Designing an SBCC Intervention for FBP Behavior Change

Step 6: Define Your Strategic Approach

At this stage, it is important to make decisions about which broad communication approach is most appropriate to achieve your communication objectives. In doing so, it is critical to consider both the needs and preferences of your intended audience and how well various approaches will work with your specific objectives and barriers and in your current context. An SBCC strategy may include more than one approach.

To determine which type of approach is the most appropriate, it is important to first answer a set of key questions:

  • Which motivational barrier or barriers are you trying to address? Self-Efficacy, Social and Gender Norms, Perceived Place in Social Hierarchy/Status, Rewards, and Work Environment.
  • How complex is the barrier? Complex barriers like social norms and attitudes are better addressed with approaches that allow for dialogue.
  • How sensitive are the issues to be addressed? Issues that the audience may not want to discuss publicly or that they feel may compromise their compensation, promotion opportunities or standing among peers require approaches that are more confidential and one-on-one.
  • What is the technical comfort among the intended audience? Group discussions, peer support groups, or mass media approaches that allow for longer explanation may be more appropriate for groups with lower technical levels to enable group or slower paced learning.
  • What is the desired reach? How large is the intended audience segment and how wide is the geographic location in which they work? Some approaches are limited in reach but allow for greater depth in coverage of a particular issue.
  • What are the cost considerations? What is known about cost per person reached and the known cost effectiveness of a particular approach? Does this fit within the available budget?
  • What is the level of acceptability of approach for the intended audience? The format should be appropriate for the intended audience in terms of what they are used to and comfortable using. For example, some FBPs may be resistant to support supervision, peer support and more interactive coaching styles, particularly if supervisors are younger or the intended audience is more comfortable with a hierarchical management style.
  • What is the level of technology and innovation and is it appropriate for the intended audience? Lower level, less educated or even older FBPs may be more resistant to new technological methods like tablets, smart phones and formats that use social media or mobile health technologies or they may not have access to these types of tools.

Communication Approaches to Be Considered

The table below does not include every possible approach, but it describes some communication approaches that have been used successfully in programs to improve FBP performance. See the SBCC Strategy I-Kit for more examples of strategic approaches.

ApproachDefinitionBarriers AddressedSBCC Examples for FBPs
AdvocacyA deliberate process, based on evidence, to directly and indirectly influence decision-makers, stakeholders and relevant audiences to support and implement actions that contribute to health and human rights.

  • Policy
  • Resource allocation
  • Legal changes
  • Status
  • Social and gender norms
  • Work environment

Using compelling evidence to advocate Ministry of Health leaders to enact task shifting policies that decrease burnout and improve the work environment.
BrandingProcess of developing a symbol, logo and design that distinguishes one product, service or idea from the competition.

  • Rewards
  • Status
  • Social norms
  • Work environment

Developing a mark or symbol and making it visible on trained or qualified providers’ lab coats, homes, or clinic signs to identify them as high-quality service providers.
Mobile HealthA tool to expand access to health information and services using mobile and wireless technologies such as mobile phones, tablets and mobile software applications.

  • Status
  • Rewards
  • Ability
  • Self-efficacy

Sharing technical videos on smart phones to help improve counseling techniques and remind providers of key technical information.

Role ModelingProcess of strategically engaging people whose behavior or success can be emulated by others to influence behavior change.

  • Status
  • Social and gender norms
  • Rewards
  • Self-efficacy

Identifying high-performing, well-liked FBPs and pairing them with less motivated providers for scheduled work-alongs.
Satisfied ClientAn intervention which enlists individuals who have successfully adopted a select behavior, service or product to conduct outreach with individuals who are non users/non-adopters.

  • Status
  • Work environment

Engage couples who report having received high-quality family planning counseling and ask them to appear in clinic-based testimonial posters or local radio shows to discuss the quality service they received.
Support Supervision and CoachingA feedback approach that promotes mentorship, joint problem-solving and communication between supervisors and their staff.

  • Work environment
  • Rewards

A supervisor works jointly with a FBP to identify areas and methods for improvement, then checks in regularly on progress.

Identify several communication approaches you would like to use by answering the questions above. Use the following table to analyze any potential approaches you are considering. For each audience and each communication objective, write the approach and evaluate it against the selection criteria.

Key ApproachIntended AudienceCommunication Objective
CriteriaMeets this Criteria (Y/N)
1. Matches the identified motivational barrier.
2. Is appropriate for the level of complexity of the barrier.
3. Is appropriate for the level of sensitivity of the barrier.
4. Matches audience literacy level.
5. Meets reach requirements for audience.
6. Is within program budget.
7. Is an acceptable approach to the intended audience.
8. Technology and innovation level is appropriate.

 Download Key Approach Table

Selecting Communication Channels

Once you determine your broad approach, the next step is to select specific communication channels. Channels are the specific set of communication tools you want to use. Generally, channels can be organized into four main categories: interpersonal, community based, mass media and social media. The following table defines the different channels and provides examples of how these channels may be applied in FBP programs.

Channel TypesDefinitionExamples
Interpersonal: Counseling, peer to peer, client-provider and supervisor to FBP The process by which two or more small groups of providers exchange information and ideas through face-to-face interaction.

  • Site visits with leaders and politicians to advocate for policy change
  • Peer learning groups
  • Support supervision visits
  • Coaching to improve counseling skills and empathy
  • Provider hotlines

Community Based: Community dialogue, community drama, community radio and community eventsA process that engages and motivates a wide range of partners and allies at national and local levels to raise awareness of and demand for a particular objective through dialogue.

  • Community dialogues surrounding norms and health-seeking behavior
  • Community-provider coalitions to define quality
  • Community radio highlighting providers' work

Mass Media: Radio and TV; serial dramas, game shows, websites, newspaper, magazines and postersDiversified media technologies that are intended to reach large audiences via mass communication including radio, film, and television.

  • TV soap opera modeling effective client-provider interaction
  • Billboards or radio spots promoting quality clinics and providers
  • Websites that connect providers and provide helpful tips for values assessments

Social Media: Facebook, WhatsApp, SMS, blogs and podcastsInternet services where the online content is generated by users of the services including blogging, social network sites and Wikis, etc.

  • Facebook page for FBPs
  • Social media user group among FBPs to share better practices, learnings and new techniques
  • Blog for FBPs
  • Motivational videos shared on WhatsApp

Refer to the resources section below for detailed guidance on how to select the best channel.

Once the most appropriate communication approach is determined, work with a creative team to develop messages and materials.


Don’t forget to ensure that these materials are pre-tested with your primary FBP audience before being finalized and produced!

Record your selected communication approach(es) and communication channels in the Step 6 section of the SBCC Strategy Template.


Resources

Resources for Materials’ Development:

Advocacy

Branding

mHealth

Social Media

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Step 5: Determine the Key Promise and Support Points (Prev Step)
(Next Step) Step 7: Match Communication Approach to Identified Motivation Barrier
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