Games people play: An innovative method for enhancing child health behaviors

Behavior change requires interaction, innovation, and iteration to create a supportive social environment for engaging communities to bring about positive health outcomes. We used The CINI method© – a multisectoral human rights-based approach for behavior change that draws on human-centered design along with the socio-ecological model. With this unique combination of approaches, our team co-created community games to drive sustainable behavior change to facilitate improvements in child health. We built on the lessons grounded in The CINI Method© to design a novel approach to engage stakeholders in co-creating community games to address child health. Community games aimed to promote change in knowledge, attitudes, and behaviors and encourage participants to be reflective about their roles and responsibilities towards ensuring healthy children. These games exposed participants to real-life situations in an engaging, yet entertaining manner. To augment our learning, we conducted informal post-game interviews to capture participants’ experiences and reflections of each game. We outline the methodology of developing community games as a child-centered approach grounded in the principles of social and behavior change communication.

With an objective to drive sustainable behavior change at the multisectoral level to facilitate improvements in child health, we made a short film capturing a novel approach to engage stakeholders in co-creating community games to address child health. Accompanying the short film is a write-up about the methodology behind co-creating the games with a multisectoral human rights-based approach for behavior change that draws on human-centered design along with the socio-ecological model.

Behaviors being addressed:

  1. Improving the role and accountability of multisectoral stakeholders in creating a safety net to improve maternal health to support healthy birth outcomes
  2. Improving the uptake of childhood immunization
  3. Reducing early marriage and teenage pregnancy

Current behaviors:

  1. Multisectoral key stakeholders don’t feel and act responsible towards improving maternal health to support healthy birth outcome
  2. Low uptake of childhood immunization
  3. Early marriage and teenage pregnancy

Source: Johns Hopkins Maternal and Child Health Center India

Date of Publication: October 12, 2023

“Building Trust and Empathy Around COVID-19” training curriculum

Breakthrough ACTION supports the Government of Nigeria (GON) to create an enabling environment for preparedness, response, and recovery from emerging pandemic threats and infectious disease outbreaks. Working with and through healthcare workers (HCWs) during the COVID-19 response efforts has been key to this support. Research shows:

  • HCWs are trusted messengers for social and behavior change (SBC) interventions. Results from the U.S. Centers for Disease Control and Prevention/Sydani Vaccine Hesitancy Study in Nigeria showed that 83% of participants said they would seek advice from an HCW in the decision to get vaccinated for COVID-19.
  • HCWs were largely more likely to be vaccinated than the general population for COVID-19. However, many remained vaccine-hesitant. This was largely due to a lack of confidence in the vaccines, followed by a lack of trust in government/public figures, fear of adverse effects, constraints to access, and a low perception of the risk of disease.
  • HCWs reported that they lacked sufficient information on COVID-19 and COVID-19 vaccines and required more information on COVID-19 and vaccination.

In response to this demonstrated need, Breakthrough ACTION in collaboration with partners in Nigeria developed the “Building Trust and Empathy Around COVID-19” training curriculum, which aims to not only build the skills of HCWs in providing empathetic care but also support them in navigating their own self-care to avoid burnout during an emergency. The training combines an in-person component along with virtual coaching support and reference materials. These include:

A blog on Breakthrough ACTION’s website describes the training curriculum and lessons learned.

Source: Johns Hopkins Center for Communication Programs

Date of Publication: February 3, 2023

Program Briefs: Changing Attitudes to Shift Contraceptive Demand

Transform/PHARE (PHARE), a USAID-funded and PSI-powered social and behavior change program, worked across Benin, Burkina Faso, Côte d’Ivoire, and Niger to break down social barriers as an entry point to generate demand for voluntary family planning and reproductive health (FP/RH) care.

This Knowledge Success blog introduces readers to several of the process and technical briefs developed under the PHARE program, presenting considerations for application in future FP/RH social behavior change (SBC) programs.

Source: PSI

Date of Publication: February 23, 2021

Reaching the Youngest Mothers to Save Lives

In Madagascar, Nigeria and Mozambique the Maternal and Child Survival Program has been testing approaches designed to connect first time / young parents (FT/YPs) to health services.

