Strategic Design Part 2
Umbrella Brand
In integrated SBCC programs, it is usually a good idea to create an overarching, umbrella brand that encompasses multiple health topics. This helps unify SBCC efforts under a single brand, link issues in the minds of the audience, draw attention to lesser-known issues and act as a force for cohesiveness in messaging and other aspects of SBCC. The Ghana GoodLife program exemplifies the umbrella brand.
Creating a Brand
The following section on developing and testing creative concepts provides more guidance on umbrella brands. Visit HC3’s three-part guide on how to create a brand strategy for additional information, including: how to use audience insight to drive your brand; how to develop positioning for a branded product, service or behavior; and how to develop the personality and look of the brand.
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When multiple donors – or even multiple projects under a single donor or multiple activity managers within a single donor on a single project – favor integration but want a lot of control of treatment of their issue, an umbrella branding strategy might be a good option.
From Strategy to Creative Concepts and Materials
Once you have achieved consensus on the SBCC strategy, your project will develop and test creative concepts, then turn these concepts into executions (i.e., samples) to test with your target audience. While this process is similar to that for vertical programs, certain aspects require particular emphasis or nuance in integrated programming. This section will focus on those aspects.
Developing Creative Concepts
A creative concept is an overarching “big idea” or unifying theme that can be used across all campaign messages, calls to action, communication channels and audiences. Developing and testing creative concepts is particularly important for integrated SBCC campaigns that need to ensure the entire campaign is coherent across multiple topics, and resonates with all audiences. Find more information on how to develop creative concepts here.
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Consider how you will develop your creative concepts. Through an internal creative team? With an advertising agency? Together with audiences through a human-centered design approach or in an Action Media workshop? If you decide to use an advertising agency, human-centered design firm or other outside organization, consider the pros and cons to having a single agency or multiple firms. Would a single firm be able to handle the workload? How might dividing the work impact uniformity?
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Develop a wide range of concepts. This will increase the chances of finding one that deeply resonates with your target audience. Consider basing your concepts around values, benefits, emotions, trends, cultural phenomena, symbols or other broad constructs that will encapsulate your integrated SBCC program’s components.
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Be sure that your creative concept is flexible. Will it be able to accommodate other topics or behaviors that you might be asked to include at a later point in time?
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Try developing a few sample executions for your different topics for each creative concept to see if and how they work for different content areas.
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Remember that your creative concept is not meant to be a final, polished product, just a rough mock-up or prototype that conveys the overarching creative link. This might be a concept board with a headline, tagline and key visual, a sample description of a radio spot or a storyboard for a television spot.
Examples of Integrated SBCC Concepts
Uganda: “How is life?”
Ghana: “What is your good life?”
Egypt: “Your health, your wealth.”
Malawi: “Life is precious.”
Tanzania: “Love me, parents.”
Jordan: “Our Health, Our Responsibility.”
Testing Creative Concepts
Once you have developed several creative concepts for your integrated campaign, you need to test them with your audience. Your objective when concept testing for integrated SBCC initiatives is to determine which concept the audience understands and relates to most strongly. An emphasis of concept testing in an integrated program is to gain insight into how the audience views the links between the various topics and whether your concepts represent those linkages in a way the audience connects with. Find more information on how to test creative concepts here.
- Starting with your first concept, test each concept by itself first, and then show sample executions of the concept that demonstrate how different topics would roll out under this umbrella. Repeat with the other concepts.
- In addition to questions about attention, comprehension, motivation, personal relevance and cultural appropriateness, dive deeper into questions that ask how the audience understands the link of the topics within the concept.
- After showing each concept individually, ask the audience to compare and rank them. Which do they prefer and why? Is the concept selected still in line with your strategy?
Developing SBCC Materials
After deciding on the creative concept, it is time to design and pre-test the actual integrated SBCC materials. Consider holding a materials review and adaptation workshop, using the materials acquired during your materials inventory as a starting point. Reviewing and updating, improving, re-branding or otherwise adjusting accurate, already approved materials helps save time during the approval process. To ensure they fit with your strategy and link with new topics, you may need to add elements from your creative concept, update some language or include a new tagline or slogan.
