Behaviours drive epidemics, they can also stop them. Effective risk communication and community engagement (RCCE) requires sociobehavioural data to identify ways to influence, predict, and mitigate the role people play in the spread of disease. This means understanding people's changing perceptions and attitudes, and the barriers and enablers influencing their ability and motivation to adopt and/or sustain positive healthy behaviours. Unfortunately, coordination and collaboration in social data collection and analysis prior to COVID-19 was severely lacking. In order to fill this gap and facilitate collective action for an institutionalised data and analysis mechanism, the RCCE Collective Service (CS) initiated an easy access RCCE Behavioural Dashboard to keep a pulse on people's perception, attitudes, questions and opinions related to COVID-19.


The CS Behavioural Dashboard is a first-of-its-kind repository of social and behavioural data on COVID-19, covering 198 countries and consisting of over 250,000 data points from 411 different data sources. The Dashboard aims to track how information, knowledge, perception, and practices are changing in the context of COVID-19. The Behavioural Dashboard is an initiative borne out of the CS's commitment to ensure critical social and behavioural information is equitably available at all levels and in all countries (wherever possible) for response actors working to end the COVID-19 pandemic. Beginning January 2020, insights drawn from the Dashboard have influenced and enhanced cocreation and codesign of people-centred interventions, policy decisions, and the incorporation social behavioural change communications (SBCC) into broader public health programming globally.

In 2019 in a bid to boost adolescent involvement in key development issues including health, UNICEF in collaboration with the Government of Uganda worked with adolescent groups to co-create an Adolescent Volunteer Initiative (AVI). To date, the initiative has recruited and empowered 1005 adolescents in seven districts.
AVI is a methodology and leadership growth path used to enable adolescents to participate in decision making, information dissemination, and service delivery processes that directly or indirectly contribute to their development and wellbeing. 
In 2020, to address growing adolescent challenges including sexually transmitted infections, adolescent pregnancies, drugs and alcohol, UNICEF supported partner AVSI to roll out the AVI in four districts. The roll out included (a) orientation of district staff in the four districts development of action plans and (b) identification, recruitment, orientation, and deployment of 150 Adolescent Volunteers (AVs) from selected sub-counties across the districts. 
AVs were clustered in groups of 10, assigned a chaperone and attached to a health facility in their sub-counties. Between July 2020 and June 2021, the AVs reached approximately 30,000 people (57% adolescents, 21% caregivers- parents, guardians, health workers, and 22% community leaders) with integrated health messages including on COVID-19 prevention. The AV support contributed to an increase in demand for adolescent health services such as antenatal care by teenage mothers, increased community/family mid-upper arm circumference (MUAC) screening of children under 5 years for malnutrition and observance of COVID-19 preventive measures such as proper use of masks and hand washing. 

Community-led Complementary Feeding and Learning Sessions (CCFLS) are an impactful community-based SBC approach. CCFLS includes a total of 12 consecutive sessions for a group of 15 mothers/caregivers and is facilitated by trained Health Extension Workers (HEWs) and Community Health and Nutrition Promoters (CHNPs). Each session lasts for about 2 hours and includes cooking demonstrations, child feeding and caring support, and nutrition education.
Introduced in Ethiopia in 2019 as part of the USAID's Bureau for Humanitarian Assistance (BHA) five-year Development Food Security Activity (DFSA), CCFLS aims to prevent malnutrition in children aged 6 - 23 months with growth faltering through improved child feeding and caring behaviors. The program seeks to enhance and sustain food, nutrition and livelihood security and compliments Ethiopia's government productive safety net program. 
Program participants greatly valued that CCFLS brought their peers together, allowed them to discuss challenges, and built community support. Positive health and nutrition outcomes have been observed. Mothers started feeding children fruits, stopped giving pre-lacteal feeds, learnt how to prepare porridges from locally available ingredients, and ensured that food was available for the child to be fed by other family members when they are away.  Among children aged 6-24 months with growth faltering who participated in CCFLS, 85% showed weight gain of 250g or more by the end of the sessions. The inclusion of weight measurement (upon admission to and discharge from CCFLS) which objectively verified outcomes kept mothers motivated and built trust, further enhancing the impact and sustainability of the approach. 

