Global Conversations on Newborn Health in India: Listening to Communities for a Change

This is the third post in our series, Global Conversations on Newborn Health in India. Join the conversation on Impatient Optimists and the Healthy Newborn Network as we explore the pressing need - and what our partners are doing to address the need - to save the lives of newborns in India.

Written by Gary Darmstadt, Vishwajeet Kumar and Aarti Kumar.

Some of our most valuable insights for saving newborn lives have come from listening to rural communities in South Asia and Africa.

The rich tapestry of their culture, myths and folklore around newborn care is intriguing and appears impermeable to newer and more effective interventions. Not surprisingly, programs aimed at increasing the acceptance of simple, life-saving behaviors like early breastfeeding have met with limited success and have frequently been attributed to communities’ reluctance to embrace change.

On the contrary and in the same geographies, we have also witnessed communities’ curiosity for new knowledge and willingness to experiment with new ideas and rapidly embrace change.

Why does the community respond so differently depending on the “intervention”? Our conversations with them over the years have improved our understanding and we want to share some insights with you.

Address a commonly perceived need or create one. Communities do not necessarily perceive a need to do anything more to save their newborns, as they are convinced that they are doing their best, and the rest is beyond their control. When families are taken through a process of realization that it is within their power to save the lives of their newborns through adoption of simple behaviors, they become receptive to new ideas and change.

Promote gateway behaviors. Communities need to perceive and experience immediate and tangible benefits. Certain behaviors, like skin-to-skin care (STSC), provide a powerful experience to mothers and families, in terms of a deeper connection with the baby and visible benefits like warmth and calming of the newborn, and milk expression by the mother. Such ‘gateway’ behaviors build trust between health workers and families, which makes it easy to ‘piggy-back’ other life-saving behaviors.

Community-centered design. Programs need to be designed keeping communities in mind, not just mothers and families. Communities are an under-appreciated part of the solution. We need to leverage existing natural groups, social and political institutions within communities to promote adoption and ensure sustainability.

Moreover, communities are willing to embrace change more readily when we integrate these approaches to create a pathway of least resistance to change.