HC3 resources provide more information on how to develop and adapt SBCC materials. Some examples of integrated SBCC materials are provided in the Project Examples at the end of this section.
Pretesting SBCC Materials
To the extent possible, pretest methods should match the method(s) being used for message delivery. For example, if topics will be phased, the messages and materials for each topic can be pretested separately. But if the messages/materials for topics will be conveyed concurrently, they should be pretested together.
Inquire about the acceptability of integrated communication, whether for providers discussing new topics with clients presenting for other reasons or for bringing different topics/behaviors together under a single brand. Do audiences make (and accept) the desired connections between topics/behaviors? In Rwanda, for example, those conducting the pretest asked vaccinators: “Is the vaccination encounter an appropriate place to communicate about family planning and PMTCT?” In Liberia, the project tested the amount of time it would take for vaccinators to use an integrated family planning and immunization job aid with a client in a clinic setting. This was important in assessing the feasibility of introducing the new step in each of their client visits.
If possible, have providers pilot-test and give the program feedback on new tools and practices so they can be adjusted as needed before full program implementation. See the HC3 guide on how to conduct pretesting for more information.
Program Experiences
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Tanzania’s Wazazi Nipendeni safe motherhood campaign initially covered the period from pregnancy to delivery. The campaign later extended to the first year of the child’s life in a second phase, and brought in a number of additional health issues, such as early and exclusive breastfeeding, immunization and post-partum family planning. The flexible and inclusive nature of the creative concept allowed for its expansion.
- In Uganda, FHI360 developed the Obulamu (“How is life?”) umbrella campaign. The concept was flexible enough to adapt to different life stage audiences. For young couples, it turned into “How’s your love life?” For pregnant women and partners, “How’s your pregnancy?” For young families, “How’s Baby Opjo?” and for adolescent boys and girls, “What’s up?”
Designing Linkages between SBCC and Service Delivery
Given the importance of quality service delivery to sustained behavior change on many health topics, it is important to think about how your integrated SBCC program connects to service delivery. As noted previously, SBCC programs can be considered integrated even when they are not integrated with or within service delivery. However, even when an integrated SBCC program is not formally mandated to integrate with service delivery, it is important to consider the implications of your program for service delivery. This is especially true when driving demand for multiple health areas. In most cases, there is at least a basic level of integration between SBCC and service delivery, and within health services themselves.
Whether or not your integrated SBCC program has a formal service delivery component, consider factoring the following into the strategic design.
Service Delivery Considerations
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Engage relevant institutions and providers in the early stages to gain buy-in for integration. Explore how to ensure service availability, and seek out input on and approval of key messages – especially information the program wants providers to deliver. Invite service delivery representatives to SBCC coordinating bodies or working groups if they are not already a part of these groups. Attend service delivery meetings, observe counseling sessions or find other ways to better understand providers’ needs. -
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Determine the extent to which service delivery health programs are already integrated. For example, how many health programs will the SBCC program have to link with? One integrated structure, or several vertical structures? How much extra effort will this require in terms of message approval, provider training, monitoring and other areas? -
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Map out all of the contact points with clients along the continuum of care for the various health areas of focus. Think about how best to optimize each of those points, and ensure no opportunities are missed to provide necessary information and links to services at each point. At the health facility, for example, there are opportunities at ANC, intrapartum, postnatal care, immunization, family planning and well child visits, among others. Similarly, map out the timing of each of the CHW’s home visits and consider other opportunities at these entry points. -
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Determine the capacity of the health system and providers to meet an increased demand for services. What efforts will be necessary to ensure a quality supply of services? Do you need to consider a phased approach to allow supply to match demand? -
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Consider how to effectively engage and train service providers. Service providers must be knowledgeable about and comfortable discussing the range of topics with clients. They must be able to provide the services or make effective referrals. They must also be willing and able to report on service delivery for monitoring purposes. All of these have implications for the design of your program. Will capacity strengthening be necessary? What job aids and other support will be required? What structures need to be put in place?
