Social & Behavior Change Communication

© Courtesy of MCHIP

Social and behavior change communication (SBCC) is a research-based, consultative process that uses communication strategies to facilitate change with the aim of improving health outcomes. SBCC is guided by a comprehensive ecological theory that incorporates both individual level change and change at broader environmental and structural levels. Within family planning and immunization integration efforts, SBCC serves a critical role for building buy-in and generating demand for both services, promoting high quality provider/client interactions, and ensuring that information shared by vaccinators and family planning providers is strategic (informed by findings from formative research; complemented by reliable, convenient services) and clearly relayed to clients. 

SBCC for integrated service delivery addresses attitudes and behaviors at multiple levels:

  • Healthcare Workers - Community- and facility-level health workers provide clear and appropriate information and referrals according to protocols for integrated service delivery, use job aids consistently, and motivate clients to accept and follow-through on referrals (without pressuring them)
  • Mothers bringing infants for vaccination – Woman listens carefully to information, asks any questions, follows through on immunization referral, follows through on family planning referral if desired, uses contraception prior to fertility return, and returns on time for the child’s next vaccination(s).  
  • Family – Husband, mother in law, and other family members support the woman to use the desired method of contraception, enable travel for consultations and/or contraceptives, encourage the woman to bring the child on time for the child’s next vaccination(s), and provide needed support or take the child if the mother cannot.
  • Community – Local leaders, village health committees, and religious leaders advocate for women to use integrated services, endorse the importance of both immunization and family planning services, and promote the benefits (including convenience) of integrated services for community members. 
  • Policymakers – Encourage and support integrated service delivery at the national and regional levels, ensure that supportive policies are in place to encourage integration, and provide any needed additional resources.

Formative research is critical to the design of an integrated service delivery approach.  Factors such as health worker and client knowledge, perceptions of postpartum family planning and immunization, what motivates and hinders use of these services, and current service delivery systems and practices should be explored.

The High Impact Practices Brief on family planning & Immunization integration also recommends that if vaccinators are tasked with providing family planning education, screening, or referrals during immunization contacts, the program should reinforce provider communication skills to provide clear, simple information in a friendly, supportive manner, as immunization contacts are often very brief and vaccinators might lack effective communication skills. Consider investments to improve the environment for communication at the time of consultations (more time, privacy), strengthen vaccinators’ communication skills, and develop and test simple, user friendly tools and job aids to ensure consistent relay of key messages. Unless they are multi-purpose workers trained in family planning counseling, vaccinators should only be asked to give brief family planning messages and referrals, not to provide in-depth family planning counseling.

This SBCC section of this Toolkit provides a range of tools and materials for designing a strategic approach to promoting key family planning and immunization practices and related social change.  Resources included in this section include:

  • Formative assessment tools
  • Guidance on SBCC strategy & activity design
  • Resources to guide messages and materials development
  • Sample job aids & IEC materials that have been used in countries

Also included in this section of the Toolkit is a table highlighting key family planning and immunization integration behaviors, developed by members of the Family Planning & Immunization Integration Working Group.

To suggest an additional resource or share your perspective on advocating for integration of family planning and immunization services, please fill out our feedback form.