In Tanzania, where 14-18% of adolescents experience malnutrition (TDHS 2010, 2015), the evidence base on adolescent nutrition (AN) has been limited and few nutrition social and behavior change communication (SBCC) materials for adolescents exist. In 2019, Lishe Endelevu, a five-year activity funded by the US Agency for International Development (USAID), faced the challenge of ensuring the rapid implementation of nutrition SBCC programming to improve nutrition outcomes among adolescents in four regions of Tanzania. The Activity made the strategic decision to use the same priority behaviors and adapt evidence-based AN SBCC materials used by USAID/Empowering New Generations to Improve Nutrition and Economic Opportunities Activity in Ethiopia. 


Adaptation steps included: (1) Review the evidence base on adolescent nutrition in Tanzania and Ethiopia and prioritize nutrition behaviors; (2) Procure copies of AN SBCC materials from Ethiopia and adapt them to the Tanzanian context; (3) Pretest the adapted materials with adolescent girls, mothers and fathers of adolescent girls, and teachers; (4) Use the pretest findings to make further revisions to adjust to local Tanzanian context; (5) Submit the materials and pretest report to government authorities for technical review; (6) Incorporate technical feedback to finalize the materials; (7) Reproduce and disseminate the materials; (8) Train teachers and community volunteers to use the materials; and (9) Monitor implementation and document lessons learned. 


In less than 2 years from adapting the set of 8 adolescent nutrition SBCC materials from Ethiopia to the Tanzania context, Lishe Endelevu reached 625 teachers and 3952 community health workers.

Challenges accessing quality care are particularly acute for young women with disabilities seeking to exercise their right to sexual and reproductive health services. These include structural barriers limiting physical access to health facilities, lack of information and communication materials tailored to meet their needs, and health care providers' negative attitudes and lack of knowledge and skills about Persons with Disabilities (PWDs). To demonstrate that capacity strengthening on social inclusion can positively influence Health Care worker's attitudes and behaviour towards service delivery for PWDs, the DESIP programme committed to enhancing the capacity of Health Care Workers (HCWs) and County Health Management Teams as key actors during the first year of project implementation (2019/20). DESIP supported the mapping of Disabled Persons Organizations, developed disability mainstreaming guides and information, educational and communication materials in braille and Kenya Sign Language format. HCWs trained from the 19 DESIP supported counties reported initiatives aimed at improving access to care for PWDs and an increase in the number of PWDs reached with FP services. Health facilities continue to undertake self-initiative for staff sensitization on social inclusion and training on Kenya Sign Language, improve service accessibility for PWDs, targeted in-and-outreaches community mobilization, and allocate financial resources towards facilitating mobility and access to FP for PWDs. The DESIP training also led to facility discussions on reduction of stigma and negative attitude among HCWs towards PWDs, demystifying myths, stereotypes and misconception about disability and FP/SRH, and enabling adequate skilled health care workers to provide inclusive FP/SRH services.

Health Marketing has most often been successful in the cities as compared to the villages, not to talk of hard-to-reach communities. It is obvious that several favorable conditions in the cities make health marketing possible and perhaps more profitable as it is often commercial in nature. 
The purpose of the activity was to improve access to health information and related highly impactful health commodities in rural communities in Northern, North-East and Savannah regions of Ghana through the establishment of a community-based distribution model. We offered small grants to community-based organizations (CBOs) as partners to carry out the activity. 
At the end of six (6) months, the CBO grantees successfully implemented the following: recruitment, training, and deployment of community members to distribute FP and related health products within their respective communities accompanied with health information and specific interventions. 13340 cycles of Secure oral contraceptives, 372 SATO pans, 1,030 condoms, 1,480 tubes of Chlorhexidine gel, and 134,800l hand sanitizers were distributed A total of 288 volunteers including the youth were deployed. This has offered great opportunity for the youth to be change agents in their communities, a model which ensures that communities are able to address urgent health issues at anytime. Including the youth in this activity provided the opportunity for their colleagues to patronize community level FP commodities and services. At least a total of 4851 individuals including the youth were reached with key messages on FP, Cord care, WASH, through the community-based distribution activity

