methods of contraception among women of reproductive age
Changes
Increase the number of clients (singles and couples of reproductive age) receiving advice from a
pharmacist on modern contraceptives.
Long time misconception about and fear of modern contraceptives and use of a traditional method,
Barriers
withdrawal by majority of Albanians (59%; Albanian DHS 2009)
There will be an increase in the number of university students who have learned about modern
contraceptives and the benefits of their use.
There will be an increase in the use of modern methods of contraception among women of reproductive
Communication
age and men (18-35 years old) from a prevalence of 20% in 2005 to 30% by 2010.
Objectives
By the end of the program there will be an increase in the number young females that discuss MCMs with
their partner.
By the end of the program, there will be an increase support for the use of modern contraceptives in the
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Strategic
Approach
Positioning
number of family planning corners and private counseling rooms at University clinics.
By the end of the program there will be reduced fear and misconception to the use of modern
contraceptives among women of reproductive age and men (18-35 years old) from a level of 84% in 2002
to 47% by 2010.
By the end of the program there will be an increase in the number of editors of prominent print products
in Albania who consider FP and RH a topic worth reporting under various sections (e.g. politics, health,
sports and culture).
By the end of the program, there will be an increase in the number of pharmacists who learn
interpersonal skills to talk with young women about MCMs.
There will be an increase the percent among clients of 18 to 35 years old receiving advice from a
pharmacist on modern contraceptives from 7%1 to 30% by 2010.
C-Change plans to develop a comprehensive SBCC program that includes a mass media campaign and
community-based interventions with pharmacists, universities and NGOs (journalist training) by creating a
positive environment for young couples to discuss, select, and use of modern contraceptive methods (MCM).
We will: 1) work with young men and women directly to address misconceptions about MCMs, 2) improve
their experiences when seeking MCMs at pharmacies (feeling more secure and empowered), and 3) increase
quality and quantity of positive media coverage of MCMs.
MCMs are a way to enjoy love-making while living full and long lives.
Modern contraceptives are safe and effective; they give full satisfaction. Modern contraceptives are easy to
use, affordable and accessible through pharmacies in all of Albania. They are popular (millions of women
Key Content
around the world and in Europe are using it confidently); modern (it is not your mother’s method). Talk with
your partner about modern contraceptive methods and choose the one that responds best to your needs.
The campaign will focus on mass media vehicles that can reflect and represent as well as effectively reach the
Channels,
target audience including television, radio, press and print materials. Television will focus on the emotional
Activities, and
appeal while radio and press materials will carry more detailed pragmatic messages on each method. Print
Materials
materials will include posters carrying the theme and emotional appeal replicating the television spot. In
addition, C-Change will utilize method-specific brochures produced by USAID projects and other programs.
3. First Year Draft Implementation Plan: The draft implementation plan presented below describes the steps that C-Change will
take to forge a coordinated effort by all stakeholders to address FP in Albania, leverage existing resources to expand access to FP
information, and develop a comprehensive communication strategy that stimulates dialogue and discussion on FP in the family,
and at the community, district and national levels.
Form a technical advisory group (TAG): Input by key stakeholders is critical to the long-term success of any strategy. C-Change
proposes to identify these individuals and routinely meet with them (perhaps monthly) to ensure that the strategy incorporates
their input. C-Change will organize multiple round tables with FP stakeholders from the public, private, donor and NGO sectors.
These will form the basis for moving the strategy forward.
Forge collaborations among current FP donor partners: Several partners such as UNFPA and the World Bank have expressed
interest in working with C-Change in specific FP communication activities. UNFPA has stated its interest in developing innovative
activities with the youth in youth centers, clubs, schools and theatre groups. The World Bank is interested in collaborating on
client-provider relationships.
Collaborate with partners that are working with the media: One idea is to sponsor an ongoing dialogue with journalists on
family planning issues to ultimately increase the number and quality of family planning reporting. C-Change will develop tools
that the media can use in a variety of ways (documentaries, articles, web-based tools) and awards to motivate journalists. CChange also will explore multiple ways of integrating FP information into existing, popular media such as the “Body and Health”
TV program.
Conduct an inventory of existing family planning IEC support materials and distribute appropriate ones through nontraditional settings to potential FP clients: C-Change will conduct an inventory of current FP IEC materials with the goal of
reprinting and distributing them widely throughout the country. C-Change will develop criteria for reviewing the publications and
1
CDC Final Report on Reproductive Health Survey: Albania, 2002. Found that 7% of married women age 15 – 44 received advice from a pharmacist
on MC if they had used the pharmacy as their source.
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select those that are accurate and are good quality products. C- Change proposes to produce an additional quantity of IEC
support materials and distribute them in venues outside the public health system. This will increase access to accurate
information and family planning facts at highly frequented locations such as pharmacies and Youth Centers. C-Change proposes
to reproduce and supply materials, and orient pharmacists and Youth Center staff in each major city by the end of 2008. CChange will determine the amount of materials and number of sites for distribution according to the budget lines and time
frame.
Conduct formative research: All behavior change communication must be evidence based. While significant research does exist,
additional formative research will be needed to design the communication strategy and the resulting materials. C-Change will
conduct formative qualitative research to obtain a textured understanding of the cultural, economic and social factors behind
family planning use (and non-use) in Albania. Formative research will be conducted using a combination of focus groups, indepth interviews, and other well-established qualitative research techniques. The research will focus on barriers, motivations,
and ways of reaching key audiences. The research will also help C-Change staff understand regional/cultural differences and
variations in rural, peri-urban and urban populations. The report of the formative research will not only inform the
communication plan but it can be used by other projects and donors to increase their understanding of family planning and its
dynamics in Albania.
Develop communications interventions and materials: Once the strategy and interventions are agreed upon, communications
programs can be developed. The center piece will be a media intervention that will include print and broadcast. Community level
interventions will support and reinforce the key messages and behaviors the media intervention is promoting. C-Change will
work with a local creative agency to develop the media campaign and other materials for community level activities. Stakeholder
will be leveraged to participate in this campaign.
4. Draft Monitoring & Evaluation Plan.
The monitoring and evaluation (M&E) plan will address key behaviors and attitudes that are the mandate of this communication
strategy among females and males 18 to 35 years old and secondarily among youth 15 to 18 years old in urban areas. Behaviors
and attitudes include the following:
Increased use of modern contraceptives, therefore reducing the use of withdrawal
A reduction in myths, misconceptions, fears and concerns that are a barrier to the use of modern contraceptives
Increased support for the use of modern contraceptives among pharmacists in urban areas
A more supportive environment in the community at large and among families and health providers for the use of
modern contraceptives
The M&E plan that has been designed will quickly allow C-Change to determine progress towards the achievement of the
program objectives stated in the previous section, as well as guide decisions related to fine-tuning the activities of the program.
The program will routinely monitor all processes and outputs on a monthly basis. Process and output indicators will focus on
program activities; monitoring their progress and to what degree the target populations are involved and participating in the
work of C-Change.
The process benchmarks listed in the M&E work plan will be used to track the type and amount of work C-Change is conducting,
while the output indicators will provide measurements of short-term or immediate-term changes among target populations.
The M&E plan is structured around the different target populations as different activities and objectives have been set for each.
The M&E work plan contains a set of tables that provide indicators and frequency of data collection for each objective.
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