Type of Material: Guidance Documents

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Nigeria Provider Behavior Change Tools and Resources

Health care providers in Nigeria are working to deliver client-centered care and adhering to national guidelines. However, while providers care deeply about serving clients, gaps in knowledge, misconceptions, biases, poor communication skills, inattention to client rights, and challenging work environments make it difficult for them to provide quality health services. Breakthrough ACTION-Nigeria worked closely with the federal and state governments to support facility-based providers by:

  • Identifying the factors that impede and facilitate client-centered care and adherence to guidelines in varied settings across Nigeria.
  • Developing, testing, and scaling innovative, evidence-based approaches that could be adapted to varied service delivery contexts.
  • Transforming professional norms and standards in respectful maternity care, malaria in pregnancy, and fever case management.
  • Strengthening interpersonal communication/counseling capacity among providers.
  • Building trust between communities and facilities.

The resources developed by Breakthrough ACTION-Nigeria can be used by service delivery and social and behavior change practitioners interested in integrating a social and behavioral lens within their work with health care professionals.

Using Behavioral Science to Uncover New Insights on Provider Behavior

Strengthening Community and Facility Relationships

Improving Interpersonal Communication Skills

Leveraging Peer-to-Peer Influence to Transform Norms and Standards

Learning Briefs, Videos, and Blog Posts

Impact Stories

Last modified: August 1, 2026

Language: English

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2024

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Follow Who Know Road Campaign: Development, Implementation, and Lessons Learned

This program brief describes the process of implementing the Follow Who Know Road campaign [TV spots and discussion guide] in Nigeria—from developing the campaign concept to producing and airing the campaign. It also offers lessons learned that social and behavior change practitioners can apply to their work, particularly during a public health emergency.

During the COVID-19 pandemic in Nigeria, community members believed COVID-19 was “a plan created by the government” or that it did not exist and that prevention strategies, such as vaccines, were untrustworthy.

Through a partnership with the Government of Nigeria, Breakthrough ACTION developed the Follow Who Know Road mass media campaign to dispel these myths and encourage vaccine uptake. The campaign was designed and implemented using systematic social and behavior change approaches grounded in theory and a deep understanding of the audience. It subsequently aired on television, radio, and social media in 19 languages.

As a result of this systematic process, more than two out of three unvaccinated people exposed to the campaign showed a positive change in their vaccine intentions and behavior. Of those unvaccinated people who heard the campaign on the radio or on television, 14 million received a vaccine soon after and 5 million more said they wanted one as soon as possible.

Follow Who Know Road Campaign TV Spots

Follow Who Know Road: COVID-19 Discussion Guide [PDF]

The Follow Who Know Road Campaign in Nigeria: Development, Impact, and Lessons Learned [PDF]

Nigeria Risk Communication and Community Engagement Tools and Resources

Source: Johns Hopkins Center for Communication Programs

Date of Publication: August 1, 2026

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Nigeria Community Capacity Strengthening Resources and Tools

From 2019 to 2024, Breakthrough ACTION-Nigeria trained 659 Ward Development Committees to plan, fund, and implement Community Health Action Resource Plans. The project supported the committees in implementing their plans in two stages. The first stage focused on delivering immediate benefits to the community, such as free emergency transport to health services for pregnant women and children under five and for other emergencies, delivery kits for pregnant women, funds to renovate health facilities and procure commodities, and community health information boards to track data. The second stage focused on strengthening committee capacity by addressing gender disparities in health care through tailored training and by forming Gender Economic and Empowerment Committees, equipping Ward Development Committees with social and behavior change resources to promote health-seeking and preventive behaviors, strengthening committees’ financial management skills, training them in decision-making and stakeholder collaboration, and encouraging community involvement in decision making.

Training Package and Community Engagement Tools

This training package was created for individuals and groups working on community-led health interventions. It contains manuals for both facilitators and participants, along with accompanying tools that provide practical guidance for community engagement, identifying issues, and developing community health action resource plans.

Mobilizing Communities for Health and Social Change
Fostering Leadership in Community Development
Community Dialogue Tools for Leaders
Ward Development Committee Gender Champions

Impact Stories

Last modified: August 1, 2026

Language: English

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2023

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Together for Each Other: Transforming South Sudan

Sawa Le Baad: Tahwil Junub Sudan (Together for Each Other: Transforming South Sudan) promotes gender equity, participatory development, and community action by bringing women and men together to explore and discuss how various aspects of gender impact their well-being. This includes discussing harmful and positive social norms and expectations as well as assumptions around gender roles and responsibilities. Through these discussions, existing norms are identified and challenged.

