Type of Material: Tools

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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

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Nigeria Community Capacity Strengthening Resources and Tools

From 2019 to 2024, Breakthrough ACTION-Nigeria trained 659 Ward Development Committees to plan, fund, and implement Community Health Action Resource Plans. The project supported the committees in implementing their plans in two stages. The first stage focused on delivering immediate benefits to the community, such as free emergency transport to health services for pregnant women and children under five and for other emergencies, delivery kits for pregnant women, funds to renovate health facilities and procure commodities, and community health information boards to track data. The second stage focused on strengthening committee capacity by addressing gender disparities in health care through tailored training and by forming Gender Economic and Empowerment Committees, equipping Ward Development Committees with social and behavior change resources to promote health-seeking and preventive behaviors, strengthening committees’ financial management skills, training them in decision-making and stakeholder collaboration, and encouraging community involvement in decision making.

Training Package and Community Engagement Tools

This training package was created for individuals and groups working on community-led health interventions. It contains manuals for both facilitators and participants, along with accompanying tools that provide practical guidance for community engagement, identifying issues, and developing community health action resource plans.

Mobilizing Communities for Health and Social Change
Fostering Leadership in Community Development
Community Dialogue Tools for Leaders
Ward Development Committee Gender Champions

Impact Stories

Last modified: August 1, 2026

Language: English

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2023

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Entre Nosotras: Guide to Form Support Circles

The Entre Nosotras (Amongst Ourselves) guide, developed by Breakthrough ACTION in Guatemala, outlines a group methodology that encourages mothers to share experiences and learn from each other. The topics covered include health, nutrition, feeding, and other issues related to the 1,000-day window.

Entre Nosotras: Guía Metodológica de Formación de Círculos de Apoyo

La guía “Entre Nosotras,” desarrollada por Breakthrough ACTION en Guatemala, presenta una metodología grupal que promueve espacios de aprendizaje donde las madres comparten experiencias y se escuchan entre sí para aprender entre pares. Los temas que se abordan son la salud, nutrición, alimentación y otros temas relacionados a la ventana de los 1,000 días.

Last modified: August 1, 2026

Language: Spanish

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2024

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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

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Malaria Service Delivery Assessment Tool: Four Steps to Identify Challenges and Opportunities

Despite progress, challenges remain in delivering high-quality malaria services. Stakeholders articulated a need for a rapid and flexible tool to help holistically examine the complex web of factors that influence the delivery of quality malaria services.

Breakthrough ACTION collaboratively developed the Malaria Service Delivery Assessment Tool: Four Steps to Identify Challenges and Opportunities to provide national malaria programs with a structured, holistic, and participatory process for investigating and responding to service delivery concerns. Such tools can empower providers and other health system actors to truly understand the challenges impacting services within a given facility by applying a behavioral lens.

An accompanying technical brief describes the pilot test in the Democratic Republic of the Congo as a use case for applying the Malaria Service Delivery Tool. The brief is helpful for those interested in learning more about the tool’s implementation and what insights can be generated from it.

Ferramenta de avaliação da prestação de serviços contra a malária [PDF]

Last modified: July 31, 2026

Language: English

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2024

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Gender Equality Check-In Tool

Designed to promote gender transformative approaches within public health programming, this practical self assessment tool helps project teams evaluate their organizational and programmatic activities. The resource guides staff through structured reflection prompts to identify how gender dynamics influence activity implementation, team culture, and service delivery outcomes. It facilitates honest internal dialogue, enabling practitioners to address gender biases, strengthen equity, and refine social and behavior change strategies. SBC managers, gender advisors, and project teams can integrate this tool into routine monitoring and pause-and-reflect sessions to ensure continuous alignment with gender equality principles.

Vérification de l’égalité du genre

Conçu pour promouvoir des approches transformatrices en matière de genre dans les programmes de santé publique, cet outil pratique d’auto-évaluation aide les équipes de projet à évaluer leurs activités organisationnelles et programmatiques. La ressource guide le personnel à travers des questions de réflexion structurées afin d’identifier la manière dont la dynamique de genre influence la mise en œuvre des activités, la culture d’équipe et les résultats de la prestation de services. Elle facilite un dialogue interne sincère, permettant aux praticiens de traiter les biais de genre, de renforcer l’équité et de perfectionner les stratégies de changement social et de comportement. Les responsables de CSC, les conseillers en genre et les équipes de projet peuvent intégrer cet outil dans les séances de suivi de routine et de pause-réflexion pour garantir un alignement continu avec les principes d’égalité des genres.

