The document summarizes findings from an end line evaluation of Listeners' Clubs under the Sustainable Development Program in Bihar, India. Key findings include: - Recall of health messages from the radio episodes was high even 6 months after exposure, including recall of characters and themes. - Most attributed learning about maternal and child health through the Listeners' Club discussions. Younger and older members reported feeling able to discuss issues openly. - Both younger and older members reported sharing new information with families and communities, seeing the messages as important to convey. - Exposure increased confidence among women to adopt recommended health behaviors for themselves and their families.

1. LISTENERS’ CLUBS UNDER SDP
Findings from End Line Evaluation

2. About Listeners’ Club Intervention
Facilitators
provided
basic
training
CDs and
players
distributed
in each
SHG
KMW episodes
re-versioned to
enable
discussion
Reached out to 5600 SHGs of the WDC
across Patna, Samastipur & E.
Champaran districts
Strategically planned to include only
those WCD SHGs which meet
regularly and those at least 1 yr. old
Handholding support and supervision
provided by BBC MA program team
Direct supervision through
observations on field
LC play-outs and discussions facilitated
through NGO deputed facilitators who
also oversee thrift and credit activities

3. Research questions
RQ 1 – What evidence is there that members attribute the Listeners Club format to
more meaningful discussion of relevant issues?
RQ 2 – What evidence is there that the Listeners Club format has created a space
for members (particularly younger members) to challenge established viewpoints
on child and maternal health held by other members of the group and / or by the
wider community?
RQ 3 – What evidence is there that listening to KMW through the Listeners Club
platform has led to word of mouth dissemination of messages to a wider audience
base?
RQ 4 – Whether listening to KMW episodes through the Listeners Club platform
has led to confidence amongst women to adopt new behaviours?

4. Mixed Method Research Design
Quantitative
Covered 409 LC members across 48
SHGs
SHGs selected on pro rata basis
across 3 districts and with U & R
representation
Members screened based minimum
extent of exposure to episodes
Recruitment done with help from
SHG president/LC facilitator
Qualitative
Qualitative FW conducted only in
Patna district and Samastipur urban
– because of complete water-logging
4 MGDs with exposed MILs/mothers
having married daughters
6 MGDs with exposed young CMW at
zero parity or with one child
Limitations: The fieldwork for the evaluation was initiated roughly 6 months after the
completion of the implementation of the project. This could and probably has impacted
recall by beneficiaries

5. Respondent profile
63 percent of
respondents 35
and above in age
52 percent were of
the sample were
MILs with DIL living
in same house
74 percent were
housewives while
16 percent were
wage labour
74 percent
without any
formal education
34 percent of
women aged below
35 yr. had a less
than 2 year old child
63 percent had
BPL cards
70 percent
belonged to HHs
where CWE is
wage labourers
66 percent
were OBCs

6. RESEARCH QUESTION 1
What evidence is there that members attribute the Listeners Club format
to more sustained and meaningful discussion of relevant issues?

7. 1 TT injection and IFA tablets
2 Pregnancy registration
3 Institutional delivery
4 Exclusive breastfeeding
5 Sanitation
Top of mind recall of key thematic areas
65
83
93
98 100
All five Any four Any three Any two Any one
Even after 6 months of the program being
concluded, recall of messages was quite
high with 83% of the exposed members
could spontaneously recall at least 4
thematic areas which they had heard in the
play-out sessions
Extent of recall by members even after 6
months (in percentage)

8. Spontaneous recall of characters
76
64
54
42
Either Mehendi or
Dr. Anita
Mehendi Dr. Anita Both Mehendi &
Dr. Anita
Base: All respondents
There was high level of recall of the central characters presented in the episodes, with
76% having recalled either Mehendi or Dr. Anita and 42% recalling both.

