Improving the Linkages between Social and Behavior Change and Health Systems Strengthening

Social and behavior change (SBC) is an approach that applies insights about why people behave the way they do and how behaviors change to affect positive outcomes for and by specific groups of people. In behavior-centered programs, all program interventions are designed to empower individual and collective changes and create enabling social, physical, market, and policy environments. Within the context of strengthening health systems, SBC activities shape the demand for accountable, affordable, accessible, and reliable care. They can also address and support the behaviors of people, communities, and organizations within the health system to promote the equitable provision of quality care.

As a part of USAID’s Health Systems Strengthening Learning Agenda, a panel of SBC experts from USAID, ICF, and PSI, with support from The Accelerator, hosted an interactive knowledge exchange on how HSS and SBC efforts can complement each other and the initial steps that can be taken to integrate SBC into HSS programming. Participants engaged in a robust knowledge exchange on improving the linkages between SBC and HSS.

What did we learn? Key themes and takeaways

The key themes and takeaways included:

Tips on “how to get started” and sustainably scale and institutionalize SBC within HSS programming:

    • Get key stakeholder perspectives informally, and if possible, through research
    • Build in strong mechanisms for community engagement
    • Take time to understand both the system aspects (e.g., policies, supervision tools, opportunities in existing job descriptions) and the behavioral drivers (e.g., what motivates people to change behavior)
    • Analyze the patient experience through methods such as patient pathways analysis, journey mapping, and empathy analysis
    • Consider how to address providers’ emotional and social needs before focusing on other types of behavior change

Anticipated challenges of bringing an SBC focus into HSS:

      • Distal nature of results (it may take several months or years to see behaviors change)
      • Engaging policymakers (shifting their thinking to apply an SBC lens to the health system)
      • Need for time and opportunities for reflection and collaborative learning (to adjust and improve approaches during implementation)

What resources were identified?

Panelists and participants shared the resources below during the webinar:

Moving ahead

Health system actors have barriers and facilitators to their behaviors, their decision-making, and their actions which impact both the performance of the health system and the health of communities. Gathering social and behavioral insights from health system actors may help stakeholders design locally contextualized policy and local solutions that are key to successful behavior change and potentially sustainable systems change. The webinar can be viewed here or below.