Reflections on Keluarga SIGAP and what it tells us about the future of behaviour change programmes

Last month, we were in Jakarta for the national dissemination of Keluarga SIGAP (translation: The Ready Family), bringing together partners, government colleagues, and practitioners to reflect on what this programme has achieved, and what it has taught us.

What made the moment particularly meaningful was not just that a multi-year programme (three years) had reached its conclusion, but that the room itself reflected the journey SIGAP has taken. Representatives from Sukabumi, Brebes, and Banjar - districts where the programme was implemented at scale - joined national stakeholders, including the recently appointed Director of Health Promotion and Community Health, Dr. Niken Wastu Palupi. Their presence underscored something important: SIGAP was never designed as a stand-alone project, but as a practical and sustainable contribution to Indonesia’s broader primary healthcare and prevention agenda.

From households to systems: what SIGAP set out to do

At its core, Keluarga SIGAP was built around a simple but ambitious idea: families are more likely to protect their children’s health when information, motivation, and support come together, consistently, and in ways that feel relevant to everyday life.

The programme focused on three behaviours that are deeply interconnected in shaping child survival and development: routine immunisation, handwashing with soap, and age-appropriate infant and young child nutrition . Rather than addressing these in isolation, SIGAP deliberately promoted this highly impactful intervention, recognising that caregivers do not experience health decisions in silos.

The programme implementation combined two complementary approaches. On the ground, trained community health volunteers worked through existing primary care platforms, making home visits and facilitating Posyandu (community based health centres) sessions that emphasised dialogue, demonstration, and problem-solving. Alongside this, SIGAP tested a large-scale digital and media approach, using television, social media, influencers, and a WhatsApp-based tool, to reinforce messages and extend reach far beyond the immediate programme areas.

Seeing these elements discussed together during the dissemination event was a reminder of how much effort went into aligning community-level delivery with wider communication ecosystems.

What the programme achieved

Across the three districts, SIGAP reached families during a critical window - the first two years of a child’s life - when habits, beliefs, and routines are still forming.

Caregivers engaged strongly with the tools and sessions designed to make complex information easier to understand and apply. Visual demonstrations helped shift perceptions around why soap matters, not just water. Simple tracking tools encouraged reflection on feeding and hygiene practices between visits. Immunisation calendars and games helped demystify schedules and address common fears.

Importantly, the programme also made visible the role of fathers and other household decision-makers, challenging the idea that child health is solely a mother’s responsibility. While engagement varied, this intentional inclusion marked a meaningful shift from more traditional approaches.

What difference SIGAP made: key impact highlights

SIGAP’s integrated approach has translated into measurable changes in behaviours and protective practices across the three scale-up districts of Sukabumi, Brebes and Banjar, even as it continued to reinforce routine primary-care delivery.

Immunisation coverage increased markedly. Across the districts, basic childhood immunisation rose by about 15 per cent on average during the scale-up period. In Banjar, this shift was particularly pronounced, from around 37 per cent to 59 per cent, meaning nearly six in ten children there are now receiving age-appropriate vaccines compared with fewer than four in ten previously. Uptake of specific vaccines also climbed: the final dose for pneumonia nearly doubled in Brebes, and polio booster coverage reached about 80 per cent in Banjar, illustrating strengthened confidence and completion of full schedules.

Handwashing with soap improved both in practice and enabling conditions. Nearly 7 per cent more households now have handwashing facilities with soap, making the behaviour easier to adopt as part of daily routines. Compliance at six critical moments, including before feeding and after childcare, rose by 6.4 per cent, and involvement of fathers in hygiene practices increased by 13 per cent, signalling broader family engagement in protective behaviours.

Nutrition behaviours also shifted positively. Early initiation of breastfeeding increased by 4.4 per cent, and the share of children achieving minimum dietary diversity, a key predictor of healthy growth and development, went up by 6.8 per cent. Practical tools delivered through SIGAP were reported to help families track diets more effectively; on average, 96 per cent of caregivers said nutrition tracking tools helped them understand and improve their children’s eating patterns.

