Stigma, a mark of disgrace and disapproval from society, can generate shame and social isolation. Historically, patients with infectious diseases have experienced stigma and discrimination. Further, fear of social stigma, discrimination, and shame can lead sick patients to delay or not seek care for their condition. This research-practice collaboration qualitatively explored experiences with COVID-19-related stigma through interviews and focus group discussions across six conflict or post-conflict regions in Sudan. Data from 69 transcripts were analyzed to understand the lived experiences of recovered Sudanese COVID-19 patients and their surrounding network (i.e., family, community members, healthcare workers).
Though often not referred to directly by name, stigma was noted across all participant groups. It manifested in three primary ways: instances of witnessing stigma, experiencing stigma, and of perpetrating stigma. Experiencing stigma can lead to (and was often noted to result in) feelings of sadness, fear, and isolation. Healthcare workers and community members were most likely to report perpetrating stigmatizing behaviors, leading to self-reports of isolating or avoiding stigmatized others. Lastly, witnessing stigma led some to suggest that witnessing stigmatizing behaviors led community members to hide their diagnoses to avoid negative social consequences.
 
Research further supported that support mechanisms are critical to individuals and families affected by COVID-19. Decision makers are encouraged to increase access to psychosocial support services in order to reach those impacted by COVID-19 where possible. This can include using behavioural and community engagement interventions to directly address COVID-19 related concerns.

Many children struggle to master basic skills despite a rise in school enrollment around the world. For instance, India's 2018 Annual Status of Education Report (ASER) found that only about half of all grade 5 students in rural India could read a grade 2 text. Assessments showed similar results in many other countries. The Covid-19 pandemic, which took 1.6 billion children out of school, further exacerbated this  loss. Programs providing information - about parents' roles in education, school quality, students' academic levels, financial aid, and wage returns to education -  address this lack of learning by making relevant information more available.


Results from 23 randomized evaluations from low-, middle-, and high-income countries show that overcoming a gap in knowledge about education often increases parental engagement, student effort, or both, leading to improved learning . Almost all of the programs led to an increase in parental involvement or student motivation, which led to small to medium increases in learning. However, disseminating information has not improved learning levels when key health, financial, or structural barriers persist that information alone cannot overcome, or when the information is discouraging, rather than encouraging, to students.


Because information-based interventions are typically very low cost and have been effective in many contexts, policymakers interested in increasing learning outcomes should consider if there are gaps in parent or student knowledge that they can overcome. This presentation will discuss some of the ways that information-based interventions have been successful, as well as implementation lessons.

Two years after the pandemic hit in 2020, social and behavior change communicators continue to take the cudgels, battling the COVID-19 global infodemic from local and community frontlines. COVID-19 response teams around the world have used social listening to navigate through the public health emergency's complex information ecosystem. In the Philippines, the Department of Health (DOH) is working together with USAID Breakthrough ACTION (BA) to sustain info-awareness initiatives and convey COVID-19 health solutions to various publics. 
Social listening helped DOH in feedback gathering, measuring its program effectiveness based on public perception and sentiments. Monitoring news and social media provided a holistic understanding of the shifting narratives surrounding public policy and scientific progress in relation to the government's COVID-19 response, enabling communications strategies and messaging to adjust accordingly. Moving from weekly to bi-weekly reporting, challenges on the time gap from data gathering to reporting resulted in limitations in responding to urgent issues. Nonetheless, results still provided insights useful in organizational decision-making. Through a periodic sweep, social listening enables DOH to "go back in time", analyze, and improve its public responses. Moreover, the opportunity is there to explore social listening as a monitoring and evaluation tool to support impact research, lessons learned activities, and after action reviews. 

The intended impact of the program is proper management of COVID-19 symptoms with pre-existing medical conditions like Diabetes,Hypertension etc, prevention of virus spread from patient to others at home and in the community, ability to recognise danger signals early to seek care and Improved outcomes for positive patients.The main idea behind this study was to test the scope of an effective family health education intervention being remote, safe, cost effective and readily scalable, in order to improve patient outcomes and reduce healthcare costs for COVID-19.Results from this study indicate that this remote, teletraining counseling program can reduce likelihood of hospitalisations.Amongst those who were trained, there was a 48% less likelihood of hospitalisations compared to those who remained untrained.Further evaluations are needed to understand the pathways and replicability of these findings.

