Behavior Change Communication Program Research Articles

Understanding fertility behavior of the Forcibly Displaced Myanmar Nationals in Bangladesh: A qualitative study.

Rohingya- the Forcibly Displaced Myanmar Nationals (FDMN)- are largely characterized by a high total fertility rate (TFR) and a low contraceptive prevalence rate. This study aimed to explore the reasons behind their high fertility behavior by utilizing the Theory of Planned Behavior. We adopted a cross-sectional qualitative research approach. Fifteen semi-structured, face-to-face in-depth interviews were conducted with the Rohingya husbands, wives, and community leaders (Majhi and Imam/Khatib) living in Camps 1 and 2 of Ukhiya Refugee Camp, Cox's Bazar, Bangladesh. We analyzed the qualitative data using the thematic analysis approach. The Muslim-majority FDMN predominantly constructed the fertility outcome as the will and order of Allah. On the one hand, the Rohingya parents highlighted various religious, political, economic, and social advantages of having more children, especially sons. On the other hand, beliefs about religious restriction, fear of side effects, and community pressure against contraception sustained the reality of the low contraceptive prevalence rate in the community. Alarmingly, the Rohingya religious leaders and mass people were found highly politically motivated to continue the practice of high fertility with a view to 'expanding the Rohingya community' or 'to increase Muslim soldiers', so that they may fight back and take control of their ancestors' place in Myanmar in the future. Furthermore, these pronatalist attitudes and beliefs translated into high TFR through various high-fertility-supportive social norms and practices widely prevalent in the Rohingya community. These include child marriage, gendered division of labor, women's subordinate nature, the Purdah system, and joint-family members' support during childbirth and rearing. Religion, ethnic identity, and the unique political context and experiences of the Rohingya people jointly explain their high fertility behavior. This study warrants the urgency of initiating social and behavior change communication programs to change the religiopolitically-motivated high-fertility notions that prevailed in the Rohingya community.

Behavior Change Communication as a Strategy to Educate Parents in Guiding Children to Successful Online Learning

Since before the outbreak of the corona virus, parents have an obligation to support their children's education in schools. The implementation of online learning as an effort to prevent the spread and transmission of this virus has made the role of parents even greater in the education of their children. The research is aimed at finding out how the behavior change communication program carried out by the government is implemented and what obstacles parents encounter in assisting their children to study at home. This is a qualitative research with a phenomenological approach. The phenomenological approach was chosen because the researchers wanted to dig deeper into the experiences of the informants, especially related to assisting children in online learning. Data was collected by semi-structured interviews with 20 informants consisting of parents of students in grades 1 to 3 of elementary schools in Jakarta. The results of this study indicate that behavioral change communication carried out in order to change the behavior of parents so that they want to accompany their children to study from home is quite successful after going through the pre-contemplation, contemplation, preparation, action and maintenance stages.

Coverage of Coronavirus Disease-2019 (COVID-19) Booster Dose (Precautionary) in the Adult Population: An Online Survey.

BackgroundThe coronavirus disease-2019 (COVID-19) pandemic devastated public health worldwide, including India. COVID-19 vaccines and their boosters are life-saving developments that have helped prevent and control the spread of COVID-19. We conducted this study to assess the coverage of the booster dose in an Indian population (the third dose of the COVID-19 vaccine in India is referred to as the booster or precautionary dose), record the reasons for not taking the booster dose, and determine the effectiveness of the booster. The levels of adherence to COVID-19 precautionary behavior was also assessed. MethodsWe conducted a descriptive, cross-sectional study using convenient sampling via an online survey of 550 respondents older than 18 in the second quarter of 2022. The respondents were distributed among 18 states and union territories in India. The data were analyzed as simple proportions and percentages.ResultsOf the 550 respondents, 152 (27.6%) received the booster dose, indicating low coverage. A small percentage of respondents (7.2%) reported suffering from COVID-19 following the booster, of whom 91% were medical professionals. The most common reported reason for not taking the vaccine was that the respondents were not yet due for their dose (48.1%). The time between the second dose of the COVID-19 vaccine and the booster had no impact on infection rates. Men were less likely to adhere to COVID-19 precautionary behavior than women, despite similar vaccination rates.ConclusionThe COVID-19 vaccine booster had a low acceptance in our study population, with roughly one-quarter of the population receiving the booster. The booster dose has been influential in the prevention of COVID-19. Most respondents followed behavioral safety measures despite the decline of active cases of COVID-19 in India following the Omicron wave. Our results indicate a need to strengthen public strategies to affect behavioral changes, such as improving India's Behavior Change Communication program to ensure adequate booster dose coverage.