Vérification de l’égalité du genre [PDF]

Last modified: July 31, 2026

Language: English, French

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2020

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Adaptations of Sick Child Feeding Tools in Guatemala

Building on the behavioral design solutions developed in the Democratic Republic of Congo related to sick child feeding, Breakthrough ACTION gathered behavioral insights from mothers and caregivers in Guatemala and adapted the tools to that country’s context. The tools have been incorporated into ongoing community-focused activities and can be used or adapted to other country contexts.

Mother’s Activity

Grandmother’s Activity

Last modified: July 31, 2026

Language: English, Spanish

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2025

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Contraception Discontinuation Testing Toolkit

Contraceptive discontinuation among women and adolescent girls who want to delay or prevent pregnancy is a challenge in many countries; however, there has been little attention paid to identifying programmatic approaches to address this challenge. In 2021, Breakthrough ACTION, in conjunction with USAID ReachHealth Philippines, the Philippines Commission on Population and Development, and the Philippines Department of Health, used human-centered design to create solutions to reduce contraceptive discontinuation in that country.

The solutions were compiled into this Contraception Discontinuation Testing Toolkit, which guides social and behavior change and family planning (FP) practitioners on testing six solutions that address contraception discontinuation in their local context.

Tested once in the Philippines, these prototypes are meant to be tested again and adapted to the needs of FP providers and women in other countries. The toolkit provides step-by-step instructions for testing the prototypes, along with details on who should test them, and testing requirements.

INSIGHTS REPORT

Examining and Designing Women-Centered Solutions to Reduce Contraceptive Discontinuation in the Philippines [PDF]

TOOLKIT AND TESTING RESOURCES

1. Testing Toolkit

2. Capacity Strengthening Slides

3. Testing Summary

4. Prototypes for Testing

5. Questionnaires and Note-taking Templates

6. Analysis Tools

7. Prototypes for Adaptation

Last modified: July 31, 2026

Language: English

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2023

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Community Empathways

The West Africa Breakthrough ACTION Community Empathways card deck is an activity designed to take young people and adult community leaders on a dynamic and engaging journey from awareness to empathy to action. The aim is to forge greater understanding between these groups and ultimately increase adult support for young people seeking reproductive health and family planning information and services.

Facilitator’s Guide

This facilitator guide includes an introduction to the tool, planning tips, and a sample script for a Community Empathways activity session leader.

How-to Video

This how-to video gives step-by-step instructions for organizing a community conversation using selected Merci Mon Héros campaign videos and the Empathways community cards. The video is for any group, organization, or collaborator that wishes to increase youth access to contraceptive, family planning, and reproductive health information and services.

Version Communautaire d’Empathways

Ce “paquet” de cartes est une activité conçue pour emmener les jeunes et les leaders adultes de leur communauté dans un voyage dynamique et engageant, de la prise de conscience à l’empathie, puis à l’action. L’objectif est de forger une meilleure compréhension entre ces groupes et, en fin de compte, d’accroître le soutien des adultes aux jeunes qui recherchent des informations et des services en matière de santé de la reproduction et de planification familiale.

Guide de facilitateur

Ce guide de facilitateur comprend une présentation de l’outil, des conseils de planification et un exemple de script pour l’animateur d’une session Empathways communautaire.

Vidéo tuto

Cette vidéo donne des instructions étape par étape sur l’organisation d’une conversation communautaire à l’aide de vidéos sélectionnées de la campagne Merci Mon Héros et des cartes de la version communautaire d’Empathways. La vidéo est destinée à tout groupe, organisation ou collaborateur qui souhaite améliorer l’accès des jeunes aux informations et aux services de contraception, de planification familiale et de santé reproductive.

Last modified: July 31, 2026

Language: French

Source: Johns Hopkins Center for Communication Programs

Year of Publication: 2021

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