Prioritizing Behaviors and Strategies for SBC
Although the Zika virus was first discovered over 50 years ago, its risks during pregnancy have only recently been understood. When Zika transmission surfaced in large urban centers of Brazil in late 2015, an international public health emergency response began. Dozens of organizations and country governments leapt into action to provide awareness and prevention information, with little opportunity to coordinate messaging. During the first year of the USAID Zika response in Latin America and the Caribbean, USAID found that over 30 behaviors were being promoted. This large number of behaviors presented a challenge to the potential effectiveness of social and behavior change (SBC) efforts to prevent Zika at the household and community level.
Such a large number of behaviors, coupled with potentially contradictory messaging, could result in confusion and be counter-productive. Families could be left wondering where to focus their attention and efforts to prevent Zika in the home. Lessons learned from behavioral science, marketing and adult learning have demonstrated that individuals need to hear a message multiple times before they are compelled to take action. It was therefore crucial for partners working in SBC for Zika prevention to promote a harmonized set of behaviors, to “speak with one voice” and increase the chances that these behaviors were adopted correctly. This conclusion prompted the need to determine which of the many behaviors being promoted had the largest potential impact to reduce Zika transmission, based on existing evidence, in order to focus prevention efforts around a shorter, common set of the most promising behaviors. USAID and Breakthrough ACTION + RESEARCH led a process to prioritize evidence-based behaviors with the greatest potential for Zika prevention to guide USAID implementing partners to focus their SBC activities. This guidance - The Zika Prevention Behavior Matrix - provided a platform to support in-country coordination, harmonize prevention messages, and create tools to support SBC efforts.
This Trending Topic provides resources and tools to prioritize behaviors for Zika prevention. It also includes a series of tools from other health areas that highlight the prioritization of programmatic strategies. The process of prioritizing behaviors and strategies may differ across health areas; however, we hope these resources and examples can be helpful to those embarking on a prioritization process. Let us know about your own behavior or programmatic prioritization materials by writing to firstname.lastname@example.org.
Banner photo: Volunteers from the Red Cross in El Salvador engage in participatory trainings to strengthen their interpersonal communication skills for Zika prevention during household visits. © 2019 Sean Maloney, Breakthough ACTION
Zika is a mosquito-borne virus with no vaccine that is mostly spread by the bite of an infected Aedes mosquito. It can also be passed from a pregnant woman to her unborn baby, causing a unique pattern of birth defects. Viruses such as dengue and chikungunya are also transmitted by the same species of mosquito as Zika.
This tool, Think BIG (Behavioral Integration Guidance), helps organizations prioritize which behaviors to integrate into their programming to make the best use of available resources and achieve rapid results. Think BIG is a behavior-centered process for reaching development goals.
High Impact Practices (HIPs) are a set of evidence-based family planning practices vetted by experts against specific criteria and documented in an easy-to-use format.
This blog describes CCP’s Breakthrough ACTION's work in five Central American and Caribbean nations to train upwards of 500 people in interpersonal communication skills for those who go door-to-door to help people prevent Zika – and other illnesses carried by the Aedes aegypti mosquito, such as dengue, chikungunya and yellow fever.
This tool (available in English and Spanish) is for community volunteers and health promoters to facilitate home visits using the GATHER method (Greet, Ask, Tell, Help, Explain, Review) in support of the promotion of key behaviors for Zika prevention.