Type of Material: Reports and Studies

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Nigeria Provider Behavior Change Learning Briefs

Healthcare providers in Nigeria work to deliver client-centered care and adhere 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 worked closely with federal and state governments to support facility-based providers.

Service delivery and social and behavior change (SBC) professionals interested in using an SBC lens as part of their work with health care professionals can use these learning briefs.

How can we increase provider adherence to fever case management guidelines? A learning brief [PDF]

How can we strengthen the relationships between communities and facilities? A learning brief [PDF]

Last modified: March 18, 2026

Language: English

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Integrating Gender for Effective and Inclusive Risk Communication and Community Engagement During Health Emergencies

This case study, developed by Breakthrough ACTION with USAID support, highlights how integrating gender considerations can enhance emergency health responses.

The project trained risk communication and community engagement (RCCE) professionals in Guinea, Niger, Nigeria, and Liberia to address gender-specific needs, improving the inclusivity and effectiveness of their communication strategies. In Guinea, participants redefined gender perspectives and applied new tools, significantly boosting their confidence in gender-responsive RCCE. In Niger, participants were introduced to essential gender considerations, laying the groundwork for broader integration in health interventions. In Nigeria, gender was embedded into all training modules, helping practitioners understand the impact of norms on health behaviors and develop gender-sensitive messages. In Liberia, regional sessions enabled county-level leaders to create local gender action plans, maintaining momentum during a politically challenging time.

This case study underscores that a gender-sensitive approach in RCCE fosters trust, addresses disparities, and supports inclusive health interventions, creating a model for effective emergency response across diverse settings.

Date of Publication: March 18, 2026

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Social and Behavior Change Guidance for Anopheles stephensi in Africa

Anopheles stephensi, a dominant malaria vector in south Asia and Arabian Peninsula, has been identified by researchers in Africa in recent years, and has the potential to threaten malaria control and elimination efforts. Social and behavior change will play a critical role in the response to this growing threat. This document provides evidence-based guidance on individual, household, and community level behaviors for potential support of An. stephensi mitigation and control interventions in Africa.

Last modified: March 18, 2026

Language: English

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Elevating Social and Behavior Change as an Essential Component of Family Planning Programs

Citing “no product, no program,” family planning (FP) interventions have traditionally focused on delivering commodities. But ensuring long-term uptake means addressing behavioral and cultural attitudes and practices regarding FP. While social and behavior change (SBC) plays an essential role—backed by almost 50 years of data—it is often underutilized. In a newly-published commentary in Studies in Family Planning, USAID and Breakthrough ACTION make a clear case and a clarion call for more intentionally integrating and funding proven SBC approaches into FP programs. The data outlined in this commentary serves as a cornerstone for advocacy efforts to help increase SBC in FP programs.

Last modified: March 17, 2026

Language: English

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WABA Provider Behavior Change for Improved Family Planning Service Delivery

Through its community engagement activities; co-creation sessions with family planning (FP) providers, community members, and local decision makers; and various research efforts, West Africa Breakthrough ACTION (WABA) sought to understand better the challenges health professionals and health systems face in ensuring quality FP service delivery. Alongside stakeholders, the project identified priority challenges in each country, including:

  1. Inconsistent provider motivation in Burkina Faso
  2. A lack of a standardized, comprehensive FP counseling tool in Côte d’Ivoire
  3. Poor service organization and client flow between services in health centers in Togo
  4. A lack of provider motivation and a need for a simplified segmentation counseling tool in Niger

These insights laid the groundwork for provider behavior change solutions across the four WABA implementation countries; each focused on improving the FP service delivery experience for all parties involved.

BURKINA FASO

CÔTE D’IVOIRE

NIGER

TOGO

Date of Publication: March 17, 2026

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West Africa Breakthrough ACTION Experiences

Breakthrough ACTION leverages social and behavior change (SBC) approaches to increase modern family planning (FP) access and informed, voluntary use in Burkina Faso, Côte d’Ivoire, Niger, and Togo. This technical brief, available in English and French, shares promising, proven, or innovative program approaches that can yield FP results in the West Africa region by providing a deep dive into three distinct activities:

  • Community dialogues and facility site walkthroughs, a multi-sectoral and community engagement approach to improve FP service quality via community-driven solutions.
  • FP provider behavior change tools to respond to regional and country-specific challenges identified to offer quality FP services.
  • The Confiance Totale (Total Confidence) radio campaign, which fostered trust in FP services and methods during the COVID-19 pandemic.

