Getting Practical: Integrating Social Norms into SBC

When behavior change is a program goal, program planners need to understand if, how, when, and under what conditions the behavior is influenced by social norms (i.e., what people in a group believe is typical and appropriate behavior).

Social and behavior change program implementers may be aware that social norms are powerful influencers of behaviors and outcomes, yet they may be unsure how to integrate social norms-shifting programming into program design.

As new evidence and learning on the importance of social norms and how to shift or transform them to influence behavior emerge, there are more resources for implementers to put guidance into practice. This new tool was developed for country-level program planners, designers, and monitoring/research staff to address the gap between formative social norms research and the other phases of the program design cycle to allow for adaptive programming. It is the result of a participatory process of input and feedback organized by Breakthrough ACTION and the Learning Collaborative to Advance Normative Change.

What is included in the Getting Practical Tool?

In addition to this guide, Getting Practical includes:

  • A slide deck for each of the four modules that facilitators can adapt and use to structure the workshop. Each slide deck has slides to introduce, conduct, and wrap up each individual activity.
  • An introductory video that explains the purpose of the tool and quickly guides potential facilitators through how to use Getting Practical.

Getting Practical Feedback Form

Thank you for taking the time to use this tool! We hope that it enables your team to have a better understanding of social norms and how you can incorporate them to achieve your program’s behavioral objectives. Your honest and open feedback is essential to helping us refine and improve the tool for future users.

As you go through the tool, please answer the questions for each module in this feedback form. At the end of the questionnaire, there are two sections with questions on the structure and overall impressions of the tool.

Related Resources

Getting Started With Norms [PDF]

Introduction to the Getting Practical Tool [YouTube]


Guide pratique : Intégrer les normes sociales dans les programmes de changement social et de comportement

Lorsque le changement de comportement est un objectif du programme, les planificateurs doivent comprendre si, comment, quand et dans quelles conditions le comportement est influencé par les normes sociales (c’est-à-dire ce que les personnes d’un groupe croient être un comportement typique et approprié).

Les responsables de la mise en œuvre des programmes de changement social et comportemental savent que les normes sociales influencent fortement les comportements et les résultats, mais ils ne savent pas toujours comment intégrer les programmes de changement des normes sociales dans la conception des programmes.

Au fur et à mesure qu’apparaissent de nouvelles preuves et de nouveaux apprentissages sur l’importance des normes sociales et sur la manière de les modifier ou de les transformer pour influencer le comportement, il existe davantage de ressources permettant aux responsables de la mise en œuvre de mettre les conseils en pratique. Ce nouvel outil, Guide pratique : Intégrer les normes sociales dans les programmes de changement social et de comportement, a été développé pour les planificateurs de programmes au niveau national, les concepteurs et le personnel de suivi/recherche afin de combler le fossé entre la recherche formative sur les normes sociales et les autres phases du cycle de conception des programmes pour permettre une programmation adaptative. Il est le résultat d’un processus participatif de contribution et de retour d’information organisé par Breakthrough ACTION et le Learning Collaborative to Advance Normative Change.

Qu’est-ce qui est inclus dans l’outil Guide pratique ?

En plus de ce guide, la Guide pratique comprend :

  • Un jeu de diapositives pour chacun des quatre modules que les animateurs peuvent adapter et utiliser pour structurer l’atelier. Chaque jeu de diapositives a des diapositives pour introduire, conduire, et conclure chaque activité individuelle.
    Une vidéo d’introduction qui explique le but de l’outil et guide rapidement les animateurs potentiels sur la façon d’utiliser la Guide pratique.
  • Une vidéo d’introduction qui explique le but de l’outil et guide rapidement les animateurs potentiels sur la façon d’utiliser la Guide pratique.

