Abstract
Entertainment education has proved its mettle in making health communication effective. The craft of designing informative but non-pedantic messages lies in packaging them in an entertaining manner. This article presents the aspects of positive deviant practices solicited through a research in identifying unique behaviours related to some very personal and familial issues like early pregnancy and adoption of contraception and family planning, safe motherhood and countering the preference for a male child. The identified positive deviant behaviours formed the crux of the substance of the script of an edutainment tele-drama series Main Kuch Bhi Kar Sakti Hoon.
Background
Edutainment has been used across the globe as a powerful medium to educate, inform and influence social and individual behaviour change. Edutainment programmes possess the potential to supplement and complement traditional and prevalent public health interventions (Wang & Singhal, n.d.). The ubiquity of entertainment media programmes lies in the truth that they can articulate educational meat in a more personalized manner than is often feasible in real life (Brown & Singhal, 1999). Edutainment programmes primarily use a two-pronged strategy to bring about the social change. First, they influence the audience’s awareness, attitudes and behaviours towards socially desirable ends; Second, they are instrumental in modifying the audience’s external environment and context, thereby, creating a favourable climate for bringing about a social change at a system’s level (Singhal, Usdin, Scheepers, Goldstein, & Japhet, 2004).
The entertainment-based social serials on television generally raise social issues and question the social norms. The usual perception towards entertainment media stereotyping women’s portrayal can be defied using the edutainment approach. Entertainment media possess immense power in framing the perceptions of the audience towards women and gendering. The entertainment media and particularly TV have lived with a disturbing trend when it has negatively portrayed women as ‘the weaker sex’ who should remain subservient (Sharda, 2014). Edutainment which thrives on entertainment-based social serials can break this regression. The usual creative line is to depict the reality of such social behaviours which are not just gender specific, but are all pervasive and are not desirable like alcoholism, domestic violence or child abuse. This is typically followed by breaking such stereotypic behaviours through the protagonist’s thought and action and thus setting an example before the audiences, to motivate them to change like the role model (protagonist).
Stories of social concern when knitted carefully can be woven into different media formats such as, popular drama, radio broadcast, comics and so on, which have the potential to reach the masses effectively (Population Foundation of India, 2014). World over, edutainment, initiatives like Soul City and Sabido Soaps in South Africa have been acknowledged as powerful agents in influencing social norms in favour of women’s empowerment (Population Foundation of India, 2014). Within India too dramas like Hum Log, Jasoos Vijay and Kyunki Jeena Isi Ka Naam Hai were based on this concept of Edutainment. Entertainment–education (EE) programmes have the potential to strategically take up media role models to endorse behaviours that are accepted and looked for in the society and to deter socially objectionable behaviours (Bandura, 2004). Hence, the purposeful use of entertainment media can effectively be inculcated as part of an organized communication campaign which can strongly assert key messages on social issues (Brown & Singhal, 1999).
A newer approach was attempted based on the notion of Positive Deviance (PD). This alternate way of approaching social messaging draws its strength from looking at ‘what is working’ to keep the systems and our communities on track rather than finding why something is not working. The recent evidence of looking beyond the ‘norm’ that is moving away from ‘what is common and seemingly not working’ seems to be promising to be used for EE. Herein, the research is designed to elicit, examine and understand people’s behaviour to identify uncommon but effective practices of some ordinary members of the community that have worked in setting alternate social norms. This approach is found to be more useful in addressing intractable problems. Once identified such behaviours and practices can be propagated or popularised through interpersonal or mass mediated methods.
The history of PD can be traced back to 1990s. The premise first appeared in a book named ‘Positive Deviance in Nutrition’ authored by M. Zeitlin, a Tufts University professor. The author and team backed the application of the PD theory and concept to attend to the issue of malnutrition among children at the grassroots by discovering what was working in the community and resonate it thereon, antagonistic to magnifying on what wasn’t working at the grassroots and correcting it (Positive Deviance Initiative, 2014).
In the early 1990’s, Jerry and Monique Sternin, explored Zeitlin’s brainchild and operationalized the PD premise as an instrument to advocate behaviour and community transformation to sort out plethora of PD-driven social change programmes across the globe (Positive Deviance Initiative, 2014). The Sternins’ thereafter successfully applied the PD approach initially in the area of childhood malnutrition and furthered its implementation in different areas of community health, literacy, child safety and so on.
The approach thrives on the principle that wisdom to solve the problem exists within the community, but may not be so obvious. According to Singhal, 2014,
The Positive Deviance (PD) approach is based on the premise that in every community there are certain individuals or groups whose uncommon behaviours and strategies enable them to find better solutions to problems than their peers, while facing worse challenges and having access to the similar resources.
In the earlier efforts to identify PD behaviours in reducing malnutrition among children in Vietnam, Sternins’ appraised practices such as mothers actively feeding their children with frequent and smaller meals in a day and mothers washing their hands prior to feeding and so on. These were simple acts that were making a big difference; children of these mothers were healthier than their counterparts even though they also came from impoverished backgrounds. These practices when applied and followed by the community at large can bring the desired behaviour change (Singhal, 2014).
