Integrated Health Social and Behavior Change Programming: Tools and Resources from Breakthrough ACTION-Nigeria

Breakthrough ACTION-Nigeria implemented an integrated health social and behavior change (SBC) strategy in four states (Bauchi, Kebbi, Sokoto, Ebonyi) and the Federal Capital Territory. This work promoted positive shifts for 17 health behaviors. Breakthrough ACTION-Nigeria implemented a coordinated package of continuous community, media, and digital activities. Coordinating and reinforcing these maximized the reach and intensity of audience engagement. Each activity focused on the same behaviors and the same core messages and approaches and was informed by the results from ongoing formative research.

Community SBC and Referrals for Health Services
Working with community health volunteers, Breakthrough ACTION-Nigeria implemented community SBC interventions and made referrals to health services. Community SBC activities included community health dialogues with referrals, compound meetings, and house-to-house visits.

Community Capacity Strengthening
Through an innovative adaptation of the Community Action Cycle, Breakthrough ACTION-Nigeria worked hand-in-hand with Primary Health Care Development Agency staff and other key stakeholders at the state and local government levels to empower Ward Development Committees to plan, finance, and implement their own health initiatives within their communities.

Women’s Empowerment Groups
Breakthrough ACTION-Nigeria used human-centered design to create Women’s Empowerment Groups. These were safe spaces outside the home, where groups of women could support each other, become economically empowered, and learn about reproductive, maternal, newborn, and child health, nutrition, and malaria.

Social and Behavior Change Advocacy Core Groups
Breakthrough ACTION-Nigeria facilitated SBC Advocacy Core Groups that enabled a systematic interaction and engagement of religious and traditional leaders with other opinion leaders in the health and development sectors, including government officials, community service organization representatives, women’s groups, media personnel, and other community opinion leaders. The groups were developed to influence social and gender norms.

Mass Media, Mobile Phones, and Digital
Breakthrough ACTION-Nigeria implemented a wide range of transmedia interventions on radio, television, mobile phone, and social media that were co-created with the government, implementing partners, community members, and other key stakeholders. The co-creation process placed users and communities at the center of designing messages and ensured ownership of the work.

Provider Behavior Change
Breakthrough ACTION-Nigeria worked closely with the federal and state governments to transform professional attitudes, norms, and standards in the areas of respectful maternity care, malaria in pregnancy, and fever case management.

Public Sector Capacity Strengthening
The project’s public sector capacity-strengthening activities were aligned in support of government priorities and strategies across national, state, and local government areas and wards. This work strengthened public sector systems for oversight and coordination of SBC at the national and sub-national levels.

Source: Johns Hopkins Center for Communication Programs

Date of Publication: August 13, 2024

Engaging Boys and Men in Gender Transformation: The Group Education Manual

This 11-chapter manual offers trainers an array of participatory experiential exercises to reach men (and their partners), exploring gender socialization and its impact on HIV prevention and care. Piloted in Ethiopia, Namibia, South Africa and Tanzania, the manual is designed to assist master trainers in developing curricula to work with men and boys on gender, HIV and AIDS issues.

After a short background discussing the scientific rationale, chapter topics include: Gender and Power, Sexuality, Men and Health, Substance Use, Healthy Relationships, STI and HIV prevention, Living with HIV, Fatherhood, Violence and Making Change-taking Action. This educational manual allows men to question non-equitable views about masculinity and develop more positive attitudes to prevent unhealthy behaviors that put them and their partners and families at risk. It can also be used to train facilitators who will implement workshop activities with groups of men.

The activities are intended for use with men of all ages, although some adaptations might have to be made depending on the ages of the men and the country and community context. These activities can also be adapted for use with groups of men and women.

