Democracy, Conflict, and Governance | Research | Sexual and Reproductive Health and Rights (SRHR) Aud des Ambassadeurs Preformed Panel Presentation
Dec 08, 2022 04:50 PM - 06:15 PM(Africa/Casablanca)
20221208T1650 20221208T1815 Africa/Casablanca The ABCs of PBC: Applying a Systems Lens to Provider Behavior Change (PBC) for Sustainable Change and Impact

Moderated by Olivia Carlson, Breakthrough ACTION, this panel will facilitate a practice-oriented discussion on applying a system lens to provider behavior change (PBC) efforts for creating sustainable change and impact. The panel will bring together four experts in Social and Behavior Change (SBC), quality improvement for family planning, and health system strengthening to discuss different modalities to address provider behaviors and create dialogue among key stakeholders.

The first panelist from Breakthrough ACTION will present the comprehensive Provider Behavior Ecosystem Map to set the context and direction for the remaining presentations. The panelist will focus on the components, need, rationale and value of designing PBC efforts, followed by three interventional case studies showcasing PBC strategies and solutions at different levels of the Ecosystem Map

The second panelist from Pathfinder will present the Beyond Bias PBC intervention operating at the individual, facility level. The panelist will highlight successes and challenges and the need for synchronizing the solution within institutional quality improvement systems and complementing it with institutional and community-based strategies for PBC. 

The third panelist from Care will share a community-based solution, showcasing Community Score Cards approach and sharing considerations for programmers on community-based strategies for PBC with specific challenges and recommendations for synergizing efforts with individual and institutional level approaches for PBC.

The fourth panelist from Results for Development (R4D) will present institutional approaches, demonstrating the application of the Market Systems Framework to guide context-specific adaptations for PBC, and how they m ...

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Moderated by Olivia CarlsonBreakthrough ACTION, this panel will facilitate a practice-oriented discussion on applying a system lens to provider behavior change (PBC) efforts for creating sustainable change and impact. The panel will bring together four experts in Social and Behavior Change (SBC), quality improvement for family planning, and health system strengthening to discuss different modalities to address provider behaviors and create dialogue among key stakeholders.

The first panelist from Breakthrough ACTION will present the comprehensive Provider Behavior Ecosystem Map to set the context and direction for the remaining presentations. The panelist will focus on the components, need, rationale and value of designing PBC efforts, followed by three interventional case studies showcasing PBC strategies and solutions at different levels of the Ecosystem Map

The second panelist from Pathfinder will present the Beyond Bias PBC intervention operating at the individual, facility level. The panelist will highlight successes and challenges and the need for synchronizing the solution within institutional quality improvement systems and complementing it with institutional and community-based strategies for PBC. 

The third panelist from Care will share a community-based solution, showcasing Community Score Cards approach and sharing considerations for programmers on community-based strategies for PBC with specific challenges and recommendations for synergizing efforts with individual and institutional level approaches for PBC.

The fourth panelist from Results for Development (R4D) will present institutional approaches, demonstrating the application of the Market Systems Framework to guide context-specific adaptations for PBC, and how they may be adapted across public and private sectors.

