What Drives Knowledge Seeking, Sharing, and Use Among Family Planning Professionals? Behavioral Evidence From Africa, Asia, and the United States

"There is an urgent need for health care professionals worldwide to access, share, and apply evidence-based and experiential knowledge to enhance health systems, achieve health and development objectives, and, ultimately, improve people's health and lives."

Family planning and reproductive health (FP/RH) professionals often do not fully engage in the cycle of knowledge seeking, sharing, and use, despite the importance of doing so. Behavioural economics (BE) can explain why this is the case and can be used to help design knowledge management (KM) activities and solutions that mitigate barriers and are driven by the needs of healthcare professionals. One project incorporating the BE approach is Knowledge SUCCESS (Strengthening Use, Capacity, Collaboration, Exchange, Synthesis, and Sharing). Knowledge SUCCESS is a supported by the United States Agency for International Development (USAID) and led by the Johns Hopkins Center for Communication Programs (CCP). This article shares findings from research conducted by Knowledge SUCCESS to identify the behavioural factors that increase or hinder the likelihood of FP/RH professionals engaging in KM to improve their programmes.

The researchers conducted an online survey, in-depth interviews, and cocreation workshops between July 2019 and June 2020 with FP/RH professionals in Africa, Asia, and the United States (US) to explore their KM behaviours. The samples consisted of 273 survey respondents from 52 countries, 23 interviewees from 14 countries, and 69 cocreation workshop participants from 21 countries. There were no significant differences in how professionals seek and share information by gender, role, or geographic region, except related to language barriers among Francophone professionals. FP/RH professionals reported using both digital sources and their professional networks to seek and share information.

The researchers identified 2 key behavioural barriers - choice overload (when people are presented with too much information) and cognitive overload (when too much information is presented in a way that is hard to understand) - that impede FP/RH professionals' ability to seek and use information effectively. Too many information sources lead to frustration and inaction, and best practices are often not contextualised or specific enough for application. To address these barriers, it may be useful to empower healthcare professionals to curate their own "one-stop shops" for information with minimal effort. It is also important to ensure that information documents programme implementation in enough detail, including key information about context, to facilitate replication and adaptation of best practices among other professionals.

Two other concepts - social norms and incentives - can act as either barriers to or opportunities for effective information sharing. Three-quarters of the survey respondents indicated that their organisations had positive KM cultures that encouraged information sharing. Structured opportunities where sharing is an expectation, such as collaborations and partnerships, can strengthen positive norms. However, reluctance to share information persists due to fear of losing comparative advantage. In terms of incentives, FP/RH professionals are typically driven by an inherent desire to share their knowledge with peers and colleagues to improve the effectiveness of their programmes. However, data suggest the behaviour of sharing information is often reactive, conducted when someone specifically asks for information.

These findings suggest several types of interventions to foster positive social norms that encourage information sharing and to incentivise people to do so:

• Recognise individuals and organisations for sharing useful information (e.g., "badges" linked to a person's profile or acknowledgment in a special section of a community newsletter for "champion" knowledge sharers).
• Create spaces for learning and sharing as part of established meetings, communities of practice, and conferences, using standard templates or platforms, formats, and features that are familiar to people, such as social media sharing icons, email communication, chat apps, and informal discussions.
• Provide feedback to people whenever others use their contributions, such as verbal recognition or in the form of a usefulness rating scale.
• Use a multifaceted KM approach that includes interactive techniques via meetings and communities of practice in addition to online platforms and tools to help reinforce the social norms of robust information sharing.

"The insights from this research have shaped the focus of new KM solutions developed by the Knowledge SUCCESS project, including FP insight, a user-driven resource curation and discovery platform, and Learning Circles, an interactive learning series focused on the details of what works and what doesn't in FP/RH programs.....The findings also have the potential to benefit and inform the KM approaches and practices of other global health projects and organizations."

Editor's note: On June 16 2022, Knowledge SUCCESS hosted a webinar to explore the question: What can we do to motivate the FP/RH workforce to share more information about what works and what doesn't work in FP/RH? Click on the video below to watch the recording.