Type of Material: Guidance Documents

Dynamics of Vaccine Hesitancy: A Practitioner’s Playbook
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Dynamics of Vaccine Hesitancy: A Practitioner’s Playbook

Over the past decade, coverage of routine immunizations for children has plateaued. During COVID-19, nearly 25 million children lost out on life-saving vaccinations leaving them still unprotected from VPDs today (UNICEF Innocenti, 2023). Almost half of these children live in the African continent (World Health Organization, 2020). Annually, nearly all children who die from VPDs are from LMICs (Frenkel, 2021). In 2018 alone, an estimated 99% of the 700,000 children who died from VPDs lived in LMICs (Frenkel L. D., 2021).

Assessing the features of vaccine hesitancy can show us that the intention to be vaccinated and the behavioral outcome of vaccination is intimately related to context, and the antecedents of vaccination vary across time, place, and vaccine. As such, Busara has been working closely with PATH to assess the dynamics of vaccine hesitancy and to develop actionable guidance on how to understand, categorize, and respond to vaccine hesitancy.

The DRIVE Demand project, launched by PATH with support from The Rockefeller Foundation, is a two-year initiative aimed at expanding the use of digital health tools to boost immunization in Honduras, Mali, Tanzania, Thailand, Uganda, and Zambia. By collaborating with Ministries of Health, we strived to enhance the understanding and influence of vaccine demand, supporting national COVID-19 and routine immunization goals while strengthening data-driven health systems across Asia, the Caribbean, and Sub-Saharan Africa.

To tackle vaccine hesitancy, Busara’s research took a four-step approach. We began with a thorough evidence review using the COM-B model to analyze behavioral dynamics. This was followed by qualitative studies with focus group discussions (FGDs) among unvaccinated adults, pregnant women, and community health workers. These discussions revealed crucial insights into the beliefs, attitudes, and concerns about vaccination across different demographics.

The study revealed that vaccine hesitancy exists on a continuum between acceptance and refusal, influenced by both abstract barriers (e.g., conspiracy theories) for those with negative attitudes, and more tangible barriers (e.g., social permission, vaccine availability) for those with neutral or positive attitudes. These findings were synthesized into actionable recommendations in our playbook for Ministries of Health to optimize immunization campaigns and pandemic preparedness, for understanding these dynamics is key to fostering vaccine intention and addressing the social and cultural factors behind vaccine hesitancy.

The DRIVE Demand project offers a valuable toolkit to help health ministries and partners effectively engage vaccine-hesitant populations and improve immunization rates.

Last modified: July 21, 2024

Language: English

Source: Busara

Year of Publication: 2024

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Measuring Social and Behavior Change in Nutrition Programs: A Guide for Evaluators
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Measuring Social and Behavior Change in Nutrition Programs: A Guide for Evaluators

Program evaluations play a critical role in improving the quality and determining the effectiveness of the social and behavior change (SBC) strategies and approaches needed to reach nutrition program outcomes. This guide supports implementing partners who are involved with evaluating an activity that uses SBC to improve multi-sectoral nutrition outcomes. The document focuses on enhancing skills by incorporating the nuances of evaluating SBC approaches for improving nutrition outcomes. Links to helpful general evaluation guidance are incorporated for reference.

Also available in French and Portuguese

Last modified: July 21, 2024

Language: English

Source: USAID Advancing Nutrition

Year of Publication: 2023

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Approaching Provider Behavior Change Monitoring and Evaluation With a Social-Ecological Lens Brief
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Approaching Provider Behavior Change Monitoring and Evaluation With a Social-Ecological Lens Brief

The Approaching Provider Behavior Change Monitoring and Evaluation With a Social-Ecological Lens brief builds on Breakthrough ACTON’s suite of provider behavior change (PBC) tools, which support the application of a social-ecological lens to design and implementation of PBC interventions. This suite of tools consists of the Provider Behavior Ecosystem Map and the Provider Behavior Change Toolkit. PBC interventions that are designed and implemented using a social-ecological lens must be monitored and evaluated through the same lens.

This brief explores the new frontiers of applying a social-ecological lens to the monitoring and evaluation of PBC interventions. It uses the organizing structure of the Provider Behavior Ecosystem Map to discuss insights, findings, and recommendations. There is also a list of illustrative indicators for consideration and use.

The primary audience for this brief is program planners and implementers working at the intersection of health systems strengthening, service delivery, and social and behavior change or otherwise working to understand and improve provider behavior through PBC interventions.

Although this brief and set of tools focuses on family planning and reproductive health (FP/RH) service delivery and use related examples, they can be applied more broadly to other health areas. This broader application is important given how commonly FP/RH providers offer services across health areas, especially in integrated service delivery.

A short instructional video in English and French was developed to provide an overview of the brief.

Last modified: June 10, 2024

Language: English, French

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2024

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Addressing stigma and discrimination toward children and youth with disabilities through SBC
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Addressing stigma and discrimination toward children and youth with disabilities through SBC – Disability Toolkit

This toolkit was developed to help achieve a world where “all children, including those with disabilities, live in barrier-free and inclusive communities, where persons with disabilities are embraced and supported, across the life cycle, to realize and defend their rights, and to achieve full and effective participation” (UNICEF Disability Inclusion Policy and Strategy, 2022-2030).

SBC programming has a critically important and urgent role to play in identifying and implementing solutions that empower children with disabilities and their families and support their social inclusion. We are therefore pleased to share this practical guide to understanding and tackling the social norms and behaviors that limit the inclusion of children with disabilities in their communities.

