The USAID-funded NOURISH project, led by Save the Children, worked to accelerate stunting reduction by focusing on the key causal factors of chronic malnutrition in Cambodia—poverty, lack of access to quality food and nutrition services, unsanitary environments, and social norms and practices that work against optimal growth and development. NOURISH aimed to improve the nutritional status and well-being of women and children in 567 underserved, rural communities in Battambang, Pursat, and Siem Reap provinces, uniquely integrating for communities’ and families’ health and nutrition, water, sanitation, and hygiene (WASH) and agriculture. TMG provided technical assistance and support for social and behavior change and SBC communication to create demand for and increased utilization of health, WASH, and agriculture practices, services and products. TMG designed and conducted formative research and developed an evidence-based SBC and communication strategy. Working with private-sector media agencies, TMG led the development of a media strategy and materials for the Grow Together Program included television, community engagement by leaders and community agents, interpersonal communication, and support to business service centers. Finally, TMG developed small fish powder, initially for preparation at home, but later commercialized as a product for young child feeding. TMG led a market assessment for the small fish powder, trained women entrepreneurs to make it for sale, and developed their business skills to improve access for all families to this new product. To learn more about our work on the project’s “Grow Together” SBCC program , click here.
Democratic Republic of the Congo
The DRC Strengthening Livelihoods and Resilience (SLR) Activity assists the Government of the DRC to improve the resilience capacities in vulnerable households and communities and support the Congolese people, households, and communities in their efforts to sustainably escape poverty and chronic vulnerability. SLR strengthens systems and institutional capacity; fosters inclusive economic growth and improved livelihoods; improves the availability, access, utilization, and stability of nutritious foods; and promotes gender equity and the empowerment of women and youth. The Activity focuses on Ituri Province, a challenging operating environment that routinely suffers significant shocks and stresses—including resource-based conflict (especially over land issues), disease outbreaks, and severe weather and climate events—that have led to significant food insecurity and chronic vulnerability. These shocks and stresses add to the challenges faced by women, youth, and other marginalized groups. These groups have limited access to land, inputs, technical assistance, and credit, which constrains their ability to engage in the market and use inputs and technology to increase yields, boost their labor productivity, and, ultimately, increase their incomes. TMG is contributing to the Activity’s formative research to refine the project’s Social and Behavior Change (SBC) and Gender and Social Inclusion strategies, and to inform the design and implementation of pilot SBC activities. TMG is also working with local partners to integrate SBC approaches into their activities, and with MEL staff to identify, integrate and track SBC metrics in project MEL and CLA activities. Finally, TMG will provide TA to local organizations to implement and scale select nutrition and WASH-focused SBC activities to improve the availability, and stability of nutritious foods, and to increase the uptake of essential nutrition and WASH behaviors and services.
In Ethiopia, TMG is a member of the JSI-led consortium on the Feed the Future Ethiopia Study on Animal Food Markets in Rural Areas (SAFIRA). TMG, in partnership with consortium partner IFPRI, is conducting research into how to maximize the role that markets play to support improved nutrition, especially in the first 1000 days of life. Research is focused on determining if market-centered interventions can successfully increase the intake of animal-sourced foods (ASFs) in children 6 – 23 months of age in Tigray, Ethiopia. TMG provides leadership in the design, analysis and reporting of qualitative formative research that offers evidence-based recommendations to define key market-based practices that may improve the availability and affordability of and the demand for and consumption of ASFs. TMG is also helping to design a package of supply- and demand-side behavior change interventions leveraging incentives and reducing key barriers to sale, purchase, and consumption of ASFs in 30 local market areas in Tigray. TMG joined a small panel of experts to prepare the research reports and disseminate the findings and recommendations through a series of research briefs, blogs, a webinar, and presentations.
Growth Through Nutrition, a flagship, multi-sectoral nutrition project aims to improve the nutritional status of 14 million pregnant and breastfeeding mothers, adolescent girls, and young children in four regions (Amhara, Oromia, Southern Nations, Nationalities and Peoples’ Region (SNNPR) and Tigray) through health service improvements, increased production and availability of quality food, WASH products and services, and SBCC. TMG provided technical leadership for the project’s SBCC component, beginning with the design and oversight of behavioral research to support strategy development. TMG designed two major qualitative studies — TIPs for maternal nutrition and research to learn more about the behavioral and socio-cultural context of adolescent girls’ nutrition-related practices — and provided technical assistance for the data collection and analysis, as well as report writing. Research findings and recommendations were used to inform TMG’s design of creative concepts, SBCC materials, and SBCC interventions to foster the adoption of improved nutrition practices in rural households throughout the project area.
