Using the Think | BIG process, Behavior Profiles are created after defining and prioritizing the key behaviors that, if practiced at scale, will lead to the desired outcomes. A Behavior Profile is an analysis of a specific behavior. It is created for the specific context (e.g., region, country, locale) using desktop research, formative research, and what is presently known about the behavior.
The Behavior Profile is one of the tools Behavior Integration offers to support evidence-based decision making. Each priority behavior is analyzed and pathways to change are created linking factors to actions
What steps are needed to practice this behavior?
What prevents or supports practice of the behavior?
Structural Accessibility Provider competencies Facility experience Social Family and community support Gender Norms Internal Attitudes and beliefs Self-efficacy Knowledge Skills
Who must support the practice of the behavior?
Institutional Policy makers Managers Logistics personnel Providers Employers Community Community leaders Religious leaders Teachers Household Family members Male partners
How might we best focus our actions?
Enabling Environment Supply chain Institutional capacity building Partnerships and networks Policies and governance Systems, Products and Services Infrastructure Products and technology Supply Chain Quality Improvement Demand and Use Advocacy Communication Collective Engagement Skills Building
Improve maternal and child survival and reduce malnutrition
Percentage of women who had a live birth in the three years preceding the survey who had 4+ antenatal care visits
BEHAVIOR AND STEPS
What steps are needed to practice this behavior?
Pregnant women complete a full course of quality antenatal care (ANC)
Recognize signs and symptoms of pregnancy
Decide to seek ANC early, before the end of the first trimester
Plan transport, resources, and logistics
Attend all recommended ANC visits
Obtain all required services from qualified provider at each visit
Adhere to provider instructions during and following each visit, including when to return for the next visit
What factors may prevent or support practice of this behavior?
Accessibility: Pregnant women cannot access health facilities because they are too far
Accessibility: Pregnant women do not attend multiple ANC visits because they struggle to afford the costs that come in addition to on-going essential expenditures
Service Provider Competencies: Pregnant women cannot obtain quality ANC because providers neither respect them nor effectively communicate relevant technical information or explain the benefits of the different services, tests, and medications given during ANC
Service Experience: Pregnant women do not go for ANC because the health facilities often lack the tests, medications, or supplements that women need, or payment is required when services and products should be free
Family and Community Support: Many pregnant adolescents and unmarried women are reluctant to seek early care because of stigma or the risk that they will be asked to leave school or quit their job
Family and Community Support: Pregnant women do not plan to attend, or attend ANC because family and community members do not encourage or support their attendance
Norms: Pregnant women do not seek ANC because many societies have strict cultural or traditional practices around disclosure of pregnancy
Attitudes and Beliefs: Pregnant women do not always perceive a value to multiple ANC visits if they have already had one or more healthy pregnancies
Attitudes and Beliefs: Pregnant women do not always comply with provider's instructions particularly related to medications, supplements, or foods because of beliefs about the adverse effects of the medication or foods on their fetus
Knowledge: Most pregnant women attend at least one ANC visit because they understand its benefits
SUPPORTING ACTORS AND ACTIONS
Who must support the practice of this behavior, and what actions must they take?
Policymakers: Ensure maternity care is accessible via insurance schemes, conditional cash transfers (CCTs) or other financing.
Policymakers: Ensure pregnant adolescents can still attend school.
Managers: Provide effective supervision and on-site support to ensure quality ANC services.
Logistics Personnel: Monitor and properly forecast stock of essential tests, medicines, and supplements.
Providers: Offer counseling and support to pregnant women during ANC visits, including thorough explanations of services provided as well as the importance of multiple visits and adherence to supplements or medications given.
Managers/Providers: Encourage or actively support women to seek a full course of ANC and to continue following provider's instructions once at home.
Community and Religious Leaders: Publicly support or promote ANC including programs that attempt to reduce stigma and encourage women to talk to their partners about early pregnancy care.
Family Members: Actively participate in ANC and support women, especially first-time mothers and adolescents, in all aspects of pregnancy and delivery planning.
Male Partners: Actively support finances, planning, and transportation for ANC for pregnant women.
POSSIBLE PROGRAM STRATEGIES
What strategies will best focus our efforts based on this analysis?
Strategy requires Communication Support
Financing: Expand free or low-cost access to products and services through vouchers or fee exceptions to ensure access to ANC.
Financing: Finance task-shifting and explore community-based service delivery such as iron and folic acid supplements.
Policies and Governance: Adopt and enforce policies to permit pregnant adolescents to attend school.
Policies and Governance: Establish a policy for areas with poor health facility access to have the most basic ANC services, such as iron and folic acid supplement resupply managed at the community level.
Systems, Products and Services
Supply Chain: Strengthen supply chains for essential drugs, supplements, and preventative medicines for ANC.
Quality Improvement: Train and support providers to emphasize value of completing all ANC visits as well as active birth planning.
Quality Improvement: Expand services and improve structures, including hours offered, types of services available, transparent costing of services when appropriate and use of ANC outreach services to encourage pregnant women to use ANC.
Quality Improvement: Ensure that services are client- and family-friendly and that counseling on follow-up care is provided to both the pregnant women and any family members accompanying her.
Demand and Use
Communication: Use targeted media, including SMS where possible, to send tailored reminders and tips for pregnant women and their families on both ANC attendance and adherence to supplements like iron and folic acid.
Communication: Create pregnancy and new-mother groups to help mothers understand the benefit of care throughout pregnancy and the post-partum period.
Collective Engagement: Train and use traditional leaders and traditional birth attendants to encourage women to seek early and multiple ANC visits.
Behavior Profile throughout Think | BIG
behaviors that address the causes inhibiting achievement of the desired goal Launch Priority Behaviors Tool View Tutorial
your program over time View Adaptive Management Tools
Sample technical Behavior Profiles
What is a Sample Technical Behavior Profile? A Sample Technical Behavior Profile is a Behavior Profile, created by USAID/Washington technical teams for use by USAID Mission staff and Implementing Partners. Sample Technical Behavior Profiles have been developed for the original 18 health Accelerator Behaviors most closely linked to maternal and child mortality reduction and others are being created for other health and non-health development goals as the need arises. These Profiles are based on a consensus discussion among technical experts and a review of selected global evidence and the steps, critical factors and important programmatic considerations known to be important to achieving a positive behavioral outcome.
How can these Sample Technical Behavior Profiles be used? The Sample Technical Behavior Profiles have several potential uses. [However, we strongly recommend that they not substitute for country-specific Behavior Profiles based on local evidence and inputs from locally informed technical experts.] View List
As a context specific Behavior Profile is developed the Sample Technical Behavior Profiles can serve in three ways:
Orientation: These Profiles can orient program managers to the behaviors generally considered important to development goals such as reducing malnutrition, controlling malaria, and strengthening governance.
Starting Point: These Profiles can serve as a guide to prompt thinking on what might or might not be locally relevant and important, adding or deleting information from the profile as applicable or little research is presently available.
Check on the Local Design Process: These Profiles can provide a quick comparison to raise important issues that might have been overlooked and reassure the team that the contextualized profile is complete.
ACCELERATE is made possible by the generous support of the American people through the United States Agency for International Development (USAID) and is implemented under Task Order No. AID-OAA-TO-15-00052 by The Manoff Group, Inc. in association with Howard Delafield International, OneWorld UK, Social Impact, Inc., and Sonjara, Inc. ACCELERATE is issued through the Transform IDIQ (Contract No. AID-OAA-I-14-00002). The information on this website does not necessarily represent the views of USAID or the United States Government.