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

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

Rabies Prevention Poster from Zambia: Own Prevention, Save Lives

Intended to promote rabies awareness and immediate care seeking across Zambian communities, this visual poster emphasizes key action steps to prevent dog bite transmission. The material displays clear instructions on proper wound washing with soap and water, immediate reporting of suspected rabid animals, and seeking post exposure prophylaxis at nearby health facilities. It uses straightforward messaging and engaging graphics to foster individual and community ownership over rabies prevention efforts. Health extension workers, local leaders, and school officials can display this poster in public spaces, clinics, and community centers to reinforce life saving behaviors.

Last modified: July 31, 2026

Language: English

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2024

Living and Working Safely with Animals for Healthier Communities: Community Discussion Guide

This community discussion guide supports health promoters, extension agents, and local leaders in educating Zambian communities on how to live and work safely with animals to prevent zoonotic diseases. Developed by Breakthrough ACTION in collaboration with the Zambia National Public Health Institute and key One Health stakeholders, the tool blends engaging visuals with dialogue prompts and practical prevention tips. It covers diseases such as rabies, anthrax, brucellosis, and zoonotic tuberculosis, and promotes actions like safe animal handling, vaccination, personal protection, and proper disposal of dead animals. Designed for participatory learning, the guide helps communities understand their role in building resilience and preventing outbreaks that threaten human and animal health.

Last modified: July 31, 2026

Language: English

Year of Publication: 2025

Nigeria Life Stage Flipchart

This Life Stage Flipchart was developed by Breakthrough ACTION in Nigeria. It guides community volunteers in facilitating engaging conversations between men and women about family planning/reproductive health throughout every life stage to ensure their families stay healthy and thrive.

Last modified: July 26, 2026

Language: English

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2021

Rabies Job Aid for Sierra Leone Health Workers

Designed as a practical reference tool for frontline medical personnel in Sierra Leone, this job aid guides healthcare providers through clinical protocols for managing suspected rabies exposure from dog bites. The resource details sequential steps covering immediate wound care, vaccine referral procedures, and mandatory case reporting guidelines in alignment with national health standards. It equips clinical staff with tailored patient counseling points on post exposure prophylaxis and emphasizes collaborative linkages between human and animal health workers. Health facility managers and frontline personnel can utilize this tool to strengthen integrated disease surveillance and advance progress toward eliminating dog-mediated human rabies.

Last modified: July 23, 2026

Language: English

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2025

Social and Behavior Change to Increase Tuberculosis Care-Seeking in Nigeria: Tools and Resources

Breakthrough ACTION has developed and implemented social and behavior change (SBC) interventions to increase the number of tuberculosis (TB) cases identified in Nigeria. These resources can be adapted and used by professionals interested in using SBC approaches to address TB or practitioners implementing TB programs.

Check Am O! Campaign

Breakthrough ACTION, the National Tuberculosis, Leprosy and Buruli Ulcer Control Programme (NTBLCP), and other partners in Nigeria developed the first national unified TB SBC campaign in the country. “Check Am O!” (Go and Check It!) was based on an intensive human-centered design approach and rolled out through multiple channels. The campaign encouraged anyone with a cough lasting more than two weeks to seek TB testing and for their families, friends, and acquaintances to support them in doing so.

Print Materials
TB TV Spots
TB-COVID-19 TV Spots

Job Aids for Health Care Workers

These job aids provide user-friendly guidance on TB care and treatment clinical management.

Guidelines and Reports

Implementation and Success Stories

Increasing Tuberculosis Case Notification in Nigeria: The Role of Social and Behavior Change


Finding Childhood TB Cases in Nigeria

Tuberculosis has a devastating impact on children. Yet the signs and symptoms can often go unnoticed or mistaken for other common illnesses. This video shows the collaborative efforts made by Breakthrough ACTION and partners in Nigeria through community-based initiatives to improve early detection and ensure children receive support to combat this curable disease.

Source: Johns Hopkins University Center for Communication Programs

Date of Publication: August 13, 2024

Breakthrough ACTION Nigeria Malaria SBC Tools and Resources

In collaboration with the United States President’s Malaria Initiative, Breakthrough ACTION-Nigeria worked with the Nigeria National Malaria Elimination Programme (NMEP) and other partners to implement social and behavior change programs across a third of Nigeria’s 36 states and the Federal Capital Territory. Through community engagement, provider behavior change initiatives, and widespread media campaigns, Breakthrough ACTION-Nigeria and the NMEP ensured communities and healthcare workers were motivated to prevent, test, and accurately treat malaria. Through community engagement, provider behavior change initiatives, and widespread media campaigns, Breakthrough ACTION-Nigeria collaborated with NMEP to ensure that communities and healthcare workers are motivated to prevent, test, and accurately treat malaria. Here are resources developed by Breakthrough ACTION-Nigeria that can be used by others interested in leveraging the power of SBC into malaria programming.

Community-Based Stakeholder Job Aids

School-Based SBC Tools

Mama Put Campaign

Television Spots
Audio Spots

Malaria Radio Spots

Learning Briefs and Blog Posts

Source: Johns Hopkins Center for Communication Programs

Date of Publication: August 13, 2024

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

Community Conversation Guide- A Job Aid for Community Health Assistants in Liberia

The Community Conversation job aid is a tool that enables community health assistants (CHAs) to spark dialogue around critical health issues. Through guided storytelling, CHAs introduce important health information in a memorable way. The Community Conversation approach encourages action by strengthening the linkage to the health system and highlighting key services that community members can use to improve their health status. The stories also encourage ownership of community health interventions, local resource mobilization, and community feedback.

Last modified: May 2, 2024

Language: English

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2023