The USAID WASH for Health in Ghana project is working to ensure that all residents have sustainable access to dignified, safe and improved water supply and sanitation, and the knowledge, attitudes and behaviors needed to appropriately use these facilities to meet their basic needs and to be healthy. Now in the second year of a two-year extension, the project objectives are to: (1) Increase use of improved household sanitation; (2) Improve community water supply services; (3) Improve sector governance and policies; (4) Expand the practice of key hygiene behaviors; (5) Leverage public-private partnership investment to magnify the impact of USG funding; and (6) Improve water supply and sanitation infrastructure for schools and health facilities. TMG is responsible for the design and implementation of the project’s SBC strategy to facilitate the adoption of key healthy behaviors.
Nutri-Salud was one of USAID/Guatemala’s flagship projects to support two priority areas of the US Government’s Global Health and Feed the Future Initiatives: (1) improving access to quality health services in Guatemala, with an emphasis on reducing inequitable health outcomes among rural and indigenous populations and; (2) preventing and treating chronic malnutrition and in children under two years of age. TMG provided technical leadership for the project’s SBCC program, including leading development of the project’s SBCC strategy, and contributed expertise to activities aimed specifically at preventing chronic malnutrition. TMG also led technical assistance to the Ministry of Health in implementing an integrated SBCC program for families with a member in the first 1,000 Days (pregnancy – the child’s first 2 years) using the Wheel of Practices for Better Living tool. Based on the Mayan calendar, the tool allows each family to tailor their behavior change goals to their situation.
In Kenya, TMG is working within the CRS-led consortium on the Feed the Future Nawiri Activity to promote sustainable food and nutrition security through research and interventions implemented with national, regional and local stakeholders. The project is currently in the first of two phases; during this learning phase, staff are working to shape, target and maximize the effectiveness of the subsequent intervention phase. In Phase 1, TMG provides SBC leadership through our Behavior Integration Advisor, on behavior prioritization and formative research. The outcome of this work includes mapping pathways to change critical behaviors to prevent and mitigate acute malnutrition in the ASALs, and to determine how to leverage the rich tradition of oral storytelling to reshape the narrative of young child growth and well-being. TMG is also contributing behavioral expertise and guidance to the project-wide gender analysis, the Village Graduation pilot and the Milk Matters pilot. And TMG is supporting development of the project’s Monitoring, Evaluation and Learning and Continuous Learning and Adaptation efforts by identifying appropriate behavioral metrics for monitoring progress and the ongoing continuous Learning and Adaptation efforts.
TMG is collaborating with prime URC and the Millennium Challenge Corporation staff to apply Behavior Integration to develop a behaviorally-focused strategy for the Lesotho Compact: Health Systems Strengthening and Reducing the Burden of HIV/AIDS activity, and to develop a draft Lesotho project implementation plan.
In Rwanda, TMG is a partner on the Feed the Future Orora Wihaze Activity led by Land o’Lakes/Venture 37. Orora Wihaze is applying a market system development approach to sustainably increase the availability of, access to, demand for and consumption of animal-source foods (ASF) through the development of profitable markets. TMG’s role is to ensure that social and behavior change considerations are fundamental to the design and development of the market-based activities wherever they are focused along the prioritized ASF value chains. Recognizing the extremely low levels of ASF consumption especially among vulnerable populations in Rwanda, in Year 1 TMG led a study of consumption practices and the factors that influence them to better understand the root causes of low consumption and to inform decision-making on interventions within the project’s ASF value chains (sheep, goats, pig, chickens and fish, and their products milk and eggs) that would address consumer need. TMG integrated critical social and behavior change priorities across the Orora Wihaze strategy for each of its intervention areas from production through marketing to and family consumption. Additionally, TMG provides technical assistance to consortium partner CRS for SBC communication activities, and capacity development in this area to consortium partner Urunana. This assistance focuses on enhancing innovative communication as a tool of strategic social and behavior change, a role beyond information dissemination.
