8
Social Mobilization Steps
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For IDD program managers or teams following the social mobilization approach, communication activities generally follow five sequential steps for each segment of society: (1) clarify objectives, (2) identify partners, (3) develop a program of action, (4) support partners and alliances, and (5) monitor and evaluate results. Since evaluation inevitably leads back to program reassessment, these steps are repeated in a continuous cycle of revision and program refinement. Since programs are already in progress and many activities may be going on at many levels at the same time, it is more useful to consider social mobilization steps as a sort of checklist of essential tasks.
This all seems like a lot of organizational work, but it is much simpler than it appears. For some segments of society, all these steps need not be so complex. For example, the idea of approaching "the salt industry" or "the government" may seem daunting, but this just means forming a relationship with the heads of one or two influential companies or government leaders. Then, the process of finding partners and building alliances works to expand the network of support.
If one objective is to change government policy, an alliance of four or five organizations might convince a leader to support IDD legislation. Joining forces with the leader, the alliance moves on to influence lawmakers. If legislators become partners, the alliance moves on to include a majority of the legislature. With each new ally, common ground is found and conflicting interests resolved.
The target is behavior
Critical to the success of alliances is the idea that partners are not targets to be shot at from afar. Behavioral change is the objective to our communication efforts and this requires a certain closeness and exchange of views. It is doubtful that we will ever give up using the term, "target audience" because it is such an important concept in audience segmentation and message design. But thinking about people as target audiences that receive, rather than participate, is somewhat contrary to the social mobilization approach to development.
Individuals and organizations become IDD partners because they realize they have an interest or a stake in the success of the program, not only because they have been hit by a message. This is also why those individuals who directly benefit from the IDD program and those who come into contact with those beneficiaries should not be treated differently from other stakeholders. We should encourage ordinary people in households as well as people in business and in government to question, discuss, become involved, and finally to use and promote the use of iodized salt because they realize it is in their own best interest to do so.
Programs which emphasize individual behavior change find it useful to specify primary, secondary and tertiary target audiences such as mothers, shopkeepers and health workers/school teachers. In the context of mobilizing social groups, all groups are primary. Business people are as important as lawmakers, lawmakers as important as health workers and shopkeepers. We are all linked together like a chain, and if a link is missing, the whole program can break down. Ultimately, the object of all our efforts is behavior change to end brain damage and physical impairment caused by IDD.
Step 1. Clarify objectives
National IDD programs throughout the world contain two universal communication objectives:
(1) Helping individuals to adopt a range of behaviors that will prevent the effects of iodine deficiency. Examples include purchasing iodized salt, storing it away from the damp and heat and cooking with it.
(2) Creating a social and political environment which fosters the behaviors promoted at the individual level. This includes changing community norms, policies, or structures. Examples include school activities such as having children test salt for iodine in schools and participating in IDD art competitions, displaying ads for iodized salt in shops and markets, creating and enforcing regulations for the production and quality control of iodized salt, improving transportation and storage systems, and sponsoring youth events or organizing IDD Days.
Clarifying objectives is a first crucial step, but this can be a haphazard process unless communication objectives are set for each segment of society.
Step 2. Identify partners
At any stage in developing and continuing an IDD program, it is useful to draw a simple grid to identify potential partners, supporters and non-supporters, and consider what they know, what opinions they hold, and what roles they play in advancing or hindering program activities.
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The Social Mobilization Framework Grid (Figure 3) provides general categories for identifying intermediary groups. Schools, women’s credit unions, labor pools, sports teams, religious congregations, youth programs -- no group that can influence the consumption of iodized salt should be left out. Veterinarian and farmers groups and farmers markets, for example, can disseminate IDD information and iodized salt samples. Their constituencies need to know about the causes of IDD because animals have it too, causing miscarriages, lower milk yields, and other harmful effects. Moreover, if animal salt is not iodized, somewhere along the line that non-iodized salt will get to people.
Going through the exercise of filling out this grid, planners have uncovered a great diversity of IDD partners, not only obvious ones like the Ministry of Health and Ministry of Finance, but also ones often overlooked like the Internal Affairs Ministry’s marriage license bureaus that can inform young married people of the importance of iodized salt. In China, for instance, the marriage license bureau is a good entry point. Women of reproductive age, especially newlyweds, are among the most vulnerable groups. If the couple is expecting, the "brain damage" consequences might come within months.
