Communications for Development

In 2012, Ghana Health Services (GHS), with funding from the United Nations Children’s Fund (UNICEF), launched a Communication for Development (C4D) program in twelve districts of the four poorest regions of Ghana. The main objective of this program was to encourage families to adopt and consistently practice five health behaviors which are critical for preventing under-five mortality: sleeping under an insecticide-treated mosquito net (ITN), utilization of oral rehydration solution (ORS) for the treatment of diarrhea, hand-washing with soap, exclusive breastfeeding and delivery with a skilled birth attendant. The C4D intervention package tried to achieve behavioral change through four main activities: (1) Home visits and counseling by Community-Based Agents (CBAs) affiliated with GHS; (2) Ghana Community Radio Network (GCRN) community radio broadcasts of focus group discussions and jingles; (3) Theatre dramas supported by the Center for National Culture (CNC); and (4) Video screening of recorded drama supported by the CNC. Additionally, a mobile messaging intervention (Mobile for development or M4D) was developed to complement the ongoing C4D activities. The M4D program targeted the same behaviors as the C4D program. Rather than relying on home visits, drama or radio programming, the program relied on voice messages directly delivered to female respondents through their cell phones. The main objective of this evaluation was to determine the impact of the C4D and M4D programs on the practice of the five key behaviors mentioned above. In order to allow for a rigorous evaluation of these programs, the C4D program was randomly rolled out at the community level, while the M4D program was randomized at the individual level. To capture changes in behavior, three survey rounds were conducted: A baseline survey in 2012, a midline survey in 2014 and an endline survey in 2016. Two round of qualitative data collection were also conducted to complement and explain the findings of the quantitative analysis.