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Six Steps for Understanding and Improving Health Provider Behavior

Health providers are key influencers in the patient-provider interaction. They serve as gatekeepers for malaria prevention,testing, and treatment, and heavily influence the quality of health management information systems data.

Making strides in malaria control therefore requires a strong focus on provider behavior. But what drives provider behavior and how can we improve it?

PMI Impact Malaria and Breakthrough ACTIONcollaborated to createA Blueprint for Applying Behavioral Insights for Malaria Service Delivery: Methods and Frameworks for Improving Provider Behavior. In late June, PMI Impact Malaria co-hosted a webinar outlining the Blueprint's six steps for understanding and improving provider behavior:

1. Define behaviors you wish to change

For instance, “adherence to guidelines” sounds straightforward but involves a complex set of behaviors, so mapping out sub-behaviors and pinpointing where providers are struggling the most can help design programs that emphasize 2-3 priority sub-behaviors at a time.

2. Identify specific groups of providers to target

A tailored approach is better than a generic one. For example, malaria service delivery quality assurance can be resource intensive, but targeting specific facilities based on high caseloads and low levels of performance can lead to greater impact.

3. Diagnose factors affecting behavior

Provider norms, beliefs, and attitudes can affect adherence to guidelines. Use a socioecological model to understand the many interlinking factors within and beyond the individual that influence behavior. Consider malaria service delivery issues from the client, the provider, and the health system manager perspective.

4. Involve providers in design

Mindfully involving both providers and clients throughout the design process can ensure that interventions are feasible and desirable for users, as well as sustainable in the long-term. User participation can range from high levels, for instance human-centered design, to lower levels like informative design where users inform design decisions but do not make them.

5. Match interventions to drivers of behavior

Different types of interventions are better suited for different levels, and interventions can be strategically coupled to amplify impact. For example, PMI Impact Malaria found that supportive supervision using OTSS+ checklists coupled with a mentorship approach improved malaria in pregnancy services in Côte d’Ivoire.

6. Use holistic approaches to monitoring and evaluation

Do not collect just service statistics, use multiple data sources. Document how a project was implemented, how it evolved over time, and how it was tailored to different settings.

Improving malaria service delivery requires lasting behavior change from providers. These steps highlight best practices for designing provider behavior change interventions.

For more information, read PMI Impact Malaria’s blog post: Using Insights into Health Provider Behaviors to Improve Malaria Service Delivery. To watch the webinar, click here.

Header Photo Caption: Nurse Ursla Wasinda checks the pregnancy of Syprose Atieno at Nyalenda Health Centre in Kisumu, Kenya. Credit: Mwangi Kirubi, PMI Impact Malaria

Written by Katherine Kemp, PMI Impact Malaria Communications Coordinator

PMI Impact Malaria is led by Population Services International (PSI) in partnership with Jhpiego, Medical Care Development International (MCDI), and UCSF.

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