Digital Pulse - Ch 3 - Sec 3 - ToolxCHANGE Project

Development Issues: Nutrition, Maternal Health, HIV/AIDS, Public Health, Capacity Building

Programme Summary

The CHANGE Project helps make programs more effective by developing and applying practical solutions to behaviour change problems relevant to health and nutrition. Our ultimate objective is to increase the impact, sustainability, scale and cost-effectiveness of health interventions worldwide. To reach these goals, CHANGE:

• Increases the extent to which public health projects and programs, particularly those supported by USAID, address behavioural issues and frame public health problems in terms of behaviours and the factors that influence them, starting during the assessment and planning phases;
• Builds the capacity for good behaviour change diagnosis, strategy formulation, monitoring and evaluation, especially among USAID-supported projects and Private Voluntary Organizations (PVOs); and,
• Contributes to the state-of-the-art in behaviour change relevant to health and nutrition by identifying, developing, assisting with implementation and evaluating tools and approaches that can be applied to achieve behaviour change.

CHANGE tests tools and approaches in field settings through collaborative partnerships with local governments, private voluntary agencies, non-governmental organizations and USAID cooperating agencies. CHANGE focuses on sustainable solutions to key behaviour-related challenges in the areas of maternal health, child health and nutrition, as well as HIV/AIDS and infectious disease. Because peoples' choices can be limited by the context in which they act, CHANGE works not only at the level of the individual, but also at community, institutional and policy levels. The CHANGE approach involves focusing on assets as well as deficits with an emphasis on community-health system collaboration and increasing participation of local populations. In addition, CHANGE advocates comprehensive approaches and building self-regulatory systems that rely on feedback – both positive and negative – to sustain practices.

Summary of ICT Initiatives

The ToolxCHANGE consists of brief descriptions of new tools and approaches addressing what CHANGE Project staff, partners and expert colleagues consider to be important gaps in our current array of methods for bringing about positive health-related changes at the individual, household, community, institutional and policy levels. We believe the ideas and instruments described (or proposed here for development) will help to advance the state-of-the-art in health behaviour change. Health program implementers, policy makers, community mobilization experts, health researchers, private voluntary organizations (PVOs), USAID staff, members of collaborating organizations and others interested in furthering our knowledge of health behaviour change are all invited to contribute.

ToolxCHANGE contains tools in various stages of development. We are seeking partners who will help us move a tool or approach to the next stage. We also want to know about difficult problems (related to health behaviour change) that need better tools. The ToolxCHANGE kit includes:

• Ideas for innovative new approaches to changing health behaviour;
• Ideas for new methodological tools (such as research instruments);
• Promising tools and approaches that have already been used on a small scale but that need further development or field testing; and
• Approaches and tools that have been implemented with apparent success but that need to be evaluated.

Each description explains the state of development of a tool or approach and what step CHANGE hopes to take next. Descriptions also include contact information for anyone wishing to collaborate or contribute to the discussion. The ToolxCHANGE does not include ready-to-use tools. The ToolxCHANGE primarily includes tools and approaches in development. The ToolxCHANGE is designed to illustrate a comprehensive behaviour change methodology. The entries represent important gaps in the current array of methods and approaches.

Addressing a set of four, common, cross-cutting problems: CHANGE is interested in the full array of health behaviour challenges, however, the project has chosen as priorities a number of problems that cut across several technical areas:

• Problems Resulting From "Deadly Delay" – Why do family members sometimes delay seeking treatment until the consequences have become deadly? CHANGE is interested in looking at why people act when they do - what are their cues for high risk, or severity of a condition, for example? What other factors motivate people to act?
• Problems Related to Obtaining and Taking Medicine – CHANGE is interested in looking at various factors that influence adherence (and lack of adherence) to drug protocols.
• Problems Associated with Health Worker Performance – What are the critical elements of effective health worker/client interaction? What are the elements of effective training? How do we motivate health workers who are unpaid and overworked?
• Problems Related to Household Habits – Good health for women, children and infants begins in the home. Many healthy practices such as breastfeeding and hand washing do not even strike people as "disease-related.”

CHANGE invites both formal and informal collaboration from groups and individuals. This interactive format helps the organization and its participants to identify critical health behaviour problems and alerts them to behaviour challenges for which current approaches do not seem to be effective. CHANGE attempts to reach out to policy and programme development officials and create collaborative solutions. Use of the Internet, ICTs and conferencing technologies allows this to occur on a global scale. All types of participants are invited to work with the ToolxCHNAGE to develop and apply tools, to evaluate tools and approaches already in use and search for universal applications and identify new tools that might be useful in addressing their priority health issues. Program implementers, funders responsible for programs, or researchers who think one of these tools or approaches is relevant to their intervention or for testing in their site are also encouraged to contact the organisation.

Partners: The CHANGE Project is implemented through a USAID cooperative agreement with the Academy for Educational Development, in collaboration with the Manoff Group.CHANGE is implemented in partnership with USAID field missions, USAID-financed collaborating agencies, international agencies and US-based and local Private Voluntary Organizations (PVOs).