Frontline health workers (FLWs) were identified early on in the Shaping Demand and Practice (SDP) project as one of the primary touch-points for reaching pregnant women and new mothers with behaviour change communication, as they had already had direct access to them in their homes. But However, we soon found that the FLWs- who are key to providing valuable lifesaving information to families – were often challenged by inadequate training, lack of tools, and communities that did not take them seriously. Given these limitations FLWs’ ability to convince women and families to practice healthier behaviours for herself and her children, was seriously compromised.
How do you convince a woman who is struggling to make ends meet that she should invest in better healthcare for herself and her children?
Our solution was to design a comprehensive face-to-face training program where Accredited Social Health Activists (ASHAs) and Anganwadi Workers (AWWs) in Bihar were trained how to persuade families to take up positive health practices using the interpersonal communication (IPC) tool – Mobile Kunji and the mobile-based IPC training course – Mobile Academy.
Creative approach: the art of persuasion
BBC Media Action and its partner, Pathfinder International, developed the IPC skills of FLWs by teaching them a five-step sales cycle process of persuasion. Drawing insights from the commercial sales sector, the training involved guiding FLWs on how to build a relationship with a client: to listen and understand her needs; work with her to formulate a solution; encourage her to make a commitment to a new health behaviour and then follow up on and reinforce this commitment. Having this structured approach to two-way communication helped to build the confidence of FLWs in their ability to bring about change with their clients.
Another powerful device was the oath taken at the end of the FLW communication training which poetically emphasised the critical role played by FLWs in their communities.
By the end of the three-day training, the shyness and uncertainty of most of the trainees was replaced with confidence and enthusiasm, as each woman took ownership of the valuable role she plays in her community. FLWs emerged from the training more sure-footed, motivated, and excited about their role in helping to save lives.
By May 2018, a total of 105,046 FLWs were trained in 28 districts of Bihar, with both project and government funds.
From 2016, FLWs were trained using institutional capacity from within the government. The state government scaled up the training of FLWs in Bihar, with support from BBC Media Action and DFID. Prior to this Pathfinder International supported the roll out of these trainings, training government officials and providing the project trainers.