In his widely discussed maiden Independence Day speech, Prime Minister Narendra Modi pitched for efforts to build toilets to do away with the obnoxious reality of a majority of our women folk having to defecate out in the open. He also urged parliamentarians and the corporate sector to help build separate toilets for girls in Government schools across the country.
Modi’s clarion call was hailed by both friends and opponents alike. Welcoming the Prime Minister’s move, Congress leader and former Union Minister Jairam Ramesh suggested collective efforts to end the menace of open defecation in the country, while the corporates extended their support to Modi’s mission in a big way with huge funds. Several parliamentarians cutting across political lines too have agreed to come together to function as a public voice for an open defecation-free India.
As Gujarat Chief Minister, Modi had launched ‘Nirmal Gujarat’, a sanitation campaign that had elicited enthusiastic response from the State’s industrial houses, a model he has sought to replicate at the Centre. Modi’s penchant for cleanliness, whether it be of Ganga river or public spaces or Government offices, is well-known. His statement on the need to build more toilets rather than places of worship had hogged the national headlines, ahead of the election.
India’s record in providing proper sanitation to its people has been abysmal. According to Census data, over 70 per cent of rural households lack any facility. Even in the urban areas, one out of five households does not have in-house provisions for sanitation. Therefore, it will not be a cake-walk to make India open-defecation free by 2nd October, 2019, the 150th Birth Anniversary of Mahatma Gandhi, as envisioned by the Prime Minister.
Mere funding and infrastructural support from the governments, corporate sector and elected representatives alone won’t be able to facilitate or influence habits and behaviours which have shaped up over the centuries, whether it be pertaining to sanitation or use of river waters. Many an ambitious plan of successive governments including the much publicised Ganga Action Plan have failed to take off in the past due to the absence of a scientific approach in informing, educating and communicating with the target population.
The World Health Organisation defines Information, Education and Communication as “a public health approach aiming at changing or reinforcing health-related behaviours in a target audience, concerning a specific problem and within a pre-defined period of time, through communication methods and principles.” According to a WHO study, the use of IEC strategies can play a pivotal role in bringing about desired positive behavioural changes in a community.
The basic components of the IEC schemes in any given public health approach largely involve specific problem (a specific health problem that the behaviour change intervention addresses); target behaviour (a specific health-related behaviour that needs to be changed/reinforced); target audience (a specific target population whose behaviour needs to be changed), and time-frame (a given time period within which change in behaviour should be observed). To achieve desired positive health behaviours, posters, flyers, leaflets, brochures, booklets, messages for health education sessions, radio broadcast or television spots are used.
In India, under the umbrella of several ministries including the Union Ministries of Information and Broadcasting, Rural Development, Health and Family Welfare, and Women and Child Development, successive Governments at the Centre and the States have been employing IEC strategies to create awareness, mobilise people and make development participatory through advocacy and by transferring knowledge, skills and techniques to the people.
During the 12th Plan Period (2012-2017), the IEC Scheme was merged with the human resource development and capacity building Scheme. IEC, the largest component of the scheme, had an allocation of Rs 151 crore during the 12th Five-Year-Plan.
Unfortunately, huge gaps exist between the recommendations of the government and implementation of the IEC system. Despite State budgets having an impressive amount allotted for IEC activities, implementation has been a casualty. On an average, only 2.31 per cent of the allocations made are actually spent.
The funds allocated are also not well-utilised. For instance, between 2008 and 2011, more than Rs 100 crore was allocated to Uttar Pradesh, of which nearly 57 per cent remained unspent. In between 2010 and 2011, funds sanctioned under the project implementation plan for IEC and behaviour communication change stood at Rs 53.91 crore, while the expenditure was Rs 36.60 crore. As a result, nearly 32 per cent of the sanctioned amount remained unspent.
Currently, there exists no comprehensive IEC strategy with uniform standards and principles. Each IEC unit of a programme is operated separately even though the IEC messages for several programmes may be similar or the target populations may overlap.
The government’s IEC activities depend largely on English media for information dissemination, but studies have found that vernacular media, which extends to the most remote areas, has greater impact on people’s behaviour, since news reports read/heard in people’s mother tongues linger in their minds for longer.
Similarly, for most IEC programmes, material is largely limited to posters, television advertisements, radio announcements and other conventional channels of communication, despite the fact that different health issues have different target audiences, messages, etc. It is highly unlikely that the same channels of communication will be effective for all IEC programmes. There is a need to explore more participatory, innovative and unconventional methods of disseminating health-related information.
Information on IEC programmes and strategies are not readily available in various ministries and departments, posing a challenge. This makes it imperative to put in place up-to-date websites and to publish reports on paper or online, which can be used by both professionals and public alike.
As for the loopholes in the feedback mechanisms and monitoring of IEC programmes, there is no standard system in place. This is especially important for ongoing IEC programmes, such as anti-smoking campaigns, which are required to be carried on for several years and need to be improved and updated regularly.
Clearly, looking for fool-proof solutions to these problems is the need of the hour. To begin with, the Government is not investing enough in trained professionals for the promotion of IEC programmes or health awareness. Health writers need to be trained, if need be, with help from outside agencies, to participate in IEC campaigns.
Voluntary media organisations such as the Indian Media Centre and health awareness groups like the Heal Foundation provide strong social advocacy platforms which facilitate communication between stakeholders in order to raise public awareness on health and hygiene issues and bring about desirable changes. The Government should involve such groups to meet its IEC objectives.
Similarly, collaboration across ministries for IEC-based programmes would make the effort more effective. Most of the existing IEC programmes are limited to publishing and disseminating materials. To move forward, it is important to help the target audience take decisions and motivate them to change their behaviour rather than simply provide information.
It is not enough to publicise health messages as is done in most IEC programmes. Once the enabling factors and barriers are identified, the Government must take concrete steps to remove barriers and create a conducive atmosphere to bring about a positive behavioural change. Only then can ambitious programmes involving popular participation such as cleaning of Ganga and ending open defecation can succeed in the long run.
(The writer is Senior Fellow and Editor with Vivekananda International Foundation)