The “Thematic Convergence Project: Arts Interventions and Health Behaviour in Ahmedabad Slums”, project outlined in this document took place in 2015. The project aimed to raise demand for health services and encourage health-promoting behaviours using the arts (principally drama) in the informal settlement of Ahmedabad in Gujurat, India. The team aimed to evaluate the success of the project using a 'quasi-experimental controlled trial' method.
India is rapidly urbanizing. Informal settlements lie at the heart of urban populations, however, they are largely ignored in urban planning and development. This impacts on health in particular, with water borne disease and malnutrition being major concerns.
Preventable diseases take a huge toll in urban populations living in informal settlements. Women and children face specific challenges often leading to infant and maternal death. Research has shown that one serious illness can put a family into debt for years. The nomadic lifestyle of many who live in informal settlements makes it difficult to arrive at policies for improving people’s health simply through resource provision.
This pilot project was funded by the National Mission for the Empowerment of Women (NMEW) under the Ministry of Women and Child Development. It tested the effectiveness of the use of the drama in bringing about a change in health-related behaviour, particularly women’s health. The project was conducted by Darpana Academy (for Dance and Music) in Ahmedabad, with the Indian Institute of Public Health, Gandhinagar as its research partner.
The focus was primarily on:
1) General health, sanitation and hygiene;
2) Breastfeeding, antenatal care and vaccination;
3) Menstruation;
4) Family planning
Two informal settlements in Ahmedabad were identified for their demographic match. Base-line surveys were conducted to identify key health-related issues and understand the level of health related information amongst the public. Based on the findings of the baseline survey, Darpana devised the scripts for the performances, developed characters and composed songs. The dialect of the performance and the body language was devised based on that of the population of the intervention settlement Vasana. Professional actors were trained into becoming actor-activists, and using the arts for social change. An extensive training session was conducted with the actors to train them into the health issues, as well as in the dialects, behaviours, beliefs and the sub-culture of those living in the targeted informal settlements.
Darpana also involved the local link-workers and attempts were made to involve the local aanganwadis (mother and child health centres), doctors and health officials so as to access the community and also to link audiences with health service provision available.
Keeping Kubernagar as a control settlement, seven theatrical interventions were conducted in the Vasana settlement. For maximum interaction and involvement with the audience, the project included participatory theatrical performances (using Boalian Forum theatre*) after every two performances, and one at the very end on all the themes covered.
Upon completion of the performance programme, an end line survey was conducted to measure the impact upon the audiences. Disclosures of intended behaviour change and recall of health-related messages were evaluated.
The methodology of the analysis was “difference-in-difference” in which the average change over time of the control group was compared to that of the intervention group. The results indicated a statistically significant positive change in people’s level of awareness. For a more in-depth understanding of the impact of the arts-based interventions, and to ensure that the change in attitudes were translated into measurable action (healthy behaviour), a longer term project needs to be conducted along these lines.
Caption:Film showing Boalian drama activities
*If you are interested in knowing more about about Augusto Boal’s emancipatory theatre please visit our overview and resources available on Mesh Here
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