Out with the Old: Gates Funded Social Engineering Health Effort in India
Northwestern University Professor Noshir Contractor and his collaborators are studying how to use networks to spread messages about public health knowledge. The idea is to pair social networks with social motives to “close the science gap.” In other words, to put authoritative findings into direct action and overcome cultural caution.
Researchers cite that the infant mortality rate is 10 times higher in India than in the developed world. But to further illustrate their need to infiltrate the culture using social networking ties with Indian health surveillance workers, they cite another extreme example to highlight superstition.
While clinical trials found that applying an inexpensive topical solution of chlorhexidine to cleanse a newborn’s umbilical cord reduced the neonatal mortality rate by 24 percent, many Indian parents did not receive or follow this information.
You think you can just tell someone the scientific facts, and that will solve the problem. There is very good evidence that it doesn’t solve the problem at all because personal beliefs interfere.
In the case of chlorhexidine, for example, some parents are hesitant to use it because of deep-rooted traditional beliefs dating back several centuries that encourage parents to apply mustard oil to the umbilical cord. Some parents, they say, worry that breaking the ritual will cause bad luck for their child.
Contractor describes Indians’ superstition, and thus the need to step in:
It’s like the sports fans who always wear the same lucky shirt. You can tell them as much as you want that wearing the same shirt will not help their team, but they are still going to do it.
Noshir Contractor said:
The challenge is not that we don’t have solutions to solve major societal problems, but that we struggle with how to take a known solution and get a large number of people to use it. There is a big gap between what science offers us and what gets applied.
To find out which people fall into each category, Contractor is leading a survey of 14,000 family health workers in India. The paper-based survey involves family health workers for the Indian government as well as several non-profit organizations and development partners.
We are asking them about who they go to for advice on family health solutions as well as questions that will help us assess the extent to which these people are driven by the need to be right or the need to be liked. Based on those characteristics, we can identify who is most likely to influence them and what message is most likely to influence them.
The results of the survey will be implemented in a digital dashboard that Contractor calls the “Do Board.” Members in a technical support unit from the NGO Care India (partnered with Merck, targets poor women) will possess the Do Boards, using the information to help health officials interested in scaling up innovations identify who is likely to influence whom and with what message.
“A lot of people think that networks just make pretty pictures and nice visualizations,” Contractor said. “We want to prove that networks can do something very actionable and solve major world problems.”
But the real story is that while polio has statistically disappeared from India, there has been a huge spike in cases of non-polio acute flaccid paralysis (NPAFP)– the very types of crippling problems it was hoped would disappear with polio but which have instead flourished from a new cause.
There were 47,500 cases of non-polio paralysis reported in 2011, the same year India was declared “polio-free,” according to Dr. Vashisht and Dr. Puliyel. Further, the available data shows that the incidents tracked back to areas were doses of the polio vaccine were frequently administered. The national rate of NPAFP in India is 25-35 times the international average.