Key lessons from these studies include:

  • Applying an approach that engages key influencers of young parents (particularly mothers and mothers-in-law) in addition to engaging FT/YPs directly.
  • Ensuring these individuals with significant influence over FT/YPs have accurate information about safe delivery, postnatal care (including postpartum FP for healthy timing and spacing of pregnancy), and newborn care – while challenging attitudes and social norms that stigmatize FT/YPs.
  • Implementing an approach that also engages young fathers, addressing gender norms, building capacity for couple communication, and encouraging positive male involvement in postpartum FP and parenting.
  • Strengthening health system capacity to provide services that are friendly and attractive to adolescents and young people.
  • Using messaging to emphasize the benefits of health service use, particularly the reduction of risk to both mother and baby.

Source: Maternal and Child Survival Program, USAID

Date of Publication: June 11, 2020

Setting Newlyweds Up for Success: A Young Couple Talks Straight about Family Planning in Congo

This blog relates the story of a young couple who made a choice that broke the mold for newly married youth in the Democratic Republic of the Congo (DRC): they decided to use contraception to delay having their first child.

Source: Institute for Reproductive Health, Georgetown University

Date of Publication: June 10, 2020

Disinformation and Disease: Social Media and the Ebola Epidemic in the Democratic Republic of the Congo

The proliferation of disinformation online amidst the DRC’s outbreak of the Ebola virus is a serious threat to global health.

Efforts to curb bad information and conspiracy theories on social media about the disease and other health issues have been no more successful in health than in other contexts. Read this blog post to learn more.

Source: Council on Foreign Relations

Date of Publication: April 10, 2020

The Importance of Prioritizing and Being Specific in Key Community Messages/La importancia de ser específicos y prioritarios en los mensajes clave comunitarios

This is a blog/report on a 2018 training of trainers (TOT) refresher workshops held by the Community Action on Zika (CAZ) project in four countries (Honduras, Dominican Republic, Colombia, El Salvador).

The trainings were led by the CAZ project, with support in curriculum development and facilitation by Breakthrough ACTION. The workshops were aimed at project community technicians with the goal of updating knowledge around the key Zika behaviors, exchanging experiences and lessons learned, strengthening capacities, and providing tools that contribute to improving daily work.

The workshops mainly focused on improving the delivery of key messages about Zika to achieve the adoption of healthy practices in the prevention of the virus and lasting behavior change in the communities where the CAZ project works. In addition, the training curriculum included step-by-step guidance to carry out household visits, activities with children in schools, and during support group meetings. The curriculum also included a “how-to” on the correct use of materials depending on the audience, interpersonal communication to reinforce public speaking and counseling skills, and the tools to deal with the different barriers and difficulties that exist when working with communities. In addition, the sessions were accompanied by a field visit on the third day, where technicians were able to put what they learned into practice during a household visit, school activity, or a pregnant women’s support group meeting.

The experience demonstrated a need to emphasize the promotion of the key Zika behaviors with communities

Source: Johns Hopkins Center for Communication Programs

Date of Publication: August 30, 2019

Taking Aim at Zika (and Other Mosquito-Borne Illnesses)

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.

In an additional four Caribbean countries, the project has also led trainings in how to use social and behavior change approaches to deliver the messages far and wide. The main issue everyone was encountering was that more than two years after WHO announced that Zika was no longer a public health emergency, many people no longer saw it as a threat.

The trainings focused on skills for household visits to talk about Zika, this being a better way to deliver the messages to motivate families to change their behaviors and how to deal with common myths and misperceptions.

The team developed seven recommended behaviors for Zika prevention:

  1. Use mosquito repellent (DEET, Picaridin, IR3535 and eucalyptus lemon oil only), as directed by each product manufacturer during pregnancy to reduce the risk of Zika transmission from mosquito bites.
  2. Use condom to prevent sexual transmission of Zika during pregnancy.
  3. Regularly remove unintentional standing water both inside and outside of the house, and in communal areas.
  4. Cover water storage containers at all times with a cover that is tight fitting and does not warp or touch the water.
  5. Eliminate mosquito eggs from the walls of frequently used water storage containers weekly.
  6. Attend prenatal check-ups to monitor the pregnancy and learn about the risk of contracting Zika and how to prevent it.
  7. Seek counseling from a trained provider about modern family planning methods if you do not plan to become pregnant.

Source: Johns Hopkins Center for Communication Programs

Date of Publication: August 30, 2019