ROLE OF ADVERTISING AGENCIES IN BEHAVIOR CHANGE COMMUNICATION SHALINI PRASAD AND MANISHA SINGH Background The role of advertising agencies in social communication for development in India has evolved over the years. While earlier their role was limited to developing mass media materials, advertising agencies are now adopting a wide range of approaches including infotainment, advocacy, social mobilization and interpersonal communication (IPC) to promote targeted behavior change. Indeed, advertising agencies now have specialized units dedicated to social communication that are involved in research, analysis, strategic planning and implementing communication programs. Given their extensive experience in reaching rural populations using integrated multi-media approaches, advertising agencies can provide valuable insights on the critical issues to be considered when planning an innovative behavior change communication (BCC) strategy to promote positive family health outcomes such as institutional delivery, postpartum care, early and exclusive breastfeeding, appropriate complementary feeding, immunization and postpartum contraception for birth spacing in rural settings. Objectives In 2009, R K Swamy BBDO, a premier advertising agency in India, and a partner in the Population Council-led consortium, conducted a qualitative study of advertising agencies to explore: (a) media planners experiences with regard to planning and implementing BCC campaigns on social and health issues for rural populations, Shalini Prasad, Consultant, and Manisha Singh, Development Strategy Director, Social Rural Direction, R K SWAMY BBDO Private Limited, 1-E/1, Jhandewalan Extension, New Delhi 110055. Vol. 56, Special Issue - 2010 101
(b) their perspectives regarding the challenges in implementing these campaigns and possible strategies to make them more effective, (c) the role of the Directorate of Advertising and Visual Publicity (DAVP), the nodal multi-media unit of the Ministry of Information and Broadcasting, Government of India, in reaching rural populations with information on government policies and programs. The findings of this study will help in planning appropriate BCC strategies and identifying potential partnerships with leading advertising agencies to effectively implement these strategies. The study was funded by the Population Council as a subcontract to R K Swamy BBDO, from an award granted by the Bill and Melinda Gates Foundation. Methodology A representative sample of advertising agencies was selected based on three criteria: (a) annual turnover of at least `3 billion, (b) prior experience in developing and implementing BCC campaigns in the social and health sector, (c) experience in the innovative use of media channels to reach below the line groups. Based on these criteria, apex advertising agencies were identified, and 15 organizations were selected for the study in consultation with the Population Council. A detailed guideline was prepared for the in-depth interviews. Senior program mangers and media planners in the selected advertising agencies were interviewed in detail by an experienced professional from R K Swamy BBDO. An expert in qualitative research from the Population Council also participated in the interviews. Transcripts of the interviews were prepared and analyzed. Although 15 advertising agencies were selected, only 9 interviews could be conducted. The key reason for nonparticipation was that, given the extremely competitive nature of the advertising world, several agencies were reluctant to share information on clients and best practices with a rival advertising organization. Key Findings Experiences in the social/rural sector While sharing their experiences on social communication, media planners were of the view that communication strategies can be effective only if key inputs such as advocacy, social mobilization and mass media tools complement each other and the campaign aims to achieve clearly defined goals. 1 Managers felt that due to the complexity of the issues and the limited reach of the mass media in rural settings, it is critically important to engage at the individual and community level for an effective BCC campaign. While the mass media creates awareness, it cannot address all the information needs of different target roups; IPC can, however, provide detailed information that allows people to make informed decisions. According to an agency manager: Mass media is spreading awareness while mid media and IPC are trying to reinforce this to bring about behavioral change. Managers also was noted that activation, which includes one-to-one communication, demonstration, use of visual aids, and engaging with the community and local celebrities, and adopting an integrated approach are critical for behavior change: 102 The Journal of Family Welfare
Since major sections of the primary target group are in the media shadow, mass media can play a very limited role for this audience. IPC and communitybased information, education, and communication (IEC) initiatives are critical for entering homes and reaching women. For effective IEC and IPC initiatives, flash cards, flip charts and storytelling can be used as communication tools to activate target groups. Mass media can create an enabling environment for messages communicated through IPC and IEC, and provide credibility to these messages. Another manager said: Right now the role of the mass media is restricted to building awareness. Changing the mindset of target audiences is not happening through mass media campaigns. You have to go to the grassroots level and spread awareness so that the messages can flow from there. You have messages in the mass media for example, do boond zindagi ki but demonstration is important to convince the audience. Somebody must say, I have taken polio drops and nothing has happened to me. Very few advertising agencies are doing this; their focus remains the mass media. Communication for behavior