The Future of Behavior Change: I, A Woman, Can Do Anything
By Poonam Muttreja
Executive Director, Population Foundation of India
Family planning issues are complex. They are grounded in deep-rooted social norms concerning gender roles and family life, and they must be addressed from a holistic perspective. If we want to increase the use of family planning, it isn’t enough to simply provide information and access to contraceptives. People must be motivated to change their behavior. As the old saying goes, “knowing and not doing is the same as not knowing.”
Population Foundation of India (PFI) recognizes that entertainment education, or edutainment, is one of the most powerful approaches for influencing behavior change, as the global evidence indicates. Edutainment serials in South Africa, Mexico, Peru, and elsewhere have shown that tackling social issues through carefully crafted popular dramas can have an immense effect. This is the approach we took with Main Kuch Bhi Kar Sakti Hoon (MKBKSH), which translates as “I, A Woman, Can Do Anything.”
MKBKSH is a popular television serial that revolves around the character of Dr. Sneha, a compassionate young doctor from a small village in India. Dr. Sneha is a modern independent woman who is unafraid to challenge harmful social norms, taking on some of the most difficult and controversial issues of the day: child marriage, son preference, lack of contraception, domestic violence, and gender inequality. The stories are all based on real-life case studies, and the scripts are developed in consultation with experts in social and behavior change. Director and co-creator Feroz Abbas Khan treats the material with dignity, sensitivity, and courage—the same qualities he brings to his award-winning work in Bollywood and the theatre.
The serial debuted on Indian national television in March 2014, along with a radio version and an Interactive Voice Response System (IVRS) for audience engagement. It is not an overstatement to say that the response has been phenomenal. More than 58 million viewers watched the serial and 625,318 telephone calls were received on the IVRS in the first season alone. Viewers find the programs compellingly well-crafted and thought-provoking, while the character of Dr. Sneha has become a beloved role model for many young Indian women.
Most importantly, the serial is inspiring profound changes in attitudes and behaviors, as viewers themselves tell us. An evaluation study was undertaken in the states of Madhya Pradesh and Bihar to track the impact of the serial, revealing positive shifts across the board. Before watching the serial, for example, only 2 percent of men in the study area realized that early marriage poses a risk to the lives of both mothers and babies; this figure rose to 31 percent among those who watched MKBKSH. The percentage of mothers-in-law who understood the importance of spacing childbirths by at least two to three years increased from 57 percent to 86 percent. The percentage of men who were aware of the Prohibition of Child Marriage Act rose from 54 percent to 90 percent. And the percentage of women who cited fear of side effects as a reason for not using modern contraception dropped from 57 percent to 32 percent.
One reason for this impact is the 360-degree communication approach that is built into the MKBKSH initiative. Behavior change does not happen in isolation, and effective communication needs to be grounded in the socio-cultural context: enabling environments, service delivery systems, and community and family settings. With MKBKSH, the message is delivered and reinforced through multiple channels. The TV and radio serial is complemented by a social media presence, mobile phone engagement, and the IVRS, which delivers information and advice and provides a platform for sharing. Viewer clubs, discussion groups, and community events are reinforced by one-on-one meetings with facilitators and frontline health workers. As people hear the same message from multiple sources, knowledge is increased, attitudes are changed, and social norms transformed and shifted.
We believe this methodology—entertainment education using a 360-degree approach—is the way forward for behavior change. Social and behavior change strategies are an essential aspect of preventative care, and large-scale interventions need to be designed that engage with the full range of factors shaping people’s lives and decisions. At PFI we are eager to share what we’ve learned from MKBKSH, and offer to join hands with governments and multilateral agencies to build the capacity for similar initiatives in India and beyond.
The success of Main Kuch Bhi Kar Sakti Hoon shows how much is possible. Today, MKBKSH is more than just a popular television serial. It has become a national call for women’s health and empowerment, with the potential to inspire and change the lives of millions of women and girls.
Poonam Muttreja is a member of the FP2020 Reference Group.