1. Key family practices: promoting social and behaviour change for child survival and development

2. KFP

3. 1.Behaviour change communication Interpersonal communication by community volunteers Proximity and traditional media, cinema, theatre 2. Community participation for social change Open discussions and village meetings 3. Social mobilization Creation of partnerships and networks 4. Advocacy Strategies

4. Community empowerment Collective and individual learning: 1.Advocacy meeting in each village Introduce approach, build trust 2.Village meeting to elect the community volunteers 3.Training of key persons from each village (chief of the village and community volunteers) Collective action: 5.Creation of a local core group for the promotion of KFP 6.Participatory community assessment / auto-diagnosis 7.Interpersonal communication : Door to door 8.Village meetings to discuss the progress 9.Annual assessment and development of action plan 10.Annual celebration of champions (villages and families)

5. Participants at community level Health staff Women groups, local associations, youth Relevant network: Traditional chief Imam Village chief Community volunteers (relais) Population of the village

8. Results: social change Oumarou Kachallo, village chief, Gidan Bawa: «I organize people to clean the village and organize village meetings to discuss child health” Example of Gidan Bawa:  Every case of non-vaccination or of infectious child disease is discussed in the village meeting  Sundays are public sanitation days  Public garbage bins. Making compost and transporting to fields.  Mandatory delivery in health centres  Organization of medical transportation for pregnant women to the prenatal consultations visits and delivery

11. Challenges Some KFP are easier to adopt than others Social norms approach can help us understand some behaviors and the barriers behind to adopt The example of exclusive breastfeeding

12. Factual beliefs about breastfeeding Babies need water to survive in Sahel region. “Do the health workers themselves not give water to their children?” (Need of empirical expectations) “Depriving the child of water is violating the right of the child” (core belief) Mothers need to check if they have good or bad milk. (scripts) The lack of milk is a sign of bad milk. If milk is hot is a sign of bad milk. The yellow color of colostrum, is seen as bad. If it’s thick, the child who consumes it will have a strong force, he will walk quickly.

13. Social expectations matter What do the husbands expect of his wives (normative expectations) Protect their babies from danger. They ask Marabouts to prepare a beverage and give to the child “Rubutu”. What people in the community think mothers should do with their babies Older women think mothers should conduct the test of milk « kaikai » Older women think mothers should give the « bauri» to the baby. « When the child doesn’t drink the bauri, he constantly upset stomach”. Older women think mothers should give animal’s milk to children as the Prophet did Are there consequences for not complying: Not to accomplish the functions of good mother The fear that child can die

14. Social expectations matter What mothers see/think than others do (empirical expectations) Old women say what they did in the past (generational expectations about what mothers in law did when they were young) The community expect from elders to counsel young people

16. Further analysis is necessary Conditional preferences Mothers prefers to wait and check their milk before breastfeed their babies. What does it matters mothers? Who is affecting mother’s decisions? Social expectations If you breastfed your baby without giving water, what would others do/say? If the rest of the mothers starting breastfeeding without giving water to their babies, what would yours mothers in law say/do?

17. How we can reinforce positive social and behavior changes? More focus in the relevant network (discussions in special focus groups mothers in law, young adolescents, husbands) Dialogue strategies focus in core beliefs. Values deliberations with the core group Building on influential persons in a coordinated action. Encouraging interdependent decision to abandon and follow the new norm. “Elder declaration”. Visibility Research about context analyse, social dynamics, behaviour rules, social networks

18. How we can engage social change faster? Focusing in changing people’s expectations through a collective action Recategorizing KFP: -Customs create a new norm approach use treated bed-nets; use of ORS; washing hands; feeding children after 6 m; using preventive health services; appropriate care seeking - Social norms abandonment of a norm a shift to a new one norm Exclusive breastfeeding and birth spacing

19. THANK YOU!