Mass media and digital engagement extended reach. Between May and November 2025, SIGAP public service announcements reached more than 4.7 million people nationwide through television, while digital content generated over 1.14 billion impressions across platforms such as Meta, YouTube and TikTok. On YouTube alone, 8.1 million completed views suggested strong engagement beyond surface-level exposure. 

Taken together, these results show that SIGAP did more than raise awareness, it helped embed protective behaviours across families and communities, supported by both traditional primary-care platforms and wide-reach digital and media channels.

The role of catalytic funding and partnership

None of this would have been possible without aligned, catalytic financing and long-term partnership. Implemented by WPP Media and Inke Maris, Keluarga SIGAP was supported through a collaboration between Gavi, the Vaccine Alliance, Unilever Lifebuoy, and The Power of Nutrition, working collaboratively with government counterparts at national and district levels within Indonesia.

What made this partnership distinctive was not only the scale of resources mobilised, but how those resources were effectively used. Funding enabled sustained engagement with families through existing primary healthcare platforms, while also supporting an ambitious national media and digital strategy that reinforced behaviours beyond programme districts. Crucially, it allowed space for independent evaluation, ensuring that impact measurement and learning, not just delivery, remained central.

This combination of public, private, and philanthropic funding created the conditions for SIGAP to test integrated delivery at scale, take measured risks on digital innovation, and generate evidence that can inform future investments. As discussions during the dissemination made clear, such catalytic models are particularly valuable where governments are seeking scalable, system-aligned approaches that can be gradually and sustainably absorbed into routine financing, including district budgets and village funding mechanisms, over time.

What the independent evaluation tells us, and what it doesn’t

An independent, mixed-methods evaluation provided a rigorous lens on what changed, how, and why. The findings were encouraging, but also refreshingly honest.

On the positive side, there were clear improvements in knowledge, confidence, and motivation across all three behavioural areas. Gains were particularly strong for child feeding practices and handwashing with soap, where interactive tools and demonstrations translated into measurable improvements in reported behaviours. Early initiation of breastfeeding and dietary diversity also improved, signalling that integrated counselling can influence some of the most critical nutrition behaviours.

At the same time, the evaluation surfaced a familiar - but important - challenge across all behaviour change efforts: improvements in knowledge and intent do not always translate immediately into sustained changes in practice. While positive trends were observed across multiple outcomes, similar shifts were also occurring beyond SIGAP areas during the same period, making it difficult to isolate programme effects within the study timeframe. This reinforces the reality that behaviour change is shaped not only by information and motivation, but by wider structural and social factors - including service availability, household decision-making dynamics, time and resource constraints, and persistent concerns or misconceptions - which require longer-term, system-level responses.

Rather than diminishing SIGAP’s value, these findings reinforce a crucial lesson for the health sector: behaviour change programmes operate within systems, not above them. They can strengthen demand and confidence, but they must be paired with reliable services and supportive environments to fully close the gap between intention and action.

Key learnings we take forward

Several lessons from SIGAP stand out.

First, integration works, but it needs careful pacing. Delivering messages on immunisation, hygiene, and nutrition together can be efficient and reinforcing, but too much information at once risks overwhelming families. Supporting frontline workers to prioritise and adapt content remains critical.

Second, evaluation is not just about proving impact, but about learning. The insights on spillover, contamination, and baseline strength of behaviours are valuable not only for SIGAP, but for any programme combining media and community engagement at scale.

Third, sustainability depends on systems, not pilots. The strongest signals for SIGAP’s future came from discussions on how elements of the programme are already being absorbed into routine processes, from village funding mechanisms to district planning and supervision structures. Where local ownership is strong, programme principles are far more likely to endure.

Looking ahead

As we left Jakarta, what stayed with us was a sense of confidence, not that SIGAP has solved every challenge, but that it has demonstrated what is possible when partnerships align around families, evidence, and systems.

Digital and technology-enabled approaches will undoubtedly play an increasingly central role in the development and delivery of public health interventions. SIGAP shows both the promise and the complexity of that shift. When combined thoughtfully with trusted community platforms, digital tools can amplify reach, reinforce behaviours, and support learning at scale.

Photo credits: WPP Media Indonesia

More detail on the programme design, delivery approach, and results is set out in the Keluarga SIGAP programme brochure, link here.