Audience Segmentation for Nutrition

Social and behavior change (SBC) strategies are critical for addressing social and structural barriers, and encouraging positive behaviors around nutrition. SBC can foster increased utilization of health services, improved client-provider interactions, and improved dietary diversity, among other outcomes.

To increase the effectiveness of SBC strategies, program planners must understand the intended audience(s) and the factors driving their behavior. Audience segmentation is a technique that divides a population into groups with similar characteristics related to a topic or behavior of interest, enabling a deeper understanding of the demographic factors, norms, and attitudes that enable or inhibit positive behavior change among each group. The use of audience segmentation can help SBC practitioners develop interventions tailored to each group’s particular characteristics and needs.

This course is intended for use by SBC and service delivery professionals seeking to encourage positive nutrition behavior change by employing segmentation based on needs, attitudes, and behaviors of intended audience(s).

Building Trust and Empathy Around COVID-19: A Client-Centered Communication Approach

The role of a health care worker (HCW) is pivotal for quality health care delivery, demanding both competence and empathy. Despite being recognized as a trusted source for COVID-19 vaccine-related information, HCWs were infrequently engaging and counseling their clients about COVID-19 testing and vaccine uptake. Moreover, in-depth interviews conducted by Breakthrough ACTION with HCWs in four states of Nigeria–Akwa-Ibom, Bauchi, Enugu, Lagos–reported that they lack sufficient information on COVID-19 and COVID-19 vaccines and require more information on COVID-19 and vaccination (Breakthrough ACTION, 2022). Recognizing the critical role HCWs play in vaccination decisions, there was a need to enhance their knowledge, attitudes, and communication skills.

In response to these challenges, Breakthrough ACTION initiated a comprehensive, multi-component intervention, “Building Trust and Empathy Around COVID-19: A Client-Centered Communication Approach.” This intervention aimed to enhance HCWs’ knowledge of and attitudes about COVID-19 and vaccines, improve communication skills and, in turn, client-provider interactions, and foster resilience to the stress induced by the COVID-19 pandemic.

The Building Trust and Empathy curriculum supplements the Nigeria Federal Ministry of Health’s National Interpersonal Communication and Counseling manual to equip health workers with tools to address vaccine hesitancy and promote COVID-19 prevention, testing, and vaccination as per national guidelines. This two- to three-hour long online course is adapted from a two-day in-person training.  

Learners should also explore the Nigeria country page of the COVID-19 Communication Network for additional supplemental materials that were developed to reinforce this training, which includes the participant’s training bookletawareness cards (also available in Hausa, Igbo and Yoruba), posters, and learning videos.

Social and Behavior Change for Sexual and Reproductive Health Service Delivery

Applying social and behavior change (SBC) approaches and techniques to service delivery efforts can motivate clients to access services, improve client-provider interactions, and boost adoption and maintenance of healthy behaviors. It can improve health outcomes by helping providers enhance the quality of community engagement and dialogue; client education and health promotion; and counseling and shared decision-making. SBC approaches can improve clients’ overall experience of care, which may result in increased satisfaction with health care delivery, improved trust in health care providers and the health system, and improved health seeking or maintenance behaviors.

The primary purpose of this course is to demonstrate how SBC can be integrated into sexual and reproductive health (SRH) services to improve acceptability, access, quality, and outcomes. In addition, this course aims to strengthen the ability of service delivery partners to integrate SBC into their work and summarize how and where SBC can be used at each stage of the service continuum, that is, before, during, and after a client receives services.

Allowing for pauses to complete short reflection exercises, this course will take approximately three hours to complete.

Course Audience

This course is aimed at public sector staff overseeing SRH service delivery at the national and sub-national levels, such as SRH Coordinators; service delivery-focused non-governmental and community-based organizations; and private sector service delivery partners, such as franchisees. The course is relevant to all but focuses on those with limited background knowledge about SBC. It may be applicable to other health areas but focuses on SRH service delivery.

Implementing the SBC Flow Chart

This toolkit provides an introduction on how to implement the SBC Flow Chart. It is designed to be a flexible and unique experience that integrates multiple approaches and methodologies, providing recommendations of tools and inspiration that may be helpful along the way.

What we know is there is no one way to do things. The toolkit takes you on a five point journey; three phases where you collect information, build your solution set, and implement what works, and two points of convergence where validate what you have.

So, while the SBC Flow Chart is laid out as a step-by-step process, it is not meant to be prescriptive. You can build upon what is provided or replace a tool if you have something that will work better in your context.

Don’t be afraid to experiment! And remember that SBC is as much an art as a science; use the basis found here to let your creativity flow and adapt based on the unique needs of your team and context.

Phase 1 Define: Mine existing knowledge, Intent statement, Deepen understanding; Phase 2 Design & Test: Imagine, Refine, Prototype, Test; Phase 3 Apply: Implement & Monitor, Evaluate & Refine, Adapt & Scale

We invite you to take the Social and Behavior Change 101: An Introduction course for additional resources!

Interpersonal Communication and Counseling: Improving Dialogue About COVID-19 Vaccination and Other Sensitive Topics

The rollout of the COVID-19 vaccine has highlighted the need for improved interpersonal communication and counseling (IPCC). Mis- and disinformation has muddled COVID-19 messaging, meaning that health providers have to spend extra time communicating with and counseling clients on vaccine side effects, risks, and benefits to ensure their concerns are addressed.

