mNutrition: Behaviour Change in 160 Characters or Less?

This mNutrition initiative presented for the International SBCC Summit 2016, Addis Ababa, Ethiopia, February 8-10, discusses the mNutrition approach to behaviour change communication (BCC):
* "Knowledge dissemination vs. BCC
*Understanding our “consumers” and end users
    • Beyond ensuring the message is understood
    • Profiling and testing to tease out motivations, barriers, aspirations
    • The limits of SMS
* Linking consumers to tangible resources through the mobile channel
* Using other mediums – audio, video, quizzes, social media etc.
*Anticipated impact: The case of Wazazi Nipendeni (Tanzania), Farmer Club (Ghana)"

The GSM Association (GSMA) initiative is designed to develop and scale-up the delivery of nutrition messages through existing agriculture and health mobile phone platforms: in Nigeria, Mozambique, Tanzania, Kenya, Uganda, and Zambia, as health messaging; in Pakistan, Sri Lanka, Bangladesh, and Myanmar, as agricultural messaging; and in Ghana and Malawi, as both..

The Generation Challenge Programme (GCP) consortium and the organisation GAIN work towards:
* "Development of detailed national nutrition landscape analyses;
* Development of both a global content framework and country specific content frameworks which determine content development needs (e.g. language, channel)
* Development of a centralized knowledge bank in which to organize all government validated factsheets and messages
* Development of quality assurance processes and quality control;
* Development of localized and validated mobile ready content with the support of a local content partner for 14 services (12 countries)
* Development of tools to support local content partners: especially in terms of the meaning of localized content: Locally relevant/understood vs. locally generated/meeting the needs of local users."

A chart illustrates the movement of knowledge to end users through the mNutrition approach that is based upon human-centred design, which uses information on: "my barriers..., I am motivated..., I trust..., I am traditional sometimes..., and we eat together..." as starting points for message development. User profiles are gathered from influencers and women of reproductive age, with message samples attuned to each.

Lessons on the limits of SMS text messaging include the following:
1. "Audience Segmentation is essential." It includes gathering insights from users, generating and validating user persons, and message formulating, user testing, and feedback.
2. "Short, snappy, accurate but BCC-centered is too much for too little!" Within the 160 character limit, user understanding is central and can be tested.
3. “SMS as a one-way channel is missing real engagement.” Examples of solutions include:
* "In the Start Smart project in South Africa, a mobi site has been developed for users to solidify their knowledge ...through quizzes, rewards etc."
* "In the GAIN Baduta project, users are able to engage with content through digital media (adding comments, likes etc. on Facebook)."
4. Using mobiles doesn't take away the need for multiple touch points. These can include national TV and advocacy, health system strengthening, digital media, and street visits. Messages can align with those already disseminated by community health workers, nurses, and midwives. The recommendation is to use multiple channels for linked messages, ensured through developing factsheets and social and behaviour change communication (SBCC) materials for all partners.

A sample of a monitoring record is shown, including: name of product, operator, service provider, core service details, languages, business model, number of users and launch date, local content partner, content domains, and formats created (example: SMS and voice transcripts). A record of messages sent in GAIN projects is followed by the conclusions:
* "Primacy of user insights: No matter what medium used to disseminate BCC messages, user insights are essential to driving at motivations, aspirations, and overcoming barriers. Without users at the center, messaging becomes too clinical and instructive, missing the points which would create change entirely. Constrained by 160 characters, it is very easy to focus only on conveying essential info, and missing the BCC components entirely.
* Mobile as a complimentary tool: When using mobile especially, messaging must be in alignment with national policies/programs. As mobile cannot change realities on the ground (no effect on real barriers) it can highlight to users how to access resources that are available to them.
* Beyond SMS: Text may be a good start in some cases. Early on we realized in contexts like Ghana, that we needed to generate voice recordings or risk missing our target demographic entirely. Increasingly even users at the bottom of the pyramid are able to afford basic smart phones and are looking for more engagement with user generated content (e.g. social media, blogging, instagram etc.). "