While individuals and organizations on the grid differ from country to country, generally there is a need to systematically review:
- Who are the international and national partners in IDD?
- Who needs to be involved at the district, provincial and community levels?
- What are the knowledge, attitude, beliefs and role of each partner?
- What needs to be done to involve everyone who has a stake in the program?
Ideally, each partner will have a high level of credibility and connection with a limited number (perhaps only one) group of people that will be the focus of its attention. There are two effective ways of finding such partners:
(1) The target audience approach
The program identifies groups to receive services and messages -- for example, pregnant women, adolescents, household heads, isolated geographic groups. Which groups already work most effectively with these target audiences? Partners are chosen on the basis of their connection with the intended beneficiaries. The lead agency and partners develop a plan of action to reach each audience.
(2) The problem-solving approach
The program wants to accomplish certain tasks -- perhaps distribute iodized salt samples through health workers; perhaps see that all municipalities draft ordinances for iodized salt. Which groups can help get the job done? Which groups potentially could block or hinder the work? Partners are selected on the basis of their relevance to these tasks and what they have to offer (resources, influence, power) to help get the job done. The lead agency and the partners plan strategies together.
With both of these approaches, the important point is to encourage participation, decide communication strategies together, and extend the sense of ownership among stakeholders and groups responsible for carrying out the program. The lead agency might arrange communication planning sessions to bring national, regional, and district level stakeholders into the decision process.
In a communication planning workshop, researchers might summarize findings while communication specialists and stakeholders discuss ways of using communication to promote desired behaviors. Participants could identify needed research, plan an inventory of resources, and begin to incorporate strategies into a program of action.
Step 3. Develop a program of action
A program of action for IDD encompasses systematic efforts to mobilize the various segments of society. It includes a marketing plan for iodized salt and a plan for mobilizing the various segments of society.
Marketing plan
In IDD programs, the only aspects of product development that may remain open to change are the packaging and price of iodized salt. Iodine level will be determined by technologists, and most countries choose to promote only one form of salt, top quality refined salt.
Program managers should consult communication specialists early in the planning process because mistakes made in packaging and pricing cannot be fixed later by even the best communication efforts. Advertising may help the product’s "image," for example, high quality, clean salt with an added ingredient to promote health at a price affordable to virtually all. However, if the price and packaging work against this image, if packaging tears easily, printing is sloppy, or if salt is priced as a luxury item, there is little that communication can do to reposition the product in the eyes of the consumer.
Message strategy
With the major marketing questions researched and decided, the communication manager or management team can focus on developing message strategies. This begins by carefully defining the behaviors to promote among different groups, then analyzing the group’s motivations to perform the behaviors as well as the obstacles in their path.
Audience segmentation, or the process of defining target audiences based on research, is perhaps the most critical step in developing a message strategy. People who can be combined because they share a set of opinions, values and attitudes, would be motivated by the same appeals and are affected by the same obstacles relative to using iodized salt are considered a "target audience."
The next step is to develop different messages to address the most important concerns for each target audience, choosing a combination of communication channels (health workers, schoolteachers, radio, television, religious settings, political gatherings) to reach distinct groups in such a way that they move up the "Stages of Change" ladder from unaware to concerned to motivated to trying and finally sustaining the new behavior. (See Figure 4)
One of the most effective ways to move people through these stages of change is by "modeling" or letting people observe others experiencing the behavior and its consequences. People can learn, rehearse and gain mastery of behavior by watching role models (usually within a dramatic context) work through their doubts about the behavior change. Their emotions and minds engaged, people evaluate for themselves the value of using iodized salt or some other modeled behavior.
It is important to note that target audiences are not based simply on socio-economic characteristics, such as "women of child bearing age." They are based on a deeper understanding of what would motivate a group of people to try iodized salt or what would cause them to fear or avoid using it, what would motivate leaders to endorse salt regulation or turn against it. Qualitative research, usually interviews, at the outset of the program give planners rich, but not statistically valid, information about target audiences -- their knowledge, attitudes, beliefs, and practices (KABP) concerning IDD and the use of iodized salt, as well as insight into their lifestyles, and media habits.