9. Sources of information for four critical
themes
89 89 89 92
76
65 63 62
12 10 8 8
0
20
40
60
80
100
Family planning Birth preparedness Exclusive breast
feeding
Complementary
feeding
Listener's Club OR Radio Any FLW (ASHA, AWW or ANM)
Television Local Doctors/TBA/RMPs
Base: All respondents
Close to 90% of the respondents who could individually recall the four central themes of
family planning, birth preparedness, exclusive breastfeeding and complementary feeding
had reported that one of their sources of information on these themes were the listeners’
club play-outs

10. Quality of Episode Content
1. The younger members of my SHG could empathise very well with Mehendi and her life story
(Favourable - Strongly Agree or Agree)
2. I used to have a hard time following the discussion on the radio episode (Favourable -
Strongly Disagree or Disagree)
66Agree with
statement 1
86Agree with
statement 1
66Agree with
statement 2
86Agree with
statement 2
86% of the members could
empathize with Mehendi
and her life story and most
reported that the episode
constructs resonated well
with the situations they
face in their lives
Close to two-thirds had no
problem in following the
narrative of the individual
episodes
The proxy indicator construct

11. Listeners’ Club format is a discussion
enabler
1. I believe have learned a lot about mother and child healthcare through my SHG / Listeners
Club (Favourable - Strongly Agree or Agree)
2. The large age difference between members of this SHG makes it very difficult to encourage
people to participate in a discussion after each episode (Favourable - Strongly Disagree or
Disagree)
99Agree with
statement 1
98Agree with
statement 1
64Agree with
statement 2
73Agree with
statement 2
Irrespective of age, all had
admitted that they had learnt
a lot about mother and child
care through the LC
> 3/4th of the younger and
2/3rd of the older participants
had confirmed that the age
difference inherent to the
SHG membership profile was
not a prohibitive factor for an
open discussion
The proxy indicator construct

12. Efficacy of the format: findings from
qualitative research insights….(1)
Since financial transaction will always remain the primary activity of a SHG and as
a result, any other activity tends to get side-lined
This has a clear impact on regularly playing the radio as in few groups where it was
reported that the radio was rarely played or played at the very end
The common excuse given for delaying the playing of the radio episode was that it
interfered with the accounting process and getting the paperwork right is crucial
when dealing with public money
It may be worthwhile to mention here that after the pilot exercise, it was agreed
by most SHGs that the play-out needs to happen after the conclusion of the
financial transactions and accounting activities are over and hence, was adopted
as the norm

13. Efficacy of the format: findings from
qualitative research insights….(2)
Availability of adequate time to play an episode and have a meaningful discussion
towards the end of a meeting was an issue – especially with the younger lot who either
have household chores to attend to or look after small children
Again there are others who are engaged as daily wage labourers and they come in for a
very short time for just depositing their money. In all, prior engagement at times does
not allow members to sit for any significant length of time – this compromises the full
exposure to KMW episodes
To make this a success, it would be necessary to ensure that a majority of the members
stay back because changing the playing times to before the main event or in-between is
probably not a feasible option
There are some socio-cultural barriers as well. For instance, some women had reported
that the fact that they have joined a SHG to save money is kept a secret from their
alcoholic husbands. Again, more conservative families are against their women-folk
staying out for long as they start suspecting an affair
For this reason, they tend to spend just enough time to complete the financial
transaction and leave. But these are aberrations as by and large, the SHG movement is
strong and these groups enjoy community approval

14. Relevancy of content: findings from
qualitative research insights
The key messages of the programme had got a very favourable reaction and were
remembered by all.
There also seems to be a high level of trust on the advice and suggestions given
through KMW, leaving little doubt on the credibility of the information
Linking the need for immunization with preventable diseases like polio was an
example quoted by most and so are messages linked to exclusive breastfeeding,
institutional delivery, consumption of IFA tablets, etc.
Most of these thematic areas have come out very strongly as recall elements in the
quantitative survey as well.