Formulaire de commentaires

Merci d’avoir pris le temps d’utiliser cet outil ! Nous espérons qu’il permettra à votre équipe d’avoir une meilleure compréhension des normes sociales et de la façon dont vous pouvez les intégrer pour atteindre les objectifs comportementaux de votre programme. Vos commentaires honnêtes et ouverts sont essentiels pour nous aider à affiner et à améliorer l’outil pour les futurs utilisateurs.

Au fur et à mesure que vous parcourez l’outil, veuillez répondre aux questions de chaque module de ce formulaire de commentaires. À la fin du questionnaire, il y a deux sections avec des questions sur la structure et les impressions générales de l’outil.

Les normes : un point de départ [PDF]

Introduction à l’outil Guide pratique [YouTube]

Formulaire de commentaires

Last modified: July 31, 2026

Language: English, French

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2023

Democratic Republic of the Congo National Malaria Advocacy and Resource Mobilization Strategy

Breakthrough ACTION partnered with the National Malaria Control Program, U.S. President’s Malaria Initiative, and key stakeholders in the Democratic Republic of the Congo to develop the National Malaria Advocacy and Resource Mobilization Strategy, a pioneering document aligned with the National Malaria Control Strategic Plan 2024–2028. This strategy serves as a blueprint to coordinate stakeholders around shared goals, ensuring that advocacy efforts for malaria control are focused, coordinated, and impactful. By setting clear priorities and resource mobilization pathways, it lays the foundation for progress toward a malaria-free Democratic Republic of the Congo.


Stratégie nationale de plaidoyer & mobilisation des ressources en faveur delutte contre le paludisme

La République démocratique du Congo (RDC) occupe la 2ème place en termes de nombre de cas de paludisme et de décès associés dans le monde (12% des cas et 13% des décès), et représente à elle seule 54,6% des cas en Afrique centrale (OMS, Rapport Mondial sur la situation du paludisme 2022).

Breakthrough ACTION RDC s’est associé au Programme national de lutte contre le paludisme (PNLP), au PMI et aux principales parties prenantes pour élaborer la Stratégie nationale de plaidoyer et de mobilisation des ressources pour la lutte contre le paludisme, un document pionnier aligné sur le Plan stratégique national de lutte contre le paludisme 2024-2028. Cette stratégie fournit un plan stratégique qui coordonne les parties prenantes autour d’objectifs communs, garantissant que les efforts de plaidoyer en faveur de la lutte contre le paludisme sont ciblés, coordonnés et efficaces. En fixant des priorités claires et des voies de mobilisation des ressources, elle jette les bases d’un progrès vers une RDC sans paludisme.

Source: Johns Hopkins Center for Communication Programs

Date of Publication: July 31, 2026

Applying a Provider Behavior Ecosystem Lens to Maternal, Newborn, and Child Health Services

Applying a systemic ecological framework, this technical brief explores how environmental, structural, and social drivers shape healthcare worker practices within maternal, newborn, and child health settings. The resource demonstrates how moving beyond provider knowledge gaps allows health programs to address underlying workplace pressures, institutional culture, and health system bottlenecks. It presents real world insights and programmatic considerations for designing holistic provider behavior change strategies that improve respectful, high quality clinical care. SBC professionals, health systems managers, and clinical leaders can utilize this brief to diagnose systemic service barriers and strengthen health facility environments.

Last modified: July 31, 2026

Language: English

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2024

WABA Community Engagement to Identify and Address Barriers

Building on the techniques used by the Agir pour la Planification Familiale (Acting for Family Planning) project, which used health center walkthroughs to inform community leaders about FP services in five West African countries, West Africa Breakthrough ACTION (WABA) developed an approach to engage communities further to improve informed, voluntary family planning and reproductive health (FP/RH) service use. The approach leverages existing community strengths and resources to identify and address local challenges rather than relying on external support. WABA worked directly with community members, officials, and leaders in 19 health districts across Burkina Faso, Togo, Côte d’Ivoire, and Niger to conduct community dialogues and health facility site walkthroughs to identify and address FP/RH service barriers and quality concerns.

