Governance, Systems Strengthening, and Accountability

The Food and Nutrition Education (EAN) mobile application, developed by CARE Guatemala, is an innovative digital tool designed to strengthen nutrition education in schools and communities. By combining interactive learning with CARE's proven in-person methodologies, such as Farmer Field and Business Schools (FFBS) and school-based training, the app enhances the sustainability and scalability of social and behavior change communication (SBCC) processes.
The app addresses one of Guatemala's most urgent challenges: high rates of child stunting and malnutrition. Through 10 thematic modules, it equips teachers, women educators, and community leaders with practical knowledge and tools on food security, healthy diets, hygiene, and household well-being. Its interactive design allows users to progress through modules, complete self-assessments, and earn a certificate, making it attractive and engaging for diverse audiences.
Breyond providing information, the app enables households translate theoretical knowledge into action, promoting healthier diets and improved hygiene. In doing so, it contributes to breaking the intergenerational cycle of child malnutrition in Guatemala. At the same time, it empowers teachers and women leaders as change agents who multiply knowledge within their schools and communities.
This multimedia showcase will present the app0s design and implementation, highlight early results such as improved nutrition knowledge, healthier food choices, and greater family engagement, and explore its potential for scale in similar contexts. This submission aligns with the sub-theme "Action and Impact: Mobilizing Systems for Collective Resilience."

Social and Behavior Change (SBC) has emerged as a cornerstone for achieving sustainable health outcomes and advancing national goals. The Breakthrough ACTION project supported 126 local civil society partners across the globe who then invested their own resources to sustain SBC interventions, signaling strong local ownership and institutionalization beyond donor support. Increasingly, governments are recognizing SBC as a strategic investment-demonstrated, for example, by growing national budget allocations for family planning demand creation in Senegal, Burkina Faso, Niger, and Côte d'Ivoire or malaria prevention and treatment in Guyana. 
This presentation highlights how participatory approaches, evidence generation, and advocacy have catalyzed policy and financial commitments to SBC. Data and experiential learning show that positioning SBC as both a behavioral and structural intervention enhances health system performance, accountability, and community trust. By integrating SBC into national costed implementation plans, budgets, and cross-sectoral coordination mechanisms, governments are institutionalizing the approach as a permanent element of system design rather than an ad hoc intervention.
Findings from the project reinforce that investments in SBC connects communities to systems, strengthens local leadership, and enables governments to adapt and respond to evolving health and social challenges. The lessons presented offer a scalable model for mobilizing systems that respond to, and are sustained by, the people they serve. It further provides a roadmap for institutionalizing SBC within national strategies, budgets, and implementation frameworks to achieve people-centered health systems.

Somalia faces major public health challenges, including low uptake of sexual and reproductive health (SRH), family planning (FP), and immunization services. In 2020, immunization coverage was only 11%, contributing to repeated outbreaks of vaccine-preventable diseases. Maternal mortality remains high at 563 deaths per 100,000 live births, driven by conflict, weak health infrastructure, sociocultural barriers, and widespread misinformation that undermines trust in health services. Community Health Promoters (CHPs) play a crucial role in bridging these gaps by promoting behavior change and mobilizing households for essential services. Their effectiveness, however, has been limited by inconsistent training, weak supervision, and the absence of a unified Social and Behavior Change (SBC) framework. To address these challenges, the Ministry of Health, with partner support, implemented a structured CHP empowerment program to strengthen community-level service delivery and monitor key health outcomes. The program included capacity-building, job aids, uniforms, transport support, and structured supervision. Its impact was assessed using pre- and post-intervention Health Information System (HIS) data and descriptive analyses. Following implementation, immunization coverage rose from 11% to 68% by 2023, maternal mortality declined, and FP and SRH service utilization improved significantly. Motivation and accountability among CHPs increased through regular supervision, incentives, and stronger community trust. Somalia's CHP empowerment model demonstrates that structured, SBC-aligned community health systems can enhance resilience, improve service uptake, and support sustainable outcomes in fragile contexts, offering lessons for countries seeking to institutionalize community-based health promotion within national SBC and primary health care frameworks.

La República Dominicana redujo significativamente la incidencia de uniones tempranas entre 2019 y 2024. El porcentaje de mujeres entre 20-24 años casadas o unidas antes de los 18 años bajó de 31.5% a 24.9%, y antes de los 15 años de 9.4% a 4.8% (ENHOGAR-MICS). A este logro contribuyó la implementación del programa multisectorial de prevención de uniones tempranas, acompañado por UNICEF y aliados, enfocado en estrategias de cambio social y de comportamiento.
Desde 2017, UNICEF ha generado evidencia para el diseño de una Estrategia SBC, orientada a eliminar el matrimonio infantil y reducir las uniones tempranas. En este marco, se impulsaron campañas de sensibilización pública y procesos de abogacía política, que en 2021 contribuyeron a la reforma legislativa que prohibió el matrimonio infantil y al lanzamiento de la Política Nacional de Prevención de Uniones Tempranas y Embarazo Adolescente, consolidándose un marco sostenible de acción pública.
Paralelamente, en 2019 inicia la implementación del primer programa público multisectorial de prevención de uniones tempranas en nueve municipios priorizados, diseñado con un enfoque transformador de normas sociales. Las intervenciones basadas en el modelo socioecológico incluyeron Clubes de Chicas para promover su empoderamiento, herramientas educativas integradas en secundaria, intervenciones con hombres para promover masculinidades positivas, formación de servidores públicos, entre otras. 
Este caso evidencia que, cuando SBC combina evidencia, participación comunitaria, abogacía política y articulación intersectorial, puede transformar normas sociales profundamente arraigadas. La experiencia dominicana constituye un referente regional para escalar intervenciones sostenibles, generar cambios culturales y garantizar los derechos de niñas y adolescentes.