Over the past decade, programmers have integrated PD-informed strategies into a number of large-scale multifaceted interventions. PD draws its strength from the notion that ‘the faraway stick does not kill the snake…it is about discovering the closest stick and using it’ (Pascale, Sternin, & Sternin, 2010). Hence, PD is led by internal catalyzing agents who present the social evidence to their acquaintances. Since it intensifies already subsistent native wisdom, solutions and prospects are sustainable (Singhal, Buscell, & Lindberg, 2010).
In order to identify socially desirable behaviours related to ‘planning families’, a formative research for a tele-serial to provide creative insights into message design and plot construction was carried out. The research was based on the belief that the results of a PD enquiry can serve to feed the process of systematically and creatively designing messages through the lives of characters in a drama that can lead to better outcomes. This is expected to catalyze the process of positive behaviour change and to make edutainment more effective as the characters are easy to identify and go through similar emotions as those of the audiences. The actions of these likeable characters are likely to resonate with people facing similar problems and therefore will be easy to emulate (Anand & Batra, 2015).
Research for the Real
The research for identifying positively deviant behaviours was purposively conducted in four states of Madhya Pradesh, Rajasthan, Haryana and Delhi. The objective of the study was to capture positively deviant behaviours/practices related to family planning, spacing, and contraceptive use and counselling of the young couples living in rural/semi-urban India. It attempted to identify behaviours which are uncommon and therefore hard to identify in those conditions.
Focus group discussions with the local communities and in-depth interviews with the front line health workers helped in identifying micro behaviours/practices of both the health care providers like medical officers and health workers and the health seekers that is women, men, mother and father-in-laws. To elucidate the process, the questions to be posed were framed differently; like while conducting this action-based PD field research in a city hospital, the question was ‘What enabled certain health service providers to convince their clients more effectively to adopt temporary or permanent methods of contraception relative to their peers? What did they do?’ The enquiry led to one staff nurse among several others working in the same unit, but was far more effective in convincing her clients to adopt an intra-uterine device (IUD) than her peers. She is a positive deviant in her lot. ‘Positive’ because she provides her clients an opportunity to gain some control over their biology, and ‘deviant’ because what she does is not a normative practice. In a statistical sense, the staff nurse is a ‘positive outlier’.
So, what does the staff nurse do to counter these heavy odds? What positively deviant behaviours and practices does she engage in?
First, she begins the conversation about adopting a Copper-T, a common form of IUD, only when the women come in for their check-ups late in the third trimester of their pregnancy. This is the time that pregnant women feel ‘most pregnant’, get tired easily, and may find it difficult to juggle their current pregnancy alongside taking care of their previous children. Timing-wise, the client women are more likely to be receptive to entertaining such a conversation.
Second, she emphasizes that adopting an IUD is like ‘tying a rubber-band in one’s hair’. The rubber band keeps the hair tight and secured, and can be removed any time. Women readily grasp this rubber-band analogy as they are quite used to tying and untying their hair, several times, on a daily basis.
Her accomplishment was even more commendable given her clients mostly women came from a religious minority group from low socio-economic class representing one of the toughest groups for adoption of any form of birth control.
The process of engaging with the local community women in conversations about the desirable family size and the available options for planning families led the research team to one of the Auxilliary Nurse Midwife (ANM) in Alwar, Rajasthan. She has surpassed all records. She has been awarded by the State Health Ministry for going an extra mile to promote vasectomy which is indeed praiseworthy. The health data of the village are a proof that the village stands apart for the number of vasectomies performed. Her success is certainly extraordinary.
So what was it that Kamlesh did which made her positively deviant? How is Kamlesh able to convince male members of the community to adopt vasectomy?
This 42-year-old woman, Kamlesh popularly known as Bhenji (elder sister) always wore an innocent smile, reflective of her warm, hospitable nature and a firm confident voice full of determination. She has been working as an ANM for the past 17 years in the same village.
She skilfully identifies families to convince them about the imperative need to plan a family. She prefers visiting families with young couples in the comfort of their home rather than talking to them at the centre. It ensures that the entire household is very comfortable with her. She sits with the family when men are likely to be home and initiates conversation with the family elders about general issues of the community. Gradually after having informal discussion about children, their future, family matters, she broaches the idea of taking decisions well in time about family planning.
She tells couples about the various opportunities that they will miss if they do not plan their families. For example they would not be given a chance to stand for elections; they might face problems to get into government services, might fail to receive an increment after two children (in government jobs) and they would not be able to avail the benefits of various government schemes. She leaves them to ponder over the idea of a small family. She then follows up without exerting pressure. Once the family elders are convinced, then all the younger couples within household are spontaneous followers.
The joint families are a norm in this region of rural Rajasthan. Her strategy has been quite successful with examples of five men from a single joint household going for sterilizations across two generations. There are many such houses where all men have gone for vasectomy after having two children, leading it to becoming an alternate norm as compared to other regions where vasectomy is still a taboo.
