The Drum Beat 443 - Information, Education, and Communication (IEC)

While the words "information", "education", and "communication" have individual meanings, when grouped together as "IEC", they are familiar to many within the field of health communication. However, the definition and scope of IEC can vary. In an effort to explore how IEC can be integrated into social change efforts, this issue of the Drum Beat presents just a few examples of what types of IEC strategies and resources are being used in diverse health contexts, worldwide.

Please send us information about your IEC initiatives, evaluations, and resources. We welcome this information at any time to: Deborah Heimann dheimann@comminit.com

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ONE DEFINITION OF IEC

1.Reproductive Health in Refugee Situations: An Inter-Agency Field Manual
Appendix One: The Essentials of IEC
"Information, education and communication (IEC) combines strategies, approaches and methods that enable individuals, families, groups, organisations and communities to play active roles in achieving, protecting and sustaining their own health. Embodied in IEC is the process of learning that empowers people to make decisions, modify behaviours and change social conditions....The influence of underlying social, cultural, economic and environmental conditions on health are also taken into consideration in the IEC processes. Identifying and promoting specific behaviours that are desirable are usually the objectives of IEC efforts....Channels might include interpersonal communication (such as individual discussions, counselling sessions or group discussions and community meetings and events) or mass media communication (such as radio, television and other forms of one-way communication, such as brochures, leaflets and posters, visual and audio visual presentations and some forms of electronic communication)."
Click here for the full appendix: The Essentials of IEC.

EXAMPLES OF THE STRATEGY IN ACTION

2.Fact Sheet – India PolioPlus Programme: Muzzafarpur, PolioPlus Orientation Seminar
This document reviews the immunisation and advocacy work of an orientation that was held with the aim of mobilising the polio eradication work force and the general populace in the state of Bihar, India, in August of 2007. As detailed here, IEC materials included a Ramzam (holy month) calendar distributed to Hajis (pilgrims). The calendar includes appeals by Ulemas (Islamic religious leaders) with pictures of adults and children taking the immunisation drops. Other IEC material, such as booklets, pamphlets (routine and appeal), and posters, were also distributed through the Haj stalls and booths. Routine immunisation pamphlets with "a complete info book on immunisation – detailing all the diseases and the time frame for each immunization and their dosage - and including a Pulse Polio message" were prepared for distribution in Moradabad at immunisation booths and for house-to-house distribution, and orange-coloured polio message t-shirts were created for a polio rally.

3.Strengthening Surveillance, Information, Education, Communication, and Procurement Planning to Address Avian Influenza in Georgia
This was a communication-centred pandemic prevention campaign in the Republic of Georgia from June 2006 to April 2007. The purpose of the project was to build the capacity of public health workers and medical professionals to respond to a pandemic by introducing them to the new surveillance procedures and measures to control avian infection in humans. IEC-related features of the project involved training sessions, on-the-job technical assistance, the development of key "talking points" for spokespersons, a workshop with media representatives, roundtables with national and regional officials, and the crafting of guidelines for health workers on how to communicate with the public.
Contact: Ketevan Goguadze k.goguadze@curatio.com OR Anton Luchitsky aluchitsky@path.org

4.Social Mobilizers Being Re-Deployed To Respond To P3 Transmission
This article describes the urgent deployment of social mobilisation coordinators within the Indian states of Uttar Pradesh and Bihar, which, at the time of publication, were the two remaining polio endemic states in the country. The communication strategy leading into these activities was altered from routine attempts to increase campaign visibility and date awareness, in favour of re-branding in honour of the upcoming Indian festive season. IEC materials such as street posters and local language media combined polio immunisation messages with wishes for an "Eid Mubarak" ('blessed festival'). These dual messages were also promoted in Urdu through television channels in Uttar Pradesh and Bihar. It is the hope that these efforts will increase public acceptance of the vaccine, and allow India's polio eradication initiative to stay one step ahead of P3 poliovirus transmission.