15. Reported activities of facilitator
Play the CD
player Ensure
attendance
during playout
Answer
questions
raised by
members
Initiate a
discussion
among the
listeners and
regulate the
same
No real
involvement
76.5
36.2
60.1
41.1
1.2

16. Issues with facilitation: findings from
qualitative research insights
The same SHG facilitators who help groups with their record keeping of thrift and credit
activities have been entrusted with the additional responsibility of facilitating the play-out
sessions in the LCs and promote discussions
This is a problem area because as there is one such facilitator for 20 groups there was a distinct
lack of attention given to the LC responsibilities after they re done with their primary function
In several cases facilitators viewed their role as to just act as the custodian of the radio set and
ensure a play-out and this often prompted them to send other family members (often
children) with the radio set to the SHG meetings
Interestingly enough, most members clearly understood what the prescribed role of the
facilitator was meant to be in the context of this project and in this context the prevailing
opinion was that since the LC work of facilitators was hardly supervised at any level, they were
not taking it seriously
Once again, it would be wrong to conclude that this was universal because across many SHGs
which were reached during the quantitative exercise, many of the facilitators enjoyed a high
equity among members

17. RESEARCH QUESTION 2
What evidence is there that the Listeners Club format has created a
space for members (particularly younger members) to challenge
established viewpoints on child and maternal health held by other
members of the group and / or by the wider community?
RESEARCH QUESTION 3
What evidence is there that listening to KMW through the Listeners Club
platform has led to word of mouth dissemination of messages to a wider
audience base?

18. Impact on the younger members (< 35 yr)
63% had found the information received to be something new
Out of these, 79% had reported that this information was
different from what they had known earlier or what the
prevalent practice was
Out of these, 93% had completely agreed with the information
provided
Out of these, 98% did share this information with others 45%
46%
50%
Fixed base
For 50% of the younger members, some of the information received through the play-out
sessions were not only new but it was also different from what they had known earlier or what
the prevalent practice was
Despite that, 93% were convinced that the information was correct and needed to be followed
and nearly all of them had gone forth and discussed the same with others within and outside
their family circle.

19. Impact on the older members (≥ 35 yrs)
71% had found the information received to be something new
Out of these, 85% had reported that this information was
different from what they had known earlier or what the
prevalent practice was
Out of these, 88% had completely agreed with the information
provided
Out of these, 95% did share this information with others 50%
53%
60%
Fixed base
For 60% of the older members, some of the information received through the play-out
sessions were not only new but it was also different from what they had known earlier or what
the prevalent practice was.
Despite that, 88% were convinced that the information was correct and needed to be followed
and nearly all of them (95%) had gone forth and discussed the same with others within and
outside their family circle

20. Listeners’ Club exposure enabled members
to challenge existing social
1. In our listeners club there are several members who have changed their traditional outlook
towards issues several health issues after listening to the episodes (Favourable - Strongly
Agree or Agree)
2. Hearing healthcare messages directly from a doctor makes me want to believe the
information, even if I thought differently before (Favourable - Strongly Agree or Agree)
The proxy indicator construct
98
Agree with
statement 1
97
Agree with
statement 1
81
Agree with
statement 2
90
Agree with
statement 2
Over 95% of the survey respondents
(young and older) had reported that
in our listeners club there were
several members who have changed
their traditional outlook towards
issues several health issues after
listening to the episodes.
In this context, 90% of the younger
members and 80% of the older
members clearly identified that
hearing healthcare messages directly
from a doctor made it more
believable

21. Why do members share the information
with others?
50%
17%
11%
6%
4% 12%
I thought this was a very important piece of
information that others should know
Wanted to share this newfound knowledge
with others
Wanted them to know that what was being
practiced was wrong
Needed to impress them with my newfound
knowledge
Needed to inform the decision
makers/influencers at home what a doctor
was advising
Needed a second opinion/wanted to find out
whether the information was truly correct
Base: Those who reported to have shared info with anyone outside SHG

22. With whom do they share? Findings from
qualitative research insights….(1)
The younger members preferred to discuss this with people outside their family (friends
and peer groups) and to a lesser extent with husbands, primarily because family
traditions dictate that the custodian of MCH related decisions is traditionally the
domain of the MIL.
On the other hand, the exposed MILs of the groups discussed their newfound
knowledge within the household, often targeting the daughter-in-laws and other older
relatives.
78% of those who discussed the issues with others after exposure did so because they
wanted to share this new-found knowledge with others
12% of the discussions took place because the exposed member wanted to get a
second opinion and test the validity of the messages through others they considered
knowledgeable.
Only 2.7% of the respondents had reported that there were some specific topics that
they found uncomfortable in listening to or discussing in an open forum in front of
others