Focus group research
Selection of the number and composition of the focus groups on preliminary hypotheses concerning which target groups are critical to launching the campaign at a national or provincial level. These hypotheses are informed guesses based on the planners’ experience, and assumptions will need to be verified or rethought on the basis of field research. Technical experts and stakeholders use their best judgment in considering the proposed actions for these groups as well as the groups’ possible motivations and potential objections.
Communication Tool Kit 7 suggests a way to compose focus groups. These groups are described in terms of the actions that will be eventually asked of them, but not all groups need be interviewed at the planning stage.
Focus group research is key to the success of message design and somewhat tricky to do right. Many groups are successful at actually conducting research, only to find they have no results worth using or that it is difficult to shape the results into a communication strategy. To prevent this from happening, outside technical assistance is particularly indicated for this task. It may be necessary to search the private sector for market research companies or media-production or media-relations firms. Universities may have schools of journalism, communication or public health with the necessary skills. Non-governmental organizations (NGOs) may have experience in mass media campaigns.
The in-house staff of the lead agency will still have to be able to provide specific topic guidelines, analyze research findings, develop strategies and plan and manage supporting activities as they form a communication plan that answers the questions:
1. What is the purpose of the communication campaign?
2. To whom will the campaign be addressed?
3. What message(s) will be delivered?
4. What tone and manner will be used?
5. What media will deliver the message(s)?
Step 4. Support partners and alliances
Perhaps by this point, technical experts and stakeholders who participated in the communication planning workshop will have formed a Steering Committee or management team to coordinate messages and activities in the different segments of society.
Earlier chapters discuss the process of supporting partners in government, industry, health and education. It is also important not to neglect mass media organizations, important partners for reaching out to the public, creating demand and sustaining political will.
The management team will need to review liaison with the media on a regular basis and whenever events demand or opportunities arise. If a marketing research group has been contracted to develop message strategies during the planning phase, it may be time to review the scope of their work. Marketing professionals may be used to budgets that allow them to pay for media time or space. Researchers in academia may not pay enough attention to media outreach. Sometimes public relations or media-relations people can do a good job in this area by presenting ideas in such an interesting way that the press is quite willing to use program information materials without payment.
Step 5. Monitoring and evaluation
During implementation, even though message strategies are already decided and communication channels selected, communication planners should do a preliminary review. Managers, technical experts and communication specialists can look for effective use of research findings, accuracy of technical content and long-term feasibility. Reviewers may be able to suggest improvements and identify problems before they arise.
Material, training and operational refinements
Meanwhile, material development, orientation, and training move ahead with particular emphasis on pretesting for comprehension, relevance, acceptability and potential for changing attitudes and eliciting action. Finally, materials are produced and distributed. (See Figure 5 and Figure 6 for examples of materials and services developed in Ecuador and Pakistan.)
Monitoring of message delivery and audience responses now become the central concern of the management team along with tracking the iodine content in salt by manufacturer and putting pressure on government to enforce regulations. The Steering Committee or management team monitors progress towards all program objectives, modifies communication strategies, and looks for ways to take advantage of changing conditions or new information. It may be necessary to strengthen the program alliance by including influential religious leaders, social workers, unions, or another individual or group that was unanticipated or overlooked.
Managers, project planners, technical experts and stakeholders on the national and provincial levels make site visits and hold discussions with field staff to analyze and resolve operational problems by finding out:
1. Are communication activities taking place?
2. Are communication materials and messages reaching target audiences?
3. Are communication activities associated with changes in knowledge, attitudes, beliefs and practices among target audiences?
Monitoring also means reviewing communication activities in relation to methods, budgets and timelines specified in the plan of action. This helps ensure that shortcuts, such as skipped pretesting or missed consultations with health providers, do not jeopardize the program. Funds may be inadequate or used improperly. Perhaps some activities can be accomplished at lesser cost or costs shifted through the involvement of salt producers, packers, or other interested parties.
The re-planning process
Communication review sessions, held at least every six months, should revisit the communication strategies using surveys and studies of iodized salt sales, quality, and use to redefine program goals for the next phase of activities.
- How much and in what ways have communication activities helped to achieve program objectives?
- Have partnerships led to coordinated activities and quicker responses to changing conditions?
- Are communication components encouraging sustainable progress?
- How well does the program match up against social mobilization indicators (See Tool Kit 1)
These are key questions in the re-planning process. With assessment, the cycle of social mobilization is restarted so that the IDD effort is continuously renewed and strengthened in every social sphere.
