Quality social and behavior change (SBC) is key to achieving nutrition outcomes. SBC is the thread that ties nutrition sectors and strategies together. Whether an activity aims to improve the nutritional status of women and children, foster more resilient communities, or increase the availability of safe, affordable and nutritious foods, individual behaviors are at the heart of the solution.

Most nutrition programs intend to use quality SBC approaches, but key steps are often missed. Nutrition SBC is particularly challenging due to the nature of the behaviors—small, frequent, and additive.

Building on partner experiences and lessons learned, USAID Advancing Nutrition is developing a suite of practical tools to harmonize design, implementation, monitoring, and evaluation of nutrition SBC programs in food and health systems. These tools were first introduced during a webinar in December of 2020 and are meant to support each of the six steps in SBC programming.

Step 1: Prioritize Behaviors

Behavior prioritization is the first step in program design. No matter how skilled a program’s SBC team is, no program can do everything. To help with this step, we highlight the six core nutrition-specific behaviors (English) (French) that research shows will lead to improved nutrition outcomes. This list of illustrative nutrition-sensitive agriculture behaviors can spark ideas and discussion to prioritize behaviors to improve nutrition-sensitive agriculture.

The Prioritizing Multi-Sectoral Nutrition Behaviors tool presents a simple step-wise process to help narrow your focus and avoid overloading or overwhelming people and programs. Priority behaviors guide formative research and SBC strategy development to achieve intended social and behavior change.

Step 2: Plan and Conduct Research

Use the Factors That Influence Multi-Sectoral Nutrition Behaviors tool (English) (French) to explore the literature on the main barriers and enablers or "factors" that influence someone to practice and maintain prioritized behaviors. Then, focus any formative research on gaps in the literature to better understand people and their context. This Formative Research Decision Tree tool can help to decide which methods would best answer research questions.

Step 3: Design a Nutrition Social and Behavior Change Strategy

With priority behaviors and formative research, the Using Research to Design a SBC Strategy tool (English) (French) can help organize and distill research into an evidence-based SBC strategy.

The SBC strategy provides a roadmap to ensure that interventions address critical factors and are coordinated to achieve outcomes—including change in the priority behaviors. It is the foundation for implementing, monitoring, and evaluating activity success. These nutrition SBC strategies offer examples: USAID Ethiopia Growth through Nutrition, USAID Rwanda Orora Wihaze, and USAID Cambodia NOURISH, and multiple examples in this collection.

Use this SBC Strategy Checklist and Workplan Checklist to ensure that all key SBC elements are covered.

Step 4: Plan for Implementation and Monitoring, Evaluation, and Learning

Use the Defining Social and Behavior Change Competencies for Multi-Sectoral Nutrition list (English) (French version) to guide hiring decisions, identify areas for capacity strengthening, and track changes in performance over time. Community Health Worker Competency List for Nutrition Social and Behavior Change (English) (French version) can also help with planning capacity strengthening for community health workers and others on the frontline.

Another key element of quality SBC is monitoring priority behaviors and factors and using the Monitoring SBC for Multi-Sectoral Nutrition tool (English) (French) can help. The tool walks you through identifying appropriate indicators, selecting and applying methods, analyzing results, and making adaptations.

Step 5: Implement, Monitor, and Adapt

Implementation of SBC is just as important as high quality design for outcomes. The Social and Behavior Change Do's and Don'ts: Getting It Right for Multi-Sectoral Nutrition Programming tool (English) (French) offers reminders of good implementation practices and problems to avoid. This resource can help to identify areas to check and adjust as needed in order to improve quality at every stage.

Step 6: Evaluate

Strong evaluations are also key to achieving high quality SBC. Using the MEL plan and the Measuring Social and Behavior Change in Nutrition Programs: A Guide for Evaluators resource to manage an evaluation that demonstrates progress toward goals.

Achieve high quality SBC by—

• Prioritizing behaviors that will have an impact on the intended outcome.
• Addressing the most important factors that influence the priority nutrition behaviors.
• Setting up activities with a clear linked pathway between behaviors, factors, and interventions, and continually adapting.

These tools help lead you through the different steps for designing, implementing, monitoring and evaluating high quality SBC programs.