Impact Evaluation of Kalyani TV Serial Magazine on RCH Communication

1.0 Background of the study:

Doordarshan has started Kalyani programme on National channel. This programme has covered all aspects of health. But then they felt need of the women and children of the community and bifurcate Kalyani programme in two parts Kalyani I and Kalyani II. Kalyani II has complete focus on reproductive and child health needs of the community. The objective of the programme was to high light & create awareness of focused interventions of Reproductive & Child Health (RCH) in EAG/ North East States. This weekly programme for half an hour on any of the RCH theme relating to women’s empowerment, population stabiization relating to girl child and reproductive behavior of men and women was telecast on DD channels from DDK Lucknow, DDK Patna, DDK Jaipur, DDK Ranchi, DDK Raipur, DDK Guwahati, DDK Dehradun, DDK Bhopal, DDK Bhubaneshwar. This study is to evaluate the impact of these programmes designed and telecast on TV channels (9). The programme had been successful in creating a brand out of Kalyani. Doordarshan with the help of Panchayats, Mahila Mandals and Nehru Yuvak Kendras. It had established over 1,200 Doordarshan Kalyani Health Clubs with over 24,000 members. These clubs help improve awareness among the people in the community. This programme brand has created a niche for itself achieving the No.1 position in some of the regions surpassing the popularity of all-time winner, the Regional News.
The campaign employed music, dance and song to broadcast information on RCH as well as comedy sketches, health tips, quizzes, news stories, phone-ins, letters from the audience, competitions, success stories and clubs. Kalyani is different from the usual run-of-the-mill educative programmes and has large viewer ship. It has been conceptualized as an entertaining, participatory, need-based, multi-segmented interactive programme that aims at behaviour change and social action.

2.0 Objectives of the study:

This study aims at:


a- To assess the impact of the programme on the target audience and to assess how Kalyani-II is different from other similar programmes in taking up the issues in terms of contents, presentation, language, instant reactions, timing duration etc.
b- To assess extent of awareness/watching of programme.
c- To assess knowledge gained about the issues taken up in the programme.
d- To identify source of knowledge gained.
e- To assess extent of change in attitude and behaviour relating to issues (as per audience)
f- To identify source of motivation for change in attitude and behaviour.
g- To assess reach of programme, recall of information/massages given opinion about the programme etc.
h- To assess the awareness about RCH & F.W. issues.

3.0 Methodology:

Kalyani programme is telecast only in 9 EAG states thus the study was limited to only networking area of DDK Lucknow, DDK Patna, DDK Jaipur, DDK Ranchi, DDK Raipur, DDK Guwahati, DDK Dehradun, DDK Bhopal and DDK Bhubaneshwar. The target audience was the entire population in the EAG States-UP, Bihar, Rajasthan, Jharkhand, Chattisgarh, Assam, Uttranchal, Madhya Pradesh and Orissa.

The study was conducted in following 8 steps.

Step I: Finalization of the objectives of the study and Desk research:

Step II : Deciding indicators/attributes for evaluation

Step_III : Design the Data Collection Instruments:

The main research tools were:

Quantitative Tools:
a- Target Audience Schedule
b- Health Service Provider Schedule (like ANM/MPW, MO)
c- Health Media Officer Schedule
d- Check list for designers, programme producers and anchors of Door Darshan Kendras
Qualitative Tools:
a- FGD with Community/target audience
b- Observation Study.

Step_IV : Developing an outline for the Study report:

Step_V: Development of Sampling Procedures:

The multistage sampling criteria was used.

Stage – I (Sampling of District in EAG States): In each state 2 districts were selected on the basis of having number kalyani clubs established.

Stage II. Selection of wards & Villages in the sampled District:

In each district at district town 100 households were selected for study. Five wards were selected randomly. In each ward 20 households were selected for study on random basis. In each of the district 30 villages were selected.

Stage-III: Selection of respondents:

In these selected villages 20 interviewers watching Kalyani programme were selected for impact evaluation of the Kalyani programme. In each village 5 interviews, with those who were not watching Kalyani programme, were also interviewed to analyse barriers in reach of the programme. Thus total 700 respondents were scheduled in a district.

Selection of FGD Groups:

In each district atleast 3 FGDs were conducted out of them 2 were women groups & 1 for male members separately.

Step_VI: Training of Investigators & Collecting the data.

Step-VII: Verification and entry of data collected from the field

Step-VIII: Report Writing:

Analyze, interpret and report the findings.

The qualitative data & the tabulated data were analyzed and interpreted. The quantitative data were analyzed by using SPSS package to prepare the report.

