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Strategic communication for better services

Jahangir Hossain Sharif
THE human life passes through several cycles and the reproductive health part consists of several stages of development and change covering the major span of life. The reproductive health is such an issue that occurs in the human body usually but, if anything goes unusual or if a person fails to cooperate with the changes easily, it impacts heavily on the behavior and mental health of the person. There are several initiatives in the developed countries to help persons in these stages of changes with required information and services. However, say one and a half decades ago, the people of Bangladesh were seen leaving it upon the fate resulting into the highest rate of child-marriage, early pregnancy, unacceptably high mortality rates, maternal malnutrition, infections during pregnancy, anemia and suffering from delivery complicacies. Access to reproductive health services by unmarried adolescents was restricted and seeking services related to antenatal (ANC), delivery care (DC), and post-natal care (PNC) by the people was very poor.
Although the first phase of the Family Planning services (the reproductive health services) had begun in 1953, a multi-sectoral and broad-based population control and FP programme started in 1973 and the activities gradually progressed through four Five-Year Plans. A comprehensive Health and Population Programme was drawn up for the Fourth Five-Year Plan to promote and support the development and operation of a comprehensive health and family welfare system. To add further impetus to the country's FP program, Bangladesh Center for Communication Programs (BCCP) and its predecessor JHU/CCP in Bangladesh developed the National FP-MCH IEC Strategy for Bangladesh (1993-2000). A nationwide multi-year campaign, called Green Umbrella Campaign, was launched under this FP-MCH Strategy in 1996 to raise aware-
ness, create an enabling environment for Family Planning services and advocacy for policy change.
The five-year long Smiling Sun Campaign launched subsequently in 2000 under an overarching Behavior Change Communication Strategy for National Integrated Population and Health Programme (NIPHP). The "Smiling Sun" logo marks the "Paribarik Shastho Clinic" or Family Health Clinics run by Urban Family Health Partnership and Rural Service Delivery Partnership and its slogan "come with your family for health care" assures the customer that it offers health information and quality service. For three years, the
Reducing Maternal Mortality (RMM) Campaign went together with the Smiling Sun Campaign to raise awareness about the five danger signs of the pregnant mothers.
Another programme that made a significant difference in the reproductive health issues of Bangladesh is the Adolescent Reproductive Health (ARH) Programmme. The adolescents make about one third of the population of Bangladesh who are posed to extreme vulnerability in regard to reproductive health. A survey undertaken by Population Council Bangladesh, reveals that 55% of the patients with sexually transmitted diseases are aged less than 24 years (Population Council 2003 cited in ICDDR, B 2005) and they require strategic programming to sensitize them about their health and possible risk factors.
For the adolescents and the youths, BCCP had undertaken an evidence based communication intervention (2003-2006) in order to increase knowledge on reproductive health issues, negotiation and behavioral skills and seek services when needed. Under this communication intervention, an integrated multimedia communication package was developed, known as "Know Yourself" or "Nijeke Jano" in Bangla, involving adolescents in all steps of the process. It is provocative yet sensitive enough to reach the adolescents and to provide them with the information, motivation and skills they need to develop positive reproductive health behaviors. Along with the mass media intervention, parents of the adolescents, community leaders and service providers were also exposed to the programmes and were sensitized on the issue. The Know Yourself package and the Pictorial Card on five dangers signs are being widely used by the national and international communities.
THE WRITER IS ASSISTANT DIRECTOR, BANGLADESH CENTER FOR COMMUNICATION PROGRAMS (BCCP).