TCI Global Toolkit: Demand GenerationSocial Mobilization
What Is It?
The process through which ministries, donors, implementing partners and communities work together strategically to raise awareness of and create and increase demand for a common goal.
Community health workers are not fully functional in Nigeria. As a result, TCI trains the state and local governments on effective social mobilization, which is used to increase knowledge, facilitate behavior change and generate demand for family planning services, usually by using strategic communication channels including:
- Interpersonal communication (in the training of community health workers)
- Mass communication (in the form of songs, radio plays, and similar media
- Community-level advocacy (by engaging communities and their leaders in town hall meetings)
It is crucial for government, implementing partners and other key stakeholders to engage communities throughout the entire social mobilization designing, planning, implementation and evaluation process. By working with communities from the beginning, community leaders and members can help highlight important social and cultural issues that could help promote or inhibit the community’s knowledge of the health issue and their use of related services. It can also lead to greater sustainability of behaviors because communities are empowered to address their own needs and have a sense of ownership in the plan.
What Are the Benefits?
Social mobilization approaches:
- Can reach people who may not come into contact with the health system, particularly marginalized groups and men
- Get people talking about family planning
- Educate the general public about family planning before they see their providers, which may make counseling sessions easier and more beneficial
- Use real-life situations in local languages to describe the benefits of family planning
- Can expand the reach of family planning messages by attracting crowds at events or creating a growing following, in the case of a radio drama series
- Reduce and eliminate family planning myths and misconceptions
- Can help create culturally appropriate and sustainable solutions by working with communities to identify their knowledge, perceptions, attitudes and needs
How to Implement?
Assess Community Needs, Issues and Resources
Potential limitations to social mobilization activities could include:
- Lack of equipment, training, motivation or compensation/incentives
- Too few mobilizers, such as peer educators, health workers and so forth
- Limited materials
- Poor logistical support
Identify Existing Government Social Mobilization Structures
In Nigeria, TCI helps local governments establish or strengthen State Social Behavior Change Communication (SBCC) Committee. The SBCC committee consists of people from the State Ministry of Health, State Primary Health Care Development Agency, local government health promotion units, journalists, young people, community influencers, and other relevant agencies. It is responsible for coordinating all demand generation activities, including social mobilization, and is setting the path for the work to continue in a sustainable manner.
As a result, TCI provides an orientation to the SBCC Committee as well as a training of trainers (ToT) workshop for selected Committee members who will conduct the cascade trainings. Each State adapts the social mobilization approach and materials to suit its context and recruits social mobilizers who will work with and are supervised by the LGA Health Educators.
In an effort to further institutionalize the approach, TCI is working closely with government to strengthen the capacity of the Community Health Influencers, Promoters, and Services (CHIPS) program. The federal government of Nigeria, through the National Primary Health Care Development Agency, created the CHIPS program to improve access and equitable coverage to essential health services, especially those relating to maternal, newborn, and child survival. The CHIPS program is also meant to serve as a means of coordinating all social mobilization/demand generation activities at the community level.
Finally, TCI along with other stakeholders is working to develop a national social mobilization guideline and capacity building program for National Orientation Agency of Nigeria (NOA) based on integrated social mobilization, including FP/RH issues.
Design a Social Mobilization Strategy
Ideally, you should develop a social mobilization strategy in a community participatory workshop-type setting. The social mobilization strategy will include a description of the overall implementation plan including:
- How the social mobilizers will be selected
- What roles and responsibilities they will assume
- What activities will be conducted and why
- How social mobilizers will be trained and supervised
- What materials and equipment they may need
- How the strategy will be monitored and, eventually, evaluated
Design, Test and Produce Social Mobilization Materials
Social mobilization materials may be developed within a workshop setting that includes program staff, stakeholders and, possibly, graphic designers or artists. In Nigeria, participants of the media and materials development workshop:
- Identified local languages and phrases or words that would best communicate the program’s goal
- Identified equipment needs
- Determined what materials should be developed (for example, referral cards and branded badges, pins, bags, shirts, jackets, hijabs and pens)
- Designed and pretested material prototypes
After the workshop, additional materials may be developed, such as tools or implementation kits, pamphlets or checklists for facilitators and social mobilizers.
Under TCI a similar approach has been taken to designing and pretesting materials and FP messages, as outlined in the Adapt & Air Media Spots approach.
Select and Train Social Mobilizers
Potential social mobilizers must meet specific criteria in order to be selected. This often includes that potential mobilizers must:
- Be willing to volunteer
- Be between the ages of 18 and 35
- Live in urban slums
- Be an artisan (barber/hair stylist, driver, mechanic or tailor)
TCI uses the NURHI developed orientation guide for social mobilizers along with the Social Mobilizer’s Training Curriculum on Life Planning for Adolescent and Youth.