The critical role that the child's father plays in improving a child's health and nutrition in the same household is being recognized more and more. More attention is being focused on incorporating the child's father into counselling interventions, such as parenting sessions.
However, the evidence in West Sumba shows that fathers' participation was lower than mothers. Parenting classes in West Sumba showed that fathers' participation was 17,9%, compared to mothers which was 82%. Moreover, the average of parenting intervention in West Sumba to lower the prevalence of Stunting was 16,3%. Stunting data of 0-59 months of children in West Sumba showed an increase. In 2020, the percentage was 25,90%, while in 2021, it rose to 28,8%.
REAL (Responsible, Engaged, And Loving) Father is an approach that involves the participation of parents, especially fathers, in parenting practices. This approach has been used in Save the Children Indonesia programs, to promote positive parenting values, strengthen positive gender norms, and involve men's participation in equal parenting practices at home. 
Using local language adaptations and audio messages to convey key messages in parenting sessions, parenting practices have succeeded in increasing fathers' awareness of their role and the importance of father-child involvement from infancy to adulthood especially in decreasing stunting prevalence in West Sumba to 22,7% in 2022. This approach hopefully, can share experiences and inform other programs specifically designed for the role of fathers in parenting.

Child, early, and forced marriage (CEFM) has many negative impacts on the lives of girls and women, including disrupted education, early childbearing and associated risks of morbidity and mortality. More than 4 in 10 girls in Malawi are married before the age of 18 despite recent changes in policy to end child marriages. Drivers include poverty, social norms, and individual attitudes and beliefs of both caregivers and girls and young women themselves. Since 2020, Breakthrough ACTION, in partnership with local NGOs offered multi-session dialogue-based groups with adolescent girls and young women (AGYW), adolescent boys and young men (ABYM), and fathers and mothers. These groups addressed leadership, goal-setting, gender norms, harmful traditional practices with a focus on CEFM, and advocacy for the protection of girls and women. To monitor changes on CEFM opinion and attitudes that could be taking place as a result of the Breakthrough ACTION project groups, we collected qualitative data among AGYW, ABYM, and within their households. We conducted 16 focus group discussions (FGDs) across 4 project sites and post-tests from AGYW (n=381) and ABYM (n=316) to explore aspirations, attitudes, and self-efficacy. The results indicate that participants experienced positive changes across thematic areas discussed in the groups: educational aspirations, gender equitable norms, shared household responsibilities, and a commitment to advocating for their rights and ending harmful practices. Insights from the monitoring activities reinforce the benefits of community-based activities to shift attitudes, and findings informed project re-design going into its second year.

Equitable access to vaccines entails including vulnerable population such as migrants, refugees, internal displaced persons (IDPs) and asylum seekers, regardless of their legal status or documentation. 

The significant higher risk of severe disease or death by this sociodemographic group is recognized by SAGE and moreover, their vulnerabilities have been exacerbated due to the secondary effects of the COVID-19 pandemic.[1] Furthermore, limited engagement of health system with this population groups deepens challenges on accessing immunization services. [2] They are more likely to suffer physical, mental health and socioeconomic consequences of COVID-19 and therefore need to be included in planning purposes. 

Previous analysis reveals that the inclusion of these vulnerable population groups in national vaccination plans in Eastern and Southern Africa region is not systematic, and there is a dissonance between their inclusion in plans and actually accessing COVID-19 immunization services[3]. Ensuring regular social and behavioural data collection is critical to increase evidence-based advocacy, inform effective and targeted interventions and improve equitable demand for and uptake of COVID-19 immunization services.
[1] World Health Organization. (‎2021)‎. WHO SAGE roadmap for prioritizing uses of COVID-19 vaccines in the context of limited supply: an approach to inform planning and subsequent recommendations based on epidemiological setting and vaccine supply scenarios. (20 October 2020, latest update 16 July 2021). WHO
[2] Mukumbang, F.C., Ambe, A.N. & Adebiyi, B.O. Unspoken inequality: how COVID-19 has exacerbated existing vulnerabilities of asylum-seekers, refugees, and undocumented migrants in South Africa. Int J Equity Health19, 141 (2020). 