23. With whom do they share? Findings from
qualitative research insights....(2)
Back home, both, husbands and non-member MILs of young SHG members were
aware of a radio programme being played in the SHG meetings but they lacked
detailed knowledge
Husbands were clearly keener on the financial benefit derived from the SHG
rather than show any interest on the MCH related knowledge.
The MILs in the group agreed that they discuss their new-found knowledge with
their DILs and daughters BUT rued the fact that these days they tend to do what
they feel like
Older women expressed that there were things which even their young DILs were
also not aware of but they informed them about it after listening on the radio
hoping that their advice would be heeded
Given that the position of a MIL within the decision making hierarchy of a typical
rural household is often a decisive one, this is a good outcome

24. RESEARCH QUESTION 4
Whether listening to KMW episodes through the Listeners Club platform
has led to confidence amongst women to adopt new behaviours?

25. Made members more confident to adopt
new behaviours…(1)
The response to RQ4 includes the following psychographic statements:
I. In our listeners club there are several members who have changed their
traditional outlook towards issues several health issues after listening to the
episodes
II. I sometimes feel uncomfortable in listening to some of the issues like family
planning in an open forum like this because there are people there who are
much older / or younger than me also present (Reversed)
III. I fully intend to put the information I have learned from Dr. Anita into practice at
home
IV. Older women exposed to these episodes often instruct their
daughters/daughter-in-laws to adopt the prescribed practices
V. I think people like us who are members of this SHG and have had exposure to
these radio episode sessions are really lucky because we know much more
about how to bring up a healthy child than other women of this village

26. Made members more confident to adopt
new behaviours…(2)
Young
Old0
20
40
60
80
100
80-100
60-80
40-60
20-40
0-20
Proportion who agreed with the statement

27. Self efficacy towards adoption of priority
behaviors
percent of the younger members who were exposed to various
priority behaviour messaging through LC play-outs and had
confirmed that for them some of these information were new
– had also reported that they intended to adopt the prescribed
behaviour at the appropriate time
percent of the older members who were exposed to such
messaging and had reported that some of these information
were new - had also reported that intended to ensure that the
prescribed protocols were adopted in their household (by DILs
and daughters)

28. Perceived impact: Findings from qualitative
research insights….(1)
Most women agree that their level of knowledge has improved post exposure to
KMW
It was reported that the maximum impact has been reported in areas of
institutional delivery, breastfeeding, vaccinations and family planning
The impact on practice of breastfeeding, vaccination compliance and institutional
deliveries was highly visible
The prevalent opinion was that these days, topics such as family planning are
being discussed at least among a group of peers whereas earlier this as taboo.

29. Perceived impact: Findings from qualitative
research insights….(2)
Earlier the MILs did not let their daughter-in-laws the first milk (colostrum) to the
baby. But now this has changed
It was acknowledged that unlike earlier, members are now given a neutral platform
where both generations are jointly being exposed to similar messaging, and which
is very much unlike the environment at home where in most cases the inter-
generational gap is unsurmountable
The qualitative findings reflect the fact that the program perhaps had a greater
impact on older women who appreciated the availability of knowledge (they rued
the fact that they were ignorant earlier as they had no source of information other
than their mothers/MILs)
Change in attitudinal predispositions was observably more among the elder
members who have become open to changes in their established social norms

30. WAY FORWARD

31. Way forward towards scale-up
Rethink of the 20 village catchment rule for FLWs to a more realistic level based on
workload
Block level supervisory meetings of facilitators at regular interval to improve
accountability. This needs to be a separate meetings from the regular meetings on
SHG finances and activities
Explore involvement of Panchayat in supervising the meetings conducted by
facilitators
Explore ways to expose the husbands to KMW. This could probably mean
leveraging other platforms in the village where membership is male dominated.
Evident that impact is higher where both DIL and MIL are members. Therefore,
need to create a provision for both to attend the Listener Club irrespective of the
SHG membership status
Younger women suggested making a provision where men could be educated and
made to hear a similar programme