La stratégie nationale de riposte à la COVID19 au Maroc s'est démarquée au niveau mondial, Le bureau de l'UNICEF au Maroc s'est mobilisé pour appuyer le Ministère de la Santé et de la Protection Sociale (MSPS) et ce à plusieurs niveaux ; en termes de Communication de Risque et Engagement Communautaire (RCCE), plusieurs axes d'intervention ont été identifiés et initiés avec plusieurs départements institutionnels et la société civile :
Communication de masse à travers les différents canaux médiatiques et réseaux sociaux en coordination avec les partenaires clés et notamment le MSPS ;Communication interpersonnelle et engagement Communautaire ;L'Engagement des jeunes et adolescent.e.s. à travers la mise en œuvre d'initiatives avec et par les jeunes ainsi que la cocréation de contenus de sensibilisation ;Plaidoyer public pour la réalisation des droits des enfants en situation de pandémie avec la mobilisation de célébrités et enfants défenseurs des droits de l'enfant ;Le renforcement des capacités des acteurs nationaux en matière de RCCE ;La génération d'évidences pour orienter la planification RCCE ;Le développement et la mise en œuvre de partenariats innovants.

Despite the importance of vaccines being well documented (Cella et al., 2020), during the COVID-19 pandemic, public health officials were challenged with people's hesitation to get fully vaccinated against COVID-19. Vaccine hesitancy was identified as one of the top ten global health threats in 2019 (WHO, 2019). As of March 2022, 16% of Ghana's population is fully vaccinated. This two-part study leverages a behavioural insights (BI) approach to detect implicit drivers of vaccine acceptance in Ghana. The proposed BI approach employs a Define, Diagnose, Design and Test methodology. First, a survey administered using an Interactive Voice Response (IVR) system focused on respondents' vaccination status, their intentions to get vaccinated in the future, self-reported attitudes towards the vaccine, and factors such as perceived risk, social norms, and ease of getting vaccinated. After completing this part of the survey, respondents heard a jingle encouraging them to get vaccinated and were again asked about their intentions. Respondents were randomly assigned to one of six messages, which varied with respect to the messengers portrayed (i.e., healthcare workers, doctors, and religious leaders) and the message framing (i.e., fear, altruism, and social norms). All data have been collected, and at the time of this writing, data analysis is nearing completion, which includes confirmatory factor analysis (CFA), analysis of variances (ANOVA), chi-square tests, multiple regression, and relative weights analysis. The results of this study will play a crucial role in understanding vaccination behaviours and developing effective COVID-19 vaccine campaigns in Ghana.

Even though the World Health Organization (WHO) recommended the uptake of vaccines to reduce the effect of Coronavirus Disease of 2019 (COVID-19) across the world, there was a lot of misinformation about its efficacy across different communities in Nigeria. These included conspiracy theories around population control, change of genetic composition, potential to cause sterility, amongst others. 
This made accelerating uptake of COVID-19 vaccines very difficult especially within rural communities. Sokoto State, which is a religious powerhouse within the country had one of the lowest uptake of the vaccines in Northern Nigeria with only 1.58% of the eligible population having received their first dose as at December 2021. Whereas, Nigeria has a national target of at least 50% uptake of the vaccines among the eligible population by March 2022.
Considering the importance attached to religion in Sokoto state, the United States Agency for International Development (USAID) funded Breakthrough ACTION project collaborated with the State's health officials to engage religious and traditional leaders to identify the reasons for vaccine hesitancy, debunk rumors and provide them with accurate information. This helped the religious leaders to develop their own key messages to encourage vaccine uptake within their communities. Through this effort, the number of fully vaccinated persons in Sokoto state increased by five-fold in two months. 
Identifying and engaging trusted voices such as religious leaders as behavior change agents is critical to improve outcomes of public health responses especially during emergencies, as this helps to build confidence in recommended behaviors.

While health provider capacity hampers service delivery in low-resource setting, behavior change interventions can be used to improve skills and knowledge. Many countries rely on didactic training with minimal on-the-job exposure. Coaching as an intervention can help reduce the skills gap while ensuring retention of knowledge among health providers even with exit of funders.

