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Tackling gender equity, one nutrition TV spot at a time

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About the author: Ann Jimerson is a Behavior Change Specialist, Alive & Thrive

This blog post is originally featured on the Alive & Thrive LESS GUESS blog which discusses the art of using data for strategic behavior change design.

As the clock ticks to mark the first hour of the baby’s life, a young mother raises her hand to contradict her mother-in-law, who wants to give the baby honey instead of breastmilk. It’s one of my favorite TV spots from Alive & Thrive’s (A&T) program in Bangladesh. Every time I view this TV spot, I feel a surge of emotion when the young mother firmly says, “No, give her to me. I have to breastfeed.”
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This young mother surprised viewers by taking control of her baby’s first hour of life.

So it caught me off guard when a participant in the recent SUN Movement Global Gathering questioned the program planners’ decision to portray this young mother standing up to the authority of elders. “Why did you show the mother that way? It’s completely unrealistic. That would never happen,” the participant said.

We didn’t have much time during that session on Social and Behavior Change Communication (SBCC) to follow up on the participant’s question, but I did take the opportunity to talk about the value of emotional messages that are “aspirational”—that is, that model an action or a situation that our audiences may wish were their reality.

The discussion was enough, though, to trigger a personal response from Mona Girgis, Country Director in Lao PDR for Plan International. Mona had been asked to report to the Global Gathering on the content of the SBCC session. Mona and others in Lao PDR are deeply committed to gender equality and women’s empowerment in their work on nutrition. In its publication “Women’s empowerment for improved community nutrition,” the SUN’s Civil Society Alliance in Lao PDR points out that “there is evidence of a positive association between women’s empowerment and improved nutrition outcomes, and conversely, the disempowerment of women can result in reduced nutritional status for themselves and for their families[1].” But Mona confessed that she has at times felt discouraged at the gap between the rhetoric and the reality of women’s lives.

“We do have a problem at the moment at the global (and national) level where we have the rhetoric on women’s empowerment, and it is clearly defined in policy, but we are struggling to translate to practice.” Mona wrote to me following the conference.

Seeing the young mother’s bold move in the TV spot—and similar depictions of empowered young women in other nutrition materials—gave Mona a glimmer of hope.

I went back to the TV spot from Bangladesh and recounted the ways that 40-second drama shows us what a more gender-equal community might look like: When the mother expresses her wish, the elders hand her the baby to breastfeed. Her husband watches the scene and lovingly affirms, “I’m lucky the mother of my baby is so intelligent.” Perhaps most importantly, the spot opens on the anxious men waiting outside the home for news of the birth. The young father beams at the joyous cry, “It’s a girl!”

If Sanjeeda Islam had been with us in the Global Gathering session, she would have given a definitive response to the participant’s question about why the spot was written as it was. Sanjeeda led A&T’s creative team for the design of our TV spots, and she is clear that when she wrote the line “It’s a girl!” she wanted to break through the age-old preference for a son. She reports that “surprisingly” there were no raised eyebrows. In fact, in our pretests of the TV spot, mothers had a highly emotional and positive response to the scene where the mother proactively asks for the baby. Mothers also liked the proud father’s praise for his wife. The groups of mothers who saw the spot scored it high for credibility—and opinion leaders did too.

A&T’s behavior change activities intentionally targeted grandmothers and other older women, along with fathers, frontline health workers, and community leaders. Our evaluation didn’t measure these groups’ attitudes, but we know that Bangladeshi women of different ages watch TV together. With the shared experience of seeing the image of that empowered young mother, the older women were likely more open to listening to the ideas of the young mothers in their community.

And the data for A&T’s Bangladesh evaluation suggest that our strategy worked to increase mothers’ self-efficacy related to breastfeeding. After three years of program implementation, mothers in A&T areas were significantly more confident than their counterparts in comparison areas that they could prevent others from feeding a child aged less than 6 months anything other than breastmilk (73% vs. 47%). In areas where the only A&T intervention was mass media, women who viewed one of our breastfeeding TV spots were 48% more likely to initiate breastfeeding within an hour of birth, compared with those who had not viewed one of the spots.

“It is possible to subtly address the wide gender gap that exists not only in Bangladesh but in many countries using different channels and mediums,” Sanjeeda wrote me recently. “Gender roles are changing, though very very slowly, but we need to keep trying to sneak in our messaging initially. We need the change to happen soon if we want to make any progress in the nutrition scenario, where success depends on gender equity.”

Let’s all take hope, then, in the power of emotive messaging that can model a better world. Our communication materials may be explicitly addressing improved child feeding practices. But these same messages and materials can subtly, almost subliminally, introduce changes in gender roles and power as we move from rhetoric to action.

Read the Bangladesh approach and results brief.

Thanks to Silvia Alayón, Mona Girgis, Sanjeeda Islam, and Tina Sanghvi for their contributions.

[1] Quisumbing, A.r., Van Den Bold, M. & Gilespie, S., 2013. Women’s Empowerment and Nutrition: An Evidence Review. In International Food Policy Research Institute Discussion Paper 01294.

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