Reflections From a Journey to Design and Test Programs in Rural Bihar
The ProgramsPCI and Dalberg, with support from the Bill & Melinda Gates Foundation, set out in 2019 to answer the question: How might we engage men in nutrition and family planning through innovative and gender transformative programs in rural Bihar? We used an interdisciplinary approach anchored on human-centred design (HCD) research and behavioural science, supported by a literature review, expert interviews, rapid prototype testing and a proof-of-concept phase (with 2000 households in two blocks of Samastipur district, Bihar) to design and test innovative programmatic solutions. We closely collaborated with community representatives as partners during research, co-creation, and testing, and explored multiple program ideas, ultimately arriving at two innovative programmatic solutions:
Implications of the Findings
Findings from the learning pilot show the immense potential of these programs to change couples’ family planning and nutrition behaviours and provide early indications of influence on gender and health outcomes. We see these programs as ready to enter large-scale testing, to strengthen our evidence on sustained behaviour change and outcomes. This can be done by saturating the state of Bihar; deploying the programs across multiple Indian states; or at-scale testing to make further program refinements and adjustments. In addition, lessons on using an integrated HCD and behavioural science approach to program design, with a strong gender lens; as well as an approach to health programming that builds both individual and couple’s agency and joint decision-making, can be applied to other fields, both within and outside the domain of health.
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