April 2019 marked an HIV epidemic in Ratodero Town, District Larkana, Pakistan, where over 1100 children were diagnosed with HIV. Previous HIV campaigns have relied upon medicalized messaging, which may have further perpetuated stigma. To address stigma against people living with HIV (PLHIV), a contextualized three-month-long mass communications campaign, Sujaag (meaning 'To-Awaken'), was piloted in Ratodero Town  - the epicenter of the outbreak. 
Formative research conducted through a survey with 404 respondents, revealed that people held negative perceptions towards children and adults living with HIV (scores of 67% and 69% respectively). Focus Group Discussions (FGDs) revealed that the majority of community concerns were non-medical and centered around the social aspects of the disease. In light of this context, the campaign focused on strengthening social ties for PLHIV: Rishta Na, Soch Badlio (meaning 'change mindsets, not relationships'). Branded local vehicles, interactive social media, and television advertisements, were deployed around this key message.
At the campaign's conclusion, 395 respondents were surveyed: 30.3% were exposed to at least one campaign feature. Those exposed had an aggregate score of 72%, reflecting a moderate to high HIV knowledge and perceptions score, compared to 63% amongst those not exposed. Post-campaign FGDs indicated that emphasis on lived realities had an impact on PLHIV and their families' communal lives.
Sujaag aligned the campaign to community insights and showcased destigmatizing attitudes via narrative of communities celebrating life together. Contextual campaigns building social capital can address HIV stigma effectively by improving knowledge and perceptions.

PLM is a public-private partnership that deploys The Coca-Cola Company's supply-chain management and marketing expertise to support African governments in strengthening access to and uptake of health commodities and services. With support from USAID, since September 2021 PLM has worked with the NDoH in South Africa to improve uptake of COVID-19 vaccines. 
In the early stages of the COVID-19 vaccine roll-out, NDoH needed to share how, why, and where eligible and willing population segments could be vaccinated. As vaccine roll-out progressed and COVID-19 restrictions relaxed, there was increased complacency and a reduced sense of vaccination as a priority, slowing vaccine uptake rates, particularly amongst young people.
Initially, PLM implemented a mass media strategy, reaching an average of 27 million people per month through mass media channels. In early 2022, as vaccine uptake slowed, a need for more targeted interventions emerged. PLM began to test a range of non-traditional platforms to reach and motivate segments with low vaccine uptake, especially focused on youth 12-35Y.
These interventions included engaging with TikTok and Radio DJ influencers, nudges and incentives, micro-influencers, and community influencers to spread approved vaccine messaging. The digital format for the campaigns enabled innovative approaches to evaluate the impact of the campaigns.
Learnings from the non-traditional platforms tested can offer insights on how to effectively adapt and tailor different communications platforms as risk communications needs evolve, and how to leverage a range of communications interventions to reach specific target groups.

Le COVID-19 a changé le mode vie avec les confinements et les distanciations sociales obligatoires.  Chacun est resté chez lui tout en essayant de rester connecté aux autres grâce aux réseaux sociaux, notamment Facebook.  Il a été ainsi utilisé comme un canal de communication, notamment dans la lutte contre le COVID-19 et  la vaccination.
PSI Madagascar a bénéficié d'une opportunité de collaboration avec Facebook qui a octroyé une formation en ligne pour optimiser l'utilisation de ce réseau social, en tant qu'outil de communication pour le changement social et comportemental dans la lutte contre le COVID-19. Un crédit de communication a été également alloué pour faire des publications boostées. 
Trois phases de campagnes de communication ont été menées d'Avril à Décembre 2021. A chaque phase, différents constats et leçons ont été tirés afin d'augmenter le nombre de personnes atteintes ainsi que les réactions obtenues.
Utiliser Facebook comme outil de communication offre de nombreuses possibilités et avantages comparativement aux canaux traditionnels. En effet, on peut piloter et ajuster plus rapidement les campagnes, comme le choix des visuels, messages, ciblages précis … et surtout avoir une plus grande interaction avec le public.
Cependant, dans le cas présent du COVID et de la vaccination, le changement social et comportemental est complexe car il résulte de multiples expériences, influences, croyances et valeurs personnelles. Faire évoluer les attitudes à l'égard des vaccins par Facebook seul est insuffisant. D'autres interventions de communication complémentaires à plusieurs niveaux (masse, personnel, communautaire, institutionnel) sont nécessaires.

Across the globe behavioral research is being used to understand what motivates individuals to get vaccinated against COVID-19. Behavioral models and theories ground much of this research but scaled items to measure motivation are not readily available to practitioners. As part of our COVID-19 vaccine demand creation work, FHI 360 developed scaled items to measure elements of motivation based on the BJ Fogg Behavioral Model (FBM). According to the FBM, elements of motivation include hope and fear, pleasure and pain, and social acceptance and rejection. 
 
