Setting out Sightsavers’ approach to behaviour change

Cathy Stephen, July 2020
An illustration of a Bangladeshi family outside their home.
An illustration produced by Sightsavers' Bangladesh country office. Illustrations like these have helped to support Sightsavers' inclusive eye health work in South Asia.

In the context of COVID-19, Sightsavers’ new lead on behaviour change communication introduces her work and explains why behaviour change is so crucial to our mission.

None of us will forget the year 2020, when the COVID-19 pandemic spread across the world and affected every part of our lives. At Sightsavers, our staff, partners, communities and supporters have all been impacted by the disease and have had to undertake actions – or practice ‘behaviours’ – mandated by governments to prevent its spread.

In the absence of a vaccine, the only way to stop the transmission of COVID-19 is to change people’s behaviours. These changes have included reducing our movements and staying at home, keeping a safe distance from others, regularly washing our hands with soap and, in some contexts, wearing masks in public spaces.

A floor marking on a concrete path showing a two-metre gap.
COVID-19 government communications have included giving us ‘nudges’ to change our behaviours, like these floor markings in London, UK showing a two-metre gap. @Unsplash/Chloe Evans

Society-wide behaviour change is complex, and people are not always as rational or predictable as we might hope they would be! A person’s decision to practise (and keep practising) COVID-19 preventative behaviours are affected by a huge range of factors. People are influenced by their ability to understand and carry out the actions they are being asked to do, by the incentives they feel towards change, as well as by the wider society around them.

To address some of these challenges, COVID-19 communication by national governments have focused on emphasising the severity of the disease and the ease of transmission, as well as giving us ‘nudges’ to change our behaviours.

But during this pandemic, preventative behaviours are especially difficult to carry out in many of the contexts Sightsavers work in. Communities may not have easy access to water and soap to wash their hands more frequently and they may live in crowded housing with large multigenerational families. They may rely on daily income for food and are likely to hear rumours and misinformation from different sources, such as social media. For many people with disabilities, carrying out preventative behaviours could be even more difficult, and may require adapting for their own situation.

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A group of four people stand outside wearing protective masks and washing their hands.
Community health volunteers in Jharkhand, India, have been carrying out COVID-19 awareness and prevention messaging.

Our inclusive behaviour change journey

While COVID-19 has brought behaviour change into the spotlight, influencing people’s behaviours has always been at the heart of Sightsavers’ work with communities, schools, health centres and employers, and in the treatment and prevention of neglected tropical diseases (NTDs).

Social behaviour change is about understanding and influencing healthy and inclusive behaviours and providing a supportive social environment for these to flourish in. This means that we need to influence the behaviours of parents, young people, community leaders, teachers, health care workers and government officials, among many others, in order to influence whole communities. If we can encourage people to change their everyday behaviours, then we might get some way towards having healthier and more inclusive societies for men, women and children with and without disabilities.

As Sightsavers’ new behaviour change technical lead, I’m helping the organisation to understand and learn from what we’ve done so far. I’m guiding a process to think about how behaviour change can help us to deliver our ambitions to ‘Protect sight and fight for disability rights’ and where we might need to strengthen our strategies, approaches and capacity to deliver this.

We have a strong foundation to build upon, with examples of good practice in our work on NTDs, inclusive eye health, education and economic empowerment.

Inclusive handwashing during COVID-19

A young woman using a wheelchair sits outside a hairdressing salon with her employer.
Irene, a student on the Connecting the Dots programme, began an internship at a local salon in Masindi, Uganda, after completing her hairdressing course. ©Sightsavers/Martin Kharumwa

In Uganda, for example, our Connecting the Dots programme has placed young people with disabilities into internships with local employers. Together with parent peer networks and community dialogue sessions, this has helped to positively change community attitudes and perceptions towards people with disabilities in the workplace, reducing stigma and discrimination.

Under the UK aid-funded Ascend West and Central Africa programme, we are adapting activities in some of the countries where we work to support the COVID-19 response – for instance targeted behaviour change messaging around hand hygiene, social distancing and wearing masks. Within this we are also striving to ensure that people with disabilities are not left behind in relief efforts. The programme as a whole aims to include people with disabilities in its design, delivery and evaluation.

And we are using a behaviour change and WASH framework to help change healthy hygiene and sanitation behaviours to support the trachoma elimination programmes in 14 countries under the Accelerate programme.

Looking to the future

In order to ensure that social behaviour change is given greater emphasis in Sightsavers’ work, here’s what we will be focusing on over the coming year:

  • Improving the clarity and guidance on social behaviour change, both in terms of our strategy and how we develop effective interventions.
  • Increasing our capacity and confidence to plan, deliver and measure interventions with our local partners.
  • Focusing on disability stigma and discrimination to help us support people with disabilities to access their rights.

Lastly, we want to ensure that we embed core inclusive social behaviour change principles into our work. These include using participatory and local design to ensure that images and messages are appropriate for different community contexts, developing materials that are accessible for everyone and using evidence and learning to help us make the right decisions.

COVID-19 has reminded us of the central importance of understanding and influencing people’s behaviours. As we move into a post-pandemic world, addressing these priorities will mean that healthy and inclusive behaviours are more likely to be practised in the communities where we work, ensuring we continue to make a real difference to people’s lives across the world.

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Cathy Stephen.Cathy Stephen
Cathy Stephen is Sightsavers’ global technical lead for behaviour change communication.

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