Implementing a behaviour change communication interaction for enhancing male involvement in maternity care among the Saharia Tribes in Gwalior District, Madhya Pradesh: a feasibility study.

Background: The Indian tribal population is varied, with a wide range of customs, ways of life, and cultural practices. However, there is one thing that all Indian tribal communities have in common: they have worse health indicators, a higher rate of illness and mortality, and very restricted access to medical care. Their health issues require extra consideration in the right setting (Salil, Health and Population Perspectives and Issues 23:61-70, 2000). Growth in the utilization of reproductive and maternal health services will not only curtail down the reproductive morbidities, but it will also reduce the child mortality (Sharma et. al, Utilization of health services and RCH status in Madhya Pradesh: a District Level Analysis. In Proceedings of National Symposium on Tribal Health 2011). Men's participation in prenatal care, delivery and postpartum period is rarely found, especially among tribal communities, due to their economic instabilities and priorities. Also our health system does not promote the involvement of men in the maternal and child health care. Hence, there was a need felt for development of gender and community sensitive interventions package that could address the individual and the community health care facility level barriers of male involvement in utilisation of the maternal care services. Our study was an effort to determine the feasibility of implementing a behaviour Change Communication Interaction developed for improvement in utilisation of maternity care services through male participation among the Saharia Tribes in Gwalior District, Madhya Pradesh.

Methods: The Study utilised a qualitative approach. Various activities were organised as a part of BCC, viz., Community mobilization, Campaign/Rallies, Interpersonal Communication-Drama & Mock Sessions, Face to Face counselling and Quiz etc. Action technique called Transect was used in order to know more about the environment and living of the people of Saharia Tribes in Gwalior District, Madhya Pradesh. Feasibility of the model was assessed by focusing on three main principles i.e., acceptability, integration and limited-efficacy testing.

Result: Acceptability testing study reveal that BCC intervention was successfully accepted by intended individual- both targeted individuals and those involved in implementing programs. Integration approach reveal that no major change in infrastructure of Govt. Programmes and facilities is required. Instead, effective application relies on the engagement of key community members and local health service workers. Limited-efficacy testing reveals that there is a behavioural change in men's perception of accompanying their spouse to the health centre; same was observed on the vaccination day in the village.

Conclusions: The BCC intervention proved to be feasible to implement. The Proposed BCC interaction is feasible and accepted by both Programme stake holders and beneficiaries.