Developing the Public-Private Partnership Handwashing Initiative Behavior Change Campaign

“Remember to HWWS for the Health and Development of Your Child”

Steps in Designing our Audience Centered Communications in Vietnam

Step 1: Who do we want to communicate to? •  Method: Audience Research with mothers/caretakers

Step 2: How do we organize research findings? •  Method: Use a behavior change model to guide research

questions and to analyze data Step 3: What do we want to say?

•  Develop Key Communications Messages Step 4: How do we convey our messages most

effectively? •  Campaign positioning and execution •  Below the Line activities •  Interpersonal communications component

Step I: Audience Research Research Objectives •  Investigate hand washing behaviours among

mothers of children under 5 years; •  Examine availability of sanitation, water and soaps

in and around household; •  Understand motivating factors and barriers in

doing HWWS •  Document current channels of communication

Completed in Dec. 06 Location - 8 provinces

North: Son La, Phu Tho, Hung Yen Central: Nghe An, Binh Dinh South: Vinh Long, Dong Thap, Ninh Thuan

Methods •  Qualitative –  16 FGDs –  56 product trials with bar

soap –  56 in-depth interviews

•  Quantitative –  720 structured observations

from 6-9 am daily

Understanding our audience - Mrs. Thuy •  Lives in rural VN •  Farmer •  HH: $50-150/month •  Complete primary/

secondary school •  Values: The most

“important” and “enjoyable” daily activities are related to well-being of their children.

•  “Everything I do is for my children first”

•  “I work to have money for my children”

•  “I care for my children by cooking good meals, teaching them, making sure they are clean and so on”

What our moms like Ms. Thuy value •  Having a child = huge involvement among all moms •  The family is the corner stone of Vietnamese society •  It is well entrenched in the society that dedicating oneself to

your children and hence the future is of great importance

Rewarding When the child develops well in

terms of both physical and mental health

Why Mrs. Thuy does not HWWS “I only need to HWWS if my hands are dirty or

smelly”

“HWWS takes too much time”

“I simply forget to HWWS when I’m in a hurry”

“Soap is too expensive to be used for HW”

“HWWS is simply not important”

“Weather and/or uncooked food cause diarrhea”

How do we reach Mrs. Thuy? Mass Media: •  More than 80% of mothers watch TV

–  Most popular time: 6-9 pm –  Most popular channel: VTV3, and HCMC TV in south –  Favorite programs: #1- films, #2 - news, #3 – music programs

and contests –  Most viewers switch channels during TV spots but over 2/3 can

recall messages on HW •  Only 15-20% listen to radio or read newspapers

Interpersonal Communications: •  Health Workers & Women’s Union are both important

sources of information. Health Workers are credible sources of information

FOAM Questions for HW Behavior Change Focus Opportunity/

Resources Ability/ Knowledge

Motivation

How easy is it to get the goods/

services?

What is the product like?

What traditions influence the

practice?

What do I know about the

behavior/product?

What kind of support do I get

or give?

What attitudes and beliefs do I

have?

What do I plan to do?

What will happen if I

practice this?

What risks are there?

Target Audience

Desired Behavior

MAIN RESEARCH FINDINGS

Knowledge

Motivation Beliefs,

Attitudes & Locus of Control

•  “Handwashing with water alone is enough to clean hands”

Motivation Intention –

Cues to Action

BC DETERMINANT

•  “I simply forget to wash my hands with soap”

•  “Handwashing is not linked to diarrhea”

•  “Handwashing with soap takes too much time” (later taken out)

•  “Changes in the weather causes diarrhea – there’s nothing I can do about it”

Step III: What we want to say from Determinants to Communications Objectives After the campaign, the target audience will: •  KNOW that even clean-looking and clean-smelling hands

can have germs (knowledge) •  BELIEVE that HW with water alone is not enough - soap

in needed (belief) •  BELIEVE that HWWS is time well spent (belief) (later

changed based on tracking survey) •  BE REMINDED to HWWS at critical junctures (cues to

action) •  FEEL empowered that HWWS is something they can do

to ensure the well-being of their children (locus of control)

Media Campaign Development Campaign Positioning – driving wheel

•  The next slide is the framework or blue print in which all campaign messages will be developed under

•  The single one message that we wanted to convey via TV to audiences is: Know that handwashing with water alone is not enough to get rid of germs

Brand Direction

Acceleration Target

Emotional Driver

Brand Promise

Brand Rationale

Driving Idea

WHAT: The direction in which we want to move the brand

HOW: The critical, untapped emotional need and want that our brand must address

Benefit: The crucial brand benefit or promise that will inspire and activate the target to action

WHY: The reason to trust in and believe that the brand can deliver on its promise

Positioning of Handwashing with Soap

Brand Direction

Acceleration Target

Emotional Driver

Brand Promise

Brand Rationale

Good Motherhood

The most important role in my life is being a mother. Everything I do is to ensure that my child is healthy and develops properly so that they can reach their full potential (developmental milestones)

