Reflections on a Legacy of Change

As I was moderating a final panel for C-Change’s end-of-project meeting in Washington, D.C., it occurred to me that successful development programs usually raise as many questions as they answer. The Communication for Change (C-Change) project was no exception. Indeed, a project as wide-ranging and prolific as C-Change was bound to inspire thoughtful reflection well beyond the question, “Where do we go from here?” The project, the U.S. Agency for International Development’s (USAID’s) flagship program in social and behavior change communication (SBCC) since 2007, has worked with national and local governments in nine countries, universities in five countries, many local nongovernmental organizations in 15 countries and four regional networks with 212 member organizations. All of those partnerships were crucial to embedding SBCC into the hearts, minds and institutions that they reached. But would any of these partnerships endure without a central coordinating body? Or would they even have to endure to be successful? Would it be enough that C-Change, in the words of Rafael Obregon, Chief of Communication for Development at UNICEF, “provided a space for people’s engagement and participation” in a nonprescriptive or message-driven way?

One of the ways C-Change provided this “space” was in strengthening the capacity of organizations and individuals to use SBCC in program planning, development, implementation and evaluation. Project staff developed a set of tools, the C-Modules, that have been widely adapted and used by many partners, thereby expanding C-Change’s influence beyond the project end date of December 2012. The C-Modules have been downloaded almost 25,000 times, incorporated into five university courses, adopted by 73 host government programs and used in face-to-face trainings of more than 2,500 individuals. That’s a great start.

The end-of-project meeting also highlighted C-Change’s work in six areas: SBCC capacity strengthening; family planning/reproductive health research and country experience; HIV/AIDS research results; SBCC tools development and use; malaria research and programs; and gender research and programs. During the meeting,  project staff displayed the many communication products they had developed, including an electronic repository (C-Hub) of more than 3,000 items.

During the panel I was moderating, Dr. Elizabeth Fox, Director of USAID’s Office of Health, Infectious Disease, and Nutrition, challenged the gathering to address three important questions facing health communication in a post-C-Change world. The first one acknowledged that while we, the health communication community, are committed to capacity strengthening of health communication, “What is the impact of capacity strengthening on health programs themselves? How is it making them better, stronger?”

Dr. Fox also asked, “What is the impact of SBCC on health outcomes? There is already some good evidence, but we need more and we need to disseminate it strategically. We need to show that SBCC works.”

Her final question was, “What is the impact of country ownership? This is a major thrust of the USAID Forward policy, and we are committed to give greater ownership of health communication to local country partners. But is this country ownership going to have a positive impact on development? We need to show the data.”

Listening to these questions, I felt positive about the future. Our organization is positioned to tackle these questions with our vast network of experts in health, research and communication. Building on our successes and lessons from the C-Change project, our work in global health communication will complement the science and evidence-based work also conducted by FHI 360 and will help shape our communication programs to create impactful interventions that improve lives.

To learn more about the C-Change project, please visit

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