The Drum Beat 813 - The "S": Social Change in SBC

• 1.Communication for Social Change: An Integrated Model for Measuring the Process and Its Outcomes
  This working paper was developed by Johns Hopkins Center for Communication Programs for the Rockefeller Foundation as part of the Foundation's Communication for Social Change Grantmaking Strategy. "The guiding philosophy of communication for social change can readily be traced to the work of Paulo Freire (1970), the Brazilian educator who conceived of communication as dialogue and participation for the purpose of creating cultural identity, trust, commitment, ownership and empowerment (in today's term). The proposed model builds on this principle and a broad literature on development communication developed by practitioners, communication activists and scholars..." [Jun 2002]
  
   

• 2.Webinar Recording: What Does It Mean to Prioritize Social Accountability in SBC Programming to Address Equity and Social Determinants of Health in FP/RH?
  This Breakthrough ACTION webinar focuses on social accountability (SA) as a process that can be leveraged across SBC programming to address equity and social determinants of health to shape and influence family planning (FP) and reproductive health (RH) outcomes. SA approaches can address both inequities in the quality of service delivery and power dynamics between different actors, including health facility staff and community members. Working through existing platforms (e.g., local community oversight committees), these approaches can support citizens' participation in dialogue with service providers and other officials. SA interventions like these are expected to lead to changes in how community members and providers engage in demand and supply of services. [May 2022]
  
   
• 3.Improving the Linkages between Social Accountability and Social and Behavior Change
  Literature and programming priorities suggest that work on SA and SBC tends to ignore opportunities for overlap and synergy between the two. SA approaches revolve around the interactions between government, health system, and citizens - actors who play a role in SBC. However, the defining objective of SBC programming is to facilitate individuals changing their behaviours and shifting to optimal health choices and actions, not the relationship of the various actors and the context of the system. Conducted as part of the Health Systems Strengthening Accelerator (Accelerator) initiative, this study aims to identify and support promising opportunities for SA-SBC linkages to increase equity and efficiency through universal health coverage, with a focus on Côte d'Ivoire, Ghana, and Guinea. [Oct 2020]
  
   

• 4.COVID-19 and Health Inequities: Insights from Communication Research and Practice
  by Renata Schiavo, Gretchen Van Wye, and Erma Manoncourt, Editors
  The articles in this special issue of the Journal of Communication in Healthcare offer insights on the role on communication research and practice in addressing health inequities that existed and/or emerged during the COVID-19 pandemic. They also highlight perspectives and/or implications of relevant findings - not only as related to COVID-19 response and recovery but also future public health and healthcare emergencies in both national and global settings. [Mar 2022]
  
   
• 5.What's Next in Design for Global Health? How Design and Global Health Must Adapt for a Preferable Future
  by Ayush Chauhan, Krista Donaldson, Ana Santos, and Michael Ngigi
  Design for global health - the implementation of design methods in the development of global health products and services - gives voice to the need for empathy, equity, and inclusion in the field of global health. This commentary traces the influences that have shaped the practice of design for global health, describes the state of the emerging field, and envisions the future that awaits those working to create health equity through design. [Nov 2021]
  
   
• 6.Webinar Recording: How Can SBC Programming Address Equity and Social Determinants of Health Considerations in FP/RH?
  This Breakthrough ACTION webinar focuses on how SBC programming is well suited to addressing equity and social determinants of health (SDOH) in FP/RH. It also explores how to apply these concepts to efforts to effect social and structural change pertaining to contraceptive autonomy and reproductive empowerment. Presentations feature the voices and experiences of global researchers and practitioners based in Kenya, Nigeria, and South Africa. [Apr 2022]
  
   

• 7.Webinar Recording: Why Do We Need to Elevate the "S" in SBC to Improve Family Planning/Reproductive Health Outcomes?
  FP inequities hinder access to FP information, services, and methods for women, men, and other gender-diverse people across socioeconomic statuses. Addressing SDOH is an approach to achieving health equity. Hosted by Breakthrough ACTION, this webinar makes the case for explicitly considering and addressing SDOH in FP and RH programming. The webinar also explores how to build effective coalitions with multi-sectoral actors working in this field. [Mar 2022]
  