Being a mother takes a lot of work but it’s worth every minute when I see my child developing properly (physically and mentally)

Recognition as a good mother:

My child will be happy and healthy because he’s developing like he should. What better way to demonstrate that I’m a good mother

HWWS clearly indicate: 50% reduction in infections and disease 25% reduction in infection the prevention of millions of deaths and hidden costs (medical fees, children deprived of learning due to illness-caused missed school days)

Handwashing with soap is a part of everyday life

A mother does many things:

Works for her family’s livelihood, toils with housework, care for child etc

All this is done so that her child doesn’t have to…so her child can develop physically and mentality, so her child can be a child

A mother is rewarded when her child laughs, sings innocently, gives love back, eats her food

A child can do these things and give joy to his mother because he is healthy and happy

Washing your hands isn’t enough. Invisible germs get left behind. You can use any kind of soap. And it only takes a few extra seconds

A mother knows that she is key to her child’s future successes

Step IV(a): Mass Media Message Development Process

•  The following slides show the extensive and participatory process that we went through to develop the campaign. Before each presentation, extensive comments were provided by HW staff and MoH

•  Agency then presented each round to Technical Advisory Group (TAG) consisting of MoH, NGOs, Women’s Union and Unilever to provide input the campaign

ROUND I Creatives (Dec. 07) – “In A Mother’s Hands” and “Five & Soap Means

Clean”

Round I Feedback from TAG

• Group like “In A Mother’s Hands” • Group thought that 5 & Soap

Means Clean was more for children than adults

• Grey to develop another concept for testing

ROUND II Creatives (Jan 08) – “In A Mother’s Hands”and “Pure Love”

Round II Feedback from TAG •  Group thought “Pure Love” was too

abstract •  Group suggested that the “5 Fingers Clean”

concept be revisited •  Grey to fine tune those “5 Fingers Clean”

and “In a Mother’s Hands” concepts for pretesting

Pretesting Round I Locations: 2 Groups each in Phu Tho, Son

La and Vinh Long for a total of 6 FGDs Audience: Mothers with children under five and grandparents, separately

Materials for Pre-testing Round I Three TV Spots

“In a Mothers Hands” 1“Two “5 Clean Fingers” – smooth and

nonsmooth Posters Logo

Two concepts pretested

Results of Pretesting Round I In A Mother’s Hands •  Very Emotional, very appealing, that is US…….. •  But In a Mother’s Hands is more than HW, it’s about the future of our

children and our role as a mom •  It makes us feel as if we are not doing enough – guilt! •  The hands on the posters are interesting but not related to HWWS

•  No direct connection between campaign and HWWS message. 5 Fingers Clean – •  Appealing, but more importantly reminds us to HWWS! •  “Everyone knows the song and my grandkids would sign the song to

remind me”

•  It reminds us that water is not enough. Tagline “Health,” “development” were most closely associated with mother’s

concerns for children under five. “happiness”, “future” were not associated with such young children

•  Pretesting once was not enough!

•  Need new posters, two more TV Spots before pre-testing AGAIN

Pretesting Round II •  Location: Ninh Thuan •  Audience: 2 FGD with Mothers of children

under five and 2 with Grandparents for total of 4 FGDs

•  2 Versions of nonsmooth TV spot •  One direct •  One indirect

Main Poster and 4 Critical Junctures Poster

•  Direct TV spot easier to understand. Non direct version considered more for kids who play with dirt/pets but not with Moms

•  HWWS before feeding is totally lost – HWWS is associated with dirty pets

•  Poster should say MoH and would be more clear with these adjustments

•  Poster should be in light blue or light green. Orange is too “hot”

•  How to best depict before preparing food?

•  Having Ministry of Health Endorsement would make the TV spot credible as people would know the source of the information

Pretesting Round II Audience Feedback

Trước khi… Trước khi…

Sau khi đi vệ sinh Sau khi làm vệ sinh cho trẻ

chế biến thức ăn cho trẻ ăn

Bộ Y Tế khuyên…

Various Logos

Pretesting Round II – Audience Feedback

Logo • Include flowing water to improve impact of message • Include Call to Action, “HWWS for the Health and Development of Children” • Soap and bubbles be the same color • Water color should be white to indicate clean water • Hands should be white or else they will be understood as wearing gloves • Green Lime color best indicates, “fresh, clean, spring, new”

Step IV(a) Output: evidenced based messaging, design and coloring of the mass media campaign

Intermediate Result

•  Complete buy-in and endorsement of MoH and Women’s Union

•  Evidence based materials that are attractive and resonate with audiences

•  Catchy song that everyone can remember

Outcome •  MoH’s recognition that audience research/

pretesting provides valuable feedback – there is a basis adjusting materials

•  More rest and increased happiness for Nga (show TV spot)