Behavioral Objectives

  • Promote gender equity, participatory development, and community action
  • Engage women and men in a critical exploration of how gender norms operate in their lives (positively and negatively), how to take action to eliminate harmful norms and practices, and how to reconstitute new equitable norms
  • Demonstrate equitable communication and decision-making around health
  • Model community reflection and dialogue

The modules include:

  1. Introduction to the Workshop and Key Concepts
  2. Social Roles
  3. Traditional and Cultural Norms
  4. Couples’ Communication/Conflict Resolution
  5. Gender-Based Violence
  6. Women’s and Men’s Reproductive Health
  7. Safe Motherhood
  8. Water, Sanitation, and Hygiene

How to Use

The toolkit has two main components: one is a series of real personal stories of women, men, and couples who have overcome gender barriers to reach their goals and improve their lives as well as those of their families. These personal stories are available in video and audio versions.

The personal stories are to be used with the Facilitator’s Guide, which leads women and men through a series of exercises and questions to explore the role of social and gender norms in their lives. The personal stories form the centerpiece of each session in the guide and serve to ground the discussion in the reality of people’s lives.

Facilitators Guide

This guide is 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. Therefore, a section of the guide includes a section on training facilitators and strengthening their facilitation skills.

Sawa Le Baad Facilitator’s Guide [PDF]

Together for Each Other: Transforming South Sudan Guide

The Together for Each Other: Transforming South Sudan Guide is designed to be used along with the video and/or audio personal stories.

Video and/or Audio Personal Stories

The personal stories, as well as the other activities in the individual sessions, help participants analyze their experiences, learn new information, improve their skills of interaction, and understand and identify opportunities for change.

Stories of Transformation

Social Roles

This video reflects and discusses the different roles and tasks society teaches women and men what they should do. Nyantong Garang is a woman who challenges gender norms through her job as a pump mechanic in her community.

[ English | Juba ]

Traditional and Cultural Norms

This video explores cultural practices and norms that affect men and women. Chief Madalina Ihisa Tito is the only female head chief in Eastern Equatoria and is a role model for women and men alike.

[ English | Juba ]

Couples’ Communication and Conflict Resolution

This video explores issues around couples’ communication and conflict resolution. Angua and Abdulwahab share how making decisions together and supporting one another leads to harmony in the home and enables their family to thrive.

[ English | Juba ]

Gender-Based Violence

This video reflects and discusses violence between partners and identifies ways of addressing and preventing violence. Yar Makuei is a survivor of gender-based violence who stayed in an abusive marriage for the sake of her children and was eventually able to leave and stand on her own.

[ English | Juba ]

Women’s and Men’s Reproductive Health

This video reflects on and discusses the different reproductive needs of men and women and the benefits of making decisions together about family planning. Peter and Veronica share how spacing their children has led to improved pregnancy outcomes and better opportunities for their family.

[ English | Juba ]

Safe Motherhood

This video explores issues around safe motherhood. Abdulwahab shares how he supports his wife during and after her pregnancy, including by going with her for antenatal visits and sharing household and childcare responsibilities.

[ English | Juba ]

Water, Sanitation, and Hygiene

This video explores issues around healthy water, sanitation, and hygiene behaviors and the roles that both women and men play in ensuring improved hygiene and sanitation at the household level and within their communities. Data Gordon advocates with boys and men to raise menstrual hygiene awareness and provides girls and women with menstrual hygiene products.

[ English | Juba ]

Last modified: August 1, 2026

Language: Arabic, English

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2022

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Know, Care, Do: Case Studies

These Know, Care, Do case studies showcase how the male engagement approach was applied to programs and projects implemented in the Democratic Republic of the Congo, India, Nigeria, and South Sudan. Each case study follows the structure of the theory of change to illustrate how it can be applied to program design and implementation across diverse country contexts. The programmatic examples highlight ways to work with a variety of actors, institutions, and channels (such as religious leaders and the health system) to engage men and boys in family planning across the key roles as clients, partners, and agents of change and the core components of Know, Care, Do.

Ces études de cas Savoir, Veiller, Agir

Ces études de cas Savoir, Veiller, Agir montrent comment l’approche de l’engagement masculin a été appliquée aux programmes et projets mis en œuvre en République démocratique du Congo, en Inde, au Nigéria et au Sud-Soudan. Chaque étude de cas suit la structure de la théorie du changement pour illustrer comment elle peut être appliquée à la conception et à la mise en œuvre de programmes dans divers contextes nationaux. Les exemples de programmes mettent en évidence les façons de travailler avec une variété d’acteurs, d’institutions et de canaux (tels que les chefs religieux et le système de santé) pour engager les hommes et les garçons dans la planification familiale à travers les rôles clés de clients, de partenaires et d’agents de changement et les composantes essentielles de Savoir, Veiller, Agir.

