SBC Overview: Integrated Framework for Effective Implementation of the Social and Behavior Change High Impact Practices in Family Planning

"Evidence shows that SBC interventions are an essential component of high-quality family planning programs but remain underutilized."

The purpose of this overview brief is to explain what social and behaviour change (SBC) for family planning is and why it is important in supporting individuals and couples to achieve their reproductive intentions, including their desired family size. The brief provides a framework to show how the different SBC High Impact Practices (HIPs) work together to strengthen family planning programmes, and it offers tips on how to choose and implement SBC programmes.

In brief, SBC is an evidence-driven approach to improve and sustain changes in individual behaviours, social norms, and the enabling environment. SBC interventions can be used to address a range of behavioural determinants influencing the uptake and continuation of modern contraceptive methods so that individuals and couples can achieve their reproductive intentions. SBC complements the areas of service delivery and the enabling environment to create a set of interconnected HIPs that work together to strengthen family planning programmes. For instance:

• During service delivery, SBC approaches can be used to empower clients, improve provider behaviour, and build trust. After a client leaves a clinic, SBC can enhance follow-up, support behavioural maintenance, and reinforce health and cross-sectoral linkages.
• SBC approaches can help create an enabling environment for family planning by, for example, promoting social accountability by bringing together community members with health workers and local officials to establish common goals. SBC approaches can also be leveraged to galvanise commitment and create supportive laws, policies, and financing for family planning.

Tips for implementation include:

• Use formative research based on theoretical models to guide which determinant to address. (For example, if social norms are a critical barrier to desired family planning behaviours, an intervention focused on individual knowledge is not likely to result in significant behavioural change.)
• Ensure early and frequent pretesting of materials, messages, and approaches to ensure that programmes are designed with the full input of the intended audience and their influencers.
• Select channels to meet the intended audience and objectives based on formative research.
• Work with existing community groups and communication platforms.
• Segment audiences into subgroups based on demographic, psychographic, life stage, and/or behavioural factors, and tailor interventions accordingly.
• Intentionally incorporate equity and the social determinants of health into SBC programmes for family planning.
• Use a gender-synchronised approach in SBC programmes for family planning - that is, work with both men and women, girls and boys to ensure that interventions are mutually reinforcing and outcomes do not reinforce inequitable power dynamics.
• Design and use monitoring and evaluation methodologies to assess the impact of interventions, and make real-time adjustments to programming.

Additional tips for implementation are provided in each of the 6 SBC HIP briefs, which document proven and promising practices to help individuals and couples achieve their reproductive intentions and desired family size. Three of the 6 briefs explain how to understand and address different determinants of family planning behaviour, and 3 help to identify a mix of channels to reach an audience. Five of these briefs are available at Related Summaries, below; all 6 are linked to and described in this overview brief.

The SBC HIPs are interrelated, and a list of tools is provided in the overview brief that can assist in different aspects of developing and implementing these practices. For more specific tools to assist with individual practices, please see the tools and resources section of each HIP brief.