Social and behavior change (SBC) approaches can increase the use of modern contraceptives by addressing the attitudes and social norms that influence demand. However, they often do not receive attention, partly because many practitioners are not effectively measuring SBC efforts. Breakthrough ACTION interviewed voluntary family planning stakeholders in West Africa to learn why.
Access and demand are crucial levers in voluntary family planning programming. However, “understanding how these two are linked and when each should be prioritized is difficult,” note Michelle Weinberger, Emily Sonneveldt, and John Stover. This challenge is illustrated by the relatively weak attention to social and behavior change (SBC) approaches in voluntary family planning programs. SBC is an evidence-based, theory-driven process that uses communication to identify and address behavioral determinants, and positively influence individual and collective behaviors to improve health outcomes. Available evidence shows that SBC approaches can increase the use of modern contraceptives by addressing the attitudes and social norms that influence demand. Despite proven results, SBC interventions often do not get as much attention, in part because many practitioners are not effectively measuring SBC efforts.
Breakthrough ACTION interviewed voluntary family planning stakeholders in the Ouagadougou Partnership countries and identified a lack of awareness that SBC is needed to improve outcomes, and a belief that it does not generate the same return as investments in service delivery and procurement.
These responses reflect a broader trend across francophone West Africa, where investments through initiatives like the Ouagadougou Partnership have focused more heavily on access-driven programming. Yet Weinberger, Sonneveldt, and Stover note that without greater investments in strategies to increase demand, efforts to expand voluntary family planning use in countries with a high desired ideal number of children may achieve limited success. Investing in SBC measurement enables programs to engage in continuous learning and improvement, enables them to demonstrate how SBC interventions improve desired outcomes, and provides evidence of SBC’s effectiveness that can be used to mobilize further investment.
SBC voluntary family planning indicators measure the effectiveness and impact of SBC processes and interventions by type of indicator (e.g. output, outcome) and socio-ecological levels. A recent Breakthrough RESEARCH report examined SBC approaches in Burkina Faso, Côte d’Ivoire, Niger, and Togo to understand how SBC was measured and identify gaps in measurement. Drawing from more than 1,500 indicators collected from 55 current stakeholders and projects in the four countries, the report provides important insights:
Sustainable investment in voluntary family planning requires coordination across governments, funders, implementers, and civil society organizations. Although the report is not an exhaustive review, it provides recommendations for different stakeholders to assess, implement, and monitor current and future voluntary family planning and SBC programs. These include:
Read Breakthrough RESEARCH’s list of 12 Recommended SBC Indicators (in English and French) to determine how you can start incorporating SBC approaches and measuring SBC efforts in your voluntary family planning programming.
Breakthrough RESEARCH catalyzes social and behavior change (SBC) by conducting state-of the-art research and evaluation and promoting evidence-based solutions to improve health and development programs around the world. Breakthrough RESEARCH is a consortium led by the Population Council in partnership with Avenir Health, ideas42, Institute for Reproductive Health at Georgetown University, Population Reference Bureau, and Tulane University.