In Tanzania, TMG supports the Save the Children-led, USAID-funded Lishe Endelevu consortium to strengthen nutrition services, improve Infant and Young Child Feeding (IYCF) and WASH behaviors, promote nutrition-sensitive livelihoods, and encourage positive shifts in gender norms and equitable household decision making. TMG leads the project’s SBC strategy design, including developing tools to support the planning of gender-sensitive programming; conducting a gender analysis of national government policies and socio-cultural settings in the four region; developing a MIYCAN SBC strategy emphasizing gender transformative interventions; and rapidly adapting and improving MIYCAN SBCC tools and interventions developed under previous projects by TMG with our partners in both Tanzania and Ethiopia. By the end of the second year of project implementation, 110,481 mothers of children under two years of age had been reached through community interventions using the TMG-designed First 1000 Days Parents’ SBCC Kit. TMG also led the development of an innovative set of adolescent nutrition SBCC materials with adolescents, parents and teachers, presenting the work to a national technical review committee comprised of representatives of the National Ministry of Health and the Tanzania Food and Nutrition Center. As a result, the Government of Tanzania has adopted the materials as part of the coordinated national response to improve adolescent nutrition. More than 300,000 adolescent boys and girls will benefit from the use of these materials by the end of the project.
In Uganda, TMG is a partner on the Abt Associates-led Integrated Community Agriculture and Nutrition Project (ICAN), USAID Uganda’s flagship project on resilience. ICAN is working to enhance the resilience of vulnerable Ugandan households in eight districts across the country. ICAN strategically layers services onto other activities to maximize efforts to improve economic opportunities for vulnerable households, stabilize their access to and consumption of diverse and nutritious diets and increase social capital by reinforcing relationships between formal governance systems and communities specific to Karamoja, Acholi and the Southwest Regions. TMG provides strategic advisory services for SBC and communication on food security and nutrition, livelihoods, and governance, girls’ education, and natural resources management. This work includes oversight and assistance in the design of the SBC and communications strategies for the project, related formative research, and technical support to local organizations working in SBC at the community level. The project’s SBC Advisor, a TMG team member, is leading an innovative behavior monitoring system to track progress in behavior change and the factors influencing the behaviors. TMG also spearheaded public commitment ceremonies among community members for change on behaviors requiring collective action. And to enhance community ownership and action on resilience plans, TMG led the development of community dialogue models with local leaders.
In Zambia, The Manoff Group is working with prime Akros on a Mass Drug Administration to Control Lymphatic Filariasis. TMG is leading the design, development, roll-out and monitoring of a demand creation campaign for the MDA. TMG conducted a rapid assessment of factors that influence participation in such a campaign; designed a message and media strategy and supporting materials; and developed a plan for coordinating social mobilization, training of frontline workers and mass media activities. Once door-to-door visits begin, TMG will monitor the implementation of the demand creation activities and provide a recap of lessons at its conclusion.
Amalima Loko, funded by the Bureau of Humanitarian Assistance and led by CNFA, is designed to improve food security in Zimbabwe through increased food access, sustainable watershed management and improved livlihoods and health. Amalima Loko builds on the legacy of its predecessor Amalima, a seven-year Resilience Food Security Activity also implemented by CNFA and TMG that worked to sustainably improve food security and nutrition for vulnerable Zimbabwean households. Amalima Loko seeks to elevate the livelihoods of more than 67,000 vulnerable households across five districts of Zimbabwe’s Matabeleland North: Binga, Hwagne, Lupane, Nkayi, and Tsholotsho. To accomplish this, the program utilizes a Community Visioning approach designed to strengthen community and household-level resilience, promotes nutrition-sensitive initiatives including a blanket food distribution program, and improves watershed infrastructure and practices that provide long-term foundations for improved resilience and agriculture-based livelihoods. TMG provides our expertise through several staff on the project who are tasked with designing and implementing social and behavior change (SBC) activities across all project purposes; contributing to formative research design and implementation as part of USAID’s “Refine and Implement” model leading to SBC strategies including a Communication Plan to promote the adoption of improved behaviors for critical program activities. TMG will support implementation of SBC activities by orienting and mentoring program staff to become agents of social and behavior change and in activities directly with key stakeholders, especially participating families. Beginning with the formative research and continuing with M&E plan, TMG is supporting collaborative learning and will actively participate in the adaptation of activities to enhance behavioral outcomes. As we did on Amalima TMG will document and disseminate successes, challenges, and learnings related to SBC.
