Getting the Message Across
Nepal is a country of rich cultural diversity within which
the majority of communities are made up of highly stratified,
ethnically mixed populations. Individual settlements are
often isolated from one another due to the mountainous
terrain, scarcity of roads and difficulties of traveling
during the monsoon season. Most people live in traditional,
patriarchal family structures within which the status of
women is particularly low.
Under these circumstances, communicating safe motherhood
messages to key audiences is particularly challenging.
Messages, materials and methods need to be carefully tuned
to local levels of knowledge, cultural context and availability
of Essential Obstetric Care (EOC) services in each specific
district. This even includes modifying the drawings in
publications to reflect cultural diversity e.g. local dress
codes. Feedback loops play an important role in continually
improving materials.
In approaching this task, the Nepal Safer Motherhood Project
(NSMP) has played a central role in developing a National Safe
Motherhood Information, Education and Communication (IEC) strategy
and worked with its implementing partners to develop a wide
range of BCC materials and methods.  Partners have
mostly used these to disseminate key safe motherhood messages
at the community level through public events, such as street
dramas, puppet shows, rallies and song competitions. To complement
and reinforce the messages, the project has produced a series of
printed materials, such as flipcharts, leaflets, diaries and calendars.
NSMP has
used mechanisms within government, such as the District Public
Health Office (DPHO) and District Education Office (DEO), to deliver
key safer motherhood messages at community level. For example,
locally developed teaching materials on safe motherhood were included
in the DEO's Non-Formal Education (NFE) programme. Such classes
are thought to have been very effective in increasing community-level
awareness of these issues.
The project has also worked with selected partners to
produce a weekly radio magazine called 'Aama' (Mother),
which is broadcast from two regional and one local FM stations.
Radio programmes follow the themes of the National Safe Motherhood
IEC strategy, but also highlight local issues and promote the
obstetric services of local district hospitals. The programmes
invite listeners to send in questions that are then answered on-air
by local experts. 
Other broadcast media produced by NSMP include
three videos. These include 'Safe
Motherhood: Little Effort, Big Achievement' which was
produced on behalf of HMGN's Family Health Division and broadcast
on Nepal Television on National Women's Day in 2003.
In addition, NSMP collaborated
on the development and production of printed and audiovisual materials
under the SUMATA ('Care, Share and Prepare') national
communications initiative. This was in partnership with HMGN's
National Health Education, Information and Communication Centre
(NHEICC) and the Maternal and Neonatal Health Program (MNH).
The community-level impact of this multi-layered communications
approach is measured in two main ways. These are formal knowledge
surveys and a community-based survey process known as key-informant
monitoring. It involves trained villagers
interviewing their peers in order to assess how perceptions
and attitudes to obstetric care have taken place over time. | 
