Provider bias and judgmental behavior is a major barrier to the use of contraception by young people. Training and supervision efforts have been inadequate to address bias towards youth and adolescents seeking contraceptive services. To disrupt the status quo, Beyond Bias project, implemented by Pathfinder International in collaboration with YLabs, Camber Collective and BERI, developed an innovative behavior change strategy to combat this entrenched barrier to care.
The Beyond Bias Behavior Change Strategy integrates three solutions: i) Summit - a story-driven event designed to facilitate dialogue and reflection on provider bias and build empathy for young people's needs; ii) Connect – an interactive forum for knowledge sharing and learning, and iii) Rewards – a growth-oriented non-monetary performance-based incentive assessed through client feedback on provider behavior. The model is designed to empathetically support health care providers at every phase of their journey from developing awareness of their own bias, working to overcome them, applying unbiased care practices, to becoming advocates for improving contraceptive services for youth in their community. This new approach seeks to humanize bias by building empathy, giving social affirmation, and providing concrete support and social rewards that can change behavior.
Beyond Bias employed a rigorous multidisciplinary approach that included an intensive human-centered design (HCD) process. HCD was used to generate more than 100 brainstorming ideas by partners, providers, and youth; and to winnow them into one integrated intervention through multiple rounds of testing, iteration, and refinement.

Midwives in Mali are overworked, stressed and work in difficult situations. An emotionally strained and exhausted midwife might not always treat their clients empathetically. Between 2020 and 2021, ThinkPlace worked with Jhpiego to improve the interactions between midwives and pregnant women by 1) helping midwives cope with trauma and chronic stress and 2) improving pregnant women's experiences of maternal health services. 
Through a journey map, we defined the key interactions between midwives and pregnant women and, using human-centered design, developed three interventions between midwives and clients by using empathy to improve quality of care and empathetic service delivery. The first intervention leveraged existing support groups to help midwives cope with the trauma and chronic stress of their work. The second intervention focused on improving interactions between pregnant women and midwives during antenatal consultations to help foster a caring and honest relationship. The last intervention focused on improving the waiting time for pregnant women, as long wait times can be a source of frustration that can extend to the consultation.
We realized that empathy was vital to creating a culture of sharing that helped recreate relationships, build a sense of mutual understanding and restore trust. Empowering midwives to be intentional with how they are transferring knowledge to pregnant women allows the consultation to feel more like a discussion. When people open up and share, it creates a bond that improves interactions. The recommended concepts all revolve around empathy and focus on sharing experiences, anxieties, stress and  joy.

Improving health provider behavior is crucial to achieving health and development goals. Providers operate in complex systems, and many factors influence their behaviors, including norms, health systems, client interactions, and individuals' own beliefs and attitudes. Breakthrough ACTION used an empathetic, co-design approach with providers (as experts of their own behaviors) to create a provider behavior change toolkit for family planning.


Breakthrough ACTION's provider behavior change toolkits help users understand and prioritize the factors influencing facility-based provider behavior. They guide users through an empathetic process that supports providers, clients, and district health teams in understanding the manifestations and causes of provider behavior challenges. The toolkits position providers as part of the inquiry and solution development process rather than as part of the problem. The toolkits, which are tailored for family planning programs, give stakeholders, providers, and health systems the tools to identify and prioritize the root causes of provider behaviors and generate local solutions. 


During the panel, Breakthrough ACTION will demonstrate the importance of placing empathy not just at the center of provider behavior change efforts, but also in the process of developing tools that seek to better understand provider behavior. Breakthrough ACTION will showcase the real-life use of an empathy-focused, co-design process used to create, test, and refine the provider behavior change tools in Guyana, Uganda, Kenya, and South Sudan. Breakthrough ACTION will demonstrate how the tools led to new insights in family planning efforts, with the possibility of broader applicability.