HOW AND WHY CAN IEC WORK?: EVALUATIONS

5.The Role of Information, Education and Communication in the Malawi Social Action Fund
by Bridget Chibwana and Prasad Mohan
This report, from 2001, examines the effectiveness of the IEC component of the Malawi Social Action Fund (MASAF)'s quest to foster community participation in that country's self-help projects and programmes. Organisers felt that the various waves of IEC initiatives (radio messages, posters, bus advertisements, interpersonal exchanges) established very clearly in the minds of prospective stakeholders the norms of the project, the roles they were expected to play, and their attendant responsibilities. This strategy was perceived to foster participation in the project. Amongst the lessons learned reported here:

• "An IEC campaign should precede project implementation to inform and shape opinion on project features.
• An IEC component helps a great deal in moving from an asymmetrical information environment to a symmetrical one...
• It is important to have an IEC professional in the Project Management Unit (or its equivalent)...
• Training in IEC needs to be provided to the project's first line of contact with communities...
• The first wave of messages must be clear and simple, and open to as little misinterpretation as possible...
• A communication initiative needs to follow up its first information campaign with a second wave of clarification...
• ...Community faith in MASAF was high because, unlike most other projects, very little time elapsed between hearing about the project on the radio and their being contacted.
• One of the best sources for an evolving IEC component is a Beneficiary Assessment.
• Regular dissemination of project experiences helps to reinforce the politically non-partisan nature of the project...
• Documenting and disseminating the experiences of communities, in print and on the radio, tends to restore faith in one's capacity to contribute to a solution, and to reinforce a sense of community between peoples across a country."

6.Social Marketing Zinc to Improve Diarrhea Treatment Practices - Findings and Lessons Learned from Cambodia
by Malia Boggs, Dainah Fajardo, Susan Jack, Susan Mitchell, and Patricia Paredes
This report details the design and implementation of, as well as the results and lessons learned from, an ongoing pilot project to introduce zinc, co-packaged with oral rehydration salts (ORS), through the private sector. In March 2006, a diarrhoea treatment kit (DTK) was introduced in selected districts of 2 provinces of Cambodia; one component of this effort was IEC. Evaluators found that: "Mass media combined with the IPC [interpersonal communication] of partners' volunteers, village shopkeepers, and others have resulted in high awareness, improved knowledge, and use of the DTK...Most frequently cited communication channels from which people learn about DTK are the TV spot, radio, village shopkeepers, and NGO volunteers and comedy groups. Partner NGOs developed IEC materials (banners, pamphlets with graphic demonstrations on the use of the product) that are used by shop owners for promotion and education, and by trained provincial- and district-level public health staff, health center volunteers (members of the [village health support group, or] VHSG), village shopkeepers, and community-based care groups in their demonstrations, health days, and health education sessions. Improved health practices are also promoted through home visits and edutainment sessions..."

7.Effective Information, Education and Communication (IEC) in Vietnam: A Literature Review
This 2002 review was carried out to identify publications that describe IEC interventions to promote the health and well-being of people of Vietnam. In particular, a total of 44 publications, consultants reports, conference presentations, evaluations, and anecdotal testimonies that provide an evaluation of the effectiveness of IEC interventions are included. Based on the perception that there are few rigorous evaluations of the effectiveness of IEC, the document identifies IEC approaches that have been found to be both effective and ineffective in the Kinh population and in Ethnic Minority Groups (EMGs) in mountainous regions. This document was produced as part of the United Nations Children's Fund (UNICEF)'s support to IEC strategic development in the water supply and sanitation sector, but may be of interest to other professionals working in Vietnam.

8.Taking Community Empowerment to Scale: Lessons from Three Successful Experiences
by Gail Snetro-Plewman, Marcela Tapia, Valerie Uccellani, Angela Brasington, and Maureen McNulty
This 2007 document describes 3 programmes that used community empowering approaches to achieve public health impact at scale in 3 different settings - Africa, Asia, and the Middle East. The third case examined here is the Madagascar Child Survival and Reproductive Health Program, which was an effort to raise levels of vaccination, child health and nutrition, and family planning. One of the success factors the authors identify in this project was the counselling card, which they say helped communities ensure message consistency throughout the project. A toolkit that included community tools, advocacy tools, and IEC materials reportedly enhanced access to quality health services. Amongst the strategies suggested is the development of simple, action-based messages focused on small, do-able actions that clearly benefit the community - communicated through inexpensive, easy-to-use tools such as basic tools for frontline workers (the family health card, the women's health card, and the youth passport).

9.Pilgrims visit Ghazi Baba's Dargah as Their Children Get Polio Drops
by Anupam Srivastava
This article describes an immunisation drive that incorporated IEC material and social mobilisation support. As indicated here, as a result of these strategies, Bahraich, India, was polio-free from the 2002 outbreak until 2006, when another outbreak occurred.