Can mass media prevent AIDS: the need for well planned behaviour change communication programmes

Thispaper reviews two ways of media utilization:to provide regular entertainment programmes and news events;and to relay specific messages for the purpose of influencing attitudes and behaviour. Obstacles to the effective use of the media for attitude and behaviour change are outlined and communication and training activities in order to overcome these obstacles are recommended

PROTOCOL: Strengthening women's empowerment and gender equality in fragile contexts towards peaceful and inclusive societies: A systematic review and meta-analysis.

This review builds on 3ie's (international initiative for impact evaluation) evidence gap map (EGM) of the impact evaluation and systematic review (SR) evidence base of interventions aiming to promote peaceful and inclusive societies in fragile contexts. The EGM identified a cluster of studies evaluating gender equality-focused behaviour change communication programmes and raised interest in investigating the evidence base for understanding the role of women more broadly as agents of change in developing peaceful and inclusive societies. Building on the cluster of evidence identified in the EGM, our review will increase generalisability of findings from single studies and focus on interventions across a broad range of geographical locations, settings and populations, types of implementations and outcomes. We will also address (when possible) the identified gaps in literature regarding metaanalysis in conflict-affected contexts. As such, we propose the following objectives: (1) The primary objective of this review is to identify, assess and synthesise evidence on the effect of gender specific and gender transformative interventions within the context of the four pillars of United Nations Security Council Resolution (UNSCR) 1325 on women's empowerment and gender equality in Fragile and Conflict Affected States/Situations (FCAS). The SR will facilitate the use of evidence in informing policy and practice decisions within the field of transition aid, particularly as it relates to gender focused programming. (2) Our second objective is to assess how these interventions contribute to inclusive and sustainable peace in conflict affected situations. We will compare the effectiveness of these different types of interventions through the lenses of their ecological level, types of impact on women's empowerment, local context of gender inequality and conflict. To achieve these objectives we aim to answer the following questions: (1) What are the impacts of gender transformative and specific interventions on women's empowerment and gender equality in FCAS? (2) What are the effects of these interventions on sustainable peace? (3) To what extent do effects vary by population group, ecological level and types of interventions? (4) What are contextual barriers to and facilitators of intervention effectiveness?

Evaluating capacity strengthening for social and behavior change communication: a systematic review.

SummaryInternational social and behavior change communication (SBCC) programs often include capacity strengthening (CS). Quality evaluations of CS can help justify investing in these activities and guide the design of future CS activities. To inform and improve future CS efforts, a comprehensive examination of ways in which activities aimed at strengthening capacity for improved SBCC are assessed is needed. Unfortunately, systematic literature reviews about the assessment of CS activities in SBCC programs are rare. This systematic review helped fill this gap and explored ways in which CS interventions for improved SBCC in low- and middle-income countries (LMICs) evaluated their success. A search of electronic research databases yielded a total of 1033 potentially eligible publications. Reviewers identified 19 eligible publications that assessed the effects of activities for improved SBCC capacity. Reviewers identified seven findings, including the fact that evaluating CS for improved SBCC is rare, with only three publications having focused exclusively on evaluating SBCC capacity. This current review also identified several shortcomings around the quality of writing as well as sufficient detail to support certain claims and conclusions, especially around issues of sustainability. Until quality evaluations of CS activities are better documented, future CS activities for SBCC will find it difficult to identify effective CS approaches and demonstrate their contribution to improved SBCC in LMICs. The review discusses several implications and offers practical recommendations regarding ways to improve the evaluation of CS activities in SBCC.

Knowledge, attitude, and health seeking behavior on leprosy among urban adults in Kancheepuram district of Tamil Nadu: A Community-based cross-sectional study.