Implement and Monitor Social Mobilization Activities
Each of the LGAs develop a monthly workplan/schedule of social mobilization activities which they plan to implement. The SBCC Committee develops a social mobilization work plan with the social mobilizers to ensure that activities are implemented in a timely manner. They also use a social mobilization coordination chart to enable better planning. These tools help the SBCC Committee to monitor activities as well. By measuring progress, programs and activities can make decisions and adjust plans based on evidence. TCI-supported States implements four types of social mobilization activities:
- Neighborhood campaigns – During neighborhood campaigns, mobilizers move from door to door talking about the benefits of FP and referring people to access FP services at nearby facilities.
- Indigenous events and festivals – Obtain permission to man a booth/table with materials on family planning
- Engagement with community associations, like market women, hairdressers, barbers, tailors and motorcycle drivers – Share information on family planning in an association meeting, for example
- Key life events – Mobilizers will identify key life events (weddings, naming and graduations) in their communities, where a mobilizer can have a slot to talk with guests about the benefits of modern FP
The neigborhood campaigns are planned by LGA health educators with the SMAs. They work with and also supervise the mobilizers during this activity. The engagement with community associations as well as key life events are led by social mobilizers after which they provide feedback to the on the outcome to the LGA health educators and SMAs. In addition, the social mobilizers utilize other avenues to generate demand for FP services. They support the SBCC Committee workplan implementation by leveraging on indigenous events to conduct referrals and also utilize community theater performances to conduct referrals.
The social mobilization approach also supports key service delivery interventions such as the 72-Hour Clinic Makeover and the training on LARC for service providers. These activities provided the opportunity to increase service visibility, facilitate knowledge exchange and refer prospective clients using branded referral cards.
Monitoring of these activities included measuring mobilization meeting attendance, supervisor checklists and family planning uptake—through the number of referrals provided compared with the number of completed referrals.
What Is the Evidence?
While evidence for social mobilization within family planning activities and programs is still limited, other health areas – such as polio, tuberculosis, Ebola, nutrition and gender-based violence – have provided evidence of the importance and value of social mobilization activities to facilitate behavior change, increase knowledge and generate demand for products and services.
A total of 215,520 persons were reached with FP information and counseling through social mobilization efforts in 12 supported states. Of this number, 53,709 were referred out of which 33,636 (63%) completed the referrals process and received FP services as of December 2020.
Evidence from the Urban Reproductive Health Initiative (URHI)
More than 375 social mobilizers in NURHI project cities educated their communities about family planning. Between 2010 and 2014, the modern contraceptive prevalence rate increased from 21.1% to 30.7% among all women and from 18.8% to 29.0% among poor women in the six NURHI cities (Measurement, Learning and Evaluation Project Nigeria Team, 2017).
Modern contraceptive prevalence rate (percent) by woman’s age at time of baseline and endline NURHI survey in six urban sites
Social mobilization is one of several contributing activities that led to the increased uptake of modern contraceptive methods by women in the NURHI cities. While sometimes challenging to measure on its own, it is clear that social mobilization activities help increase awareness and generate demand by engaging communities in the social mobilization process.
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For the Urban Reproductive Health Initiative countries, social mobilization was used to increase knowledge, facilitate behavior change and generate demand for family planning services, usually by using strategic communication channels, including:CorrectIncorrect
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It is typically best to engage government, implementing partners and other key stakeholders after implementing the social mobilization plan because their input can often impede the effectiveness and the sustainability of communication and advocacy campaigns.CorrectIncorrect
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What are some of the benefits of social mobilization approaches?CorrectIncorrect
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What criteria did the Nigerian Urban Reproductive Health Initiative (NURHI) team use when assessing which local NGOs to partner with to implement and manage social mobilization activities?CorrectIncorrect
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Demand Generation Approaches
- Working with local civil society organizations can help identify and build capacity, create and sustain trust in health and family planning services and build linkages between communities and family planning services.
- Social mobilization activities should be developed with communities to ensure that social and cultural beliefs are considered and local languages are used to communicate messages.
- By increasing awareness and social consciousness, communities can transform demand into action – increasing use of family planning services and methods.
- Involving communities in all the stages of the social mobilization process gives communities a sense of ownership and can motivate them to sustain new practices.
- Overcoming social and cultural beliefs, values and practices to discuss and use family planning among community members may take considerable time.
- Poor infrastructure or supply chain issues may need to be resolved before implementing social mobilization activities.
- If proper community-entry practices – that is, gaining the approval and acceptance of community leaders – are not followed, communities may not accept or respond to social mobilization efforts.
- Community-based Family Planning Toolkit
- UN Women Virtual Knowledge Centre to End Violence Against Women and Girls
- WHO and Stop TB. Advocacy, Communication, and Social Mobilization Tools
- Social Mobilisation, Advocacy and Communication for Nutrition
- Overcoming Social Barriers to Family Planning Use: Harnessing Community Networks to Address Unmet Need