   
• 8.Supporting Sexual and Reproductive Self-Care through Social and Behavior Change: A Conceptual Framework
  Sexual and reproductive self-care is strongly influenced by the social, cultural, and structural context in which individuals and couples live. Social and behavioural determinants including health literacy, motivation, agency, social norms, laws, access, social policies, and provider training and attitudes all influence demand for and use of self-care products and behaviours. From Breakthrough ACTION, this framework articulates how SBC can support sexual and reproductive self-care initiatives and contribute to improved health outcomes. It considers behaviour from a socio-ecological perspective, recognising that individuals are grounded in a complex system of household, community, health system, and national influences. [2021]
  
   
• 9.South Sudan Social Norms Assessment
  by Paul Bukuluki, Moses Okwii, Kamden Hoffmann, and Melinda Pavin
  There is a growing evidence base suggesting that understanding the social norms that influence behavioural intentions and actions is critical to effective messaging and programming for FP interventions. Conducted by the United States Agency for International Development (USAID)-funded MOMENTUM Integrated Health Resilience and implementing partners, the goal of this assessment was to inform the development of the USAID/South Sudan's SBC efforts. Recommendations include building on positive norms as an asset to promote FP, supporting male engagement strategies, engaging influencers as change agents, and including health providers as partners in SBC and social norms transformation. [Jan 2022]
  
   
• 10.Addressing Provider Bias in Contraceptive Service Delivery for Youth and Adolescents: An Evaluation of the Beyond Bias Project
  by Zachary Wagner, Corrina Moucheraud, Alexandra Wollum, et al.
  This randomised controlled trial of the Beyond Bias intervention, which sought to reduce FP provider bias toward young and adolescent women aged 15-24 in 233 clinics in 3 countries, found that bias manifests differently across settings. The roots of provider bias in Burkina Faso were found to be largely situational and practical, whereas biases in Pakistan stemmed more from social norms and values. In contrast, in Tanzania, provider biases were found to be influenced more by biographical, situational, and cultural factors. [Mar 2022]
  
   
• 11.Improving Households' Attitudes and Behaviours to Increase Toilet Use (HABIT) in Bihar, India
  by Shruti Viswanathan, Ruhi Saith, Arpita Chakraborty, et al.
  Findings of this study "highlight the limitations of short-term behavioural interventions in changing entrenched social attitudes. These interventions can work only in conjunction with bottom-up social change and will not be sufficient, in isolation, to change deep-seated biases." To try to explain persistently high rates of open defaecation, social scientists have established a link between deep-rooted caste bias and sanitation practices. In response, Oxford Policy Management, ideas42, and World Vision India designed and developed an intervention directed at shifting norms, correcting underlying cognitive biases, and promoting the development of intention to use latrines. [Apr 2020]
  
   

• 12.Using SBC to Enhance Programs to End Child, Early, and Forced Marriage
  From Breakthrough ACTION, this set of 7 technical briefs focuses on the use of SBC approaches to strengthen the collective effort to reduce child, early, and forced marriage (CEFM). For example, the brief on Collective Action notes that, when behaviour change is an outcome of collective action, an individual's change can happen within the context of a supportive environment, which increases the likelihood that the change will become permanent and result in a more sustainable shift on a larger scale. This brief explores how to incorporate collective action into CEFM programming and provides examples of, and links to resources on, collective action in CEFM programmes. [Nov 2021]
  
   
• 13.Save the Children's Community Action Cycle (CAC)
  This community mobilisation approach fosters individual and collective action to address key health programme goals and related outcomes. By working through the CAC cycle, communities and individuals will identify the socio-cultural barriers/enhancers, resources, and risk factors, especially for those most marginalised, to access health services and begin to work towards positive change. They will also identify bottlenecks to accessing services and will link with internal and external partners to address these barriers.
  