Using the FBM as a guide, we conducted formative research to understand people's motivation to get vaccinated against COVID-19 in Yopougon Est, Cote d'Ivoire. Data from this formative research were used to develop scaled items for each FBM element. We then used cognitive interviews to assess whether the scaled items accurately measured the elements of interest for people in Yopougon-Est. 
 
In this poster, we describe our experience developing and testing scaled items to understand determinants of COVID-19 vaccination uptake in Côte d'Ivoire. We present the final items and discuss strategies for using cognitive interviews to contextualize them. These scaled items can be adapted and used by practitioners to understand motivational factors of vaccine uptake and hesitancy in other contexts. 

UNICEF, together with the Uganda Ministry of Health (MOH) and other partners adopted U-Report as a risk communication tool to help combat the spread of the COVID-19 pandemic. U-Report, through polls, alerts, and the COVID-19 vaccine chatbot was used to reinforce key messages on COVID-19 preventive measures, vaccine awareness campaigns, and assessments on vaccine compliance and acceptance.
Overall, 135,885 U-Reporters benefited from the RCCE interventions including through the COVID-19 vaccine chatbot, polls, alerts and awareness messages conducted in response to the vaccine hesitancy. Data received from the rapid assessment on vaccine acceptance and compliance polls enabled UNICEF and MOH communications teams to address concerns and safeguard against anti-vaccination rumors and misinformation. 
U-Report is best positioned for use as a risk communication and community engagement (RCCE) tool during emergencies and disease outbreaks. Dissemination of life saving information and flagging out emerging issues within the communities across the country is another effective use of the tool. The platform is fast, cost-effective, reaches many people at once, and provides opportunities for direct communication with affected people including those in hard-to-reach areas.

Low modern contraceptive use among youth in Cambodia and recognition of young adulthood as a critical period to establish social norms and behavioral patterns led Population Services International's Promoting Healthy Behaviors Activity (PHB), with funding from USAID, to design a digital campaign for youth to provide a safe space for youth in Cambodia to learn about sex and sexuality, prevent unplanned pregnancy and plan for their future. The results of the six month campaign, launched in January 2022, will be assessed through social media data and a pre and post quiz advertised on Facebook at the start and end of the campaign measuring changes in knowledge, attitude and social norms on SRH and modern methods, and misconceptions around FP use.
Till date the digital campaign has reached over 800,000 youth. The pre-assessment quiz, completed by 182 youth aged 18-29 years old in Phnom Penh in early 2022, found that only 24% of youth correctly recall the five modern methods of contraception (male condom, pills, injection, implant and IUD). 14% of participants incorrectly stated that use of modern methods will affect future fertility while 19% believed that prior use of an IUD will affect future fertility. 37% of respondents believe that women need their partners approval before using contraception. Youth are a critical priority for SRH SBC interventions and the exclusive use of digital tools and youth-friendly digital touchpoints can provide a sustainable and cost-effective way to raise awareness of SRH issues and encourage use of modern contraception.

As the national lockdown eased off and people returned to a semblance of their normal life, risk perception decreased as evidenced by a low-level of compliance with non-pharmaceutical preventive measures. To address this, the Center for Communication and Social Impact (CCSI) supported the design and implementation of the Powerful HANDS campaign.
The Powerful HANDS campaign was a national, social and behaviour change (SBC) communication campaign in Nigeria, targeted at reducing the spread of COVID-19 by increasing the adoption of non-pharmaceutical preventive measures. It communicated the key message that "the power to stop Covid-19 is in our H.A.N.D.S". The acronym HANDS innovatively depicts the five key COVID-19 preventive actions in a simple manner:
H- Have your hands washed or sanitized frequently; A-Always cough or sneeze into your elbow;  N- No going out without a face mask;  D- Distance of at least two arm's length should be maintained; and  S - Stay indoors and self-isolate if you feel sick. This abstract shares learnings from the implementation of the HANDS campaign which include positive behaviour deviants, leveraging on existing structures and engaging persons living with Disability (PLWDs). Key lessons drawn from the implementation of this campaign include managing distrust of the government regarding  Covid-19 through other community structures such as market leaders. Also, in programming for PLWDs, lessons include need to  modify  COVID19 messaging for this group as they might require a human aid thereby rendering physical distancing impossible to practice.

