UNICEF Communication for Development Support to Public Health Preparedness and Disaster Risk Reduction in East Asia and the Pacific: A Review

The United Nations Children's Fund (UNICEF) East Asia and Pacific Regional Office EAPRO) began this review process, culminating in this publication, to analyse the thematic and technical debates about communication for development (C4D) and related programmatic approaches that have evolved rapidly within UNICEF. "There is also a rich, although not well documented or widely understood, history of positive experiences with participatory and dialogue-based development programming as well as with campaign and interpersonal communication-based behaviour change communication."

UNICEF commissioned in 2012 a review, carried out by an international consultant, of its C4D programming in relation to disaster risk reduction (DRR), preparedness, communicable disease control, institutional systems strengthening, and community resilience, as well as programming strategies to reach the most-at-risk, vulnerable, and marginalised communities. Assessments and fact-finding visits were conducted in Cambodia, Lao People’s Democratic Republic, and Mongolia. "The purpose was to solicit and contrast the views, perceptions and recommendations of UNICEF colleagues, donors, government and health ministry partners and international nongovernmental organisations (NGOs) and civil society representatives. Structured, thematically focused and informal discussions were conducted around a range of issues linked to DRR, C4D and health systems challenges and priorities."

The document cites global and regional enabling mechanisms and processes - frameworks and agreements - that are national or regional, discusses donor funding and priorities, and analyses institutional preparedness for DRR in the three countries (See the chart on pages 15 and 16 of the review) and public health preparedness. In the analysis of C4D, the review cites attempts to redress the criticism of top-down communication with development of local DRR programming and capacity development, particularly through education sector interventions that include the mainstreaming of DRR in school curricula (information, education, communication - IEC). To increase work at the subnational level, UNICEF implements dialogue-based approaches through partnership with NGOs, local governments, and civil society groups, "primarily because it does not have the financial or human resources to undertake such interventions [programming for advocacy, capacity development, and positive health seeking-behaviour change (BCC)] at scale....Being focused on resilience, on the enablers of resilience and on how they might be better conceptualized for improved results and fundraising purposes necessitates a clearer demarcation between campaign-based C4D and C4D targeting dialogue and participation. This is necessary as much for the social benefits that such processes beget as it is for the support they can provide for BCC and IEC-based health campaigning and social marketing." The review cites "elite capture" (the prevention of youth and marginalised voices from being heard) as a problem where authority is a barrier to genuine participation for vulnerability reduction.

Recommendations include the following:

1. "There is now scope to nurture a more considered understanding of what constitutes C4D...
2. It is critically important to understand the context and local barriers to C4D and dialogue-based approaches...
3. ...Ultimately, the effectiveness of C4D approaches to improve population health is fundamentally linked to the capacity of health workers and health systems to support messages and promote health-seeking behaviours...
4. C4D and dialogue-based approaches as focal areas for operational research and programme modelling that have a direct bearing on social policy and advocacy support and actions. Modelling interventions and subnational programme strategies and then using the emerging evidence to advocate for integrated approaches to C4D and community and dialogue-based approaches offers the means to enable and enhance local capacities as well as the processes that can be used to test assumptions about local-level programming...
5. There is great potential to position UNICEF cooperation as an innovator of community-based approaches. The organization should respond to the lack of coordination for C4D and dialogue-based approaches to DRR, preparedness and improved population health by filling current leadership gaps... and...serve more as a technical and strategic hub for C4D dialogue.
6. It will be opportune to expand the use of both quantitative and qualitative evidence to monitor and assess C4D interventions...
7. There is a need to invest time and human resources to leverage funding for C4D...
8. There are important opportunities to harness and support improved partnerships for C4D and dialogue-based approaches with NGOs that envelope child-centred risk reduction and preparedness...
9. ...Developing an improved understanding of both the shortcomings and potential of C4D and dialogue-based approaches - and better packaging and sharing of that understanding and the guidance it informs - will help to ensure the ongoing relevance of strategic communications within the broader child rights mandate and equity focus...."

The document concludes with a chart of C4D interventions as regional trends on page 27.