Cultural traditions, unequal gender relations and limited access to information represent the main factors that affect adolescents' rights and well-being in Mozambique. 'Ouro Negro da Malta' is an adolescent-led SBCC radio program produced by young people and for young people. For many, it is the only source of information on critical topics that affect younger populations, particularly sexual and reproductive health, education, child marriage, and gender equity.  
Analysis of qualitative results, including testimonials, indicates that young people are engaged in the program. 'Ouro Negro da Malta' demonstrates that if properly supported by adults, adolescents, especially girls, use the program to redefine their life, their perspectives for the future, and their roles in the community. Programs like these can also help inform future initiatives implemented in partnership with youth and marginalized groups.  
The discussion will explore both the successes and the challenges of facilitating meaningful participation of adolescents in SBCC programs that address adolescent issues, as well as important considerations, such competing priorities affecting youth and adult engagement critical to achieving social behavior change objectives.  

Depuis mars 2020, le Sénégal traverse une crise sans précédent avec la COVID-19. L'impact est la plus dure pour les couches vulnérables. Le gouvernement du Sénégal a mis en place un plan d'urgence afin d'accompagner les populations; cet effort, fort appréciable, ne permettait pas de couvrir les besoins des populations les plus vulnérables. Des enfants « talibés », évoluant dans les écoles coraniques traditionnelles (daaras), vivent dans des situations de précarité accentuées marquées par une promiscuité, une insalubrité et un déficit alimentaire. C'est ainsi que Breakthrough ACTION avec ses partenaires gouvernementaux ont développé une initiative de prévention de la COVID-19 ciblant les daaras de six régions. Ayant obtenu l'engagement et le soutien financier de divers acteurs à travers le plaidoyer, l'initiative a permis de fournir les informations sur la COVID-19 et de doter les enfants en équipements de protection individuelle pour minimiser ainsi les risques d'exposition au virus. Le projet a aussi remis des kits alimentaires pour atténuer les effets liés à l'état d'urgence, au couvre-feu et au ralentissement de l'activité économique. Le succès de cette initiative a encouragé les partenaires à continuer à considérer les besoins de ce groupe, extrêmement vulnérable, dans ses stratégies de prévention de la COVID-19.
 Les programmes de riposte doivent intégrer  les stratégies pour  l'équité pour s'assurer que les efforts de prévention n'excluent pas les communautés  hautement marginalisées. Les partenariats stratégiques multisectoriels avec les acteurs du secteur privé, de l'Etat et des partenaires appuient la réussite des initiatives d'équité.

In the last decade there has been a global trend to apply approaches informed by evidence and methods from the behavioral sciences to achieve Social and Behavior Change program and policy objectives. This talk provides a focused reflection on unique and important ethical considerations for applying "behavioral insights" approaches to work that implicates children. 
The talk describes the results of a collaboration between UNICEF's Office of Research-Innocenti, the Behavioural Insights Team, and the Young and Resilient Research Centre at Western Sydney University to undertake a systematic exploration of relevant literature along with direct consultations with youth in Australia, Chile, and Ghana on the subject. The literature review, interviews with experts, consultations with youth, and pretesting with potential end users were used to develop a simple set of resources for practitioners. The talk will outline the process and describe the resulting three core principles and a checklist of 10 process criteria to help practitioners navigate ethical considerations specific to applying behavioral insights approaches to programming with children.

