Social and behaviour change in Papua New Guinea

Port Moresby 11May15Tulodo is in Port Moresby for a few days as part of its research project funded by Australia’s DFAT. So far we’ve had useful meetings and found an interesting variety of organisations working on social and behaviour change. Here is a selection of a few with some of their programs and initiatives:

We look forward to completing the research and getting back here to PNG again. Let us know if you have any suggested additions for our list.

Cold turkey better than hot pharma for smoking cessation

cold-turkeyIt turns out most people quit smoking without any assistance, despite the push by big pharma to sell their products and services. While some people think cold turkey implies there are no “interventions”, years of efforts to change behaviours and social norms have probably produced the effect of an intervention on those who choose to give up without help.

Mini insight on social networks and behaviour change

Social networks – and the social support provided through them – can improve a person’s ability to gain access to new connections and information as well as to identify and solve problems. If this support can help to reduce uncertainty or help to produce desired outcomes, then a sense of personal control will also be enhanced, including to change behaviours.

How social marketing can ensure the success of clean cooking programs in Indonesia

Indonesia’s Ministry of Energy and Mineral Resources, together with the World Bank, announced a multi-phase program to introduce affordable, biomass-fueled cookstoves to the 24.5 million families – or 40 percent of households across Indonesia – who still use traditional biomass, mostly firewood, for cooking.

For a stove program to succeed in Indonesia, we must frame the intervention to focus on marketing behaviour change for clean cooking. If we focus only on manufacturing and selling units, the program will lose focus on consumers’ needs and wants. Evidence from the Tulodo-led 2014 review of behaviour change and clean cooking shows how this impacts demand, sustainability and scale. Stove sales are still core to success, however ensuring correct and sustained use is critical to Indonesia enjoying the full health, environmental and economic benefits of clean cooking.

The challenge in marketing cleaner stoves in Indonesia is the creation of value in the minds of the consumers and their communities. Value can be both intrinsic and extrinsic; it can include the direct health and economic benefits as well as social and other value. Central to marketing is the idea of exchange (cost vs. benefit) that provides the foundation for the relationship between the consumer and a brand. Effective social marketing, which is the application of marketing techniques and tools to change individual behaviours for the benefit of a community, has six key elements:

  1. The importance of customer orientation, rather than top down approaches, putting the individual at the centre of the intervention;
  2. Insight based on formative and behavioural research, using proven theoretical approaches;
  3. Clear and measurable behavioural goals for an intervention, not broad policy priorities or political statements;
  4. An understanding of the consumer’s barriers and benefits to the change, leading to creation of intrinsic and extrinsic value, often through the creation of brands, for which the intended recipient is willing to exchange their resources (money, time etc);
  5. A mix of methods for communications activities, e.g. media and traditional forms of communication, as well as adjustments to price and promotion of products, services and behaviours; and
  6. Take into account competition from opposed interests and behaviours as well as from other public issues.

Segmentation is an important component of marketing as it clearly defines an intervention’s target group(s) demographically, geographically or attitudinally (using psychographics). Consumers can be segmented by their propensity to adopt an innovation (‘innovators’, ‘early adopters’, ‘early majority’, ‘late majority’ and ‘laggards’). Another way is by their desire to convert to the new behaviour. Simple demographics are not sufficient for segmentation, these must be behavioural. Segmentation helps the marketer to develop archetypes or personalities that enable a program to be targeted to the needs of different groups of consumers.

Brands build relationships between consumers and products, services, or lifestyles by providing beneficial exchanges and adding value to their objects. Brands in public policy are the associations that individuals hold for behaviours, or lifestyles that embody multiple behaviours. Since many clean cooking interventions involve products, services and behaviours, e.g. purchase of an improved stove and its fuel and their consistent use, change can require more than just affecting consumer choice. This makes the use of effective branding strategies a key consideration for a clean cooking program in Indonesia.

Journey to scale: the Tulodo review included case study programs that achieved scale by reaching a “tipping point” where the new clean cooking technology became the norm. An example is Indonesia’s transition to LPG, where the government learned from early problems by building a national regulatory framework and reaching out to change agents in beneficiary communities. Interventions should take into account relationships and context at the individual, interpersonal, community and national levels. The recruitment of change agents (especially as early adopters) and the use of cooking demonstrations, are keys to success.

A successful clean cooking program needs to ensure the availability of accessible and appealing financing options. New stoves are often a large investment for the targeted households and therefore creative and realistic ways should be developed to enable and facilitate the purchase. Financing options include subsidies, micro loans, trials and rent-to-own programs. An example comes from the Shell Foundation Room to Breathe project in India, which initially fell short of the sales momentum needed to achieve scale and impact. The project subsequently negotiated partnerships with microfinance institutions and sales increased significantly.