Source: EngenderHealth, Promundo

Date of Publication: October 15, 2021

African Transformation Written Profiles

African Transformation is a participatory tool that enables men and women to examine critically gender and social norms, including masculinity, and how they affect their well-being; to overcome gender barriers in their own life: and to work on eliminating harmful gender norms and supporting positive ones. “African Transformation” is an adaptation of the successful “Arab Women Speak Out” (AWSO) model to the African context.

The key component of AWSO is a series of video profiles showing positive role models of women from relatively low socio-economic status who overcame gender barriers and reached goals they had determined for themselves. The profiles are shown during a participatory, facilitative training, whereby participants review these women’s stories, and explore resources and strategies they can use to attain their own goals. The guide has been designed to help people explore thoughts, ideas, and behaviors and make positive changes in their lives using a technique called “participatory learning.”

Participatory learning uses facilitation to encourage people to actively participate in their own learning. The role of the facilitator is key to the success of the program and to enabling participants to use their own experiences and knowledge as a basis for solving problems. The guide should be used along with the video, audio, and written profiles. The profiles, as well as the discussions, role-plays, small and large group discussions, in the individual sessions help participants analyze their experiences, learn new information, improve their skills of interaction and understand and identify opportunities for change.

Source: Johns Hopkins University Center for Communication Programs

Date of Publication: August 5, 2021

Early Marriage and Female Genital Cutting – Ethiopian Orthodox Church Faith Leader Toolkit

This toolkit is designed to educate faith leaders and make it easier for them to talk about early marriage and female genital cutting. Included are medical facts and theological references that help faith leaders to speak out against these harmful practices. The toolkit also helps leaders to answer the tough questions they will receive along the way.

Each piece of the toolkit has been designed for a fairly specific audience since different audiences require different approaches. The sections contain discussion questions, religious references, and activities appropriate for that audience. The modules can be taught as an entire unified lesson or excerpted, and lessons can be modified.

Source: Center for Interfaith Action on Global Poverty

Date of Publication: December 22, 2019

African Transformation Facilitator’s Guide

African Transformation™ helps women and men explore gender norms and social roles, and provides them with tools to begin changing the negative and reinforcing the positive. Project Components include The Facilitator’s Workshop Guide; Video and Audio Profiles; Photos from the Video Profiles (to be used with the Audio Profiles or written profiles); and Written Profiles. This is a guide for facilitators to teach about HIV, STDs, IPV, and life skills, to be used in tandem with the actual profiles. Included are chapters on implementing the program, tools for training facilitators, and a detailed guide for leading community based workshops. Available in French and English.

Source: Johns Hopkins University Center for Communication Programs

Date of Publication: March 25, 2019

Community Conversation Toolkit – Community Mobilizer’s Guide

Materials in this toolkit include a facilitator’s guide, community mobilizer’s cards, roleplay cards, storytelling finger puppets, promotional proverbs and best kept secrets throw boxes, promotional playing cards, and dialogue buttons. These formats are designed to mobilize adults aged 20 and above in communities to take action toward HIV prevention.

The toolkit is intended to complement existing HIV prevention activities and address several key drivers: concurrency, cross-generational sex, gender-based violence, and alcohol abuse. Each material in the toolkit was tested with community mobilizers and men and women ages 20 and above in community. Sixty-nine focus group discussions and 34 in-depth interviews were conducted with men and women and with trained community facilitators who lead discussions using the materials. The toolkit has also been adapted in Lesotho, Nigeria, and Swaziland and is available in 10 languages.

This Community Mobilizer’s Guide is a step by step guide to help prevent the spread of HIV in a community. It includes illustrations and actions for each step:

  • Forming an Action Group
  • Understanding the Situation
  • Consulting the Stakeholders
  • Finding the Information
  • Developing the HIV Action Plan
  • Present the Action Plan to the Community
  • Using the Toolkit
  • Reflecting on the Community’s Plans

Source: FHI 360

Date of Publication: March 25, 2019

Community Conversation Toolkit Discussion Cubes

Materials in this toolkit include a facilitator’s guide, community mobilizer’s cards, roleplay cards, storytelling finger puppets, promotional proverbs and best kept secrets throw boxes, promotional playing cards, and dialogue buttons. These formats are designed to mobilize adults aged 20 and above in communities to take action toward HIV prevention.

