Application of the Breakthrough RESEARCH social and behavior change costing guidelines to the RISE II Project in Niger

Breakthrough RESEARCH drafted its Guidelines for Costing Social and Behavior Change Health Interventions, in consultation with affiliate Breakthrough ACTION and other programmers, to promote quality social and behavior change program costing studies for a range of uses including budgeting, planning, economic evaluation, and advocacy. In March 2020, Breakthrough RESEARCH began applying the Guidelines to the Resilience in the Sahel (RISE) II program in Niger for a cost-effectiveness analysis through 2022. This report shares findings from application of the Breakthrough Costing Guidelines and provides an example and guidance for social and behavior change researchers and implementers on how these guidelines can be applied to other case study applications

The business case for investing in social and behavior change for family planning

Although the development field generally considers social and behavior change interventions essential parts of quality health programs, lack of synthesized information on costs and effectiveness means that decision-makers under-appreciate and under-fund social and behavior change efforts. This business case uses evidence to answer questions about the effectiveness, cost, cost-effectiveness, and return on investment from social and behavior change efforts. To develop this family planning social and behavior change business case, nearly 200 studies were evaluated. All USAID strategic priorities for global health—preventing child and maternal deaths, controlling the HIV/AIDS epidemic, and combating infectious diseases—employ social and behavior change approaches to varying degrees. This is the first in a planned series of complementary, health area-specific business cases

Capturing Single Cell Genomes of Active Polysaccharide Degraders: An Unexpected Contribution of Verrucomicrobia

Microbial hydrolysis of polysaccharides is critical to ecosystem functioning and is of great interest in diverse biotechnological applications, such as biofuel production and bioremediation. Here we demonstrate the use of a new, efficient approach to recover genomes of active polysaccharide degraders from natural, complex microbial assemblages, using a combination of fluorescently labeled substrates, fluorescence-activated cell sorting, and single cell genomics. We employed this approach to analyze freshwater and coastal bacterioplankton for degraders of laminarin and xylan, two of the most abundant storage and structural polysaccharides in nature. Our results suggest that a few phylotypes of Verrucomicrobia make a considerable contribution to polysaccharide degradation, although they constituted only a minor fraction of the total microbial community. Genomic sequencing of five cells, representing the most predominant, polysaccharide-active Verrucomicrobia phylotype, revealed significant enrichment in genes encoding a wide spectrum of glycoside hydrolases, sulfatases, peptidases, carbohydrate lyases and esterases, confirming that these organisms were well equipped for the hydrolysis of diverse polysaccharides. Remarkably, this enrichment was on average higher than in the sequenced representatives of Bacteroidetes, which are frequently regarded as highly efficient biopolymer degraders. These findings shed light on the ecological roles of uncultured Verrucomicrobia and suggest specific taxa as promising bioprospecting targets. The employed method offers a powerful tool to rapidly identify and recover discrete genomes of active players in polysaccharide degradation, without the need for cultivation

Review of performance-based incentives in community-based family planning programmes

Background: One strategy for improving family planning (FP) uptake at the community level is the use of performance-based incentives (PBIs), which offer community distributors financial incentives to recruit more users of FP. This article examines the use of PBIs in community-based FP programmes via a literature search of the peer-reviewed and grey literature conducted in April 2013. Results: A total of 28 community-based FP programmes in 21 countries were identified as having used PBIs. The most common approach was a sales commission model where distributors received commission for FP products sold, while a referral payment model for long-term methods was also used extensively. Six evaluations were identified that specifically examined the impact of the PBI in community-based FP programmes. Overall, the results of the evaluations are mixed and more research is needed; however, the findings suggest that easy-to-understand PBIs can be successful in increasing the use of FP at the community level. Conclusion: For future use of PBIs in community-based FP programmes it is important to consider the ethics of incentivising FP and ensuring that PBIs are non-coercive and choice-enhancing

Creating reproductive health behavioral profiles for women of reproductive age in Niger using cross-sectional survey data: A latent class analysis

Objectives: To identify health behavioral profiles for women of reproductive age in Niger. Methods: We interviewed married women of reproductive age in Niger in April 2021 (N = 2,709). Latent class analysis based on sociodemographic and behavioral determinants was used to identify classes of women related to use of antenatal care, facility delivery, and modern family planning (FP) use. Results: We found similar classes between the use of antenatal care and facility-based delivery classes with the first class composed of less educated and poor women with weaker behavioral determinants while the second class was more educated and had stronger behavioral determinants. In the facility-based delivery class was the presence of a third class that was poor and uneducated with low levels of knowledge and social norms, but in contrast had much higher levels of positive attitudes, self-efficacy, and partner communication than the first class. A fourth class of younger, more educated women with strong behavioral determinants emerged related to FP. Conclusion: The application of empirical subgrouping analysis permits an informed approach to targeted interventions and resource allocation for optimizing maternal and reproductive health

The impact of vouchers on the use and quality of health care in developing countries: A systematic review

One approach to delivering healthcare in developing countries is through voucher programmes, where vouchers are distributed to a targeted population for free or subsidised health care. Using inclusion/exclusion criteria, a search of databases, key journals and websites review was conducted in October 2010. A narrative synthesis approach was taken to summarise and analyse five outcome categories: targeting, utilisation, cost efficiency, quality and health outcomes. Sub-group and sensitivity analyses were also performed. A total of 24 studies evaluating 16 health voucher programmes were identified. The findings from 64 outcome variables indicates: modest evidence that vouchers effectively target specific populations; insufficient evidence to determine whether vouchers deliver healthcare efficiently; robust evidence that vouchers increase utilisation; modest evidence that vouchers improve quality; no evidence that vouchers have an impact on health outcomes; however, this last conclusion was found to be unstable in a sensitivity analysis. The results in the areas of targeting, utilisation and quality indicate that vouchers have a positive effect on health service delivery. The subsequent link that they improve health was found to be unstable from the data analysed; another finding of a positive effect would result in robust evidence. Vouchers are still new and the number of published studies is limiting

Estimating the cost of the design, production, and dissemination of social media videos for social and behavioral change: Evidence From Merci Mon Héros in Niger and Côte d’Ivoire

Merci Mon Héros (MMH) is a youth-led multi-media campaign in Francophone West Africa seeking to improve reproductive health and family planning outcomes using radio, television, social media, and community events. One component to this project is the development of a series of youth-driven videos created to encourage both youth and adults to break taboos by talking to each other about reproductive health and family planning. A costing study was conducted to capture costs associated with the design, production, and dissemination of 11 MMH videos (in French) on social media in Côte d\u27Ivoire and Niger. The total costs to design, produce and disseminate 11 of the campaign videos for MMH in both Côte d\u27Ivoire and Niger were $44,981. Unit costs were calculated using three different denominators, resulting in average unit costs of$0.16 per reach, $1.29 per engagement, and$4.27 per video view. These findings can be useful for future studies of SBC interventions using social media for framing the analysis and selecting the appropriate metrics for the denominator, as well as for budgeting and planning SBC programs using social media