Introduction:Although various measures are taken to create awareness about the epidemiological features of leprosy and encourage health-seeking behavior, they have seldom been able to tackle the high incidence of new leprosy cases in India.Objective:To determine Leprosy-related knowledge, attitude, and health seeking behavior among the urban population in Kancheepuram district of Tamil Nadu.Materials and Methods:This community-based cross-sectional study was conducted among a sample size of 640 people above 18 years of age residing in the study area, selected by multistage random sampling. A structured pretested questionnaire was used for data collection, and the data analysis was done using SPSS version 22.Results:Among the study participants, 54.7% of the participants had adequate knowledge and 23.3% had favorable attitude towards leprosy. With regard to knowledge, 66% of the participants believe that leprosy is a serious disease, and 71.2% of them were aware of transmission of leprosy from person to person. With regard to attitude, 57.7% were afraid of being diagnosed with leprosy, and 57% felt compassion and desire to help those diagnosed with leprosy. With regard to health-seeking behavior, around 83% preferred treatment from government hospitals and allopathic treatment. Male sex, occupation, education, and marital status were found to be having statistically significant association with knowledge, while the latter two were found to be associated with favorable attitude towards leprosy.Conclusion:Unfavorable attitude and inadequate knowledge regarding leprosy was found among the study participants. Behavior change communication programs have to be enhanced at community level to improve the knowledge and attitude regarding leprosy among the population.

Hand washing behavior change effect of community-based hygiene and sanitation intervention in low resource setting.

Lack of hygiene and sanitation causes significant disease, disability and death. Majority of diarrheal diseases are related to hygiene and drinking water. Hand washing with soap after toilet use and before eating reduces these risks significantly. This report is based on a behavior change project in the rural community setting (union council Nahqi), Peshawar, Pakistan aimed to improve hygiene- and sanitation-related behavior. A pre-intervention survey was conducted at household level (n=958), followed by a structured behavior change communication program with motivational and educational material and key health messages for three months. Lastly, an end-line survey was conducted measuring change in practice domains. All the domains of hygiene and sanitation showed statistically significant improvement (11-59% P<0.001), including handwashing before meals (28.2%), before cooking (54.1%), before child feeding (21.2%), after defecation (30.6%); tooth brushing twice daily (7.3%); nail clipping at least weekly (16.3%); bathing daily (11.3%); change of clothing twice weekly (24.7%); covering the water containers (59.3%) and house orderliness (30.6%). The findings conclude that a behavior change communication program that is in accord with community needs, level of their understanding, beliefs and sociocultural norms is well received for positive behavior change.

The fidelity and dose of message delivery on infant and young child feeding practice and nutrition sensitive agriculture in Ethiopia: a qualitative study from the Sustainable Undernutrition Reduction in Ethiopia (SURE) programme

BackgroundIn Ethiopia, 38% of children under 5 years of age are stunted (low height for age). A novel government-led intervention called the Sustainable Undernutrition Reduction in Ethiopia (SURE) aims to tackle the burden of stunting by improving complementary feeding and dietary diversity among young children. The SURE programme design applies a transtheoretical model of behaviour change, whereby exposure to recommended infant and young child feeding (IYCF) and nutrition-sensitive agriculture messages is a first stage to adopting key behaviours. This qualitative study explored the fidelity and dose of the IYCF and nutrition-sensitive agriculture messages delivered by extension workers.MethodsA qualitative study was conducted across four regions in Ethiopia (Oromiya, Amhara, SNNP and Tigray) between April and October 2017. Across the four regions, 81 key informant interviews, 90 FGDs and 81 observations were conducted with 180 extension workers, 18 development agents and 54 mother-father pairs. Digitally recorded audio files were transcribed verbatim, and the data were analysed based on a framework analysis approach using NVivo (version 12) by coding and categorising texts into major themes and sub-themes.ResultsSURE target households had the intended exposure to messages about exclusive breastfeeding, timing of initiation of complementary feeding, food groups, diversified food consumption, irrigation, rearing small animals and vegetables. Few households reported receiving messages on the content or frequency of complementary feeding of a child beyond 6 months of age. Frequency of household visits and hence exposure to SURE messages was also variable. Agricultural messages delivered during household visits focussed on improving standard agricultural practices and rarely covered the importance of nutrition-sensitive agriculture to improve household or child nutrition.ConclusionDespite variability observed in the breadth and depth of messages delivered, large-scale behaviour change communication programmes can achieve moderate to good message exposure among target groups. Qualitative data provide an in-depth insight into fidelity and may supplement our understanding of programme roll-out and implementation. Further research is required to understand longer-term message saturation including frequency and reach.

