The Good, the Bad and the Ugly: Reflections of 20 Years of Proving What We Do Matters

"Even when we use the ecological model, our practise defies what we say."

Lebo Ramafoko begins her keynote speech by observing that we have long articulated what social and behaviour change communication (SBCC) means, citing the 1999 paper "Communication for Social Change: A Position Paper and Conference Report" (Editor's note: Click here to read this paper in PDF format) that followed meetings in Bellagio (1997) and Cape Town (1998). It outlines the following SBBC principles, characterised by a move...:

• away from people as the objects for change...and on to people and communities as the agents of their own change;
• away from designing, testing, and delivering messages...and on to supporting dialogue and debate on the key issues of concern;
• away from the conveying of information from technical experts...and on to sensitively placing that information into the dialogue and debate;
• away from a focus on individual behaviours...and on to social norms, policies, culture, and a supportive environment; and
• away from persuading people to do something...and on to negotiating the best way forward in a partnership process.

A few years later saw the publication of the "Communication for Development Roundtable Report" (Editor's note: Click here to read this paper), which emerged from the 8th United Nations (UN) Roundtable, Nicaragua, November 2001. Here is an excerpt: "The long-term goals for communicators included improved inter-agency collaboration in areas such as education and communication in reproductive health for adolescents, the retention of prevention, care and mitigation of the impact of the epidemic high on participants' agendas, and strengthened alliances between governments and civil societies to maintain progress on such themes as rights, gender equity and social equality and reproductive and sexual health." And the Rome Consensus 2007 (Editor's note: Click here for the document in PDF format.) described communication for development (C4D) as "a social process based on dialogue using a broad range of tools and methods. It is also about seeking change at different levels including listening, building trust, sharing knowledge and skills, building policies, debating and learning for sustained and meaningful change. It is not public relations or corporate communication."

Not only have we long shared what SBCC consists in, we have long had evidence that SBCC works. Ramafoko again cites the Rome Consensus, which shared examples such as: the India Radio Farm Forum from 1959 (Editor's note: Click here to read a case study by J.C. Mathur and Paul Neurath in PDF format) and a reduction of female genital cutting (FGC) by 33% attributed to participatory communication. Advocates of SBCC have included individuals, partners, governmental support, and funders such as the United Kingdom (UK) Department for International Development (DFID). Successes have included SBCC as a professional field with professional courses offered at different institutions, non-formal capacity building opportunities, various types of innovation, creation of brands.

All that said, for Ramafoko, the question remains: Do we have a common understanding of what we are talking about? She notes that we recognised a long time ago that context matters for change to take place. We also recognised that, while we use products and tools to communicate messages to influence, change behaviour, SBCC or C4D is about a social process of engagement, debate, reflection, and practice. Most of what we do focuses on individual behaviour change and less so on the social part (the community norms and the broader socio-economic-political sphere). For example, we do not question why women are at the bottom of the social strata and work with them to place their voice at the centre; instead, we develop tools to make them cope better with their situation. "If we really believed in the social, we would have supported and strengthened social movements more than we have and in some instances created a social revolution."

Ramafoko observes that there is a constant need to evaluate our work and prove that it works. Yet how can we do so if we continue to use the randomised controlled trial (RCT) as the golden standard for evaluations? There are very few studies that test the effectiveness of behavioural interventions to reduce risk using behavioural and biomedical endpoints, Ramafoko asserts. "We never point to the limitations of the evaluation methods, rather to communications." The focus is on numbers and counting, as evidenced by the example of all reporting to 2 major funders around HIV was how many people were reached with various packages. Context and quality is not taken into account; what is looked at is blanket implementation in a community, which is rigid. Timelines are very short, and there is an assumption that change is a mechanical, linear process.

Ramafoko's question is: Whose agenda are we serving? When funders set the agenda and length of funding, and there are bilateral decisions with governments, non-governmental organisations (NGOs) are reduced to service providers. How we evaluate what we do? Who tells us what works/what does not work? She asks additional probing questions about consistency of principles of partnerships and decision making, such as: Where does power really lie? Who controls the agenda? What is the relationship here? Where is the command centre if we open country offices? Capacity - by whose definition? Are local NGOs simply training grounds for big international organisations?

Looking ahead, Ramafoko notes that the media landscape is evolving. Social media as an important platform suggests we can reach audiences on different platforms, but we must also reach them differently. The role of the expert with neat messages is also questioned - we have yet to harness this successfully. "Let's bring back the social into SBCC."

Click here for the 17-slide presentation in PDF format.