Similarly, the enquiry led to a few individuals who had been able to persuade their spouses or elders to open up and accept alternate viewpoints about the number and sex of children they desired. Deviant behaviours like delaying first pregnancy after marriage, adoption of reliable contraception (condom, pills and copper T) and terminal methods of sterilization after completing family with one or two children in communities where having three–four children was a norm, were unearthed.
The study process enabled the research team to meet an illiterate woman who opted for tubectomy after her second child was born at her own behest unlike many others. She lived in a not so well-connected village in Bundelkhand region (Madhya Pradesh). She was convinced of the fact that with more than two children, she will not be able to provide the upbringing she wanted to give to her children. She had broached this idea with her husband, a high school pass out but he was sceptical about them taking this decision. She said,
I knew very well that he will not use or let me use any contraceptive, I went to the camp with my neighbour and got my tubectomy done. I was sure that I will be able to convince him and elders in the family about my decision to not to have any more children.
Her firmness and will to stand against her husband and the family made the difference. She showed courage in going against the will of her husband to plan the family, against the norm and rationalising instead of following her husband like many other of her age in a patriarchal set-up. She was able to negotiate with her family and now lives happily with her husband and two children.
In Haryana, a young man, principal of a private middle school, in the process of enquiry, shared how he resisted the pressure from his mother and wife, to have one more child since they had two daughters. After repeated cajoling by his mother, he sat down with her to explain that in school, he always talked about girls and boys being equal. He considered himself to be an example before his colleagues and young students, and therefore, how could he go for another child in want of a boy child? He put his mother’s anxiety to rest by affirming; he would bring up his daughters like sons. They will become independent. They would be able to look after their own family needs and also will be able to take care of him and his wife in old age if the need be. He opted for vasectomy.
These were few of the many stories which were documented through a systematic distillation of PD formative research before scripting. These identified behaviours and the family and social dynamics in which these were being practiced, formed the warp and weft of the stories of change (narratives 1 ). The narratives were then scripted into episodes of tele-serial drama that transcended real-life PD stories into fictional drama series titled Main Kuch Bhi Kar Sakti Hoon’ (See Figure 1) aired on National TV. The tele-serial today is a successful example of edutainment that has used a prime time slot to spread awareness and sensitize people about these very personal issues and actions which can pave way for healthy lives for mothers and children and problems of women across the life cycle.
Transcending Results to Reel
The tele-drama series directed by Feroz Abbas Khan and endorsed by Sharmila Tagore and Soha Ali Khan, telecasted on Doordarshan, Main Kuch Bhi Kar Sakti Hoon, focuses on sex selection, prevention of early marriage, domestic violence, women’s reproductive health and sensitizing men about alternate masculinity of being a responsible husband and father. Aimed at bringing about a change in the attitudes and behaviours of the target audience, and especially increasing women’s freedom and self-empowerment, the serial has garnered overwhelming response that is reflected in the successful TRP (Main Kuch Bhi Kar Sakti Hoon reached the TRP of 2.0 within four weeks of its launch, which made it the forerunner among all new shows on Doordarshan (IndianTelevision.com, 2014). Against the background of a small town set-up of ‘Pratappur’, Main Kuch Bhi Kar Sakti Hoon revolves around the rousing expedition of the protagonist, Dr Sneha (Population Foundation of India, 2014). An epitome of the young Indian woman of today, Sneha, represents the strong woman who tries to balance her professional and personal life, which is succumbed to various vicissitudes. It is her journey that forms the very crux of this tele-show. Her unique ways are but an example of what actually was found to be positively deviant from the health workers’ perspective through the field research. The real-life stories from the grassroots thus have formed the foundation around which the episodes of the tele-drama have been woven with an element of fiction. Thus, Main Kuch Bhi kar Sakti Hoon throws light on the ability of a woman to break free of the shackles of the society and prove her mettle.
Following the league of Hum Log, Jasoos Vijay and Jeena isi ka naam hai, today Main Kuch Bhi Kar Sakti Hoon’ is an example of edutainment which does not propagate out of the box behaviours, but instead promotes behaviours that are simple, practical and can be adapted to. Indeed the drama can be proclaimed as a positive deviant experiment.
The success of any edutainment intervention ultimately depends on the novelty of idea. PD approach in itself is novel; as it captures actions that are novel and at the same time doable and effective. PD is about the flip, where you look at what is working rather than what is not working. And, it is in appreciating this flip-side of the approach that PD nails it. The potential of PD cannot be denied owing to its inherent simplicity, faith in the community and replicability. What is needed today is an amplification of these PD behaviours and practices among the masses, because it addresses the social issues in the most subtle ways. It comprehends and effortlessly dictates the possible ways to overcome a problem, and again to reiterate, these ways are simple and doable. This amplification is possible only through media and edutainment programmes/interventions, thus, become the most effective tools to do the needful. Main Kuch Bhi Kar Sakti Hoon has been an intervention of this kind and it has been successful today in reaching out to its audiences with messages that are needed; giving way to innovative approaches in development communication, such as PD, in an entertaining way. It is high time that the private players, which reach out to a larger percentage of audiences, start embracing edutainment as a concept and propagating it on their channels.