Widening the arc of indigenous communication: Examining potential for use of ICT in strengthening social and behavior change communication efforts with marginalized communities in India

AbstractMarginalized communities in India have their own systems of governance, culture, and communication. They remain socially and physically distanced from mainstream methods of communication. At the same time, India is witnessing a digital revolution, represented by a phenomenal growth in mobile and internet penetration. To date, however, scholarly discourse on use of ICT among marginalized communities in India has, for the most part, been limited.Four related field studies initiated by UNICEF revealed that melding indigenous (local) and mainstream communication channels can be an optimal approach to social and behavior change communication with marginalized communities across multiple social development themes. They indicated the increasing popularity of mobile and other digital media among marginalized communities, especially youth, and the potential for utilizing local communication methods along with new digital media. This hypothesis is supported by findings from one of the field studies, a digital training and communication tools/materials pilot for frontline workers, to improve nutrition behaviors among marginalized communities. They also provided field evidence for the efficacy of mobile technology in civic participation, education, and health. These findings have far‐reaching import for designing inclusive social and behavior change communication programs for marginalized communities where local and mainstream channels (particularly digital) complement each other.

A study on addiction pattern among construction workers in a metropolitan city of Southern India

Background Construction sector is a booming industry and an important sector which contributes significantly to GDP. Construction labour form 7.5 of the world labour force. In India nearly two thirds of the contribution to the net domestic product is by the unorganized sector. The Substance Abuse and Mental Health Services Administration study shows that Substance abuse among workers poses major health risks and productivity of workers.Objective To understand the health problems and addiction pattern among the construction workers and to enable appropriate interventions.Methodology A cross sectional study conducted at two construction sites in a metropolitan city during 2015.The construction sites were selected in southern Bengaluru and all workers were enrolled as study subjects. A pretested semi structured questionnaire was used to collect the data. Descriptive statistics like percentages were calculated and Chi square test was done to check the significance of difference. Results Majority of them 87.3 belonged to 15-45-year age group 40.3 to class IV socioeconomic status 40 were Hindu by religion. Around 40 of them were Illiterates and 68 of them were unskilled workers. The prevalence of Tobacco smoking Tobacco chewing and Alcohol consumption were 26.98 47.62 and 32.28 respectively. There was a statistically significant association P lt 0.05 between Tobacco smoking Tobacco chewing and morbidity status.Conclusion The prevalence of Tobacco use and alcohol consumption is high among the construction workers. There is need for intervention programmes like regular health education sessions behaviour change communication programmes screening camps for cancers and counselling for de-addiction therapies

A study on addiction pattern among construction workers in a metropolitan city of southern India

Background Construction sector is a booming industry and an important sector which contributes significantly to GDP. Construction labour form 7.5 of the world labour force. In India nearly two thirds of the contribution to the net domestic product is by the unorganized sector. The Substance Abuse and Mental Health Services Administration study shows that Substance abuse among workers poses major health risks and productivity of workers.Objective To understand the health problems and addiction pattern among the construction workers and to enable appropriate interventions.Methods A cross sectional study conducted at two construction sites in a metropolitan city during 2015.The construction sites were selected in southern Bangalore and all workers were enrolled as study subjects. A pretested semi structured questionnaire was used to collect the data. Descriptive statistics like percentages were calculated and Chi square test was done to check the significance of difference. Results Majority of them 87.3 belonged to 15-45-year age group 40.3 to class IVsocioeconomic status 40 were Hindu by religion. Around 40 of them were Illiterates and 68 of them were unskilled workers. The prevalence of Tobacco smoking Tobacco chewing and Alcohol consumption were 26.98 47.62 and 32.28 respectively. There was a statistically significant association P lt 0.05 between Tobacco smoking Tobacco chewing and morbidity status.Conclusion The prevalence of Tobacco use and alcohol consumption is high among the construction workers. There is need for intervention programmes like regular health education sessions behaviour change communication programmes screening camps for cancers and counselling for de addiction therapies.

