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The target population knows key messages on fortification of wheat or maize flour
This indicator assesses whether a target population that should have been exposed to key messages on fortification of wheat or maize flour can state them when asked, which indicates they can recall the message content.
Behaviour-change communication requires that the target group hears and is able to recall key messages, in order to increase their knowledge, motivation, demand for and appropriate use of the fortified flour and products made from fortified flour, and, by extension, that of their family as well. This indicator assesses whether the target group can recall or select the key messages that may be delivered in conjunction with fortification. This indicator reflects the quality and effectiveness of the behavior-change communication strategy. If a large proportion of the target population does not know the messages, then this might indicate that the messages are not functioning as expected. If the target population is not sufficiently exposed to the messages, or to the message content, potential adjustments may then be made to the delivery channels to make them more relevant and meaningful to the target population.
The percentage of individuals in the target population who can recall key messages regarding fortification of wheat or maize flour
Numerator: the number of individuals in the target population surveyed who can state a minimum number of key messages heard or read regarding flour fortification that were part of the messages disseminated in the fortification programme
Denominator: the number of individuals from the target population surveyed
• Divide the numerator by the denominator. Multiply the result by 100 to convert the number into a percentage.
Considerations for the calculations:
• The minimum number of key messages should be defined in advance. For example, minimum knowledge is defined as recalling two of four key messages disseminated as part of the intervention package.
• Similarly, it might also be useful to calculate the percentage recalling all or none of the key messages. The indicator definition should be revised accordingly for each of the specified calculations.
awareness, behaviour-change communication, communication, information, messages
Food fortification
Output
Beneficiaries know, demand
School age children, 12-23 months, 24-35 months, 36-47 months, 48-59 months, 6-11 months, Adolescents, All, Men, Women of reproductive age
None,
Folate, Iron, Niacin, Selenium, Vitamin A, Thiamine (vitamin B1), Vitamin B12, Riboflavin (vitamin B2), Vitamin B6, Vitamin C, Vitamin D, Vitamin E, Vitamin K, Zinc
Market-based
In some countries, fortification decision-makers may not implement any behavior-change communication, in which case this indicator is not necessary.
The primary target population for key messages is typically the caregivers or adults in the family.
It is best to ask the person to state what they have heard or read, instead of reading them a list of messages from which they might randomly select the correct answer without having been exposed to or recalling the key messages.
It is relatively easy to include questions into a survey to assess this indicator. Once the data are collected, it is easy to calculate the indicator.
The intervention package might not be the source where the participant heard or learnt about the key message, so the indicator would not be capturing the desired information. Recalling key messages is not sufficient to ensure regular consumption of fortified-flour products by the target population. The person answering the question might not be the one who determines what food products are purchased for the household.
In a country, the flour fortification alliance carried out formative research with women of reproductive age, to develop a behaviour-change communication strategy. The aim was to increase knowledge and awareness among women about the link between fortification with folic acid and reduction of neural tube defects, such as spina bifida. In an evaluation of this communication campaign among women who had recently given birth, the women were sent a written survey, 3–4 months post-partum. They were asked whether they had heard, seen or read anything about the link between folic acid and congenital anomalies, such as spina bifida. Among the 578 respondents, 514 responded “Yes”.
Numerator: 514
Denominator: 578
Calculation: 514/578 * 100 = 89% of postpartum women sampled had heard, seen or read about the link between folic acid and congenital anomalies.
1. WHO/FAO. Guidelines on food fortification with micronutrients. Geneva: World Health Organization, 2006.