10.Information, Education and Communication: Lessons from the Past; Perspectives for the Future
Published in 2001, this World Health Organization (WHO) paper examines lessons learned from more than 2 decades of experience in applying IEC interventions to addressing public health issues. The lessons presented in this document reflect a retrospective view of what was known at the time of publication about planning, implementing, monitoring and evaluating IEC interventions. The lessons focus on generic practical steps and on what has “worked”. This is followed by a presentation of special considerations which must be taken into account when applying IEC to reproductive health initiatives.

11.Participatory Communication in Malaria Control: Why Does It Matter?
by Alison Dunn
This paper explores how community-level communication can engage the most vulnerable people - such as children under 5 years of age and women in the economically poorest communities in Africa - in strategies to prevent and treat malaria. According to author Alison Dunn, traditional IEC materials have been integrated into many initiatives addressing malaria, yet this strategy can sometimes fail if applied in a top-down manner that does not draw on how people use tools to engage with the local context. In general, she claims that good IEC activities are culturally appropriate, and use combined and appropriate local channels of communication (both interpersonal and media). For example, incorporating the wisdom of traditional healers into local project activities can help to prevent limited IEC impact. Dunn stresses that choice of terminology is also critical in developing effective health communication interventions that relate to local people; local terms for malaria can be numerous, have sub-categories, and be in a state of flux. Dunn concludes by referencing several toolkits and guidelines that have been developed to help programmers explore methods of participatory communication related to malaria control.

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Please VOTE in our NEW HIV/AIDS POLL:

Over the past 10 yrs approx. 20 billion dollars of international community money has been spent on HIV/AIDS - e.g., approx. 2 billion USD by The World Bank alone. What performance grade would you give for the effectiveness of the investment decisions? [After voting, please comment in the form provided.]:

• An "A" - excellent investment performance.
• A "B" - very good, but some issues.
• A "C" - OK, but could have done much better.
• A "D" - very poor, with some exceptions.
• An "F" - failed completely.

VOTE and COMMENT - Top Right Side of the website.

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SELECTED IEC RESOURCES

12.Visualizing Information for Advocacy: An Introduction to Information Design
This illustrated handbook offers advocacy organisations support in delivering their information in visual formats. It intends to help them increase understanding of their campaigns by making their messages more clear through using information design. From the handbook: "Information design can help tell your story to a variety of constituencies. You can use it as an advocacy tool, for outreach or for education. You can facilitate strategic planning by making a visual map of a given situation. This pamphlet is divided in two parts: first an overview of information design, what it is and how it can be used for social change, followed by some basic principles, tips and advice to help you get started. The examples included in this pamphlet were made by advocacy organisations, media companies and individuals around the world. The graphics show some of the many ways information can be designed and how information design can be used in your campaign."

Focus on HIV/AIDS:

13.HIV Peer Education Picture Codes
This set of picture codes was developed as material to be used in group outreach sessions to stimulate discussion around behaviours that put people at risk of HIV infection, such as sexual violence, alcohol abuse, concurrent sexual partners, and sex for money or gifts. The picture codes are visually driven and feature photographs of real people in situations requiring certain behaviours or choices. Accompanying each photograph is a list of questions for the outreach worker to ask group participants in order to stimulate discussion. These are followed by a list of "talking points" and information the outreach worker can share with participants.

14. HIV Education Playing Cards
by Mark Van der Merwe and Estelle Goren
These IEC components include a deck of playing cards and various board games in an effort to raise levels of HIV and AIDS awareness in the workplace, home, and community centres throughout Africa. The back of the playing cards are designed to enable customisation for the client with corporate logos and branding, or other HIV and AIDS messaging.

15.Jecko Fact Cards
These illustrated cards are available as part of the Stepping Stones workshop series designed as a tool to promote sexual and reproductive health. The cards ask questions and give answers or state myths and facts in a front-to-back format. They use animated characters in reproducible black and white to address questions such as "Who can get HIV/AIDS?"; "How can I know if I have HIV?"; or "Myth: Talking about sex and condoms promotes promiscuity (having many sexual partners); Fact: The truth is, talking about it promotes knowledge, safety and responsibility". They are used to stimulate conversation among youth on HIV/AIDS, with the goal of prevention.

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This issue was written by Kier Olsen DeVries.

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Please send material for The Drum Beat to the Editor - Deborah Heimann dheimann@comminit.com

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