Formative research under the Mpilo project in South Africa found that a lack of safe, relatable sources of support was a significant barrier to engagement with HIV testing and treatment. In response, we conducted a series of workshops with 82 men, aiming to design 'the right source of support'. The Coach Mpilo model emerged from that process.
Coach Mpilo employs men living well with HIV, both clinically and psychosocially, as life coaches to men who are struggling with various barriers. Coaches provide one-on-one mentoring, tailored to each client's needs, drawing on personal experience.
The Coach Mpilo pilot showed high acceptability, feasibility, and effectiveness. 96% of clients were linked or returned to treatment during the pilot period, of which 95% were retained in care at pilot endline. 16% experienced at least one treatment interruption, though 82% of those returned to treatment during the pilot period.
The Coach Mpilo model demonstrates that a PLHIV-led peer support approach can be acceptable, feasible and effective in helping men overcome barriers to HIV treatment and achieving high rates of linkage and early retention. 
The model also demonstrates that the right messenger is as important as the right message. By leading with personal vulnerability and drawing on lived experience, coaches have been able to break through to their clients in a way that other healthcare providers have struggled to do.
Coach Mpilo challenges the conventional wisdom that men are 'difficult' or 'hard to reach'. It may just be that they need the right source of support.

Contraceptive use among young women in Nairobi remains low despite high general knowledge of family planning methods. This paper draws on social norms theory to explore the role of key influencers in women's FP use and how women anticipate normative reactions or sanctions from partners, parents and friends. This qualitative study was conducted with 16 women, 10 men and 14 key influencers across 7 peri-urban wards in Nairobi, Kenya in 2020. Interviews were conducted by phone and data was organized into themes identified during the analysis. Our findings suggest that women consult various key influencers based on the information they need or the choices they are making in relation to family planning. Women identified parents, specifically mothers, aunts, partners, friends and healthcare workers as their preferred contacts on family planning. Their interactions with key influencers shaped their decisions to use or access FP based on a key influencer's experiences, information and norms they perpetuate or challenge on FP. Our findings have implications for interventions aiming to increase family planning among young women and underscore the importance of network-level intervention delivery, of considering the normative influence key actors have on women's FP choices, and of targeting social norms surrounding family planning use to challenge misconceptions and misinformation.  

The COVID-19 Peer Hub is the world's largest network of sub-national immunization and other Primary Health Care (PHC) professionals, nurtured by The Geneva Learning Foundation (www.learning.foundation) and connecting  over 43,000 health professionals from 137 countries, across system levels and national and organizational boundaries. More than 80% of participants work in districts and health facilities and over half are government workers. Over four weeks in November 2020, in response to the inadequacy of prescriptive guidelines and descriptions of hesitancy, 734 Peer Hub participants developed, peer reviewed, and revised their own case studies, each one describing and analyzing a situation in which they had used their own, local capacity to help an individual or group overcome initial hesitancy or fear of vaccination, leading to vaccine acceptance. The primary purpose of the case studies was to foster reflective learning between peers, many of whom were likely to become involved in COVID-19 vaccine introduction. This peer learning exercise had startling effects, above and beyond expectations, for individual participants, to strengthen the network they formed, and for their countries' readiness for COVID-19 vaccine. Supporting health workers, already recognized as trusted advisors to communities, requires new ways of listening, new ways of supporting, new ways of measuring, documenting and learning. It also requires new ways of recognizing the leadership of immunization staff who work at the local level under often difficult conditions.

The USAID-funded Breakthrough ACTION project includes behavioral design activities related to COVID-19 vaccine acceptance and uptake across a range of countries, including Liberia, Cote d'Ivoire, and Cameroon, targeting priority populations like facility-based health providers as well as the general population. We leveraged insights from behavioral science and qualitative, contextual investigation in each country to identify key behavioral barriers and channels to vaccination. Given overlapping barriers and channels, several innovative and behaviorally-informed solutions have resonated across country co-creation workshops and are currently being adapted through iterative user testing to their respective contexts. These include a peer invitation to the vaccine, intended to increase the visibility of peers who have successfully vaccinated by prompting people to explain why they got the vaccine and to encourage their peer to get vaccinated as well. Another example is a professional forum in which influential health workers are invited to hear tailored information about the vaccine and have the opportunity to ask questions to a trusted source. We will share insights from the user testing process on how these solutions were received in their respective contexts, and any additional insights from piloting and scale-up to share later this year. While there are differences in specific vaccine concerns and priorities across populations, there are also emerging behavioral insights that continue to resonate strongly across contexts. They can be leveraged immediately to support uptake in LMICs with low vaccination rates and a large "moveable middle" expressing some hesitancy to vaccinate.