The toolkit is intended to complement existing HIV prevention activities and address several key drivers: concurrency, cross-generational sex, gender-based violence, and alcohol abuse. Each material in the toolkit was tested with community mobilizers and men and women ages 20 and above in community. Sixty-nine focus group discussions and 34 in-depth interviews were conducted with men and women and with trained community facilitators who lead discussions using the materials. The toolkit has also been adapted in Lesotho, Nigeria, and Swaziland and is available in 10 languages.

These cubes provide statements that are used as discussion starters.

Source: FHI 360

Date of Publication: March 25, 2019

Community Conversation Toolkit for HIV Prevention – Dialogue Badges

Materials in this toolkit include a facilitator’s guide, community mobilizer’s cards, roleplay cards, storytelling finger puppets, promotional proverbs and best kept secrets throw boxes, promotional playing cards, and dialogue buttons. These formats are designed to mobilize adults aged 20 and above in communities to take action toward HIV prevention.

The toolkit is intended to complement existing HIV prevention activities and address several key drivers: concurrency, cross-generational sex, gender-based violence, and alcohol abuse. Each material in the toolkit was tested with community mobilizers and men and women ages 20 and above in community. Sixty-nine focus group discussions and 34 in-depth interviews were conducted with men and women and with trained community facilitators who lead discussions using the materials. The toolkit has also been adapted in Lesotho, Nigeria, and Swaziland and is available in 10 languages.

These dialogue badges are made to be pinned on clothing and show that the wearer is involved in HIV prevention. It is also meant to start discussion about HIV prevention.

Source: FHI 360

Date of Publication: March 25, 2019

Community Conversation Toolkit for HIV Prevention – Playing Cards

These playing cards are part of the Community Conversation toolkit. The toolkit also includes a facilitator’s guide, community mobilizer’s cards, storytelling finger puppets, promotional proverbs and best kept secrets throw boxes, promotional playing cards, and dialogue buttons. These formats are designed to mobilize adults aged 20 and above in communities to take action toward HIV prevention.

The toolkit is intended to complement existing HIV prevention activities and address several key drivers: concurrency, cross-generational sex, gender-based violence, and alcohol abuse. Each material in the toolkit was tested with community mobilizers and men and women ages 20 and above in community. Sixty-nine focus group discussions and 34 in-depth interviews were conducted with men and women and with trained community facilitators who lead discussions using the materials. The toolkit has also been adapted in Lesotho, Nigeria, and Swaziland and is available in 10 languages.

These sets of playing cards are used as conversation starters in community mobilization settings and activities. Each card has a question about HIV.

Source: FHI 360

Date of Publication: March 25, 2019

Community Conversation Toolkit for HIV Prevention – Puppets

Materials in this toolkit include a facilitator’s guide, community mobilizer’s cards, roleplay cards, storytelling finger puppets, promotional proverbs and best kept secrets throw boxes, promotional playing cards, and dialogue buttons. These formats are designed to mobilize adults aged 20 and above in communities to take action toward HIV prevention.

The toolkit is intended to complement existing HIV prevention activities and address several key drivers: concurrency, cross-generational sex, gender-based violence, and alcohol abuse. Each material in the toolkit was tested with community mobilizers and men and women ages 20 and above in community. Sixty-nine focus group discussions and 34 in-depth interviews were conducted with men and women and with trained community facilitators who lead discussions using the materials. The toolkit has also been adapted in Lesotho, Nigeria, and Swaziland and is available in 10 languages.

These puppets are meant to be given to people in a discussion group. Then the participants are asked to use the characters to create stories about HIV.

Source: FHI 360

Date of Publication: March 25, 2019