Expériences de Breakthrough ACTION en Afrique de l’Ouest

Breakthrough ACTION s’appuie sur des approches de changement social et de comportement (CSC) pour accroître l’accès à la planification familiale moderne (PF) et son utilisation volontaire et informée au Burkina Faso, en Côte d’Ivoire, au Niger et au Togo. Ce résumé technique, disponible en anglais et en français, présente des approches prometteuses, éprouvées ou innovantes qui peuvent produire des résultats en matière de PF dans la région de l’Afrique de l’Ouest, en fournissant une analyse approfondie de trois activités distinctes :

  • Dialogues communautaires et visites de sites, une approche multisectorielle et d’engagement communautaire visant à améliorer la qualité des services de PF par le biais de solutions communautaires.
  • Outils de changement du comportement des prestataires de PF pour répondre aux défis régionaux et nationaux identifiés pour offrir des services de PF de qualité.
  • La campagne radiophonique Confiance Totale qui a permis de renforcer la confiance dans les services et les méthodes de PF pendant la pandémie de COVID-19.

Source: Johns Hopkins Center for Communication Programs

Date of Publication: March 17, 2026

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Factors Influencing Community Health Worker Behaviors

Community health workers (CHWs) are essential to a strong primary health care system and play a critical role in service provision. Uplifting CHW programs can bring further confidence to the health system, especially given CHWs’ ability to build trust with the communities they serve. It is, therefore, important to understand the many factors influencing CHWs and how to best support them in their work.

Breakthrough ACTION conducted a global literature review to identify and explore factors influencing CHW behavior. The project also conducted supplemental interviews with CHWs and others working with them in four countries to ensure a more holistic understanding of CHWs’ lived realities. Finally, Breakthrough ACTION held a virtual consultation to summarize the synthesis of the literature and interviews and gather additional insights into the multitude of factors that influence CHW behavior.

These factors were then mapped into categories against the Provider Behavior Ecosystem domains and are summarized in the Factors Influencing Community Health Worker Behaviors: Literature Review Synthesis.

Last modified: March 16, 2026

Language: English

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Using Social and Behavior Change to Address Tuberculosis in Nigeria: Implementation Stories

In 2021, Nigeria accounted for 4.4% of the world’s tuberculosis (TB) cases, ranking sixth among nations with the highest case rate. About 500,000 Nigerians are infected with TB annually.  Moreover, Nigeria struggles to identify TB cases; in 2018, the country’s National TB, Leprosy, and Buruli Ulcer Control Programme (NTBLCP) only was able to track 24% of cases.

Decisions on if, when, and where to seek testing and treatment for TB are influenced by a multitude of social and behavioral factors, such as knowledge of TB, how likely a person is to think they are to contract the disease (perceived susceptibility), how serious they think it would be if they were diagnosed with TB (perceived severity), their perception of the available health services, their confidence in their ability to seek those services, and TB-related stigma and discrimination, among others. To deepen its understanding of why TB cases were hard to find and what influenced a person’s TB care-seeking behavior, Breakthrough ACTION worked with the NTBLCP in 2019 to learn about community members’ experiences with TB-related behaviors using a human-centered design approach.

This process uncovered deep insights about what Nigerians with TB experience in their journey to get tested and treated. Four key insights emerged from this process:

  1. Individuals take a long journey, literally and figuratively, before they attain proper treatment for TB.
  2. While testing is free, sick individuals incur indirect costs.
  3. Stigma is a barrier to case-finding and care-seeking.
  4. Myths and misconceptions about TB are prevalent.

Breakthrough ACTION-Nigeria, NTBLCP, and partners, and community members used these insights as springboards to generate ideas for solutions.

Four stories detail how Breakthrough ACTION-Nigeria placed community members’ needs at the center of its work and collaborated to design and implement solutions using SBC approaches—and since their activities began, case detection has steadily increased. These implementation stories also include lessons learned in the process and recommendations:

Last modified: March 16, 2026

Language: English

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Cover page of document titled Digital Mental Health Landscaping in Low- and Middle-Income Countries
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Digital Mental Health Landscaping in Low- and Middle-Income Countries

The aim of this project was to map the landscape of who is doing what and where in digital mental health, and to provide recommendations that may assist in targeting communication efforts and funding calls. To address this, the project consisted of three studies:

  1. Social Media Review
  2. Systematic Literature Review
  3. Focused Consultation with experts.

This report presents the comprehensive results of digital mental health interventions across academic and commercial landscapes in LMICs. The findings highlight the diverse range of interventions, technologies, and mental health conditions addressed, as well as the geographical distribution and stakeholder involvement in the development and testing of these interventions.

Source: University College London

Date of Publication: August 26, 2024

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The Mission to Stop Ebola: Lessons for UN Crisis Response
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The Mission to Stop Ebola: Lessons for UN Crisis Response

This report analyzes the creation, structure, and impact of UNMEER, the UN’s emergency response to the 2014-2016 Ebola outbreak. The report assesses UNMEER’s effectiveness in coordinating the UN system’s response, scaling up logistical capacity, and mobilizing international support. It also identifies lessons for future UN crisis responses, including the need for flexible mandates, diverse partnerships, and a people-centered approach. The report concludes by highlighting the importance of integrating UN entities to effectively respond to multidimensional crises. The International Peace Institute (IPI), an independent, international think tank, published the report with a mission to promote peace, security, and sustainable development through policy research and analysis.

Last modified: August 12, 2024

Language: English

Source: International Peace Institute

Year of Publication: 2017

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