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Tools
& Approaches
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Challenges
CHANGE is interested
in the full array of health behavior challenges associated with improving
maternal health, child health and nutrition. However, the project has
chosen four common, cross-cutting problems
and five underlying theoretical issues.
Common,
Cross-Cutting Problems
Problems Resulting From "Deadly
Delay".
Why do family members sometimes delay seeking treatment until the
consequences have become deadly? CHANGE is interested in looking at
why people act when they do - what are their cues for high
risk, or severity of a condition, for example? What other factors
motivate people to act?
Problems Related to Obtaining and
Taking Medicine.
Where do people prefer to get medicines, and how do they decide how
much to take and for how long? CHANGE is interested in looking at
various factors that influence adherence (and lack of adherence) to
drug protocols.
Problems Associated with Health Worker
Performance.
Health workers not only deliver care, they also effect whether clients
are willing to use the health system, and whether they adopt practices
the system promotes. What are the critical elements of effective health
worker/client interaction? What are the elements of effective training?
How do we motivate health workers who are unpaid and overworked?
Problems Related to Household Habits.
Good health for women, children and infants begins in the home. Many
healthy practices do not even strike people as "disease-related."
We are especially interested in these behaviors, for example, breastfeeding,
hand washing and basic hygiene.
Underlying
Theoretical Issues CHANGE addresses a set of challenging
theoretical issues concerning health behavior change:
Increased knowledge in a population
or group does not necessarily lead people to change behaviors.
However, many behavior change programs focus primarily on trying to
improve knowledge. What other factors stimulate behavior change?
Many behavior-change approaches (primarily
developed in the West) focus on understanding the individual and on
changing behaviors at the individual level. However, in many cultures,
behavior change may best be looked at as a function of what groups
or communities do. How can we identify crucial factors for particular
audiences and behaviors? What approaches can we take to influence
community, institutional, and political factors to bring about changes
in health practices.
It is crucial for non-experts to
be able to monitor and evaluate behavior change. How do we know
what approaches are working? What methods can we develop? How can
participatory techniques be used in evaluation?
Trial or short-term adoption of health
practices is not enough. How can positive changes in behavior
be maintained over time, particularly after any international funding
ends?
Many behavior change approaches have
been successful at the pilot level. What are the key factors in
scaling up promising pilot efforts?
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