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Kate Holt/Jhpiego

Social and Behavior Change Communication

Beyond simply delivering a message, Social and Behavior Change Communication (SBCC) is the systematic application of theory-based, research-driven communication strategies to address individual level change and change within broader environmental and structural levels. As USAID’s flagship global program in maternal, newborn and child health, MCSP had the opportunity to reach women and their families throughout Asia and Africa with contextualized SBCC approaches at both facility and community levels.

Across our priority countries, our SBCC work focuseds on three major objectives:

1. Implement strategic, evidence-based SBCC activities at the country level

We strengthened national community health worker systems and mobilizing communities to address structural and cultural barriers. MCSP efforts also addressed provider behavior and improved the quality of client-health provider interactions, while bolstering linkages between communities and health facilities. Through use of the community action cycle, group-based dialogue and learning approaches, information and communication technologies, quality improvement approaches, and engagement of community champions, we improved quality of care and cultivated an enabling environment for optimal practices and use of reproductive, maternal, newborn and child health (RMNCH) services and gender equity initiatives.

2. Contribute to the evidence base at country and global levels

MCSP worked to advance global learning on evidence-based approaches for promoting RMNCH SBCC. For example, a study in Tanzania explored sociocultural and environmental cues to birth spacing and optimal nutritional behaviors. The study tested the use of innovative communication approaches for influencing nutrition and family planning perceptions and practices among women, their family members, village leaders, and health providers.

3. Collaborate and coordinate with SBCC partners globally and at the partner level

Finally, MCSP worked closely with SBCC partners and leverages the expertise of bilateral and global awards focused on SBCC.

Key Results

  • MCSP collaborated with the World Health Organization (WHO) to develop implementation principles for social, behavioral and community engagement interventions to meet a need identified by the WHO-convened expert group working on an evidence map for the interventions. The principles, along with a synopsis of the methods and brief discussion, are in Annex 6 of An Evidence Map of Social, Behavioural and Community Engagement Interventions for Reproductive, Maternal, Newborn and Child Health, released by WHO in November 2017. These common principles informed programming while WHO continued to systematically review the evidence (and gaps) to make formal global recommendations for the range of social, behavioral and community engagement interventions.
  • The 2016 and 2018 SBCC Summits were prime opportunities to share the work of MCSP and its predecessor, the Maternal and Child Health Integrated Program. The Summits allowed for information sharing to promote use of state-of-the-art and emerging evidence, tools and approaches, and to facilitate inter-agency collaboration to advance SBCC efforts across MCSP programming.
  • MCSP served on the advisory committee for the Communication & Community Engagement for Routine Immunization forum organized by UNICEF. The meeting: explored challenges, opportunities and lessons learned in implementing demand-generation activities for immunization services; built on existing approaches and tools to enable countries to deliver results through communication and community engagement; and identified or enhanced key performance indicators and tools for monitoring & evaluation of demand generation for immunization. The forum led to the development of a framework that can serve as a common basis for action and investment by various partners who support SBCC work for routine immunization.
  • The Program developed interpersonal counseling approaches and engaged community support groups to improve understanding of optimal infant and young child feeding (IYCF) and prevention of maternal anemia, and to increase uptake of nutrition practices and interventions (such as exclusive breastfeeding, optimal complementary feeding, and maternal iron-folic acid supplementation). In Kenya, collaboration with the Ministry of Health and UNICEF led to the finalization of the Baby Friendly Community Initiative (BFCI) Implementation Guidelines, BFCI M&E tools, and the IYCF counseling package, which aided in guiding implementation of BFCI. In Malawi, similar collaboration enabled an update to the WHO BFHI 20-hour course and existing behavior change communication materials (such as BFHI job aids and tools) to include the latest guidance on nutrition and HIV in partnership with BFHI master trainers.
  • In Mozambique, MCSP supported the Ministry of Health to implement innovative SBCC interventions for promoting healthy lifestyles, such as “model families” that focus on participatory dialogue between couples, and integrating key messages related to growth and development and the promotion of adequate complementary food.
  • In Rwanda, MCSP supported community mobilization using the community action cycle approach in four MCSP-supported districts in accordance with the national Community Mobilization Framework. In addition, the Program facilitated implementation of district communication plans in 10 MCSP-supported districts, and provided financial support to the Rwanda Health Communication Center to supervise SBCC activities in MCSP-supported districts.
  • The Program completed the formative research phase of the study “Using SBCC to improve understanding and adoption of optimal nutrition and postpartum family planning practices in Lake Zone, Tanzania.” Findings contributed to the knowledge base on current practices, barriers and facilitators for optimal nutrition and family planning practices in the region. This research informed the development of a strategic approach for re-envisioning and revitalizing the promotion of the Lactational Amenorrhea Method as a contraceptive option within the context of integrated nutrition and family planning programming. Results from the implementation phase were available in 2018.