What does it take to truly reach a scalable solution that involves behavior change? Splash's program in Addis Ababa is on target. As this international NGO has moved from a grand idea -- ensuring all children in urban school settings have access and improved hygiene practices -- into action.  Splash has designed child-focused water, sanitation, hygiene (WASH) and menstrual health solutions with government partners in one of the lowest-resource and dense cities in the country.
With over a decade of experience implementing WASH projects in nearly 2,000 child-serving institutions (orphanages, schools, shelters, and feeding centers), Splash embarked on their largest project yet: Project WISE (WASH in Schools for Everyone).  
Through Project WISE, Splash set out to design a program that could scale. And a key component was partnering with the Government of Ethiopia to reach 100% of government schools in Addis Ababa with improved WASH infrastructure; behavior change programs for students and adults; and menstrual health solutions for girls. In keeping with the core elements of reaching scale, Splash created a model that can be easily replicated across cities nationally.
For over a decade, handwashing has been at the center of Splash's work and as a result, are driven by the belief that an integration of handwashing is a key outcome for practitioners and policy makers who want to achieve strong healthy practices to fight off communicable diseases such as COVID. Handwashing is having its movement and Splash will discuss how to capture this attention to bring forth results.

A generation of young people is on the move in West Africa, in the hopes of finding a better life for themselves and their families. As shown by data and reports, many of them take the dangerous Western African Atlantic route and Western Mediterranean route with a substantial increase of fatalities in 2021. The stressors migrants are subjected to during the entire migration cycle can be extreme and may impact their psychosocial functioning. Moreover, those who return face stigmatization by their communities of origin where return is often associated with failure and social status loss.
'Migrants as Messengers' is a social and behavior change project that addresses these challenges by providing a platform for self-growth and civic engagement for West African youth that have migrated irregularly and returned. The project works with returnee migrants who share their stories of migration with young people in their communities to help them make informed choices about their future. Storytelling and public exposure represent also an opportunity to escape marginalization for returnees by addressing barriers to self-representation, social recognition and agency.


For this poster presentation, an International Organization for Migration (IOM) expert will share how mental health and psychosocial support (MHPSS) was mainstreamed into an awareness raising project. Moreover, they will share results of a longitudinal study conducted within the project, that measured the evolution of mental well-being of the returnees that have been involved in this project for the last three years.

The COVID-19 pandemic has revealed and exacerbated health and wealth inequalities globally, and especially in closed communities, with the potential to stall development efforts and widen social inequalities in low- and middle-income countries. Takunda, a USAID funded Resilience and Food Security Activity is working in Mutare district, eastern Zimbabwe, an area inhabited by the Marange Apostolic Faith Sect. Takunda promotes sustainable, equitable, and resilient food, nutrition, and income security amongst poor and vulnerable households, using cross-cutting Social and Behavior Change (SBC) approaches. 
To help inform design of the SBC interventions, Takunda conducted formative research in September 2021 to understand behavioral determinants influencing selected behaviors, including people's knowledge, perceptions, and feelings about target behaviors, and to identify appropriate practices to promote. Findings revealed deeply rooted religious norms that negatively impact women and children, and a social system supporting male dominance and limiting socio-economic progress.  The Marange Apostolic Faith Sect is a religious group with strict norms characterized by shunning medical care, polygamy (one man having as many as twenty wives), huge families (driven by the prohibition of modern family planning methods) and early marriage (girls marrying older men). These norms contribute to high rates of child mortality and poverty; children do not complete school, and women are widely dominated by men, who control household resources and decision-making. Takunda will share these findings together with innovative SBC approaches designed to work within the system to shift social norms, enhance women's agency, and improve child and family welfare.