From 2018–2024, WABA’s activities were carried out in close collaboration with Ministries of Health and Amplify-FP, a USAID-funded project, to strengthen service delivery in these four countries. The Integrated Learning Networks (ILNs) and ILN Support Technical Committees (CTARs), set up by the Amplify-FP project in two areas of intervention, provide the framework for implementing community dialogues and guided site walkthroughs in support of health districts. The community dialogues and site walkthroughs were developed to identify barriers to the use of family planning services and to propose community-based solutions to improve their quality.

This CTAR Kit provides resources to improve knowledge and appreciation of FP/RH during community engagement activities and contains practical guides for organizing health community dialogues and health facility site walkthroughs, checklists for CTAR self-assessments of their capacity to conduct community engagement activities, and resource guides to facilitate community dialogues on FP/RH topics.


Engagement de la communauté pour identifier et éliminer les obstacles PF/SR

S’appuyant sur les techniques utilisées par le projet Agir pour la Planification Familiale, lequel s’est basé sur des visites de sites pour informer les leaders communautaires sur les services de planification familiale dans cinq pays d’Afrique de l’Ouest, West Africa Breakthrough ACTION (WABA) a développé une approche pour impliquer davantage les communautés afin d’améliorer l’utilisation informée et volontaire des services de planification familiale et de santé reproductive (PF/SR). Cette approche s’appuie sur les forces et les ressources communautaires existantes pour identifier et relever les défis locaux plutôt que de dépendre d’un soutien extérieur. WABA a travaillé directement avec des membres de la communauté, des représentants officiels et des leaders dans 19 districts sanitaires au Burkina Faso, en Côte d’Ivoire, au Niger et au Togo pour mener des dialogues communautaires et des visites de sites de santé afin d’identifier et de surmonter les obstacles et les problèmes de qualité des services de PF/SR.

Les activités de WABA ont été réalisées en etroite collaboration avec les Ministeres de santé de 2018-2025, et en partenariat avec Amplify-FP, un autre projet financé par l’USAID, pour renforcer la prestation de services dans ces quatre pays. Les Réseaux Intégrés d’Apprentissage (RIA) et les Comités Techniques d’Appui au RIA (CTARs), mis en place par le projet Amplify-PF dans les zones d’intervention des deux projets constituent le cadre de mise en oeuvre des Dialogues communautaires (DC) et les Visites guidées de formations sanitaires (VGS), en appui aux districts sanitaires. Les approches de DC et de VGS ont été développées afin d’identifier les barrières liées à l’utilisation des services de planification familiale et de proposer des solutions communautaires à l’amélioration de la qualité des services de planification familiale.

Ce Kit CTAR vous offre des ressources pour améliorer les connaissances et l’appréciation de la SR/PF lors des activités d’engagement communautaire, et contiennent : 1) des guides pratiques pour organiser les DC en santé et les VGS dans les formations sanitaires ; 2) des checklists pour l’auto-évaluation des capacités des CTAR à conduire les activités d’engagement communautaires ; et 3) des guides des ressources pour l’animation des dialogues communautaires en SR/PF.

Last modified: July 31, 2026

Language: French

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2024

Resources and Opportunities to Support and Invest in SBC for FP/RH

Designed to address behavioral barriers and investment challenges, this resource guide collection assists decision makers, donors, and implementing partners in advancing social and behavior change for family planning and reproductive health. The resource synthesizes behavioral insights and evidence to outline strategic opportunities for strengthening financial and institutional support for behavior change interventions. It provides tailored resource collections and action oriented guidance to help stakeholders overcome operational hurdles, align priorities, and maximize investment impact. Program managers, advocates, and policy makers can leverage these curated collections to mobilize resources and integrate behavior change approaches into health strategies.

