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C-Change: Equipping organizations to break down barriers to change

December 04, 2012

C-Change: Equipping organizations to break down barriers to changeIn Namibia, the national government and local organizations had been using mass media to inform people about HIV prevention. These efforts appeared to be successful, with 90 percent of people surveyed able to accurately describe how to prevent HIV. But further inquiry revealed that few men and women actually got tested, used condoms consistently or took other measures to prevent acquisition of HIV.

Similar scenarios are played out in different countries and in different contexts. Experts in human development conduct research and invest time and resources to identify problems and offer solutions. But applying these solutions in local contexts can be difficult. Often, what's missing is an understanding of why people behave the way they do — the beliefs, perceptions, motivations and social contexts that influence their actions or inability to act.

Social and behavior change communication (SBCC) examines the underlying social and structural causes of behavior and uses this research to design strategies and interventions that take this "why" into account. The ultimate goal of SBCC is to develop communication strategies to help people adopt positive social norms and behaviors that mitigate larger problems.

One of FHI 360's key SBCC projects, the Communication for Change project (C-Change), has been implementing and strengthening SBCC programs in Africa, Eastern Europe, and Latin America and the Caribbean since 2007. Funded by the U.S. Agency for International Development, the project provides governments, organizations and communities with tools, training and mentoring to help them develop SBCC programs tailored for their specific situations. C-Change focuses not only on individual behaviors but also on the social and policy contexts that affect behaviors.

The project has developed a range of innovative, evidence-based tools to strengthen SBCC capacity. The core tool is the C-Modules, which take users through the process of implementing SBCC programs — assessment of the situation, program design, materials development, implementation, and monitoring and evaluation. The modules can be used online, self-paced or facilitated. Another key resource is the SBCC Capacity Assessment Tool, which helps organizations, individuals and networks assess their SBCC knowledge. These and other tools are available at

C-Change also partners with academic institutions to develop a new generation of SBCC experts by building training into degree programs. In collaboration with Ohio University and South Africa's Soul City Institute for Health and Development Communication, C-Change developed a graduate-level SBCC program at the School of Public Health of the University of the Witwatersrand in Johannesburg. The program, the first in Africa, had 147 participants from 25 countries in early 2012. Universities in Albania, Nigeria and Guatemala have followed the South African lead. Courses based on the C-Modules are also available through Ohio University's website and will soon be launched on USAID's e-learning website.

C-Change focuses primarily on a range of health areas, including HIV prevention, modern family planning and reproductive health, and malaria control and prevention. But the project also encompasses gender equality and civil society and democracy building.


In Africa under the U.S. President's Malaria Initiative, the project worked extensively with governments, USAID missions and nongovernmental organizations to coordinate and strengthen the SBCC components of their malaria programs.

In Namibia, C-Change worked with the government and civil society organizations to develop SBCC activities that did more than inform people about HIV prevention. The project developed tools that national partners could use in different programs to help people reduce their risk. The project trained 1,367 people in SBCC and developed new communication materials. In Kenya, C-Change developed and disseminated a toolkit for national and provincial governments and other partners to use to educate the community about the role of male circumcision in reducing the risk of HIV and encourage men to be circumcised. The tools are available at:

An important resource in C-Change's HIV prevention work is the Community Conversation Toolkit. Developed in collaboration with local partners, the toolkit is used to equip communities to take action to address key drivers of the HIV epidemic, such as cross-generational sex, gender-based violence and alcohol use. The toolkit has been translated into nine languages and adapted for use in Lesotho, Malawi, Namibia, Nigeria, South Africa, Swaziland, Zambia and Zimbabwe.

Gender equality

SBCC is particularly effective for addressing attitudes and beliefs about gender that prevent people from making healthier choices. In Katanga Province of the Democratic Republic of the Congo, C-Change worked to prevent and reduce school-related, gender-based violence among students at 31 primary and secondary schools. The project developed community media campaigns and strengthened the capacity of educators, parents and students to promote positive social and gender norms that counteract such violence.

Civil society and democracy building

The SBCC approach has also been used to increase citizen participation in civil society. In Peru, C-Change developed a program to improve citizens' attitudes toward democracy and increase political participation, particularly among youth. The program, Democracia Activa Peru, included a cross-sector media campaign, a national communications strategy, public policy forums, community mobilization and journalism training. According to the project's nationwide survey, Peruvians' support for democracy as a political system better than any other jumped from 56 percent in 2010 to 71 percent in 2012.

For more information, please visit C-Change: Equipping organizations to break down barriers to change.

Photo caption and credit: A young man uses the Community Conversation Toolkit during a focus group discussion in Malawi. (FHI 360)