Strengthening Social and Behavior Change Programming Through Application of an Adaptive Management Framework: A Case Study in Tanzania.

Abstract

Integrated social and behavior change (SBC) programs seek to achieve changes in behaviors and norms across a range of health areas. Realizing changes across multiple behaviors is inherently complex and requires programs to be designed and implemented nimbly in ways that are responsive to feedback, new learning, and contextual shifts. Responsive feedback (RF) promotes just this kind of data analysis, use, and programmatic adaptation. Under the U.S. Agency for International Development (USAID)'s flagship SBC program in Tanzania, USAID Tulonge Afya, we applied FHI 360's SBC Adaptive Management Framework, which shares many similarities with RF. It includes meaningful engagement with an array of stakeholders throughout project design, implementation, monitoring, and evaluation (M&E); requires close collaboration between M&E and programmatic staff to ensure data collection and use are informed by and contribute to refinement of the project's theory of change; and incorporates purposeful, routine opportunities for learning and course correction. Accompanying the framework is a suite of tools and activities to facilitate systematic collection, analysis, and application of data for project design, improvement, and evaluation. Use of the framework within a complex, integrated SBC program improved our ability to address emerging priorities and achieve greater scale, saturation, and quality execution of activities. It also facilitated significant input from local communities and stakeholders-through shared data analysis and feedback loops-ensuring project activities reflected their strengths, needs, and preferences rather than the perspectives and biases of program implementers. In this article, we discuss the key components of the SBC Adaptive Management Framework and its commonalities with RF, how use of the framework and the underlying principles and elements of the RF approach contributed to the project's success, and share lessons that may strengthen and expand the application of RF and similar approaches within future SBC programs.