The combination of these elements – segmentation, branding, change agents and financing – as part of a social marketing program will help produce a movement for cleaner cooking in Indonesia. This movement will result in increased sales of cook stoves, and more importantly their correct and sustained use. This will help ensure that Indonesia enjoys the health, environmental and economic benefits that cleaner cooking has to offer.

New report on use of behaviour change in clean cooking interventions for economic, health and environmental impact

Front coverA new report (available below) from a team led by Tulodo’s Nick Goodwin has found promising evidence for the effectiveness of behaviour change approaches in clean cooking interventions. Despite decades of effort, around 2.8 billion people still rely on solid fuels to meet domestic energy needs. There is robust evidence this causes premature death, chronic disease as well as wider economic, social and environmental problems. There is a growing body of evidence that behaviour change interventions are effective to reduce harm from unsafe and dirty cooking practices such as household air pollution and loss of forests.

The project reviewed the use and effectiveness of behaviour change approaches in cleaner cooking interventions in resource-poor settings. The authors synthesised evidence of the use of behaviour change techniques (BCTs), along the cleaner cooking value chain, to bring positive health, economic and environmental impacts and outcomes. 48 articles met the inclusion criteria, which documented 55 interventions carried out in 20 countries. A scorecard of behaviour change effectiveness was developed as part of deeper analysis of a selection of case study projects. Although behaviour change approaches have a strong track record, more application and evaluations are needed to establish stronger evidence for their use in cleaner cooking interventions.

NB: The report was funded by DFID and the full reference is: ‘Goodwin, N.J., O’Farrell, S.E., Jagoe, K., Rouse, J., Roma, E., Biran, A., & Finkelstein, E.A. (2014), The Use of Behaviour Change Techniques in Clean Cooking Interventions to Achieve Health, Economic and Environmental Impact: A review of the evidence and scorecard of effectiveness, HED Consulting, London.’

Clean Cooking Behaviour Change Study – Full Report

Executive Summary

Main Report

Appendices

Appendix D – Case Studies

Appendix E – Scorecard of Behaviour Change Effectiveness

Appendix G – Full List of Interventions

Change agents make residents feel safer about dengue fever in the Philippines

Barangay Health Worker, PhilippinesResearch by Fe Espino at the Research Institute for Tropical Medicine on dengue prevention in the Philippines shows how community trust is vital to the success of behaviour change programs. In 2010, the number of dengue cases in the Philippines rose from 37,101 in 2006 to 118,868. Dengue fever is caused by a virus transmitted by mosquitoes which are born in still water. Due to water shortages, households are forced to store water throughout the year. Espino’s research team engaged the local Barangay Health Workers (BHWs) to introduce a household water container management system to control dengue in 2 communities in Massagna City in metro Manila.

In both village ‘A’ and ‘B’, BHWs were trained to teach households to inspect water containers for immature mosquitoes. An instructional guide was provided along with a container management checklist, collected during monthly visits. The team also provided a video of dengue control techniques. Village A, however, encountered many problems and there was a poor response to the program. In Village B participants reported not only that the visits made residents more aware of dengue control, but they were more inclined to take action. Although behaviour change results have not yet been reported, it appears the difference is that the BHWs in Village B were more active and more trusted by the community. This shows that when engaging change agents, it’s important to understand both how the community feels about them and how they feel about their community.

Change agents at the USF Social Marketing Conference

IMG_0532Tulodo’s Nick Goodwin and Irma Martam attended the recent Social Marketing Conference, hosted by the University of South Florida. Irma was the recipient of the conference’s prestigious Fostering Equity Scholarship and attended the pre-conference Training Academy with social marketing practitioners and researchers from around the world.

Nick’s plenary presentation focused on the use of change agents – including community health workers, peer educators, opinion leaders and sales agents – in social and behaviour change programs. Change agents can remove barriers to change and increase the rate of the diffusion of new behaviours. Different to traditional top-down approaches, the use of change agents can make social marketing more personal and enhance empowerment and capacity building. Engaging change agents can promote and support individuals who assume responsibility for community improvement, seek new knowledge and skills, and actively engage and recruit others. Mobile and social technologies open up new ways to engage change agents, enabling mass personalisation and scaling up impact. Nick’s presentation drew upon Tulodo’s latest work and his research, including in Indonesia on health programs; globally on clean cooking interventions; and on alcohol harm initiatives in Australia.