Improving dietary practices among adolescent girls can lay the foundation for protecting the nutrition and health of current and future generations. In Ethiopia, the Bill and Melinda Gates Foundation funded the Alive & Thrive (A&T) project to implement a package of adolescent-led nutrition interventions through government schools. The interventions sought to improve the diet of adolescent girls 10–14 years of age, enrolled in primary schools in one agrarian region (Southern Nations, Nationalities and Peoples or SNNP) and one pastoralist region (Somali) in Ethiopia. School-based activities were designed to address knowledge gaps, motivations and barriers affecting the food consumption patterns of adolescent girls.  It is an example of a multi-sectoral approach where the Bureau of Education took the lead with support from the Bureau of Health and Local Government. Interactive and empowering school-based activities were designed with student involvement. Key participants in the program design and implementation in addition to adolescent girls included student peers, schoolteachers and principals, health extension workers, and parents, who were identified as most influential persons. Each group was assigned specific roles for supporting improved dietary practices and self-efficacy. Application of social and behavior change principles to intervention design and implementation of interactive school-based activities aimed at empowering adolescent girls, led to positive changes in their dietary practices. Primary schools may be effective channels for delivering and scaling up interventions to improve diets of adolescent girls sustainably.

Female Genital Mutilation/Cutting (FGM/C) is a procedure for the partial or total removal of external female genitalia for non-medical purposes and affects over 200 million women and girls worldwide. To date the prevention of FGM/C has been neglected, the responsibility has been siloed, and misinformation has persisted. Collaboration between survivors, health care providers, faith-based leaders, and men is needed. To that end our project developed an online virtual living evidence based resource (fgmtoolkit.gwu.edu) for multiple audiences to increase awareness and responsibility for the prevention of FGM/C using a multimedia format with first person stories. This presentation will present the alpha and beta testing of the toolkit among our key interested parties with a particular focus on the collaboration between female survivors of FGM/C and health care providers for the secondary prevention of FGM/C in the US. A total of over 200 women and health and social care providers and trainees completed the evaluation and the findings demonstrated the toolkit had a high level of usability and utility and that self-paced interaction with the the toolkit materials significantly increased participant awareness, knowledge, and self-efficacy. For many, the toolkit was their first time learning about FGM/C, dispelled existing myths, and created a common vernacular to enhance communications and foster collaborations. A virtual living toolkit can be regularly updated to create fresh content thus having the ability to readily address the needs and strengths of the respective audiences and ensure misinformation does not persist. 

In response to a number of complex global health challenges, NYU School of Global Public Health (GPH) and UNICEF designed a Behavioral Communication Strategies for Global Epidemics (BCSE) course that brings together UN professionals, government staff and MPH students to design innovative behavior change communication strategies that address disease outbreaks and humanitarian challenges around the world. Applying a systems approach, participants in the course work on interdisciplinary teams to design strategies, develop skills, and engage in global learning. At the culmination of the course, all teams present strategies to UNICEF country offices for implementation. This innovative model for public health education and humanitarian response provides professionals with an opportunity to develop a wide range of competencies, including systems thinking, behavior change, and human-centered design, and equips them with the necessary tools to develop more novel approaches to behavior change communication. As the number of humanitarian challenges increase each year, this format for learning can serve as a model for how professionals can effectively address these complex crises.

Pregnancies during adolescence can significantly jeopardize girls' health and economic futures, and yet family planning (FP) use among this population remains low. Existing interventions to increase FP use among youth may fall short because they don't smartly engage the population they intend to serve. Drawing from research in other contexts showing that giving advice to others can encourage action by building confidence and motivation, we developed a program that positions girls as advocates for FP among their peers and keeps girls' agency in mind – placing them as both active participants in and as recipients of the program. 



Through interviews with adolescents, community-based mobilizers, and service providers, we identified behavioral barriers contributing to high unmet need for FP among Ugandan adolescents, which persist even when services are available and affordable. With MSI Reproductive Choices and Mare Stopes Uganda, we designed a "Refer a Friend" (RAF) program where girls who use contraceptives or have received FP counseling use small, colorful cards to engage in conversations with friends and encourage them to visit health facilities for FP counseling and friendship wristbands. Clinic materials reinforce a welcoming environment for girls, and providers from a subset of clinics received a training on youth-friendly service provision.



We conducted a randomized controlled field trial and found that the program significantly increased adolescent FP uptake by 45%, even during the COVID-19 pandemic. The results underscore that empowering girls as peer advocates and offering a welcoming clinic environment can meaningfully improve access to important health services.