Using a Health Market Systems Approach to Understand the Incentives and Drivers Influencing Public and Private Providers Differently and to Design Strategies to Align Provider Behavior to Achieve UHC
Preformed Panel 04:45 PM - 06:15 PM (Africa/Casablanca) 2022/12/08 15:45:00 UTC - 2022/12/08 17:15:00 UTC
Healthcare providers operate in complex systems that influence what a healthcare provider can do and act. However, current efforts to understand and change provider behavior have mostly focused on public providers. Excluding private providers from these efforts will compromise low-and middle-income (LMIC) ability to achieve Universal Health Coverage (UHC) goals. Recent studies estimate that over 35% of outpatient care in LMICs is offered in a private facility; more than 50% is delivered by a private provider in Sub Saharan Africa and upwards of 75% in South Asian countries.
There are multiple challenges in understanding private healthcare providers. In most LMICs, private providers are not well-organized, and their healthcare services are fragmented. Moreover, LMIC government engagement is ad hoc, routine ministry processes do not include private sector representatives, and ministry regulations and systems do not reach the private health sector. Mistrust between the sectors further exacerbates these systems gaps.
Managing Markets for Health (MM4H) is an inclusive and participatory approach to diagnose, design, deliver and monitor health market system changes. The Market Systems Framework (MSF) diagnoses health market operations and identifies the root causes of a market system underperformance. Country application reveals a complex web of interrelated factors (e.g. policies and regulations, health financing, information and provider knowledge, attitudes, beliefs, and values) that directly and indirectly influence public and private provider behavior differently in a health system and health market. Understanding the differences in public/private behavior can help LMIC governments align both sectors to work together to achieve UHC.
Presenters Agha Xaher Gul
Pathfinder International
Co-authors
BO
Barbara O'Hanlon
Results For Development
AB
Amit Bhanot
Results For Development
MH
Mark Hellowell
The University Of Edinburgh
DE
David Elliott
The Gallus Edge CIC
Client-Centered and Responsive Provider Behavior Change: CARE’s Community Score Card Approach and the Implications for Improvements in the User-Centered Dimension of Quality of Care
Preformed Panel 04:45 PM - 06:15 PM (Africa/Casablanca) 2022/12/08 15:45:00 UTC - 2022/12/08 17:15:00 UTC
An Individual focused, Facility-Based Provider Behavior Change (PBC) Intervention to Improve Contraceptive Services for Youth and Adolescents: Exploration and Evaluation of the Beyond Bias Solution
Preformed PanelPractice-oriented proposals 04:45 PM - 06:15 PM (Africa/Casablanca) 2022/12/08 15:45:00 UTC - 2022/12/08 17:15:00 UTC
Quality of a client-provider interaction is largely determined by the behavior of providers. Despite interventions focusing on provider training and supervision, efforts have been insufficient to effectively shift provide behaviors for contraceptive service delivery. Beyond Bias employed a multidisciplinary approach which involved human centered design, segmentation analysis, behavioral economics, and rigorous formative assessment in order to develop an integrated Provider Behavior Change (PBC) intervention designed to address provider bias.
As a novel facility based PBC intervention, the results of the evaluation suggest that the Beyond Bias solution was effective at changing provider attitudes and beliefs to be less biased. In Tanzania and Pakistan, this led to improved patient centered care and better client experiences, but not in Burkina Faso. Despite improvements in care, there was limited evidence that this intervention impacted the types of contraceptive methods received among young women.
Further research and evaluation need to be undertaken to ascertain how facility-level interventions can be enhanced through complementary strategies operating at the community and institutional levels to account for the larger structural and community level factors and prevalent social and cultural norms that impact provider behavior. Future work should explore whether coupling the Beyond Bias intervention with community outreach efforts can increase contraceptive use for young women who would not otherwise come into the clinic.
Presenters Agha Xaher Gul
Pathfinder International
Mohamad Brooks
Pathfinder International
LM
Lydia Murithi
Pathfinder International
Co-authors
ZW
Zachary Wagner
RAND Corporation
MF
Mahnoor Fatima
Pathfinder International
Supporting Positive Provider Behavior Through a Deeper Understanding of Provider Behavioral Influences: The Provider Behavior Ecosystem Map.
Preformed PanelPractice-oriented proposals 04:45 PM - 06:15 PM (Africa/Casablanca) 2022/12/08 15:45:00 UTC - 2022/12/08 17:15:00 UTC
Health care providers play a critical role in the health system. Their behavior is connected to quality of care and can influence client actions and related health outcomes. Providers' interactions with clients can influence health-seeking behavior and the adoption and maintenance of behaviors. Thus, it is critical to understand both what influences provider behavior and what can be done to encourage and support positive behaviors.  
Providers operate in complex systems. These systems directly and indirectly impact who providers are and how they act. Provider behavior results from a complex web of interrelated factors, both internal (e.g., knowledge, attitudes, beliefs, values, and preferences) and external (e.g., social norms, medical education and training, professional development, workplace environment, and health care financing and resources) to providers' lives. Designing impactful, scalable and sustainable initiatives requires a deep understanding of providers and the people who interact with them.  
Breakthrough ACTION developed the Provider Behavior Ecosystem (PBE) Map to help social and behavior change (SBC) and service delivery practitioners, donors, and researchers appreciate the wide-ranging factors that shape health facility-based provider behavior, so they can design and implement more effective, supportive provider behavior change (PBC) initiatives. The PBE emphasizes the need for systemic thinking and supportive action when designing and implementing PBC initiatives.
This presentation will provide an overview of the PBE and the importance of applying a systems lens to PBC efforts. It will outline key actors and entities, influence factors, and components influencing provider behavior and how they interact with one another.
Presenters
HH
Heather Hancock
Johns Hopkins Center For Communication Programs (CCP)
Co-authors Danette Wilkins
Johns Hopkins Center For Communication Programs (CCP)
Janine Kuehlich
ThinkPlace Australia
JR
Juanita Rodriguez
ThinkPlace
SL
Stephanie Levy
Ideas42
CARE Malawi
Results for Development
Johns Hopkins Center for Communication Programs (CCP)
Pathfinder International
,
Pathfinder International
+ 1 more speakers. View All
 Alison Pack
,
Johns Hopkins Center for Communication Programs (CCP)
Ms. HANA  BANAT
Save the Children US-OSRA Cairo Project
Right to Care
,
Children's Investment Fund Foundation (CIFF)
,
ThinkPlace US
+2 more attendees. View All
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