change involving rural and marginalized populations requires information to be provided in a language that is familiar, culturally acceptable and disseminated in locally appropriate settings. Communication initiatives based on sound research, with audience-specific messages using multiple channels are effective in influencing behavior change. For example, managers articulated the following views: For a campaign to be effective you need to actually work at the ground level to understand how messages are diffused in the community. A feasibility study is necessary to understand the components of communication strategies that work and those that do not work. We need to go to the community and talk to the people, use the words that they use and develop the communication messages accordingly. Many advertising agencies conduct feasibility studies before developing a communication plan but not necessarily with the rigor and seriousness that the subject demands. And even if the agency wants to conduct an indepth study, available resources and time constraints do not allow it. Effective BCC campaigns should be built on evidence-based research and theories of behavior change. Findings from formative studies should be used for planning BCC campaigns and determining the resources to be allocated to each media channel so as to optimize investment and maximize reach. It was repeatedly noted that different communication media do not compete with each other for resources. It was also noted that communication strategies must be holistic, moving beyond individuals to include other key stakeholders such as community members, service providers and decision-makers at different levels. Managers expressed views such as: Opinion leaders do play a role in behavior change. We have worked with them in Bangladesh. The campaign was to sensitize men and community members about the need to take pregnant women to the facility without delay. We worked with the village leader we made him feel it is his responsibility to ensure that no woman in his village died because she could not reach the facility in time. we worked to build his pride. Most communication is directed to women in the belief that women are more receptive to messages than others in the family. But do women have a say in the family? Even if the woman receives or understands the message, male family members do not allow Vol. 56, Special Issue - 2010 103
her to make the final decision. So what is the use? It is important to target men, mothers-in-law and family members when developing a communication strategy. We were handling the WHO ORS campaign in different districts of UP. We found that people were aware of ORS and its benefits, but they were not using it, especially certain communities in some districts we finally brought in a religious leader belonging to their community from another district; we asked him talk about the benefits of ORS and convince the community that it is not against their religion to use ORS. In addition, strategies need to be based on comprehensive formative studies and promote messages that are aligned and reinforced by different media and channels. Some media experts argued that for sustained behavior change, community norms as well as the policy environment must be taken into account, making advocacy necessary at both the community and policy making levels. Accordingly, advertising agencies strongly emphasized the need to develop an advocacy plan as part of an overall communication strategy, as reflected in the following quotes: As in many development projects, advocacy plays a critical role in improving family health outcomes. Advocacy takes place at different levels. At the level of the government/ bureaucracy, program ownership is critical. For this, involving the government machinery at the state, district, block and moving down to the panchayat level is even more critical. What happens often is that we implement our communication strategy but we forget to plan and implement an advocacy strategy. These strategies should go handin-hand. A lot depends on the subject of the campaign. For example, if you are doing something linked to domestic violence, part of your advocacy would be with the police or legal authorities in order to bring about a change in the law. Advocacy is very important. One should try and keep one s partners, the government machinery and the bureaucracy on board. Using key opinion leaders and local celebrities for advocacy could be effective. Media planners were of the view that advertising agencies need to be involved in the BCC campaign from the planning to the implementation stage to ensure message consistency and effective program implementation. Managers identified Goli ke Hamjoli, the World Health Organization s ORS campaign, Jasoos Vijay, Bula Di, Vimla Rani and Balbir Pasha as examples of successful BCC campaigns in the social sector. It was felt that partnering with the government is critical for scaling up social communication initiatives as the government has access to vast resources, which can ensure the wide reach and sustainability of the program, as reflected in the following quotes: When we started talking about replicability, and scaling up programs, we came to the conclusion that the only way it can work is by engaging with the government. Otherwise scaling up is not possible. Outside the government system we neither have the resources nor the infrastructure to scale up.the best way to reach every district in this country is through the government indeed we all know that working with government is not easy, but to have wide impact you do not have any other option. Challenges Media planners were of the view that while several social communication initiatives in the rural sector have succeeded in creating awareness, they have had limited success in changing the 104 The Journal of Family Welfare