Engaging and Preparing Providers
In an integrated SBCC program, service providers at the community and facility levels usually have a role to play in delivering and reinforcing key information. It is critical that they feel involved and capable of doing what is being asked of them. Find more information about IPC interventions here.
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Assess the capacity of the providers you plan to work with, then strengthen capacity where necessary. What IPC skills and practices do they possess? What do they already know about the health topics? How able are they to make connections between health topics? Build on what providers know and be sure not to add tasks or information too quickly.
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Build health worker capacity to communicate in interpersonal settings in a meaningful way. Ensure they are truly able to understand a client’s needs and challenges, tailor communication to their needs, facilitate meaningful and participatory dialogue, and employ approaches that facilitate community-driven ownership and action.
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Determine the providers’ workload. Design strategies for helping providers effectively integrate topics and meet multiple needs at once. Train providers to probe and make connections to maximize client benefit. Help providers see the benefits of integrated programming – particularly how it can help them. Sometimes it may be beneficial to consider opportunities for task shifting, or sharing certain elements of the service delivery process with other providers, volunteers or health champions.
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In collaboration with service delivery programs, help establish systems and structures for quality services. For example, how to provide referrals between and within the SBCC and service delivery programs; how to ensure effective coordination between community-level and facility-based providers; and policies or systems for enabling task shifting.
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Integrated SBCC programs have found different ways to assist CHWs and facility-based providers in counseling and message prioritization for integrated SBCC through training and materials. Some possible approaches include: phased-in training, discussion cards organized by topic, multi-topic flip charts, pre-loaded tablets and mobile applications (apps) for basic or smart phones. Examples can be found in Project Examples.
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For integrated programs, providers especially need to be able to quickly get the client talking about her/his needs, issues and status to be able to cover the critical topics well, given the time available. Ensuring providers practice effective IPC can be key to helping clients adopt and maintain desired behaviors.
Program Experience
Task shifting (specifically around counseling) might be required to ensure enough time to effectively communicate multiple messages. In Malawi, for example, Mentor Mothers provide HIV education, support and referrals on TB, infant and maternal nutrition, cervical cancer and malaria, so the provider only needs to verify the clients’ understanding and needs. Additionally, group-based ANC has been a way to provide higher quality care to women in a more efficient manner.
Capacity
The capacity of program staff and project stakeholders to design integrated SBCC will influence the strategic design process and vice versa. Integrated SBCC requires the assimilation of not only new but also more varied information and potentially new ways of communicating for both program implementers and providers (e.g., information communication technology (ICT) or improved IPC).
Capacity Strengthening Needs
Identify implementer capacity-strengthening needs through working group discussions, needs assessment surveys and during SBCC strategy development. In addition to information about the topics and behaviors to be addressed, implementers need to have a common understanding of SBCC, the project’s selected theory of change, data collection and use (including formative research), supportive supervision, advocacy and a range of other topics, depending on the program.
Because integrated SBCC typically requires health workers, community health agents and others to explain and answer questions about new and varied topics, capacity-strengthening needs might be amplified as compared to single-focus SBCC. When designing your program, plan for frequent supportive supervision that includes observation, customized on-the-job training and regular follow-up group training to strengthen generally weak areas. If agents use tablets or other digital technology to access relevant messages and information, training should include how to quickly find the needed information while remaining largely focused on the client, and supervision should verify agents’ ability to use the technology effectively. Supervision guidelines and tools (e.g., checklists) should reflect integration, such as looking at how effectively providers integrate new content into their interactions with clients. As with many SBCC interventions, including frontline workers in training will not only help prepare them to provide the needed services but also help gain their buy-in.
Resources
Project Examples
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Both vertical and integrated projects often have a need for SBCC capacity strengthening. See the SBCC Capacity Ecosystem for more information on how to build capacity for SBCC programming.
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Strengthening capacity for integrated SBCC may involve the following:
Extra time, repetition and support to effectively assimilate new information and practices
Phasing in new topics over time
Nonthreatening testing of providers to ensure correct knowledge
Structured observation of providers to ensure correct use of skills
Adaptation based on experience