1. Critical Role of Social and Behavior Change (SBC)
Across the Service Delivery Continuum
Impact and measurement of SBCC in service delivery Mojisola Odeku June 8, 2017

2. Outline Background/Context
Service provider ideation for SBCC intervention
Data source
Impact of targeting provider ideation on quality of provider interaction, counseling, and provider bias in service delivery

3. Service delivery context among providers
Provider bias is high, more than half of providers do not offer some methods based on parity, marital status and age
Interpersonal communication and counselling (IPCC) needs improvement
Client-provider interaction (CPI) is poor
Clinical training has not yielded much in improving provider attitude and interaction with clients
Some of the problems from poor provider attitude includes…provider bias, poor counselling etc
4/21/2019

4. Service Provider Ideation
NURHI research showed that provider ideation affects quality of interaction and counseling.
To improve IPCC we used SBC to improve these ideational factors:
provider rejection of myths and rumors
perceived peer contraceptive attitudes and prescribing behaviors
perceived social/religious approval for family planning
gender-related attitudes.

5. provide information that allows clients make informed choices.
NURHI implemented SBC Interventions for service delivery providers to focus on:
How to:
counsel and communicate with clients in a non-judgmental and client-focused way
provide information that allows clients make informed choices.  
4/21/2019

6. Platforms adopted for SBCC interventions
Interactive distant learning videos
Client-provider Dialogue/Feedback meetings
Guidelines & Job Aids
“Know your provider” initiative
Whole site orientation

7. Data source:
NURHI study on the effect of IPCC intervention for Providers in Zaria and Benin
NURHI/MLE facility survey at baseline and endline in six urban cities
Both studies were funded by the Bill and Melinda Gates Foundation
4/21/2019

8. Mean index score1 on information provided by providers on modern methods increased across cities
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Index based on whether or not the provider provided information on the following for ten modern methods (male sterilization, female sterilization, implant, IUD, injectable, Pill, emergency contraception, male condom, female condom, LAM): how method is used or given, how method works, advantages and disadvantages, and complications/side effects.
1 Out of a possible total score of 40
Notes: *** p<0.001

9. % of providers that talked about different methods, how used, and side effects increased post intervention
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*** p<0.001

10. % of providers that restrict provision of methods based on parity and marital status (respectively) decreased at endline

11. Conclusion:
Provider ideation is related to the quality of family planning services, information provision and provider bias.
Focusing on Provider ideation using SBCC should be a critical part of effective service delivery interventions.
This study has demonstrated that provider ideation, a generally neglected concept, is related to the quality of family planning services and client satisfaction. Programs should take provider ideation into consideration when developing capacity strengthening initiatives for FP service providers.
4/21/2019