Social and Behaviour Change Communication (SBCC) Project in Manica, Mozambique: Baseline Survey Report

"The intervention’s overall goal is to improve children’s health and nutrition by promoting good practices in the areas of maternal care and nutrition, infant and young child feeding, malaria prevention, and water, sanitation and hygiene."

This baseline report was developed for an impact evaluation of a social and behaviour change communication (SBCC) project that builds on two components:

1. "interpersonal communication, consisting of the training of community health committee members who in turn train community members; and
2. mass media communication, consisting of short-duration radio spots, broadcast by community radio stations that participated in corresponding capacity development activities."

Implemented by the World Food Programme (WFP) in Mozambique’s Manica province and funded through the European Union’s MDG1c initiative, the project seeks to promote good practices in the areas of: 

1. maternal care and nutrition;
2. infant and young child feeding; 
3. malaria prevention; and 
4. water, sanitation and hygiene.

Conducted in early 2017 to describe the situation of the prospective SBCC beneficiaries and the comparison households at baseline, the survey used interviewing of 1380 women aged 18-49 who were either pregnant or had a child under age 2. The baseline survey established benchmarks against which to measure endline results and provided information for implementation, for example, identifying topics on which awareness is lower and that need enhanced focus. The three planned treatment intensities involved a comparison group, a group receiving mass media communication, and a group receiving interpersonal training and mass media communication. The endline evaluation intends to find out: whether the intervention affected knowledge, attitudes and practices (KAPs); did those KAPs lead to better health, nutrition and sanitary outcomes; was the joint provision of information through radio spots and health committees more effective than only "the behaviourally inspired radio spots"; and, if limited in effect, "why did the SBCC beneficiaries not improve their knowledge, attitudes and practices in the four priority areas?"

Baseline results included demographics including such details as: marital status; language preference among Sena, Chiute, Portuguese, Chibarue, Chitonga, and Ndau; literacy; household toilet facilities; radio, TV, and mobile phone access; listening habits; source of malaria information; prenatal and birth choice information; mosquito net usage and knowledge of malaria symptoms and protections; handwashing, sanitation, water treatment, and diarrhoea causation knowledge; breastfeeding, infant nutrition, and pregnancy care knowledge.

Findings indicate high illiteracy, high dependence on agriculture, lack of toilet facilities in a quarter of the homes; and lack of access to radio for 60% of households. Prenatal exams and clinic births were the norm, and there was some knowledge of a need for added nutrition during pregnancy. In addition, 60% of women breastfed up to 6 months, but dietary diversity was poor. 70 - 80% of respondents owned mosquito nets and had knowledge of malaria symptoms and its source, but only 51% reported that children slept under a net. Respondents could identify critical moments for handwashing but fewer reported washing hands prior to breastfeeding or after going to the toilet with a child, and the only a third of respondents could identify a cause of diarrhoea. Fifty-one percent never treated water. The three treatment groups varied, suggesting a need for statistical methods of adjustment to balance endline data.