Source: Johns Hopkins Center for Communication Programs

Date of Publication: August 1, 2026

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Entre Nosotras: Guide to Form Support Circles

The Entre Nosotras (Amongst Ourselves) guide, developed by Breakthrough ACTION in Guatemala, outlines a group methodology that encourages mothers to share experiences and learn from each other. The topics covered include health, nutrition, feeding, and other issues related to the 1,000-day window.

Entre Nosotras: Guía Metodológica de Formación de Círculos de Apoyo

La guía “Entre Nosotras,” desarrollada por Breakthrough ACTION en Guatemala, presenta una metodología grupal que promueve espacios de aprendizaje donde las madres comparten experiencias y se escuchan entre sí para aprender entre pares. Los temas que se abordan son la salud, nutrición, alimentación y otros temas relacionados a la ventana de los 1,000 días.

Last modified: August 1, 2026

Language: Spanish

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2024

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Together We Can Client–Provider Package

The Together We Can Client–Provider Package aims to increase family planning clients’ ability to make informed choices about contraception use and achieve their reproductive intentions by improving the client-centeredness of family planning services. The package has three core components: Self-Care Provider Rounds, United Client–Provider Tools, and Together Couples Games.

The Self-Care Provider Rounds are a structured forum for clinical and nonclinical health facility staff and their supervisors to reflect on and discuss the socio-emotional aspects of providing healthcare services and increase support and collaboration between colleagues. Each round has a specific topic where panelists share their experiences and participants discuss the stories shared and their own experiences.

The United Client–Provider Tools have three elements—a card deck, table tent, and a feedback form—that (1) help providers and supervisors understand the value of and build skills in providing empathetic counseling tailored to the needs of each client, (2) encourage providers to share decision making with clients, and (3) prompt clients to ask questions and share their needs and preferences with providers.

The Together Couples Games have two elements: Couples Nights and the couples card deck. Couples Nights are fun events that promote connection between couples and introduce participants to the couples card deck. The couples card deck guides couples to connect with each other, envision their future, openly discuss their reproductive intentions, and prepare for family planning counseling sessions.

Breakthrough ACTION implemented the package in 10 health facilities and their catchment areas in Tanga, Tanzania, and revised it based on monitoring data. The project designed the package for users to adapt it to the context where they are applying it. The implementation guide provides details on how to tailor and use the package.

Implementation Guidance

Self-Care Provider Rounds

United Client–Provider Tools

Together Couples Games

Last modified: August 1, 2026

Language: English

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2025

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Rabies Prevention Guide for Basic Schools in Ghana

Designed to protect school aged children from zoonotic health risks, this practical educational guide equips Ghanaian teachers with structured materials to deliver rabies prevention lessons. The guide provides age appropriate activities, safety rules regarding dog bites, and immediate first aid steps for animal exposure in primary and junior high classrooms. It empowers educators and school administrators to lead engaging health talks that reinforce safe behavior around domestic animals and encourage prompt medical reporting. SBC specialists, school health coordinators, and community advocates can utilize this tool to integrate rabies awareness into standard school health and sanitation routines.

Last modified: July 31, 2026

Language: English

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2017

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Malaria Service Delivery Assessment Tool: Four Steps to Identify Challenges and Opportunities

Despite progress, challenges remain in delivering high-quality malaria services. Stakeholders articulated a need for a rapid and flexible tool to help holistically examine the complex web of factors that influence the delivery of quality malaria services.

Breakthrough ACTION collaboratively developed the Malaria Service Delivery Assessment Tool: Four Steps to Identify Challenges and Opportunities to provide national malaria programs with a structured, holistic, and participatory process for investigating and responding to service delivery concerns. Such tools can empower providers and other health system actors to truly understand the challenges impacting services within a given facility by applying a behavioral lens.

An accompanying technical brief describes the pilot test in the Democratic Republic of the Congo as a use case for applying the Malaria Service Delivery Tool. The brief is helpful for those interested in learning more about the tool’s implementation and what insights can be generated from it.

Ferramenta de avaliação da prestação de serviços contra a malária [PDF]

Last modified: July 31, 2026

Language: English

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2024

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