Capacity to Promote Behaviours Effectively

Output

Outcome

% of [specify promoters] who demonstrate the competencies required to promote [specify priority behaviours] effectively

This indicator assesses whether people promoting the desired behaviours - such as health workers, agricultural extension workers or volunteers - have and apply the necessary competencies. How these promoters communicate with and support people can significantly influence behaviour adoption, alongside other factors such as access to services, resources and prevailing social norms.

Determine the indicator's value using the following methodology:

 

1) Decide how you will measure the promoters’ competencies. There are two main options:

       - Observing promoters while they do their work and recording what they are (not) doing in a checklist is the best way to assess their skills and to some extent also their knowledge. The checklist should focus on measuring whether the promoters follow the recommended ways of promoting the behaviour and whether what they say is technically correct. An example of such a checklist is included on pages 119 – 120 of the Make Me a Change Agent publication (see below). Consider limiting the checklist to a smaller number (e.g. 10) of the most important practices, especially those that are frequently problematic. 

       - Theoretical test helps you measure the extent to which the promoters have the knowledge they need to promote the behaviours effectively. Such tests are usually written but can also be based on an interview (however, this is demanding on the interviewers’ time). They tend to assess knowledge related to:  

                1. the main messages the promoters are expected to communicate to the target audience (and the ‘technical’ knowledge relating to these messages)

                2. the content of the SBC materials the promoters should use

                3. the main principles of effective SBC communication / facilitation methods

 

It is recommended that you either use only observations or observations combined with a theoretical test. Avoid using theoretical tests only, as it does not show you the promoters’ actual skills.

Ensure that the checklists / tests are realistic (not too ambitious). They should focus on measurable skills and knowledge. Before using the checklist or test, try it with a few promoters and ensure that assessors understand how to score each item consistently.

Select competencies that are essential for the promoters’ actual responsibilities, considering the behaviours they promote and how they engage with the target audience.

 

 

2) Decide the minimum performance that a promoter needs to achieve in order to be considered “capable of promoting the priority behaviours in an effective manner”. For example, following at least 8 out of 10 observed practices and scoring at least 70% in the theoretical test.

These thresholds are examples, not universal standards. Set the minimum acceptable performance based on the importance of the assessed competencies. Consider identifying essential requirements that must always be met, even when the promoter achieves the overall minimum score (for example, providing technically correct advice and avoiding harmful recommendations). If both observation and a theoretical test are used, the promoter should meet the minimum requirements for both.

During observations, record practices that could not reasonably be assessed as ‘not assessed’, rather than automatically treating them as failures. Exclude such items from the overall checklist score, using a scoring rule defined in advance. If essential competencies could not be assessed, arrange another observation before deciding whether the promoter meets the standard. Also define the minimum number of checklist items that must be assessed for the overall score to be considered valid. Otherwise, a promoter could pass based on only a few observed practices.

 

 

3) Conduct the observations / administer the theoretical tests with a representative sample of promoters. First, prepare an up-to-date list of the promoters whose competencies the indicator should measure. If the group is small, consider assessing everyone. Otherwise, select promoters from this list using a method that adequately represents their roles, locations and working conditions. Avoid assessing only those who are easiest to observe or who volunteer to participate. Where promoters have substantially different responsibilities, use appropriate assessment criteria and consider reporting their results separately.

It is highly recommended that the observations and tests are conducted throughout the project, as a part of its routine monitoring system. This approach has several advantages:

       - First, it saves time. Conducting observations and tests is time consuming and trying to do them all at once (e.g. during an endline survey) might be too demanding.

       - Next, the results of observations and tests can be used to provide the promoters with the support they need to address any identified weaknesses (e.g. additional training focusing on the key gaps). To have the time required to address the weaknesses, they must be identified during the project, not at its end.

Define the reporting period in advance and count each promoter only once when calculating the indicator. If a promoter is assessed several times during that period, use a consistent rule, such as their most recent valid assessment. Do not count individual observations as separate promoters. When comparing results across periods, use the same assessment criteria and reporting rules. 

 

4) Using the performance criteria defined in point 2, count the number of promoters who can be considered “capable of promoting the priority behaviours in an effective manner”.

 

5) To calculate the indicator's value, divide the number of promoters that can be considered “capable of promoting the priority behaviours in an effective manner” by the total number of promoters with a valid assessment. Multiply the result by 100 to convert it to a percentage.

This data can be disaggregated by promoters’ gender, location, and, if relevant and feasible, also age group and years of experience.

1) The publication Community Health Worker Competency List for Nutrition Social and Behavior Change (see below) can provide you with additional ideas of what competencies can be measured using the observations-based checklist. 

2) Keep in mind that promoters may perform differently when they know they are being observed. Whenever feasible, assess their normal work rather than a specially prepared session. Ensure that the observers provide constructive feedback to promoters. Remember that a single successful observation does not necessarily show that the promoter performs consistently well.

3) Use the findings to identify which competencies need further support. Where feasible, combine observation findings with feedback from the people receiving the promoted messages. Such feedback can help identify communication problems that may not be evident from the observation alone.

Also consider using the following indicators:

• Staff Understanding of Effective Social and Behaviour Change (assesses whether programme staff understand the principles needed to support effective behaviour-change interventions)

• Understanding of the Promoted Messages (measures whether the target audience correctly understands what it is being encouraged to do)

• Prevalence of Barriers to Change (helps identify obstacles that effective communication alone may not overcome)