SOCIAL AND BEHAVIOR CHANGE
PSI uses a multidisciplinary approach to social and behavior change (SBC) that draws on the tenets of public health, marketing, behavioral economics, and human centered design. This approach moves SBC beyond a communication-only focused approach to one that seamlessly connects the beneficiary’s world with the overall health system and marketplace.
PSI employs a four-step process when developing SBC solutions:
- Design and Prototype
- Deliver and Monitor
- Evaluate and Re-inform.
This process embraces the principle of “collaborate, learn, adapt”, wherein near real-time monitoring occurs throughout, and learnings are immediately applied to enhance and adapt the design.
PSI’s SBC strategies place the beneficiary (i.e., a mother of a child under five, an adolescent girl, a health provider or even a product manufacturer) at the center of our solutions, designing programs in partnership with the intended beneficiaries, not for them. PSI does this by using several unique methodologies and approaches:
Increasing empathy with our beneficiary: From researchers, to programmers, to technical experts, PSI is sending multi-disciplinary teams out to engage with our beneficiaries. PSI teams collect stories and observations that complement traditional research and help keep our beneficiary and their needs and experiences at the center of our program design. Refined research methods, such as mapping the evolution of beneficiary behavior and segmenting beneficiaries by behaviors, rather than simple demographics, are additional ways to understand and empathize with our target audience.
Prototyping: To continually sharpen beneficiary insights, PSI has begun prototyping solutions with our beneficiaries. These rough outlines of a solution are presented to beneficiaries for their feedback and critique. Prototypes represent the very early thinking of a potential solution, whether it be an experience, a product or even a message. It provides something tangible — a story board, a role play, or a physical representation of a product — that helps beneficiaries articulate thoughts and emotions about the problem and its solution that they might not otherwise be able to verbalize. In short, we can build and refine potential solutions as well as continually collect beneficiary insights through the co-creation process of prototyping.
Beneficiary engagement: With more comprehensive engagement, beneficiaries become a part of each and every step of solution design and implementation. Wherever appropriate, PSI engages beneficiaries not just as recipients of a solution but as creators of it, from data collection, to ideation of solutions, to prototyping and refinement. Special trainings and tools ensure that PSI staff create space for beneficiaries to not only participate in solution design, but to lead as appropriate
Through increased empathy with our users and sharpened insights into their lives and needs, PSI is better able to design solutions that motivate healthy behaviors and the use of health products and services.
PSI estimates the impact of our work in years of healthy life added. While proxy measures such as changes in attitude, beliefs or knowledge may be used for some SBC solutions, the ultimate measurement of our success is the behavior change and the health impact that results from it.
In every country where we work, social and behavior change (SBC) solutions are designed, implemented and managed by local teams in collaboration with a wide range of partners, including:
- Program beneficiaries
- National and local experts and officials
- International organizations
- Community-based organizations
PSI acknowledges that our program beneficiaries exist within a complex ecosystem comprised of players at the interpersonal, community, and societal levels. These players influence the beneficiaries’ enabling environment. Through their actions and interactions, each of these players helps or hinders the beneficiaries’ practice of healthy behaviors. Therefore, PSI designs solutions to not only address the individual’s barriers or motivators, but also key influencers within the individual’s socio ecological sphere.
Based on program objectives and beneficiary insights and needs, PSI implements a wide variety of SBC solutions designed to engage and motivate beneficiaries to increase demand for and use of health products, services and behaviors. These solutions include but are not limited to, mass media, peer education, school programs, community theater, mobile multi-media events, interpersonal communication, provider trainings and incentives, and special events.
Adolescents 360 (A360) aims to increase voluntary, modern contraceptive use and reduce unintended pregnancy among adolescent girls between the ages of 15 and 19 in Nigeria, Tanzania and Ethiopia. It does this by reimagining and redefining the way sexual and reproductive health programs are designed and delivered for adolescent girls and young women. This means shifting from a typical model where programmers design programs, to one where youth and adults from a range of disciplines design programs together. A360 brings together human centered design, social marketing, public health, cognitive neuroscience, and socio-cultural anthropology approaches.
Learn more about Adolescent 360.
The PHARE project develops and tests innovative and evidence-based SBC solutions that address barriers to modern contraceptive use, transform attitudes about reproductive health, and promote family planning in West Africa. The project aims to increase demand for family planning products and services; enhance active support for family planning; and address social norms to create an enabling environment for family planning. The project emphasizes the use of effective audience segmentation; social network-based research and programming; provider behavior change; and the integration of reproductive health SBC with activities in non-health sectors such as agriculture and environmental conservation.
