Developing Practical Guidance and Tools for Complexity-aware SBC Interventions

Summary:

In November 2018 the CORE Group's SBC Working Group held an expert consultation to discuss advances in public health theory and research regarding complexity and context-sensitivity. As a result of the consultation, a few projects were spun off to make the recommendations from the consultation actionable including development of: 1) An advocacy booklet to help guide communication with donors (ideally early/ in the beginning of a new project) and help to build fluency in communicating how to monitor and evaluate SBC interventions in ways that will address the complexity of both behavior and of program implementation; 2) A statement and checklist that will provide a minimum set of recommendations for reporting the process of implementing SBC interventions including details about the local context, intervention(s), delivery strategy, any adjustments made in line with shifts in context, an explanation of what contributed to a change in behavior, and contradictory or negative evidence and; 3) A core set of indicators related to adaptation, learning, and collaboration that can be used in proposals and workplans. During this session, project leads will provide an overview and update on the development of each product and solicit feedback from the audience.

Background/Objectives

SBC professionals operate in a complex landscape of epidemiological, sociocultural, economic, and environmental variables involving multiple stakeholders, each with their own interests and concerns. In November 2018, CORE Group's SBC Working Group held an expert consultation to discuss advances in theory and research regarding complexity. The objectives of this consultation were to: 1) build shared understanding of key concepts around complexity and SBC, 2) generate a list of recommendations for practice and evaluation from a range of stakeholders, 3) generate list of small-doable actions to address these recommendations and, 4) establish a monitoring mechanism to monitor follow-through on these actions.

Description Of Intervention And/or Methods/Design

There are many challenges in both implementing and impacts and outcomes of social and behavior change interventions given their complexity and context-specificity. The half-day expert consultation began with a review of the two brief readings shared with participants ahead of time. These readings were used to stimulate small group discussion on issues relating to complexity and SBC intervention. These small groups representing donors, researchers and experienced SBC program implementers worked, first, to identify and then prioritize barriers to the SBC community's capacity to address challenges associated with dynamic implementation environments. In plenary, the small groups developed a list of priority barriers whose overcoming would require guidance in complexity-awareness. Finally, small groups were again formed and assigned one of the priorities and asked to identify a small-doable action that could translate the priority into practical guidance.

Results/Lessons Learned

As a result of the process described above, several aids for bridging the gap between SBC theory and practice as it related to complexity were proposed. The SBC and M&E working groups of CORE Group narrowed the list to those that seemed most feasible: 1) An advocacy booklet to help guide communication with donors, support message integrity, and help to build fluency in communicating how to monitor and evaluate SBC interventions in ways that reflect the complexity of both behavior and of program implementation; 2) A practical checklist that provides a minimum set of recommendations for reporting the implementation of SBC interventions that highlights both the complex nature of the intervention and any adjustments made in line with shifts in context, and; 3) A core set of indicators related to program adaptation, learning, and collaboration that can be used when developing proposals and workplans.

Discussion/Implications For The Field

Complexity and context-sensitivity have long been recognized as a salient feature of SBC interventions, but most efforts have limited themselves to describing the distinctive nature of complexity as it relates to SBCvery little practical guidance for the designers and implementers of SBC interventions has been available. This expert consultation was one of the first efforts we are aware of to bring together SBC implementers with researchers and donors in a joint effort to pinpoint critical gaps in implementation guidance and propose ways of addressing them. This guidance-development effort is currently being undertaking in dialogue with reporting standards suggested by WHO

Abstract submitted by:

Lenette Golding - Save the Children

Joseph  Petraglia - Syntegral