Social Behaviour Change Communication (SBCC) for Strengthening the Maternal and Neonatal Health System in Rangpur and Lalmonirhat District (Jononi Project)

Despite global advancements in reducing under-five mortality, neonatal deaths continue to account for a significant portion of child mortality. In Bangladesh, although progress has been made toward the Millennium Development Goals, maternal and neonatal mortality rates remain high, particularly due to early marriage, poverty, and limited access to quality care. The “Strengthening the Maternal and Neonatal Health System in Rangpur (Jononi) Project” by Save the Children aims to tackle these persistent challenges through context-specific interventions, policy advocacy, and behavioral change strategies. This formative research study employed a mixed-methods cross-sectional design involving 403 married women of reproductive age across Rangpur and Lalmonirhat districts. Quantitative data was collected using multistage cluster sampling, while qualitative data included FGDs, KIIs, and IDIs. Key findings highlight the prevalence of child marriage, lack of awareness about maternal danger signs, and reliance on traditional healers. Gender-based barriers—particularly the role of mothers-in-law—and misinformation from informal healthcare providers further hinder care-seeking behaviors. Community Health Workers (CHWs) emerged as the most trusted source of maternal and newborn health (MNH) information, significantly influencing behavior through home visits and counseling. Preferred communication channels include interpersonal communication, miking, and group sessions, while billboard advertising was least favored. Based on findings, strategic Social and Behavior Change Communication (SBCC) interventions are proposed, categorized under Above the Line (ATL), Below the Line (BTL), and Through the Line (MTL) approaches. These strategies target a wide range of stakeholders—including adolescents, CHWs, religious leaders, and male decision-makers—with the goal of improving awareness, service uptake, and quality of care. Ultimately, the project aims to foster sustainable improvements in MNH behaviors and outcomes by aligning interventions with local norms, ensuring inclusive service delivery, and promoting evidence-based decision-making.