Watch some of our mass media campaigns from around the world:
HIV risk perception in India
Birth spacing in Pakistan
Breastfeeding in Pakistan
Abstinence among youth in Kenya
The images below show Jeanine Nizigiyimana, a mother from Burundi, who is educating other mothers in her village on how to protect their children from water-borne diseases.
Photos by: Benjamin Schilling
- The Adolescents 360 Blueprint for Change
Adolescents 360 listens to what girls want to deliver sexual and reproductive health solutions tailored to what girls say they need. That’s our blueprint to delivering solutions that delight, inspire and serve her, from the ground on up.
- Argumentaires Coraniques
The booklet, which 9 themes related to birth spacing, family planning, family communications and family health, serves as a guide for religious leaders to discuss such topics based on the Holy Koran, citing the verses and later commenting on them.
- “Stigma And Discrimination-Free Zones”: An Innovative Approach to Engaging the Private and Public Sectors in Creating More Inclusive Environments for Key Populations in Central America (TUPED509)
Central America's HIV epidemic is concentrated in key populations (KPs). Despite existing HIV laws and policies that respond to KP's specific needs, there is evidence of widespread discriminatory attitudes and practices towards these populations, and stigma and discrimination continue to be important barriers to accessing HIV services and care. In 2016, under the USAID Combination Prevention Program for HIV in Central America, PASMO designed an intervention entitled “stigma and discrimination-free zones” as part of a broader initiative known as Generation Zero, contributing to the goal of “getting to zero discrimination.”
- Social Network Methods for HIV Case-Finding Among People Who Inject Drugs in Tajikistan (THSA16)
HIV testing programs have struggled to reach the most marginalized populations at risk for HIV. Social network methods such as respondent-driven sampling and peer-based active case-finding may be effective in overcoming barriers to reaching these populations. Under the USAID Central Asia HIV Flagship Project, we compared the client characteristics, yield, and number of new cases found through two RDS strategies and an ACF approach to HIV case-finding among people who inject drugs (PWID) in Tajikistan.
- Sexual Practices of Men Who Have Sex with Men (MSM) in Madagascar (WEPED432)
MSM are a vulnerable population with a high prevalence of HIV (14.8%) and low HIV testing coverage (16.5%) in Madagascar. This study aims to examine barriers and motivation to HIV prevention, specifically on HIV testing, and condom and lubricant use among MSM in order to refine behavior change communication and programmatic strategies.
- Mapping Population Sizes and Hotspot Locations for Female Sex Workers Improved Targeting for HIV Prevention Interventions in Ethiopia (TUPEE702)
HIV prevalence among female sex workers (FSWs) in Ethiopia is approximately 23%. To address risk of HIV in this population, the MULU/MARPs combination HIV prevention project was launched in 2012 across 168 Ethiopian towns/cities. Implementation was challenged by insufficient data on FSW locations and sizes. A rapid size estimation approach was developed to aid program implementation.
- Transform/PHARE Creative Sparks
Creative Sparks compiles examples of participative methods to design interventions and also examples of HCD processes implemented in Benin (Academie de l’Artisanat) and Cote d’Ivoire (Didier).
- PSI Vietnam: Social Marketing for Improved Water, Sanitation, and Hygiene
Despite recent macro-economic gains in Vietnam, many
individuals still lack access to improved water, sanitation, and hygiene (WASH) services
and facilities. To bridge this gap, private sector contributions are needed to complement
public sector investment for improved WASH behaviors and to strengthen markets
related to quality WASH infrastructure.
- PSI Increases Private Sector Contributions to HIV/AIDS Prevention and 90-90-90 Targets in Vietnam
In Vietnam, underserved communities lack basic HIV services. PSI Vietnam is working towards its UNAIDS targets by increasing accessibility for underserved communities, increasing the use of private sector outlets. PSI addressed issues such as the misconceptions around HIV, the syringe market, and treatment accessibility and comfortability.
- Innovations Lab Final Report
This final report documents the Innovations Lab workshop along with prototyping of intervention targeting men in Kaya, Burkina Faso. The Innovations Lab included NGOs and non traditional actors participating in a workshop where innovative ideas to reach mean were discussed and analyzed. A ‘winner idea’ was selected to be prototyped by a consortium of local NGOs, consisting of training men to talk to their adolescents sons about sexuality and contraception.