4.0 Observation of the study:

For this study initially it was decided that the respondents were married male and female of reproductive age between 15 to 45 years. But later on senior members of the family were also included because of their hold on family decisions on health issues. For this study total 14685 respondents were interviewed. Among them 12312 were those watching Kalyani programme and remaining 2373 were non viewers of the programme.

While collecting the opinion of the respondents they were interviewed on the subjects which were covered during January 2006 to March 2006 as we started data collection in the month of June 2006 as the recall of old data would have been poor.

4.1 Respondents profile:

At the country level almost equal proportion of male (50.2%) and female (49-8%) were the respondents. The study was focused on 15-45 yrs, but the age profile of respondents was skewed to higher age groups 21-35 years (56.9%) and 35-45 years (27.2%). More number of persons interviewed were from joint family structure (56.5%) compared to unitary family (43.5%). A low proportion of the respondents (15.1%) were Scheduled Tribes. Majority (89.6%) of the respondents were Hindu followed by Muslim (7.4%). In viewers group more than one fourth (25.8%) of the respondents were housewives followed by (20.1%) land owning farmers. Majority (53.2%) of the respondents were from lower middle income group, followed by (26.4%) in low income group. Only 0.8% respondents were from high income group. The majority (81.6%) of respondents in almost all states were watching TV at their own home only, followed by viewing TV at friend/neighour’s house (16.0%). A very small percent of respondents were found viewing TV at community centres (2.1%).

4.2 Programme related observations:

The question were asked about the knowledge gained on the theme telecast in Kalyani Programme to know the impact on increase in knowledge and then to what extent they practices that knowledge. The findings are given in this para.
87.1% respondents could recall the Kalyani logo and associated that with pipal tree leaf. Only 6.0% respondents were unable to recall the name of base leaf of Kalyani logo. Only 16.6% Kalyani-viewers regularly watch the programme where as more than 50.0% are not regular. 75% viewers know the correct time of telecast. 65.1% respondents opined that they share the knowledge gained from the programme with others. 62.0% of them discuss with their spouse. More than 75% respondents found Kalyani title song as good. 85.2% respondents were able to recall that they saw episodes on RCH issues. In each state more than 75% respondents were found correct in recalling the RCH issues telecast on DD-1 as Kalyani Programme.

About half (47.2%) of respondents opined that the duration of the programme was short and it should be increased. Only 9.3% respondents felt that the duration of the programme was long. The advertisements were liked by viewers as is evident from high recall level barring a few cases. For example in Assam advertisement on PNDT was not effective one. Highest recalled advertisement was on immunization and lowest on sex determination. In Assam 37.8% respondents were aware of the existence of a Kalyani club in their villages/wards whereas in UP only 14.5% were aware. Status of membership of Kalyani clubs was poor. Willingness for opting membership of Kalyani clubs was found more than 50% in all the states. A majority (60.6%) revealed that they did not know how they can become member of these clubs. But only 61.7% respondents were aware of the format of this programme. Majority of them (92.7%) were found satisfied with the answers provided at phone in programme.

Nearly fifty percent (49.6%) respondents ever heard of ASHA. 96.8% had correct knowledge of right age at marriage. 90.6% respondents were aware of risk factors of old age pregnancy. Only 37.7% respondents could respond to correct answer for diet to pregnant women by responding that a pregnant woman needs one and half times of a normal diet. 88.7% respondents had knowledge about prevention of anaemia and out of them 94.9% respondents were practicing consumption of 100 tablets of iron during pregnancy in the family. Majority (81.1%) of respondents were aware of ANC checkup atleast 3 times during pregnancy (Table 4.4). Only 3.8% respondents do not know about the recommended frequency of ANC checkups. More than 90% of the respondents had practice of 3 or more ANC checkups during pregnancy. A majority (73.4%) of respondents had knowledge of TT immunization to pregnant mothers. Only 1.0% respondents said that no extra care was necessary during pregnancy. A majority of respondents (91.0%) were aware of anemia/unconsciousness/breathing troubles as symptoms of risk pregnancy and 90.1% were aware of edema as symptom of risk factor. Only 42.3% respondents said that the source about their knowledge of risk pregnancy was Kalyani Programme. “Bitiya ne Janam Liya” is a most common tele film telecast in Kalyani Programme. 66.3% of respondents have watched this film. 54.0% respondents informed that Kalyani Programme was source of their information on sex determination. 75.8% respondents were aware that the sex determination of foetus is a legal crime.