Resources

ENGLISH

Why Invest in SBC for FP/RH? A Resource Collection Guide for Donors [PDF]

Why Invest in SBC for FP/RH? A Resource Collection Guide for Country-Level Decision Makers [PDF]

Why Invest in SBC for FP/RH? A Resource Collection Guide for Service Delivery IPs [PDF]

FP INSIGHT

Why Invest in SBC for FP/RH? A Resource Collection for Donors

Why Support SBC for FP/RH? A Resource Collection for Country Decision Makers

Why Support SBC for FP/RH? A Resource Collection for Service Delivery Implementing Partners

EN FRANÇAIS

Pourquoi investir dans le CSC pour la PF/SR ? Un guide de collection de ressources pour les donateurs [PDF]

Pourquoi investir dans le CSC pour la PF/SR ? Un guide de collection de ressources pour les décideurs au niveau national [PDF]

Pourquoi investir dans le CSC pour la PF/SR ? Un guide de collection de ressources pour les partenaires de mise en œuvre de la prestation de services [PDF]

Last modified: July 31, 2026

Language: English, French

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2023

Provider Behavior Ecosystem Map

The Provider Behavior Ecosystem Map is a thinking tool to help those working in family planning and reproductive health:

  • Understand and consider diverse factors that influence facility-based provider behavior
  • Understand how those factors interact with one another in a system
  • Think more holistically about provider behavior change (PBC)
  • Design, implement, and evaluate more supportive, effective PBC initiatives

The Ecosystem Map presents healthcare providers as people whose behavior is influenced by many factors at multiple levels of a system. It emphasizes the need for systemic thinking and supportive action when designing and implementing PBC programming. Using the ecosystem map is a first step in the design—or adjustment—of supportive provider behavior change initiatives.

The Provider Behavior Ecosystem Map is available in both English and French.

ENGLISH

How to Use the Ecosystem Map

Provider Behavior Ecosystem Map Guide [PDF]

Provider Behavior Ecosystem Map Brief [PDF]

Prioritization Worksheet [PDF]

Provider Behavior Change Toolkit

Approaching Provider Behavior Change Monitoring and Evaluation with a Social-Ecological Lens: New Frontiers Brief

EN FRANÇAIS

Comment utiliser la carte de l’écosystème

Comportement du prestataire : Résumé de la carte de l’écosystème [PDF]

Fiche de travail [PDF]

Learn to Use the Ecosystem Map

Last modified: July 31, 2026

Language: English, French

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2021

One Health Information Guide and Key Messages on PZDs in Mali

This guide provides standardized, evidence-informed messages to support risk communication and community engagement around priority zoonotic diseases in Mali. Developed under the coordination of the national “One Health” platform, it focuses on promoting preventive behaviors and improving response capacities for nine priority zoonoses, including Ebola, rabies, anthrax, avian influenza, and others. Breakthrough ACTION Mali played a key facilitation role, supporting a literature review, formative research, and participatory message development workshops with stakeholders from human, animal, and environmental health sectors. The guide equips frontline health workers, community leaders, and media actors with consistent, actionable messages adapted to Malian cultural and behavioral contexts, and is aligned with Mali’s International Health Regulations commitments and its Global Health Security priorities.


Guide d’informations et des messages clés Une Seule Santé sur les maladies zoonotiques prioritaires au Mali

Ce guide fournit des messages standardisés et fondés sur des données probantes pour soutenir la communication sur les risques et l’engagement communautaire autour des zoonoses prioritaires au Mali. Développé sous la coordination de la plateforme nationale « Une Seule Santé », il se concentre sur la promotion des comportements préventifs et l’amélioration des capacités de réponse pour neuf zoonoses prioritaires, dont Ebola, la rage, l’anthrax, la grippe aviaire et d’autres. Breakthrough ACTION Mali a joué un rôle clé de facilitation, en soutenant une analyse documentaire, une recherche formative et des ateliers participatifs d’élaboration de messages avec des parties prenantes des secteurs de la santé humaine, animale et environnementale. Le guide fournit aux agents de santé de première ligne, aux leaders communautaires et aux acteurs des médias des messages cohérents et exploitables, adaptés aux contextes culturels et comportementaux maliens. Il est conforme aux engagements du Mali en matière de Règlement sanitaire international et aux priorités de matière de sécurité sanitaire mondiale.

