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Story and Perspective

Social & Behavior Change—Fostering Sustainable Change from Within

By: Xaher Gul, Program Design Lead and Strategy Advisor

Burkina Faso Bangladesh Pakistan Tanzania Ethiopia India Côte d’Ivoire Niger Mozambique Nigeria Uganda Democratic Republic of the Congo
Students play sit at playing a board game
Students in Burkina Faso play a board game called “La Chance” that corrected myths and misconceptions about contraception, educated them about sexual and reproductive health, and informed them about pregnancy risks. Photo: Maddie Kau, Ideas42

Pathfinder is well known for increasing access to lifesaving healthcare, reaching millions with contraception, saving countless women from dying in childbirth, and supporting mothers to raise healthy children through immunization services and nutrition support. While these results speak to the impact of our programs, they do not show us what drives people to seek care.

Pathfinder applies dynamic approaches to social and behavior change (SBC) that focus on helping individuals enhance their personal agency to make informed decisions about their health and access necessary health information, products, and services. Our SBC approaches combine globally supported, evidence-based theories of change with locally led, community-centric solutions. In this way, we are not just delivering services—we are fostering sustainable change from within the communities we serve.

Pathfinder has developed a Global SBC Framework—a comprehensive roadmap for our programs, enabling rapid customization and operationalization of SBC strategies and ensuring alignment with local contexts and health priorities. Knowing that each individual and community we serve is unique, we use the Global SBC Framework to develop strategies that provide a common lens from which to view audiences and deliver services, and identify beliefs, perceptions, and values that will encourage the adoption of lifesaving behaviors. The framework gives guidance on measurement and evaluation of our SBC impact.

Pathfinder’s Guiding SBC Strategy

Shifting attitudes through SBC requires us to focus on how people feel about a behavior, in addition to what they think the outcomes of the behavior will be. This means reaching not only the individuals themselves, but those they trust. Each program engages multiple influencers—including health providers, community and religious leaders, mothers-in-law, partners, neighbors, and friends—to shift attitudes, perceptions of social and gender norms, and in turn, intentions toward certain behaviors.

These SBC activities are integrated within health systems strengthening approaches that increase people’s access to quality health care, including services that support people to make informed decisions about their care, no matter where they live. Pathfinder applies SBC strategies across its programs spanning 19 countries in Africa and Asia. Some examples follow.

SBC Successes

Pinki Kumari, left, and Janchan Kumari, engaged through Pathfinder’s YUVAA program in India, use a video to spark discussions about safe pregnancy spacing, age of marriage, and the best time to start childbearing. Photo by Sarah Peck

Evidence to Action (E2A): E2A significantly expanded access to quality family planning and reproductive health care across 17 countries. Through tailored SBC strategies, the program engaged young people to shift perceptions about sexual and reproductive health among their peers, worked with first-time mothers to encourage pregnancy spacing and other behaviors that support health and well-being, and engaged men and women in the Sahel to adopt family planning and climate-friendly agricultural practices simultaneously, among many others.

Beyond Bias: Beyond Bias worked with hundreds of public and private sector health providers in Burkina Faso, Pakistan, and Tanzania to shift their biases and remove provider-related barriers youth face when attempting to access sexual and reproductive health care. Through human-centered design and behavioral economics, Beyond Bias pioneered solutions that put the needs of adolescents and youth at the forefront.

(re)solve: (re)solve combined consumer insights, behavioral design, and public health methodologies to discover what stops women from using contraception when they express a desire to avoid pregnancy but do not use a modern contraceptive method. Based on context-specific behavioral insights, (re)solve developed data-informed contraceptive solutions based on the lived experiences of women and girls in Burkina Faso, Ethiopia, and Bangladesh.

Youth Voices for Agency and Access (YUVAA): YUVAA supported young couples in India to make informed choices about contraception. Through innovative approaches to communication and social entrepreneurship, YUVAA challenged norms and empowered youth to take charge of their reproductive health.

Advancing the Leadership of Women and Girls Towards Better Health and Climate Change Resilience: This program has served over 150,000 people in Bangladesh and Pakistan with integrated climate and health initiatives. Central to the approach is the engagement of local communities, specifically women and girls, in building knowledge about climate and health resilience, fostering access to critical services, and strengthening health systems to combat future shocks.

A Legacy of Change

As Pathfinder continues to chart new territories in the SBC realm, one thing remains constant—an unwavering commitment to meaningfully engage communities and foster sustainable change. This is the only way to have a world where everyone, even in the most challenging environments, has what they need to be healthy, thrive, and live the life they choose.

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