After telecast of the Programme very little rise (2%) was seen in Institutional deliveries. Kalyani programme was the source of knowledge for only 16.6% respondents. Higher proportion (26.6%) of respondents ware found in Uttar Pradesh. A good proportion of (78.3%) respondents have knowledge of feeding colostrums to newborn and out of them appreciable proportion (97.0%) of respondents have been practicing the same. 86.5% respondents have knowledge of exclusive breast feeding upto 6 months age of the baby and out of them 95.4% were practicing as well. 98.4% respondents had knowledge about immunization and 97.2% respondents have got their children immunized also. Rest of the respondents which did not have knowledge and also did not get their children immunized. They had some reasons for that. Out of them 63.7 % said infants get fever after immunization so they do not opt for immunization Therefore communication strategy is to be designed to address the myths related to immunization among the large group audience. 62.3% said infants get weak, 64.9% said infants keep crying. Above 75 % respondents had knowledge of diseases being immunized. Knowledge of immunization against diphtheria (39.7), TB (49.7) and Pertusis (35.1) was lower in Orrissa. 69.0 % respondents had knowledge of right time for measles immunization. 82.1 % respondents had seen and could recall Shahrukh Khan’s Ad on immunization (Table 7.5). It seems Ad had good impact. Majority (81.9%) of respondents were aware of role of the Vitamin A in preventing night blindness. Only 28.1% respondents were able to tell the right span of bathing a newborn. At the time of managing sickness of an infant 89.5% respondents told that they take the infant to health care institution immediately. If a child was suffering from diarrhoea then majority (87.8%) of respondents said that they feed ORS to the child, 63.5% said that feeding of pulse soup or dal ka pani is done.

Majority (88.1%) of respondents were able to recall an episode on child care which was telecast on TV. In all 76.6% of the respondents were aware about HIV/AIDS. In all the states more than 90% respondents were aware about the reasons of contracting HIV/AIDS. Overall 52.3% respondents got knowledge about HIV/AIDS by watching Kalyani episode. Only 5.1% received knowledge through Kalyani clubs. About 90 percent respondents said that they can live with HIV/AIDS patients happily and even motivate them for treatment.

About 60 percent (58.8%) have opted any of contraceptive measures either temporary or permanent. In temporary methods contraceptive pill and condoms were commonly used (43.1% and 45.4% respectively). Main reasons for not opting any temporary method was that they were not aware of these methods (24.7%), not easily available (19.9%) and due to religious reasons (19.6%).

In all 25.9% respondents received knowledge of family planning methods from Kalyani Programme. About 25.4% respondents opted contraceptive methods in consultation with their spouse whereas only 6.6% opted on the advice of elders of the family. A majority (63.1%) of respondents knew correct span of spacing. A majority (67.6%) of respondents knew that NSV is a method of male contraception. 23.6% respondents confirmed that themselves or any one of their relative/acquaintance adopted NSV. On inquiring about reasons for not opting NSV, 23.4% said that it developed physical weakness and 19.6% revealed that sterilization should be adopted by women only. In 4.4% cases wife did not allow her husband to adopt NSV.

5.0 Findings from Focus Group Discussions

Some of the groups found the present timings suitable but a large majority wanted the timings for the programme between 7.30 to 8.00 PM. Even the duration of the programme should be increased as per them.
The programmes should focus on encouraging NSV so that male sterilization be increased. The male community is scared of NSV, the focus to reduce their fear be given on Kalyani episodes.
They opined that because of the Kalyani programme influence there was increase in institutional deliveries.
Because of the influence of the programme people were than more prompt towards ANC & New Born care compared to past.
The awareness programmes on the diseases which were of recent origin and not known to community should also be telecast. So that community could be made aware about them & take precautionary measures.
The traditional & home based treatment methods should also be included in the Kalyani programme. Even AYUSH should be included in the programmes as per them.
The Kalyani Programme should be produced in the format of a serial.
The dialogic mode of discussions with the doctors should also be in the drama format.
· Kalyani be included in DTH telecast.
· The CDs of the Kalyani be made available in the market.
The details given through Kalyani were different some times form the information given in health messages of the department. Therefore there was a need to integrate the contents with health messages released through other channels.
The efforts to ensure electricity supply during Kalyani Time be made by the government.
Where ever there is no access of TV, there the programme be disseminated through radio.
Where there is no electricity, the programme contents be disseminated through street plays.

Opinions of anchors and producers of Door Darshan Kendras:

