Health Promotion, Education, and Behaviour Change Communication
This domain tests whether you can move a community from knowing to doing - designing messages, choosing channels, and measuring change rather than assuming that information alone changes behaviour.
Key distinctions
- IEC is one-way information (posters, leaflets). BCC is planned, evidence-based, two-way communication addressing the specific barriers behind a behaviour. SBCC adds the social and policy environment.
- Health Belief Model: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cue to action and self-efficacy. Barriers usually decide the outcome.
- Stages of change: pre-contemplation, contemplation, preparation, action, maintenance, relapse.
Designing a BCC activity
- Define one specific behaviour and audience segment, not a vague topic.
- Find the real barrier through discussion with the community.
- Choose channels - interpersonal counselling by ASHA/CHO, women's group meetings, school sessions, wall writing, local radio.
- Pretest the material, implement, then monitor coverage and the behaviour itself.
Worked example
A village has low immunisation completion. Knowledge is already high, but mothers say the session runs during field work and the ANM is often absent. The correct response is not more posters; it is rescheduling to a fixed early-morning Immunisation Day, an ASHA reminder the previous evening, and a written assurance that vaccines and staff will be present - addressing barriers and cues to action.
Traps
- Assuming awareness equals behaviour change; knowledge is necessary but not sufficient.
- Fear-based mass messaging without a feasible action the listener can take.
- Skipping pretesting, then blaming the community for "not understanding".
- Measuring only how many leaflets were distributed.