prevailing mindset and initiating sustained behavior change. During discussions, several constraints in achieving the desired impact were identified, including the limited role of advertising agencies in the planning process, their lack of involvement in determining the resources for media mix, unrealistic timeframes for designing and implementing BCC campaigns and limited in-house capability to carry out social communications. Managers noted that advertising agencies often play only an ad hoc role in BCC campaigns and are dictated by the demands of the client: We are associated with a campaign for message design but are neither involved in strategy development nor in disseminating our creative ideas. Often guidelines for message development are provided by the funding agency, leaving little room for innovation. Other than large campaigns I have not seen too many people who would be willing to spend largely on activation alone and that is really sad....none of the agencies are competent do to direct outreach programs themselves. There is no in-house capability; you always have to outsource and again execution happens through a third party. Managers were of the view that coordinating with government ministries and departments is an extremely challenging task. For example, bureaucratic processes, lack of transparency in sharing ideas with advertising agencies and resistance to innovation hinder the timely progress and implementation of BCC campaigns. The disadvantages are the way the bureaucracy functions and the delays in decision-making, which do not work well with our very carefully planned implementation strategies. There needs to be a formal MoU between the implementing consortium and the government because that would allow the government to be involved in the program from the beginning and give the implementing agency access to its resources. Further, multiple stakeholders and differing perspectives within a ministry lead to lack of clarity regarding campaign objectives and strategies: We have a huge problem with the literacy mission because the people [various partners] have their own views. Often they are not able to understand the audience and feel that the print media and TV advertisements are adequate. Often, due to the short duration of BCC campaigns, program review, feedback and modification are limited. Further, advertising agencies are not involved in the monitoring and evaluation process and results are not shared with them; as a result, advertising agencies cannot take the learning to the next project. Directorate of Advertising and Visual Publicity (DAVP) DAVP can play a key role in implementing BCC campaigns to improve family health outcomes. The organization mainstreams information on key policies and programs of the government with the overall objective of empowering and sensitizing people across the country about key social development initiatives of the government. The organization provides single-window services to a number of government ministries and departments (96 client ministries and 1,111 departments), and is mandated to assist ministries in developing communication strategies. Further, DAVP reaches a large audience, including groups living in remote areas of the country. Vol. 56, Special Issue - 2010 105
Approximately 5,000 newspapers are empanelled with DAVP, of which some 200 are large newspapers, and while the rest are medium or small newspapers with effective reach at the regional level. Over 100 radio channels and 169 TV channels carry DAVP s media spots. Approximately 90 agencies are associated with DAVP to create content and disseminate information. In addition, DAVP has network of 32 field exhibitions units spread across the country that disseminate information on social and development issues through multimedia exhibitions. These units function as a vital communication link between the government and the people. DAVP disseminates information using a media mix, including print media advertisements, printed materials, outdoor publicity (hoardings, billboards and banners), exhibitions and audio-video spots. Several all-india campaigns are handled through an integrated media approach, using the song and drama division of the DAVP, which focuses on participatory communication and traditional media. DAVP s publicity campaigns are cost effective as its rates are lower than commercial rates. Challenges While DAVP could be an effective partner in implementing a BCC strategy nation-wide, it faces several challenges. For example, DAVP has to meet the needs of different client ministries and is required to handle a large volume of work on a dayto-day basis; however, its human resources are limited and lack the required skills. As a result, it is a challenge for DAVP to fulfill its mandate of social communication. For example, a manager said: The volume of work has increased tremendously; unfortunately we have not taken care of the human resources aspect. Our available human resources are not commensurate with the volume of work, so it is difficult sometimes people get burnt out. There is low motivation, taking leave becomes difficult, and the demands on the staff are too much. What is required is human resource training. As DAVP s media planning is based on the principle of social equity, the organization does not use the most effective media at an appropriate cost ; rather, it seeks to include a certain proportion of smaller/less effective media- -both print and electronic media--in its campaigns. Consequently, the impact of the campaign is diluted. As client ministries are responsible for message content and design, DAVP s role is often limited to disseminating information given by the client. Moreover, as media selection depends to a large extent on the available budget rather than effectiveness in reaching the target audience, appropriate media channels are not used. Managers expressed views such as: We don t have much say in the design of content...nowadays ministries also hire their own media consultants and try and thrust them on DAVP...there is a clash because the media consultant s perception is different from ours because they come from the private sector.. Message content, including the details of the schemes etc., is generated by the ministries concerned. We only help them to effectively disseminate what they want, according to the objectives they have set. Future roadmap for DAVP DAVP s mandate should be reviewed in the context of the growing role of the media in promoting social issues, equity-based social change and human rights. Wherever feasible, new emerging technologies and information and communication technology (ICT) could be used to achieve these objectives, which would also improve efficiency within the organization. There is an immediate need to build the capacity of its staff at both the organization and field 106 The Journal of Family Welfare