Prevalence and associated determinants of malaria parasites among Kenyan children

BackgroundApproximately 80% of deaths attributed to malaria worldwide occurred mainly in Africa in 2015. Kenya is one of the major malaria endemic countries, making malaria the leading public health concern in this country. This study intended to document the prevalence of malaria and determine associated factors including socioeconomic status among children aged 6 months to 14 years in Kenya.MethodsThis study analyzed the secondary data extracted from the 2015 Kenya Malaria Indicator Survey (KMIS), a cross-sectional country representative survey. Associations of demographic, socioeconomic, community-based, and behavioral factors with the prevalence of malaria in children were analyzed using multivariable logistic regression analysis.ResultsData from 7040 children aged 6 months to 14 years were analyzed. The prevalence of malaria showed an upward trend in terms of age, with the highest prevalence among children aged 11–14 years. Prevalence was also higher among rural children (10.16%) compared to urban children (2.93%), as well as poor children (11.05%) compared to rich children (3.23%). The likelihood of having malaria was higher among children aged 10–14 years (AOR = 4.47, 95% CI = 3.33, 6.02; P < 0.001) compared with children aged under 5 years. The presence of anemia (AOR = 3.52, 95% CI = 2.78, 4.45; P < 0.001), rural residence (AOR = 1.71, 95% CI = 1.31, 2.22; P < 0.001), lack of a hanging mosquito net (AOR = 2.38, 95% CI = 1.78, 3.19; P < 0.001), primary education level of the household head (AOR = 1.15, 95% CI = 1.08, 2.25; P < 0.05), and other factors, such as the household having electricity and access to media such as television or radio, were also associated with the likelihood of infection.ConclusionThis study demonstrated the need to focus on awareness programs to prevent malaria and to use existing knowledge in practice to control the malaria burden in Kenya. Furthermore, this study suggests that improving the information available through the mass media and introducing behavior change communication and intervention program specifically for those of poor socioeconomic status will help to reduce malaria cases.

English

HIV testing and counseling (HTC) indicators are captured for programming, decision making and program monitoring and evaluation. A preliminary review of Midlands province HTC data showed that a small proportion of men and children were being tested for HIV. The secondary HTC data to determine trends to inform programming was therefore analyzed. A descriptive study using secondary HTC data was carried out. Microsoft Excel was used to come up with Chi square for trends analysis and p-values were generated using Epi info 7. There were 623,174 clients in the HTC dataset from 2010 to 2014. There was a significant increase in HTC coverages from 4% (n=59 512) in 2010 to 21% (n=382 559) in 2014 (X2= 898 517; p<0.01). All districts recorded the highest HTC coverages in 2014, Gokwe having the lowest coverage of 14% (n=4 778). HTC positivity rates declined from 29% in 2010 to 7% in 2014 (X2= 32 551; p<0.01). There was a significant increase in HTC coverages across all age groups, sexes and districts. Positivity rates were significantly higher among males than females. Low HTC coverages and high positivity rates among men indicate the urgent need for routine HTC educational campaigns and behavior change communication programs for men. Key words: Human immunodeficiency virus testing and counseling, secondary dataset analysis, Zimbabwe.

Knowledge, Attitudes and Behaviours related to Sexually Transmitted Infections and HIV/AIDS among factory workers in Seethawaka Export Processing Zone, Avissawella, Sri Lanka

Introduction: Factory workers in Export Processing Zones (EPZs) have been identified as a group with vulnerable behaviour for acquiring Sexually Transmitted Infections (STIs) including HIV due to many social and environmental risk factors. This study was done to assess the knowledge, attitudes and behaviours related to STI and HIV/AIDS among male and female factory workers in Seethawaka EPZ. Method: A descriptive cross sectional study was carried out among 430 factory workers in Seethawaka EPZ, using self-administered questionnaire. Statistical analysis was done using SPSS 16.0. Results: Majority (85%) had satisfactory level of knowledge on HIV. Age (p= 0.0001), education level (p=0.031) and working category (p= 0.0001) were significantly associated with knowledge. Only 7.6% tested for HIV though 83.2% knew about testing. Knowledge on STIs was fairly good (>75%) except for awareness on asymptomatic nature of STIs (24.4%). Many (56.7%) showed poor level of attitudes towards people living with HIV (PLHIV). Education level (P=0.0001), working category (p=0.003) and HIV related knowledge (P=0.0001) had a significant association with attitudes. Sex with non-regular partners (NRP) during the past 12 months was reported by 36.2% males and 27.4% females but only 64% of men and 48.4% women had used a condom with their last NRP. Male to male sex was prevalent in 14.6% of males and only 30% of them had used condoms at last anal sex. Conclusions: Knowledge of factory workers on HIV and STIs was satisfactory but there were some areas those need further strengthening which would improve workers’ attitudes towards PLHIV. Furthermore, behaviour change communication and condom promotion programmes are highly recommended to promote safe sex.