This toolkit aims to provide insights, tools, and resources to help you understand the barriers to the inclusion of children with disabilities, with a focus on stigma and discrimination, and to offer practical support for designing, implementing, monitoring, and evaluating social and behavior change (SBC) interventions that include children with disabilities and their families and empower them to be included in their communities and enjoy the same opportunities as their peers.

This toolkit comprises an introduction, a foundational module, seven thematic modules, a user guide and a Theory of Change (PowerPoint presentation).

The modules are as follows:

Module 0: Foundation
Module 1: Inclusive evidence generation
Module 2: Empowering children and youth with disabilities and their families
Module 3: Understanding and engaging communities
Module 4: Building disability-inclusive services
Module 5: Strengthening partnerships for advocacy
Module 6: SBC for disability inclusion in humanitarian action
Module 7: Monitoring, Evaluating, and Measuring

Last modified: May 2, 2024

Language: English

Source: UNICEF

Year of Publication: 2024

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Using the EAST Framework
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Using the EAST Framework in the Social and Behavior Change Work of Community Health and Nutrition Volunteers

This document provides guidance on delivering a one-day workshop that aims to increase the ability of the Community Health and Nutrition Volunteers to promote various behaviours in a way that enables and motivates people to adopt them. The acquired skills can be used in the context of group sessions, household visits, and individual counselling. The guidance is meant to be used by people who work on enhancing the community volunteers’ behaviour change capacities.

Last modified: April 17, 2024

Language: English

Source: ADRA Yemen

Year of Publication: 2023

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Gender & Power (GAP) Analysis Guidance
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Gender & Power (GAP) Analysis Guidance

Save the Children’s Gender and Power (GAP) Analysis Guidance is an essential tool to examine, understand, and address discrimination and inequality that prevent children, their families, and communities from claiming their full and equal rights. GAP analysis is a type of action research that investigates how gender and power inequalities intersect and helps staff and partners understand the types and depth of discrimination in each context. It supports the design and adaptation of programming that positively transforms unequal power relations and ensures all stakeholders can equitably access, participate in, be decision-makers for, and benefit from activities. Ultimately, this research enables evidence-based programming and advocacy that advance gender equality and social justice.

Resource includes:

Last modified: April 5, 2024

Language: English, Spanish

Source: Save the Children

Year of Publication: 2021

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Communicating on climate change and health: Toolkit for health professionals
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Communicating on Climate Change and Health: Toolkit for Health Professionals

While climate change is a big threat to health, implementing solutions to address climate change presents a huge opportunity to promote better health and protect people from climate-sensitive diseases. Communicating the health risks of climate change and the health benefits of climate solutions is both necessary and helpful. Health professionals are well-placed to play a unique role in helping their communities understand climate change, protect themselves, and realize the health benefits of climate solutions. This toolkit aims to help health professionals effectively communicate about climate change and health.

Last modified: March 28, 2024

Language: English

Source: World Health Organization

Year of Publication: 2024

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quality-of-care-maternal-newborn-and-child-health
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Improving the quality of care for maternal, newborn and child health: implementation guide for national, district and facility levels

Quality is essential to improved health and survival, a key component for addressing health system inequities and inefficiencies, improving accountability, and providing dignified and respectful service delivery.

This implementation guide provides practical guidance for policymakers, program managers, health practitioners, and other actors working to establish and implement quality of care (QoC) programs for maternal, newborn, and child health (MNCH) at the national, district, and facility levels. The guide is intended to help anyone, throughout the health system, who wants to take action to improve the QoC for MNCH. This can include but is not limited to; national policymakers and legislators, program managers and technical staff at the national, district, and facility levels, health care practitioners working with MNCH, and other actors working to establish and implement quality of care programs for MNCH at national, district, and facility levels.

This implementation guide is a “living document” that builds on previous iterations and incorporates the rich implementation experience emerging from the 10 countries in the Quality of Care Network for improving quality of care (QoC) for maternal, newborn, and child health (MNCH).

Last modified: February 19, 2024

Language: English

Source: World Health Organization

Year of Publication: 2022

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Guidance on developing national learning healthcare systems to sustain and scale up delivery of quality maternal, newborn, and child healthcare

This guide provides direction on how countries can develop and strengthen national learning healthcare systems to learn how to improve, sustain, and scale up Quality of Care for Maternal, Newborn, and Child Health. It is a working document that will be updated as new guidance comes in from the field. The guide is meant for health system managers, QoC implementing partners, researchers, policymakers, and healthcare providers involved in developing and implementing QoC programs at the facility, district, and national levels.

Last modified: February 19, 2024

Language: English

Source: World Health Organization

Year of Publication: 2022

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Quality, equity, dignity: the network to improve quality of care for maternal, newborn and child health

As a step towards ending preventable maternal, newborn, and child deaths and achieving universal health coverage, countries in the QoC Network will work together to halve maternal and newborn deaths and stillbirths in participating health facilities in a five-year period.

This document sets out the four strategic objectives of the QoC Network: leadership, action, learning, and accountability. The strategic objectives are underpinned by the importance of community engagement in improving the quality of care. They were reached by consensus among the QoC Network countries and partners present at the Network launch meeting in Lilongwe, Malawi, in February 2017.

Last modified: February 19, 2024

Language: English

Source: World Health Organization

Year of Publication: 2018

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