The Manoff Group’s Behavior-Centered Programming methodology
October 2013

The Manoff Group has been providing expertise in Social and Behavior Change and Communications to USAID health and environment programs for over 45 years. Whether working at the community, regional or national level, the company’s approach recognizes that successful programs are built by integrating strategies to improve people’s practices with efforts to address service quality and systems efficiency.  It further acknowledges the ability of program beneficiaries to use their own assets to remove barriers that stand in the way of better welfare. 

The Manoff Group partners with local counterparts to identify the specific behaviors that contribute to public health and environmental crises, defines the factors that lead to positive changes, and develops communications strategies to promote new behaviors based on those factors.  These principles are captured in The Manoff Group’s Behavior-Centered Programming Methodology, which provides opportunities for families, health workers, and community members to participate in formulating and testing proposed practices, program strategies and activities, messages, materials and products. The central technique for doing this is the Trials of Improved Practices (TIPs), which asks potential program beneficiaries to try new products or practices before they are introduced on a large scale.

The methodology gives program planners an in-depth understanding of families’ preferences and capabilities, as well as the obstacles they face in improving their health and their motivations in trying new behaviors and practices. That is, TIPs focuses on behavior (what people do) instead of knowledge (what people know or believe). TIPs was first used in the 1980s to improve instructions for preparing homemade oral rehydration solution to treat diarrhea and to improve young child feeding. Since then, it has been applied to other public health issues, including HIV/AIDS, school health, infectious disease control, maternal health, and family planning

As part of its ongoing role in USAID/Zambia’s Communications Support for Health project, The Manoff Group has been at the forefront of developing a popular HIV-themed television soap opera known as Love Games. Through the use of a large cast of characters to tell the story, the program ensures that viewers identify with at least one character.  The characters are confronted with the risky behaviors that formative research has shown to be the key drivers of HIV in Zambia: multiple and concurrent sexual partnerships; low and inconsistent condom use, and; mother-to-child-transmission.  In a recent article on Mashable.com, it was estimated that calls to a free sexual health hotline in Zambia rise by 300 to 400 percent during and around the time that Love Games program airs.

Zambia is also one of six African nations where The Manoff Group supported the introduction of its Community-Based Growth Promotion (CBGP) approach to prevent malnutrition in young children.  In a common CBGP scenario, a caretaker would bring their infant to regular community-supported weighing sessions and, based on a volunteer-conducted assessment of the child’s growth and health status, would receive counseling on such things as feeding practices, health maintenance, illness prevention, and home management of illness. Counseling of this type is greatly aided by the development of cards that guide health volunteers in interviewing caretakers and provides illustrations to enhance understanding of the follow-up advice they receive.

Interpersonal communication methods and mass media are a powerful duo for creating social and behavior change.  But, success is ultimately driven by a well-researched approach that takes into account the feasibility of specific changes in behavior within a community, and the communications methods they trust and favor. The Behavior-Centered Programming Methodology allows for families and individuals to become part of the solution by taking an active role in addressing problematic behavior.

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