level. DAVP s financial management system would need to shift from a model based on social justice, fixed rates and a government salary structure to a business model, with competitive rates and salary packages, so as to attract the best skilled professionals to work in a competing market environment. As the nodal agency for positioning multi-media initiatives within the government, DAVP should be allowed greater flexibility and space in selecting outreach communication tools, identifying target audiences and themes for intervention, and determining the media planning process thereafter. To reduce DAVP s workload and improve efficiency and transparency, the possibility of outsourcing certain non-core activities could be considered. Implications For The Bcc Strategy Selection of an appropriate media mix Currently, BCC campaigns are not evidence-based or built on information provided by the funding agency. Effective communication strategies for behavior change need to be informed by a situation analysis that identifies key audience segments; level of media exposure and media habits; and the barriers and facilitating factors at the individual, community and system level with regard to adoption of the desired behavior. Advertising agencies and researchers need to work together to gain a clear understanding of the local context and prevailing community norms. Based on these inputs, a combination of IPC and mass media should be adopted; these approaches can play a complementary role, reinforcing each other based on audience needs. It is suggested that for rural audiences (of whom the majority are women and non-literate populations), an integrated approach with IPC taking the lead complemented by the mass media would be effective. Collaboration with the government ensures wider coverage and sustainability As discussed earlier, though working with the government is a challenge, it is the most feasible strategy to access government resources and scale up BCC interventions in the social sector. Advertising agencies and government ministries and departments should collaborate to design and implement BCC campaigns if sustained behavior change is to be achieved on a wide scale. Advocacy should be part of the BCC strategy Advocacy at all levels with the central and state government, partner organizations and community/key stakeholders is vital and should be an integral part of BCC strategies in the social sector. As a senior manager noted: A campaign is orphaned if not designed under the umbrella of advocacy communication. New and mid media can play an important role Technological innovations can play a definitive role in communicating with rural audiences. However, new media and ICTs should be used with caution in rural settings, keeping in mind issues of access and infrastructure support, and their effectiveness in meeting the objectives of the BCC strategy. Mid media, for example, community radio, could be an effective tool in promoting behavior change. Advertising agencies could provide technical assistance to selected NGOs in community radio programming to reach unreached/ difficultto-reach population groups. Need for a single window creative agency Bringing on board a single advertising agency from the time of planning to the final stage of dissemination ensures effective program implementation, consistency of messages and synchronized use of different media. As a manager said: Vol. 56, Special Issue - 2010 107
It is important to have the message consistent across all platforms and therefore you need one central agency that will be in charge from the beginning, making sure all the different levels of communication are functioning at the same time and are consistent. This is a massive logistical exercise. Monitoring and evaluation to be built into the BCC strategy A major lacunae identified by most advertising agencies is the lack of monitoring and evaluation systems in BCC campaigns. In general advertising agencies are involved in BCC campaigns on an ad hoc basis, and lack of information on the progress of the campaign prevents them from evaluating its effectiveness. It was suggested that advertising agencies should also be involved in the monitoring and evaluation of campaigns. Most BCC campaigns are of short duration and increase in knowledge is considered to be an indicator of success. Advertising agencies should be accountable for assessing the impact of BCC campaigns, measured primarily in terms of sustained behavior change rather than increase in knowledge. Reviews of successful BCC campaigns in India indicate that evidence-based longterm campaigns (spanning 4-5 years), an integrated multi-media approach, on-going monitoring and program modification, if necessary, are critical for ensuring sustained behavior change. References 1. Prasad, S. and Singh, M. 2010. Role of advertising agencies in behavior change communication, in M.E. Khan, Gary L. Darmstadt, T. Usha Kiran and D. Ganju, (eds.), Shaping demand and practices to improve family health outcomes in northern India: Exploring partnerships. New Delhi: Population Council (forthcoming). 108 The Journal of Family Welfare