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The Obama administration will continue bombarding individual nations with “family planning” and health-care messages costing tens of millions for each campaign, despite acknowledging that some of its past efforts largely failed.

The administration casts partial blame for the failures on foreign government recipients, some of whom neglected to adequately cooperate with U.S. plans to change cultural beliefs, for example, about contraception and family size.

Islamic leaders in nations such as Jordan rebuffed previous efforts to increase sterilization and other approaches to reducing birth rates. The administration backed off from that tactic and instead encouraged Muslims to space out the births of their children.

The U.S., therefore, has a new communications program in mind for Jordanians.

Awareness of health programs among Pakistanis, likewise, has not translated into increased use of the U.S.-funded health services.

The U.S. consequently developed a new information-dissemination initiative for Pakistan.

The administration’s solution to the arguable squandering of U.S. taxpayer dollars is to spend even more money on social-engineering endeavors over the next five years, according to planning documents that WND discovered via routine database research.

The discovery comes at a time when Congress is weighing the merits of the administration’s FY 2015 request of $46.2 billion for Department of State, Foreign Operations and Related Programs, of which $8 billion is slated for global health initiatives.

In one instance of a follow-up health-communications project, the U.S. Agency for International Development, or USAID, will hand out more contracts valued at tens of millions while providing unspecified cash assistance to Zambia.

The administration has been dumping money into Social Behavior Change Communication, or SBCC, programs in the Southern Africa nation “for many years,” according to a revised draft Statement of Work, or SOW.

SBCC and other similarly titled strategies combine mass media, community activities and face-to-face communications designed to sway people into healthier or less destructive behaviors.

The Health Communications Support Project will leverage SBCC interventions in Zambia “to improve health-seeking behaviors in HIV/AIDS, maternal child health, family planning, malaria and nutrition.”

The USAID program is aiming for a greater impact on Zambian health than the lackluster performance of previous outreach efforts.

USAID says that various program impediments – obstacles it largely attributes to the government of Zambia – “have markedly limited the impact of SBCC interventions.”

Infusing $20 million into a “next generation” SBCC project should help overcome obstacles such as the Zambian government’s failure to help deliver messages to rural populations, the agency says.

USAID expressed confidence that it now can help improve health behaviors and access to various health services by “intensifying” the level of behavioral messages targeted at Zambians, whether they are individuals or couples.

The agency will promote the delay of “sexual debut” among youth, while also promoting “secondary abstinence” for those who already have been active sexually.

The program, likewise, will advocate mutual monogamy and partner reduction among adults and sexually active youth, and will seek to increase condom use and male circumcision.

Awareness of family planning, or FP, services among Zambians is high. Indeed, one government survey indicated that 97 percent of all women and 99 percent of all men had heard of FP.

Despite past communications campaigns, however, modern contraceptive use “remains low at 33 percent.”

The agency will hire a contractor to design and evaluate new SBCC interventions and to help the Zambian government develop national behavior-change strategies.

USAID separately expects to provide direct financial aid to the government of Zambia in pursuit of the program goals while also awarding yet other SBCC support-initiative contracts.

Although the U.S. does not regard Zambia as a major strategic partner, the landlocked nation nonetheless enables the U.S. Africa Command to operate within its borders a bare-bones compound technically known as a Cooperative Security Location.

The U.S. traditionally has provided to Zambia significant assistance – the majority health-related – as a means of promoting “regional peace, security and stability,” according to a U.S. Department of State fact sheet.

The administration’s FY 2015 budget request, therefore, seeks $381 million for Zambia.

‘C’ change coming?

The growing health-communications industry must more effectively use evidence-based approaches to swaying public perceptions about health and sexual activity, a USAID-funded initiative known as C-Change, or Communications Change, said in a 2013 report.

C-Change also claimed successes – such as increased contraception use in Zambia – that contradicted problems acknowledged in recent government contracting documents.

Much of the overall progress that purportedly has been made, according to the report, focuses on the successful introduction of SBCC training and interventions to government entities and NGOs in dozens of nations.

Some successes were questionable, however, as USAID cited evidence via claims such as the “proportion of respondents who believed fellow community members were seeking treatment for malaria at a health facility increased from 80 percent to 89 percent.”

The report, likewise, cited the success of C-Change programs in nations including Jamaica and the Bahamas, where it held workshops with HIV-affected homosexuals (“men who have sex with men”) and prostitutes (“sex workers”).

During the workshops and in subsequent activities, USAID developed and distributed positive-health messages via “counseling cards, discussion and proverb cubes, a peer educator handbook and a services leaflet, cell phone screen savers and ring tones, as well as arm bands and carry bags.”

Additional programs unfolding

Other health-communications programs for which USAID recently began searching for contractor assistance include a $30 million, five-year initiative in Jordan, where it will use traditional mass media, social media and youth outreach activities to “affect norms and attitudes related to family planning and reproductive health.”

The USAID Jordan Communication, Advocacy and Policy, or J‐CAP, activity must be sensitive to the needs and beliefs of Muslim men, who in past initiatives rejected the notion of limiting the number of children they have.

“Approaching family planning in terms of spacing, not limiting family size, has proven more effective in the Jordanian context,” the agency said in a Request for Applications.

“For example, religious leaders objected to the limitations on the number of children, especially the use of sterilization, which was considered to be inconsistent with Islam unless there is a medical rationale.”

The U.S. considers Jordan a key ally in the Middle East, and the administration seeks to provide it with $691 million in overall aid for FY 2015. The bulk of that aid is slated for “peace and security” programs.

USAID separately is making available a $35 million grant to provide SBCC and social marketing services in the West Africa nation of Mali, where it will promote of “key healthy behaviors” while increasing demand for and use of “high impact health services.”

The Obama administration’s FY 2015 budget request proposes $122 million in overall aid to Mali, a nation near the bottom – 178th of 182 countries – of the U.N. Human Development Index.

The USAID/Pakistan Health Communication Project will work as a separate component of the agency’s existing Maternal and Child Health program.

The $24.5 million, four-and-a-half year initiative will use “mass media, ‘new’ and mobile media, community level activities, and interpersonal communication to change individual behaviors and social norms in support of improved health outcomes.”

The administration is seeking $882 million for its overall Pakistan aid program in FY 2015. While Pakistan still ranks among the top 10 U.S. foreign-aid recipients, the latest aid total represents a third of Obama’s 2010 request.

Although general awareness of key health information among Pakistanis is high, “comprehensive knowledge (leading to behavior change) is less prevalent, and this awareness has not consistently translated into behavioral or normative change.”

 

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