Most of the respondents found the programme OK but a few found the topics are excessively congested i.e. highly condensed with contents.
They suggested that the script be written considering the local culture & constraints of the TV Transmission.
· Most of the producers found the artists performing very well excepting Lucknow & Patna where they found only normal.
· The producers found them successful in communicating the desired messages effectively.
· There should be workshops to identify the issues making the community participate more actively.
· The Government department should support for the popularity of the programme.
· There should be freedom to select the local topics in stead of rigid run sheet.
· PGFs be actively involved in providing the local issues.
· There be Kalyani Rath as is done in Hath Se Hath Mila.
· The programmes be shooted in the remote locations for which the budgets & required manpower does not permit.
· Incorporation of programmes like Uljhan-Suljhan, Ab-Tab, Kalyani Workshops’
· Nautanki based on regional popularity was incorporated in Bihar.
· Connected more with the local situation & field based.
· A large proportion of the respondents said they do not get adequate time & facilities for regional research.
· For increasing the participation in phone-in prgramme they suggested-
a- Local experts should respond in local language
b- The programme be included on DTH
c- Duration of Phone-in be increased.
d- A few forward audiences should be encouraged for more phone-in calls.
· The Kalyani Rath be sent to each district with prior advertisement through local media & local administration.
· The copy of the programme through CDs be sent for dissemination as a large area of the country is media dark
· It should be screened through cables also.
· The hoardings of Kalyani be displayed at Public Places.
· Power supply be ensured or the telecast be matched with supply timings.
· Periodic surveys be conducted.
· New techniques be adopted.
· Too many segments not to be included in one episode.

Opinions of Media Officers of District Health Systems

The opinions of Media Officers of District Health Systems were as follows:

· Most of the media officers interviewed had watched the programme. Which was informative, more useful for rural folks. As per them it helped in increasing immunization.
· Most of the media officers interviewed were dissatisfied because of not using local language.
· The media officers interviewed found their performance good on a varied scale of measurement.
· The programme is successful but it should show more of field realities rather than studio setting.
· It has better impact because of involvement of local artists.
· Puppet show by local artists, local dancers, street plays be included in the programme.
· The information about the programme be given through health workers as well.
· Most of the media officers interviewed found very good synchronism in the programme.
· It should also telecast the latest government health schemes & create awareness before launch.
· A majority was found satisfied with the level of innovations but a few of them wanted more innovative ways to reach to the community.

6.0 Recommendations:

Community watching of the programme had been only in 3.5% cases which needs strengthening as Kalyani was designed to enhance community viewing and their active involvement. The awareness about Kalyani was not among 24.9% cases. Therefore the efforts are needed to advertise about the programme timing through other media and other channels. The concept of Kalyani clubs be strengthened. It may also enhance the audience involvement. The audience does not share this knowledge with health workers (2.7% only). The health workers need to be involved in the programme. Even the copies of the Kalyani episodes be given to block level & district level media personnel to disseminate in their media activities. The efforts are needed to strengthen this component with the help of health service providers. Rather it may be linked with ongoing health schemes and existing community organizations. The awareness about formation of Kalyani health clubs itself has been poor. This again necessitates linking this component with existing health systems.

Only a small proportion 37.7% of the audience was aware of right quantity of food intake during pregnancy. The contents and the formats of communication need modification so that high proportion of audience could get the knowledge of the food intake during pregnancy. The awareness generation on MTP & PNDT was less than adequate. It needs to be given more attention with appropriate strategy. The impact on practices in immunization was good but the myths against immunization still requires communication strategy to achieve 100% immunization in the states like UP & Rajasthan. Kalyani was effective only upto 27% for creating awareness on FP methods. This component of NRHM now need focus for next programmes. GOI wishes to promote adoption of NSV method but 32.4% still need to know about this method. Therefore this subject needs adequate attention on the contents and programme focus areas. A good proportion of community (37.5%) got knowledge about ASHA from Kalyani but this is a low proportion because it was asked from Kalyani ever viewers. There is a need to modify the format so that it can give knowledge to a wider group of viewers.

The programme needs focus on adolescent group as their representations among respondents had been poor. The programme requires to chalk out strategies to involve highly educated class as in the respondents group only 11.3% were graduate & above. The people from higher income group also to be towards the programme as their representation is also poor.

The music like title song was appreciated by a large proportion of audience (75%). This indicates that music like title song should be used even in other components of the programme to keep the audience involved and learn more from the programme. The programme be disseminated through AIR wherever possible as there is demand for the programme but electricity supply is irregular. Though a high proportion of audience was found satisfied with the answers of phone in programme but at the same time a large group could not get line. This requires modification in approach.

The flexibility to producers for promoting the programme, deciding the format of the programme and selection of the team be increased. The state health authorities be asked to contribute technically in the design of contents and they should incorporate the communication in their regular health programmes.

It is a unique programme because it is telecast from regional kendras helped in focusing localized issues, Phone-In Programme is another innovation of audience participation, community involvement by way of Kalyani Clubs is its uniqueness and connected more with the local situation & field based.

Timings from 6.30-7.00 be changed to another slot later when most people can access. It should also be disseminated through AIR and DTH also. Use of folk media and traditional art be made effective. Animation should also be incorporated in the telecast. CDs of the Kalyani episodes be made available in the market and local cable operators be asked to telecast them. The use of local dialects and regional languages is to be increased.