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CARE Bangladesh Drives Social Behavioral Change in Access to Antenatal Care

A Bangladeshi woman sits on a floral rug and smiles while holding her young child.

Since delivering her baby, Pavi has accessed medical support from the roving health team supported by CARE. Photo credit: CARE / Jenny Conrad

Since delivering her baby, Pavi has accessed medical support from the roving health team supported by CARE. Photo credit: CARE / Jenny Conrad

Executive summary

Every day, more than 20 women lose their lives in Bangladesh due to preventable causes related to pregnancy and childbirth, according to data from The Lancet.

CARE Bangladesh has been working to reduce maternal and infant mortality with multifaceted programming to improve maternal health, nutrition, and child immunization. In the district of Gazipur, CARE is intensively working in close collaboration with the Bangladesh Government to impact this statistic. Since 2021, CARE Bangladesh has run multiple social behavioral change communication (SBCC) campaigns on Facebook and Instagram addressing health topics such as COVID-19, maternal health, and childhood immunization.

From August to December 2022, CARE Bangladesh launched a social media campaign to provide information on the importance of four antenatal visits and to increase institutional deliveries. The campaign targeted men and women of reproductive age (18-44 years) in Bangladesh.

Here are some lessons learned on this campaign:

TL;DR summary

  • The campaign strategy ran across three phases, using a Multi-Cell Brand Lift Study to glean deeper insights.
  • “Thumb-stopping” graphics that utilized best practices led to 2.7 million people engaging with the campaign’s ads through video views, likes, clicks, shares, and comments.
  • Based on Brand Lift Study results, the campaign likely led 101,602 additional people in Gazipur to express that they know where to go for prenatal care.

The campaign

From August through December 2022, the team launched a campaign about the importance of prenatal care with three phases, each running for 3-4 weeks and building on the previous one. In addition, CARE Bangladesh wanted to understand the campaign’s performance differences between those who lived in Gazipur with exposure to offline programming, versus parents in other areas of Bangladesh.

The campaign used a mix of static images and dynamic content in phase one. Short videos and animations highlighted antenatal care and showcased the importance of four antenatal visits. The creative assets also showed how the support of all family members was essential.

“The beauty of social media is the opportunity to interact with the target audience in real-time,” said Priyotosh Das, Communications Officer at CARE Bangladesh about the creative strategy. “As they shared their reactions and opinions in the comment section, we picked up some important insights about their present behavior and concepts, which helped us to create follow-up content by addressing those concerns and misconceptions.”


To gauge the campaign’s efficacy in changing knowledge, attitudes, and behavior, Meta facilitated a multi-cell brand lift study. In a multi-cell study, the campaign is segmented to gain deeper insights on a particular variable. For this campaign, the variable was Gazipur, where CARE conducted intensive in-person programming for maternal health, versus other areas of Bangladesh (with a few areas of programming).

The survey asked both people who had been exposed and those who hadn’t been exposed to the ads about recall, importance, and access:

  1. Ad recall: Can you recall seeing an ad for CARE Bangladesh online or on a mobile device in the last 2 days?
  2. Importance: How important do you think it is to visit the doctor four times for prenatal care for a safe pregnancy and delivery?
  3. Access: Do you know where a pregnant woman in your area can go for detailed information if she needs a doctor for prenatal care?

The campaign leveraged ad credits donated by Meta and reached 9.4 million unique people across Bangladesh. As a result:

  • Overall share rate of 0.034% was 143% above goal and women in Gazipur had the highest share rates (0.037%) and were the most engaged (37%).
  • Based on creative best practices, the campaign utilized a mix of static images and short, animated videos. The top performing creative was a static image that showcased when the four antenatal visits should occur.
  • For the “Importance” brand lift study question, CARE Bangladesh discovered that 86% of people already felt that four antenatal visits were important without seeing the ad campaign. In Gazipur, this was even higher – 89%. Therefore, it’s not surprising that the campaign had little to no impact on this question.
  • While people felt that antenatal visits were important, less than half of people surveyed knew where to go. Those in Gazipur with in-person programming, saw an overall lift of +2.2 percentage pts indicating they know where to go. And, for females 25-34, the lift was even higher – +3.3 percentage pts. Overall, the campaign likely led 101,602 additional people in Gazipur to know where to go for prenatal care.
  • Outside of Gazipur, the lift was slightly less (+2.0 pts), but because of the larger population size, the number of people likely-impacted was slightly greater – 162,857 additional parents in Bangladesh indicated they knew where to go for prenatal care.

Next steps

Phases two and three of the campaign are ongoing. In phase two, the creative assets highlighted relevant aspects of antenatal care such as the family’s role, danger signs, and nutrition. These phases will also utilize a trusted messenger, Dr. Tasnim Jara, who CARE Bangladesh has previously featured in successful campaigns. Going forward, the campaign learnings will be utilized to design future campaigns and increase social media integration into the projects’ communications component.

“The importance of four check-ups for a pregnant woman is specifically explained, which is very useful. I learned when to go for ANC check-ups from the CARE campaign, which helped me,” said 25-year-old Sayeda Sadia, Community Support Group (CSG) member, Ward-17, Gazipur.

One Step Closer to Vaccination

In 2021, 20 CARE Country Offices ran 45 pro-vaccine campaigns on Facebook and Instagram. Through Meta’s brand lift study tool, we know that 8.6 million people  likely experienced a positive change in knowledge, attitude and/or behavior towards the vaccines and/or preventative measures to protect against COVID. While there are many lessons still to learn, this post shares what we learned about what works and what doesn’t.

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