   

• 14.Mobile Technology to Support Gender Equality in WASH during COVID-19
  In Nepal, to offer correct information and to combat rumours during the COVID-19 pandemic, SNV and Viamo co-created key messages that were communicated through the 3-2-1 service (Suchanaa ko Sansaar). The voice-automated response system guides the caller in navigating a menu of educational content options on topics including: COVID-19 prevention; menstrual health and hygiene (MHH); water, sanitation, and hygiene (WASH); and gender equality and social inclusion (GESI). The messages are designed to change users' attitudes and behaviours - e.g., by helping them understand how hygiene is essential for preventing infectious diseases, accessing economic opportunities, and ensuring healthy environments.
  
   
• 15.Impact of P.A.C.E. on WASH Behaviors: Program Evaluation in Madhya Pradesh
  by Prerna Kumar, Kakoli Borkotoky, and Pranita Achyut
  Literature suggests that, while women play a significant role in managing WASH at home, social norms do not allow women to participate in WASH decision-making. The Gap Inc.'s Personal Advancement & Career Enhancement (P.A.C.E.) programme intends to build women's knowledge and skill for driving change in WASH behaviours and improving women's involvement in decision-making. The International Center for Research on Women (ICRW) conducted a longitudinal study to assess the adoption and sustainability of WASH behaviours among P.A.C.E. graduates in Madhya Pradesh, India. The evaluation implies that, while the P.A.C.E. programme equips women with information and skills to negotiate the gender dynamics within the household, there is a need to shift the gender power relations both at the household and community levels. [2021]
  
   

• 16.Gender & Power Analysis Guidance - GAP Analysis: A Child-Centred & Intersectional Approach
  by Krista Bywater, Yeva Avakyan, and Karine Lepillez
  Gender and power (GAP) analysis is a type of action research that identifies, examines, and addresses discrimination and inequality in order to drive transformative, systemic change. It explores gender inequalities and intersecting systems of oppression that impact the individual and collective ability of people to fully exercise their rights. Save the Children (SC) has developed this guidance document to support - through use of a GAP analysis - the design and adaptation of programming that positively transforms unequal power relations and ensures all stakeholders can equitably access, participate in, be decision makers for, and benefit from SC activities. [2021]
  
   
• 17.Intended Outcomes Social Change Assessment Methodology (IOSCAM)
  Developed by Eran Fraenkel, IOSCAM is a methodology for conducting a needs assessment in preparation for social change programming. It is an integrated and multivalent tool that identifies and prioritises potential social change programming according to the importance of an issue and the possibility of achieving the desired change.
  
   
• 18.Guide for Developing an SBC Strategy
  SBC goes beyond improving knowledge through information, education, and communication (IEC) or behaviour change communication. Acknowledging the limitations of prior efforts, ministries of health in West Africa are focusing more deeply on analysing social and cultural norms to address barriers to improving health practices, supporting the enabling environment with updated policies that encourage improved practices, and assisting individuals and families to gain the self-efficacy to change individual behaviours. To facilitate the design of such robust SBC strategies, Breakthrough ACTION staff created this umbrella guidance document following a series of workshops and coaching efforts with ministries of health and Development Food Security Assistance partners in Burkina Faso and Niger who are implementing the USAID Resilience in the Sahel Enhanced II (RISE II) programme. [2022]
  
   
• 19.Community Engagement: A Health Promotion Guide for Universal Health Coverage in the Hands of the People
  This World Health Organization guide intends to support change agents involved in community work at the local level, particularly in low-resource settings, who seek to reap the benefits of engaging communities toward universal health coverage (UHC) in support of the Sustainable Development Goals. "A renewed engagement with communities and healthy settings is required, using health promotion actions as the main reference points for interventions, with a sharper focus on equity, inclusion and social coherence that places UHC into the hands of the people." [Oct 2020]
  
   
• 20.Complexity-Aware Monitoring, Evaluation & Learning for Social and Behavior Change Interventions
  SBC projects are complex, operating at multiple and interconnected levels of the social ecology and physical environment. In the context of supporting monitoring, evaluation & learning (MEL) activities, CORE Group's SBC Working Group developed this set of complexity-aware tools to facilitate design and evaluation of SBC-focused interventions. [Aug 2021]
  
   

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