Tools for High-Quality Nutrition Social and Behavior Change Programming: A Key to Achieving Positive Nutrition Outcomes

"We know that quality social and behavior change (SBC) is crucial to achieving nutrition outcomes; however, high-quality nutrition SBC is challenging to put into practice."

Offered by the United States Agency for International Development (USAID)'s flagship multi-sectoral nutrition project, USAID Advancing Nutrition, this suite of practical tools is designed to help programmers achieve high-quality nutrition social and behaviour change (SBC). Nutrition SBC is particularly challenging due to the nature of the behaviours: small, frequent, and additive. Building on partner experiences and lessons learned, the tools are meant to harmonise design, implementation, and monitoring and evaluation (M&E) of nutrition SBC programmes in food and health systems.

These tools were first introduced during a webinar in December of 2020 (see the video recording, below) and are meant to support each of the six steps in SBC programming:

1. Prioritise behaviours: Priority behaviours guide formative research and SBC strategy development to achieve intended SBC. Because no SBC team can do everything, the resources in this step are designed to: present a simple step-wise process to help narrow the focus and avoid overloading or overwhelming people and programmes; highlight 6 core nutrition-specific behaviours; and outline illustrative nutrition-sensitive agriculture behaviours that can spark ideas and discussion.
2. Plan and conduct research: To improve behaviours, it is key to understand the main barriers and enablers that may prevent individuals from, or support them in, practicing a behaviour. Tools offered here enable you to: explore the literature on the possible factors that influence someone to practice and maintain nutrition-related behaviours; and then select formative research methods to answer research questions from gaps in the literature to better understand people and their context.
3. Design a nutrition SBC strategy: An SBC strategy provides a roadmap to ensure that interventions address the critical factors that will improve the priority nutrition behaviours. The reader can: explore examples of nutrition SBC strategies (e.g., USAID Ethiopia Growth through Nutrition; USAID Rwanda Orora Wihaze; USAID Cambodia NOURISH; and multiple examples in the Nutrition Social and Behavior Change Strategy Library); learn how to organise research into an evidence-based SBC strategy; and access a step-by-step process for distilling research findings and applying them to programmes.
4. Plan for implementation and monitoring, evaluation, and learning: At this stage, one can: use a checklist to consider SBC content to include in an annual work plan or assess a draft work plan; use a tool that helps guide hiring decisions, identify areas for capacity strengthening, and track changes in performance over time; look at the core competencies to help plan capacity strengthening activities for community health workers and others on the frontline; and access resources and examples to integrate gender at each phase of a nutrition programme.
5. Implement, monitor, and adapt: In order to make timely adjustments to programmes, it is critical to monitor changes in identified nutrition-related behaviours, including the factors that may prevent or support behaviour change. The tools here are designed to help and include: "Social and Behavior Change Do's and Don'ts: Getting It Right for Multi-Sectoral Nutrition Programming", "Monitoring Social and Behavior Change for Multi-Sectoral Nutrition", and "Focusing on Social Norms: A Practical Guide for Nutrition Programmers to Improve Women's and Children's Diets".
6. Evaluate: Strong evaluations are key to achieving high-quality SBC. Resources that might be useful in that quest include "Evaluating Social and Behavior Change Components of Nutrition Activities: A Design Guide for USAID Staff" and "Measuring Social and Behavior Change in Nutrition Programs: A Guide for Evaluators", which are available here.