Community-based behavior change promoting child health care: a response to socio-economic disparity.

BackgroundEarly initiation of breastfeeding after birth is a key behavioral health factor known to decrease neonatal mortality risks. Yet, few demographic studies examined how a community-based intervention impacts postpartum breastfeeding among the socio-economically deprived population in Sub-Saharan Africa. A post-intervention evaluation was conducted in 2011 to measure the effect of a UNICEF-led behavior change communication program promoting child health care in rural Niger.MethodsA quantitative survey is based on a post hoc constitution of two groups of a study sample, exposed and unexposed households. The sample includes women aged 15–49 years, having at least one child less than 24 months born with vaginal delivery. Rate ratio for bivariate analysis and multivariate logistic regression were applied for statistical analysis. The outcome variable is the initiation of breastfeeding within the first hour of birth. Independent variables include other behavioral outcome variables, different types of communication actions, and socio-demographic and economic status of mothers.ResultsThe gaps in socio-economic vulnerability between the exposed and unexposed groups imply that mothers deprived from accessing basic health services and hygiene facilities are likely to be excluded from the communication actions. Mothers who practiced hand washing and used a traditional latrine showed 2.0 times more likely to initiate early breastfeeding compared to those who did not (95 % CI 1.4–2.7; 1.3–3.1). Home visits by community volunteers was not significant (AOR 1.2; 95 % CI 0.9–1.5). Mothers who got actively involved in exclusive breastfeeding promotion as peers were more likely to initiate breastfeeding within the first hour of birth (AOR 2.0; 95 % CI 1.4–2.9).ConclusionsA multi-sectorial approach combining hygiene practices and optimal breastfeeding promotion led to supporting early initiation of breastfeeding. A peer promotion of child health care suggests a model of behavior change communication strategy as a response to socio-economic disparity.

Pregnant Women Diet Quality and Its Sociodemographic Determinants in Southwestern Bangladesh.

Diet diversity of pregnant women is associated with nutrition sufficiency, micronutrient adequacy, and pregnancy outcomes. However, the sociodemographic determinants of diet diversity among pregnant women in low-income countries are not well studied. The analysis was undertaken to study the determinants of high dietary diversity and consumption of micronutrient-rich foods by pregnant women from rural Bangladesh. Pregnant women (508) were randomly selected from southwestern Bangladesh and interviewed to collect data about diet and sociodemographic characteristics. A 24-hour recall was used to collect information about diet. Diet diversity score was calculated for 9 major food groups. All analyses were conducted using STATA SE 12. The overall mean diet diversity score was low at 4.28 and was significantly high among pregnant women who have higher educational achievement, whose husbands' occupation was business, who live in households of 4 or more family members, and who were dwelling in a house with more than 1 room. Highest gap on knowledge and consumption was reported for 3 food groups including dairy foods, eggs, and dark green leafy vegetables. Consumption of dairy and eggs was lower among women from low socioeconomic status, but no significant association was found between sociodemographic characteristics and consumption of leafy vegetables. Our analysis has shown that diet quality of pregnant women was poor and intake of micronutrient-rich foods was low despite having knowledge about the importance of these foods, underscoring the need for promoting the diet quality in developing countries through behavior change communication programs.