This course is intended for all health workers that interface with clients, including both in the health facility and at community-level. It offers an introduction and overview of IPCC, and techniques for counseling clients and countering myths and misinformation on an interpersonal level. Participants will learn how to better communicate with clients, as well as how to properly counsel clients to encourage behavior change. The course introduces new IPCC-related skills, provides a framework for sensitive counseling sessions, offers interactive exercises to practice these new skills, and includes job aids that can be printed and used in any counseling setting. Though the course focuses on counseling related to COVID-19 vaccination, it is widely applicable and useful for providers working in any health topic, from routine immunization to family planning to other health emergencies.

Gender Analysis for Vaccine Response

Research on the COVID-19 pandemic has underscored the need for a more gender equitable approach to a vaccine response. As public health agencies around the world work to ensure that everyone has access to vaccines, risk communication and community engagement (RCCE) actors must recognize and address the different ways in which gender can impact vaccine acceptance and uptake.

Breakthrough ACTION developed the Gender Analysis Toolkit for Vaccine Response for RCCE actors working with national health authorities and other partners to develop, implement, and monitor a vaccine response. This toolkit provides practical guidance to identify gender related barriers that need to be addressed and identify opportunities that can be leveraged to enable a gender equitable vaccine response that increases coverage for all. While Breakthrough ACTION developed this toolkit based on improving uptake of COVID-19 vaccines, it is applicable for any vaccine response.

The toolkit includes:

  • Evidence on the importance of considering gender in a vaccine response.
  • Step-by-step guidance and tips for conducting a gender analysis.
  • Worksheets to collect, organize, and analyze existing information and make recommendations across three RCCE pillars: RCCE systems for emergencies, risk communication, and community engagement.
  • An illustrative gender analysis based on a country’s COVID-19 vaccine response.
  • Additional resources for integrating gender in RCCE activities.

Shifting Social and Gender Norms as Part of Social and Behavior Change, Part 1

When behavior change is the goal, program planners need to understand if, how, when, and under what conditions a behavior is influenced by social and gender norms. Social and gender norms are the implicit, informal rules that most people accept and abide by; these rules are learned and reinforced from childhood to adulthood through observation, instruction, and social interaction. Norms play out at all levels, in individual decisions, relationships, and communities, and are also embedded in formal and informal institutions. They can have profound effects on individuals and group behaviors and actions.

This online course was developed by Breakthrough ACTION and adapted from the in-person and virtual Social Norms Training Curriculum developed by the Passages Project. Part 1 offers an overview of social and gender norms and an introduction to using norms assessments for designing social and behavior change programs. The course uses animations and real-life case examples to illustrate the application of this work in different contexts. Part 2, which will be available in 2024, covers the design of norms-shifting interventions and the measurement of these approaches.

USAID, Passages, and Breakthrough ACTION logos

Malaria SBC Toolkit for Community and Faith Leaders

Faith and community leaders have deep roots in local communities. Local leaders also play an important role in health issues around the world, including the fight against malaria. Malaria is a deadly disease, but it can be prevented and cured. Local leaders are crucial in helping communities take action in the fight against malaria.

This toolkit will guide faith and community organizations to use their own strengths, community connections, and resources to educate on how to prevent malaria and support proper treatment in local communities. Using the processes of social and behavior change (SBC), the toolkit will help leaders influence communities’ knowledge, attitudes, beliefs, and social norms to help people adopt key behaviors to prevent and treat malaria. The toolkit consists of four sections: Context, Malaria Actions to Promote, Using Malaria SBC in Your Work, and Advocacy; and is available in English, French, Spanish, and Portuguese.

The toolkit contains:

  • Resources to learn more about malaria in your country or region.
  • Tools for communicating effectively and creating lasting behavior change.
  • A list of key actions to promote to fight malaria in your community.
  • Steps for integrating malaria into your current work.
  • Examples of community malaria activities.
  • Strategies for being malaria advocates.

Leaders can use these tools to help local people and families change their everyday actions to prevent malaria and promptly and safely treat malaria if they become sick. Together we can help stop the spread of this disease, treat those who fall ill, and save lives.

Applying Human-Centered Design to Improve Nutrition Programming

Human-centered design is a way of thinking that places both the people that programs serve and related stakeholders at the center of the design and implementation process. With emphasis on research, ideation, iteration, and prototyping, this process seeks to achieve novel solutions to complex problems. While there are many different HCD processes, all of them, at their core, are rooted in empathy: a comprehensive understanding of the stakeholder(s) involved in the challenge at hand.

This course aims to support social and behavior change programs by providing an overview of how to use HCD to address nutrition-related behavioral challenges. By understanding the key steps and methods applied in each step, learners will gain a deeper understanding of how HCD can add value to their work and access a set of practical tools they can immediately put to use to develop, support, and refine nutrition programs.

Rumor Tracking and Infodemic Management in Public Health Emergencies

The overabundance of health information—including rumors and misinformation on and offline—has been a growing challenge across the world. This situation, called an infodemic, requires public health officials and health providers to work even harder to provide the public with accurate, up-to-date information.

This course is intended for risk communication and community engagement program implementers and other professionals working to identify and respond to emerging rumors. It offers an overview of the theory and practice of creating an infodemic management system, including step-by-step instructions, case studies, and links to additional tools. Participants will learn key definitions, consider how to conduct an infodemic landscaping analysis, and select sources of rumor data. The course modules also cover a variety of analysis techniques, strategies for addressing misinformation, and considerations for monitoring and evaluating infodemic management efforts.