Game Changers: Fostering Maternal, Newborn, Adolescent and Sexual and Reproductive Health through Social and Behaviour Change Communication Strategies in Rwanda
The Barame project, a collaborative health initiative between the Government of Rwanda and the Government of Belgium, aims to ensure universal access to quality integrated reproductive, maternal, newborn, and adolescent health and family planning services. Funded by Enabel, the Belgian Development Agency, the project is implemented in partnership with the Rwandan Ministry of Health (MoH) through the Rwanda Biomedical Centre's Division of Maternal, Child, and Community Health (MCCH). It operates across seven districts in Rwanda: Gakenke, Gisagara, Karongi, Nyamasheke, Nyarugenge, Rulindo, and Rusizi.
In 2022, as part of its efforts to enhance community engagement and improve health outcomes, the Barame project commissioned hera to conduct a comprehensive Knowledge, Attitudes, and Practices (KAP) study. This study aimed to identify key gaps in community understanding and engagement with maternal, neonatal, adolescent, sexual, and reproductive health (MNASRH) services. The findings from the KAP study provided critical insights and served as an impetus for the Barame project to request proposals for the development of a social and behavioural change communication (SBCC) intervention.
In 2023, a team led by hera partner Justine Jensen and Erick Baganizi, and including Alice Rwema, Aimée Naganze, and Patrícia Lourenço, as well as hera Project Officers Eva Kayitesi and Florence Staring, and hera Communication Officer Heiko Decosas was contracted to develop, test, and implement social and behaviour change communication tools and strategies to enhance community awareness and participation in MNASRH services. The main objective of the hera team was to address the community demand side for MNASRH services by developing communication materials, optimizing mechanisms of accountability, and making health information data comprehensible and relevant for the communities.
The hera team concentrated its efforts on three main communication approaches: awareness communication, two-way communication, and community participation. They focused on adolescents (10 to 18 years) and adults (19 to 49 years) and developed 29 strategies and tools across these three approach categories. Using the human-centred design approach, community members were engaged directly to understand preferences and to help shape and co-develop the strategies and tools.
A variety of communication tools were developed by the hera team to effectively disseminate health messages. Radio spots, posters, game mats and cards, role-play cards, and a community scorecard were created to engage different segments of the community. Guides were also developed for Citizen Voice and Action programs, interactive radio talk shows, photovoice and social media interventions. All of the tools underwent concept design in consultation with community members.
Through concept design consultations, the team identified preferred and appropriate channels. Radio spots were developed to be aired on popular stations such as Radio Rwanda, KT Radio, and Radio Maria, while posters were designed to be strategically placed in high-traffic areas like health centres, markets, and churches. Interactive tools like game mats and role-play cards were designed to be used in community meetings and health centres to facilitate interactive learning.
Following the development of these tools, they were approved by the Government of Rwanda. They then underwent implementation testing across the seven districts to evaluate their potential to sustain social and behavioural changes in target communities. Implementation testing with community members revealed that they were most effective when used in tandem. The integration of various communication methods led to a higher level of message reach and engagement among community members. The interactive tools, such as game mats and role-play cards, were particularly appreciated for their innovative and informative nature, facilitating clear communication and promoting active participation.
The focus on behavioural strategies in the Barame project highlights the importance of community engagement in improving health outcomes. By leveraging a diverse array of communication tools and fostering active participation, the project aims to bridge gaps in health knowledge and practices, contributing to the overall well-being of communities in Rwanda. This approach underscores the significance of a holistic perspective in health initiatives, where medical and behavioural interventions work hand in hand to ensure the right to health and development for all.
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