Behavior change communication and mobile populations: the evaluation of a cross-border HIV/AIDS communication strategy amongst migrants from Swaziland

ABSTRACTThis study investigates the effect of being exposed to the Soul City Southern Africa Regional OneLove campaign, a behavior change communication program, on sexual behavior and condom use among a mobile population in Swaziland. Data for this study come from a nationally representative sample of 845 individuals who reported traveling to neighboring countries for at least two weeks at any time in the previous two years. Respondents were asked about exposure to the campaign through television, radio, booklets, posters, and advertisements both in Swaziland and in the other countries where they had traveled in the previous two years. Odds ratios were used to estimate the relationships between the HIV/AIDS outcomes of interest and program exposure for the full sample as well as separately for males and females. The program had no effect on reducing known risky behaviors such as having multiple sexual partners. However, men exposed in Swaziland only (AOR = 3.4, CI 1.2–9.4) and in Swaziland and another country (AOR = 2.8, CI 1.0–7.7) were more likely to report using a condom at last sex. In the full sample, those exposed in Swaziland were more likely to report using a condom at last sex (AOR = 2.6, CI 1.3–5.3) and a condom at last sex with a regular partner (AOR = 2.3, CI 1.1–4.8). Men who reported multiple sexual partnerships and who were exposed in Swaziland and another country were nine times as likely to report condom at last sex than men with no exposure. Respondents exposed in Swaziland and another country were more likely to have been tested for HIV; this was true for the total population (AOR = 2.9, CI 1.1–7.9) and for men separately (AOR = 3.3, CI 1.1–10.1). These findings provide support for more regional HIV prevention programs in Southern Africa as a way to increase positive behaviors among mobile populations.

A 2-Year Integrated Agriculture and Nutrition and Health Behavior Change Communication Program Targeted to Women in Burkina Faso Reduces Anemia, Wasting, and Diarrhea in Children 3–12.9 Months of Age at Baseline: A Cluster-Randomized Controlled Trial1–3

Background: Among young children in Burkina Faso, anemia and chronic and acute undernutrition are widespread.Objective: This study assessed the impact of Helen Keller International’s (HKI) 2-y integrated agriculture [homestead food production (HFP)] and nutrition and health behavior change communication (BCC) program, targeted to women, on children’s (3–12.9 mo old at baseline) anthropometry (stunting, wasting, and underweight), mean hemoglobin (Hb), anemia (Hb < 11 g/dL), and diarrhea prevalence.Methods: We used a cluster-randomized controlled trial, with 55 villages randomly assigned to a control group (n = 25) or 1 of 2 treatment groups (n = 15 each), which differed by who delivered the BCC messages [older women leaders or health committee (HC) members]. We used difference-in-difference (DID) estimates to assess impacts on child outcomes.Results: We found marginally significant (P < 0.10) impacts on Hb (DID: 0.51 g/dL; P = 0.07) and wasting [DID: −8.8 percentage point (pp); P = 0.08] and statistically significant (P < 0.05) impacts on diarrhea (−15.9 pp; P = 0.00) in HC compared with control villages among children aged 3–12.9 mo and larger impacts for anemia (DID: −14.6 pp; P = 0.03) and mean Hb (DID: 0.74 g/dL; P = 0.03) among younger children (aged 3–5.9 mo). However, we found no significant impacts on stunting or underweight prevalence. Plausibility was supported by greater improvements in women’s agricultural production and maternal infant and young child feeding and care knowledge and practices in HC compared with control villages.Conclusions: HKI’s 2-y integrated HFP+BCC program (HC group) significantly improved several child outcomes, including wasting (marginal), diarrhea, Hb, and anemia, especially among the youngest children. This is the first cluster-randomized controlled trial of an HFP program that documents statistically significant positive effects on these child nutrition outcomes. This trial was registered at clinicaltrials.gov as NCT01825226.

The Influence of Self-Disclosure on the use of Contraceptives among Couples in Changamwe Constituency, Mombasa County

The purpose of the research was to study the influence of self-disclosure on contraceptive use among couples in Changamwe constituency. The study adopted descriptive survey design. Multi-stage sampling was used in arriving at the target population in Migadini Estate. A self-administered questionnaire was used to collect data from the 269 respondents. The study found out that self-disclosure influenced contraceptive use because there was a weak but positive significant correlation between self-disclosure and contraceptive use. Pearson’s correlation showed that they were correlated, r (269), = .32, p < .001. Therefore, behaviour change communication programmes should focus on self-disclosure in order to convince married couples and romantic friends to disclose about their preferred contraceptives. Keywords: self-disclosure, contraceptive use, correlation