Service providers, whether facility or community based, are a key link between communities and health systems. A provider’s direct interactions with clients means they play a crucial role as facilitator and potential barrier to their clients adopting healthy behaviors. A service provider’s opinions and biases, attitudes and behaviors, capacity and skills, and working conditions can influence their ability or motivation to deliver quality services. Such barriers may be outcomes of individual, interpersonal, organizational, and institutional factors.
It is critical to understand a provider’s barriers to performing their tasks, as well as the ways in which those barriers impact their clients. Social and behavior change (SBC) approaches can help identify and address factors that lead to provider-side barriers to quality service delivery. SBC theories provide insight into the values, social norms, skills, knowledge, and structural context that may influence a provider’s actions.
In this Breakthrough ACTION Trending Topic, we focus on service providers as an audience for SBC interventions. The Trending Topic includes peer-reviewed literature and program examples from projects such as Transform/PHARE, which has applied SBC techniques such as barriers analysis, identifying positive deviants, and advanced audience segmentation to provider behavior change. It also highlights several resources that support the design and planning of provider behavior change interventions.
We welcome your contributions to this topic – if you have additional resources to share, please send them to the Compass curator, Susan Leibtag, susan.leibtag@jhu.edu.
Peer-Reviewed Literature
- Wright, Patricia, et al. A Qualitative Analysis of Provider Barriers and Solutions to HIV Testing for Substance Users in a Small, Largely Rural Southern State. Journal of Rural Health 2013 Fall; 29(4): 420–431.
- Factors Impacting the effectiveness of community health worker behavior change, Health communication Capacity Collaborative (HC3), 2013.
- Grimshaw, Jeremy, et al. Changing Provider Behavior: An Overview of Systematic Reviews of Interventions. Medical Care, Vol 39, No. 8 August 2001.
- Nxumalo, Nonhlanhla, et al. Community health workers, recipients’ experiences and constraints to care in South Africa – a pathway to trust. AID Care, Vol 28, 2016.
- Franco, Lynne Miller, et al. Determinants and consequences of health worker motivation in hospitals in Jordan and Georgia. Social Science and Medicine, Volume 58, Issue 2, January 2004, Pages 343-355
- Jenkins, Rachel, et al. Exploring the perspectives and experiences of health workers at primary health facilities in Kenya following training. International Journal of Mental Health Systems, 20137:6.
- Cattamanchi, Adithya, et al. Health worker perspectives on barriers to delivery of routine tuberculosis diagnostic evaluation services in Uganda: a qualitative study to guide clinic-based interventions. BMC Health Services Research, 2015; 15: 10.
- Chamberlain, Sarah. Training and equipping frontline health workers with mobile health education tools. Vodafone Limited.
Cover photo: A male community health worker (Village Health Team or VHT) in Uganda demonstrates the injectable contraceptive. © 2014 PATH/Will Boase, Courtesy of Photoshare