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

Intentionally Incorporating the Social Determinants of Health into Social and Behavior Change Programming for Family Planning

The field of social and behavior change (SBC) recognizes that factors beyond the biomedical model of health affect health and well-being at individual, household, community, and societal levels. However, to date, SBC interventions in family planning and reproductive health (FP/RH) have primarily focused on identifying and shifting behaviors in individuals, groups, and communities; therefore, SBC programs too often overlook the root causes of health disparities related to FP/RH and how SBC approaches can and should be used to address them.

The purposes of this brief are to:

  1. Synthesize what is known about addressing the social determinants of health (SDOH) inequities in FP/RH.
  2. Propose considerations for future SBC programmingto address the SDOH inequities in FP/RH based on the existing evidence.
  3. Identify implementation research gaps that should be explored to support the use of SBC to address inequities in FP/RH that result from the SDOH.

This document provides evidence to guide strategic decision-making among donors and governments in support of SBC initiatives to reduce inequities in FP/RH. Though the brief focuses on examples from the field of FP/RH, its content is broadly applicable to SBC across all health and development areas. Breakthrough ACTION developed this brief alongside a programmatic tool with practical guidance for SBC practitioners. This resource contributes to work under the “supporting social change in family planning” priority in the Global Shared Agenda for SBC in Family Planning.

ENGLISH

Intentionally Incorporating the Social Determinants of Health into SBC Programming for FP [PDF]

EN FRANÇAIS

Intégrer délibérément les déterminants sociaux de la santé dans les programmes de CSC dans le domaine de la PF [PDF]

Last modified: March 18, 2026

Language: English

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

Using SBC to Enhance Programs to End Child, Early, and Forced Marriage

Child, early and forced marriage (CEFM), defined as marriage before age 18 or marriage that occurs without the consent of those in the marriage, affects an estimated 15 million girls each year.

CEFM is perpetuated by many factors, including but not limited to poverty, conflict, gender inequality, social and cultural norms, religious beliefs, and economic incentives. Looking forward, efforts to reduce the number of girls at risk for CEFM will increasingly struggle to keep pace with population growth; leading to virtually the same number of girls at risk for CEFM within the next few decades if actions to end CEFM are not accelerated.

This series of briefs proposes social and behavior change (SBC) approaches to strenghten the collective effort to reduce CEFM.

There are seven briefs in the series that focus on:

  1. Advanced Audience Segmentation: By learning more about your audience and segmenting them into smaller groups you can better target your interventions and influence behavior change to end CEFM.
  2. Collective Action: By bringing together members of a community to discuss CEFM and envision a different future for their community, progress can be made at a larger scale and with greater chance of lasting change.
  3. Gender Synchronization: When designing a gender synchronized approach for CEFM, you should consider the needs of all genders and address the power imbalances that often exist in communities.
  4. Human-Centered Design: Human-centered design can help you discover new approaches that put empathy at the core and ensure the community leads the design of programming.
  5. Social Norms programming: Different social norms are often contributing factors in the persistence of CEFM in communities. By designing norms-shifting interventions, you can begin to tackle these long-standing influencers.
  6. Theories: Using theories can help you to develop effective programs to reduce CEFM. Theories can provide a framework to build your program around to lead to behavior change.
  7. Youth Engagements: By engaging youth in CEFM programing from design through to evaluation, and including activities to strengthen youth’s agency, you can increase the sustainability and impact of your program.

Each brief was developed from analyzing successful interventions conducted all over the world. Interventions and programs that are creative, multi-faceted, and innovative will be required in order to address the factors contributing to the prevalence and impact of CEFM.

Last modified: March 16, 2026

Language: English

HIPs Implementation Tools Project

Launched in 2022, the HIPs Implementation Tools project aims to compile crucial resources for FP/RH practitioners, that provide guidance on effectively implementing and expanding the Family Planning High Impact Practices (HIPs). Responding to the growing need for resources that not only explain the effectiveness of the family planning HIPs, but that also offer practical guidance on implementing and scaling up these practices, the project collaborated in 2023 with FP/RH technical experts and implementers. Together, they published an initial set of resource collections focused on implementing and scaling up 7 selected Service Delivery and Social and Behavior Change HIPs. In October 2024, with additional expert support, the project released a new set of resource collections covering 8 additional family planning HIPs and HIP enhancements. Within each collection, viewers can find accessible knowledge products designed to help FP/RH professionals strengthen the implementation and scale-up of these HIPs in their programming. (Un petit nombre de ressources et d’études de cas sont disponibles en français pour chaque dossier.)

Source: Johns Hopkins Center for Communication Programs

Date of Publication: November 15, 2024

Effect of Social and Behavior Change Activities on Malaria Behaviors in Guyana

In 2019, the USAID-funded Breakthrough ACTION project, led by the Johns Hopkins Center for Communication Programs and other partners, collaborated with the Guyana Ministry of Health’s National Malaria Program to develop a social behavior change program to improve priority malaria-related health behaviors among gold miners within Regions 7 and 8 of Guyana.

The SBC program strategy was based on the ideation model of social behavior change, which shows how different ideas, that is, “ideational factors,” about behavior, impact whether an individual practices a behavior. This research report highlights key findings from research activities undertaken by Breakthrough ACTION Guyana to assess the reach and behavioral impact of SBC activities and summarize key learnings about the work to improve malaria-related behaviors among the gold mining population in Guyana.

Source: Johns Hopkins Center for Communication programs

Date of Publication: July 1, 2024

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

MOMENTUM Integrated Health Resilience Social and Behavior Change Strategy to Enhance Resilience

Proactive social and behavior change activities among health providers, community health workers, and community members before, during, and after shocks and stresses increase health resilience and prevent disruption in health services for families and communities. This technical brief includes SBC strategies that MOMENTUM Integrated Health Resilience is taking to enhance health resilience in fragile settings. 

This resource is available in English and French.


MOMENTUM Résilience Sanitaire Intégrée travaille en partenariat avec des pays confrontés à des situations de choc et de tension permanentes (par exemple, des institutions faibles, des conflits, des catastrophes). Les activités proactives de changement social et comportemental proposées aux prestataires de soins de santé, aux agents de santé communautaires et aux membres des communautés avant, pendant et après l’événement induisant choc et stress améliorent la résilience sanitaire et préviennent les perturbations des services de soins de santé destinés aux familles et aux communautés.

Cette ressource est disponible en anglais et en français.

Last modified: May 23, 2024

Language: English, French

Source: USAID- MOMENTUM

Year of Publication: 2022

Learning from MOMENTUM: Community Engagement and Systems Strengthening Approaches to Addressing Gender-Based Violence

Published in recognition of the 2023 16 Days of Activism against Gender-Based Violence (GBV) campaign, this brief highlights six innovative approaches—related to community engagement and system strengthening—for addressing GBV. The case studies from three MOMENTUM projects offer practical insights for gender experts, practitioners, and advocates, particularly those working in GBV pre­vention and response, to apply and adapt in their own work.

Last modified: February 21, 2024

Source: USAID MOMENTUM

Year of Publication: 2023

Gender Equity and Male Engagement: It only works when everyone plays

In this brief, the International Center for Research on Women (ICRW) in collaboration with the Cartier Foundation, presents guidance for nurturing meaningful engagement with men and boys to transform the social and gender norms that reinforce gender inequality and harm both women and men. This brief provides an overview of the field and guidance for stakeholders to support the funding, design, and implementation of programming that effectively engages men and boys in creating sustainable gender norm transformation.

Last modified: February 21, 2024

Language: English

Source: International Center for Research on Women (ICRW) and Cartier Foundation

Year of Publication: 2018