Last modified: July 31, 2026

Language: French

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2020

Compassionate Care Intervention for Maternal, Newborn, and Child Health Services

The Compassionate Care intervention is a comprehensive set of solutions designed for health care providers, facility managers, mentors, and supervisors in maternal, newborn, and child health (MNCH) services. It provides strategies to enhance compassion and empathy in health facilities, particularly during the extended postnatal period (up to one year postpartum).

The intervention is intended to foster a compassionate health care environment, benefiting providers and clients by improving job satisfaction, client experiences, and overall service quality. The intervention includes several key components:

  • Practicing Compassion Training: Equips facility leaders and staff with skills to practice compassion in the workplace with one another as well as their clients and address challenges with empathy [ English ]
  • Self-care Practices: Encourages healthcare providers to prioritize their own mental health through mindfulness and relaxation techniques to prevent burnout
  • Client Feedback Mechanisms: Implements an anonymous feedback tool to give clients a voice in evaluating the care they receive, fostering continuous improvement
  • Compassion Champion of the Month: Recognizes staff who consistently demonstrate compassionate care based on client feedback, with rewards and incentives [ English ]
  • Provider Self-Assessment: Enables providers to reflect on their own compassionate care practices and improve further [ English | Swahili]
  • Mentorship and Supervision: Incorporates compassionate care into regular mentorship sessions, helping providers refine their skills and support each other [ English ]
  • Visit Observation Assessment Form: A tool for discreetly assessing client-provider interactions during health visits to ensure compassionate care and identify areas for improvement [ English ]
  • Client Rights Poster: A public declaration of clients’ rights to respectful and compassionate care, displayed prominently in health care facilities so clients can easily see what their rights are [ English | Swahili ]

In addition, Implementation Guidance for the Compassionate Care Intervention aids social and behavior change practitioners and service delivery partners in how to implement each component.

Source: Johns Hopkins Center for Communication Programs

Date of Publication: July 31, 2026

Leveraging HCD to Improve Gender-Equitable Adolescent Programming

As part of Breakthrough ACTION’s efforts to advance innovative social and behavior change approaches for youth, the project applied human-centered design to develop gender-equitable interventions with very young adolescents in three of the Global Early Adolescent Study’s multi-year cohort sites: Kinshasa, in the Democratic Republic of the Congo, and Denpasar and Semarang, in Indonesia. HCD was selected as a methodology to allow for meaningful youth engagement in designing programs that shape their lives. Breakthrough ACTION produced several resources to document the human-centered design process, including a brief that outlines learnings from Indonesia and the Democratic Republic of the Congo [ Bahasa Indonesia | English | French ].

VYA Pilot Package

Source: Johns Hopkins Center for Communication Programs

Date of Publication: July 31, 2026

Engaging Parents in Sexual and Reproductive Health Programs for Very Young Adolescents in the DRC

Engaging parents and other caregivers to create a supportive environment is a key component of successful very young adolescents (VYA) programs. A recent global review of parenting programs found that improved parent-child communication was the most important determinant of improvements in other adolescent well-being outcomes. Parent and caregiver involvement is particularly essential for programs that aim to shift or promote more equitable gender and social norms. Such programs must intervene at multiple levels and be rooted in local values to achieve the positive social change they seek.

Breakthrough ACTION produced this document, Engaging Parents in Sexual and Reproductive Health [ English | French ], to share key learnings from a human-centered design process with VYAs in the Democratic Republic of the Congo that suggests three key implications for programs and policies:

  1. Invest in activities that bring families and communities together to address gender norms.
  2. Explore game-based solutions.
  3. Integrate activities into existing community-based health platforms and organizations.

VYA Pilot Package

Source: Johns Hopkins Center for Communication Programs

Date of Publication: July 30, 2026