Clean Cities, Blue Oceans is USAID’s global flagship program for combatting ocean plastics. Clean Cities, Blue Oceans (CCBO) enhances solid waste solutions and recycling systems; promotes social and behavior change for sustainable reduce, reuse, and recycle (3Rs) practices; improves governance; and forges strategic partnerships with the private sector. CCBO, led by Tetra Tech, addresses ocean plastics pollution, and focuses on reducing ocean plastics directly at their source in cities and towns across Asia, Latin America, and the Caribbean. The objectives of CCBO are backed by growing public awareness, societal concern, and public and private sector mobilization around the prevalence of plastic waste within the world’s oceans and coastal ecosystems. TMG leads strategy design and implementation oversight of activities to promote social and behavior change for sustainable reduce, reuse, and recycle (3Rs) practices, aiming to move the field forward from an information only approach to one that enables change. TMG also leads gender inclusion, including developing new US government Women’s Global Development and Prosperity (W-GDP)-funded activities.
The Manoff Group is a partner on the JSI-led consortium for this USAID flagship multi-sectoral nutrition project. USAID Advancing Nutrition provides technical support to and implementation of nutrition interventions for USAID and its partners to address the root causes of malnutrition. TMG’s cross-cutting work facilitates multi-sectoral integration. We bring expertise in social and behavior change and communication, as well as in capacity building for government partners in evidence-based design, implementation, monitoring and evaluation to change behaviors and improve health outcomes. TMG staff lead and support large-scale coordination efforts such as the global food systems conceptual framework development, the first New Partners Initiative (NPI) for nutrition in Burkina Faso and Kenya, and coordination around the continuum of care for acute malnutrition in DRC. We lead and provide support on multiple SBC efforts that strengthen the capacity of implementers to address factors that increase demand and use of high-quality services and home practices. TMG staff on the project support the USAID Bureau for Humanitarian Assistance to improve the quality of nutrition SBC and strengthen SBC capacity in partners with guidance and tools. And TMG is advancing the quality and impact of nutrition SBC by developing tools and conducting reviews of social norms in complementary feeding and maternal nutrition, and defining appropriate measures of consumer demand for healthy diets. We are developing a guide that adapts and tailors marketing techniques (both commercial and social marketing) for USAID activities that are generating demand for healthy diets among low-income consumers.
Working with the Jhpiego-led consortium, TMG is leading MOMENTUM Country and Global Leadership efforts in SBC. This work is focused on supporting the project’s efforts to take a systems approach to SBC, promoting behaviors as an organizational framework for the design of strategies to improve maternal, newborn, child and adolescent health. This work includes leading efforts across all technical areas on the project to identify areas of slow progress requiring a new approach and then enabling the practice of priority behaviors to address that challenge. In the first years of the project, TMG has helped the project analyze and address key challenges in areas ranging from professional development for healthcare workers, to antenatal and post-natal care for mother and baby, to better institutionalizing post-abortion family planning within broader service initiatives and re-conceptualizing self-care beyond reproductive health in the context of COVID, to extracting global lessons and pathways from successful work on facilitating couples communication. TMG is also supporting project efforts to build the commitment and capacity among host-country partners to incorporate behavior-driven strategic thinking into health sector planning, implementation and monitoring. Country buy-in efforts in Ghana, Sierra Leone, Indonesia and Nigeria to address entrenched obstacles in the delivery of quality MNCH/FP/RH services, to prevent intimate partner violence and child or early forced marriage, and integrating gender considerations into WASH behavior change programming have also begun.
TMG joined the JSI Research & Training Institute-led consortium to support MOMENTUM Routine Immunization Transformation and Equity. The project is tasked with collaborating with local partners to sustainably strengthen routine immunization programs to overcome the entrenched obstacles contributing to stagnating and declining immunization rates in USAID-supported countries, and to address the barriers to reaching zero-dose and under-immunized children with life-saving vaccines and other health services. In light of the COVID-19 pandemic, and the disruption of immunization services, MOMENTUM Routine Immunization Transformation and Equity will also support countries with the maintenance, adaptation, and/or reinstatement of immunization services and the introduction of COVID-19 vaccines. TMG staff work to sustainably improve the immunization service experience by improving health worker performance and leadership (including “people skills”), adaptive management capability, and use of information to strengthen decision-making and introduce actions to reduce obstacles to equity. TMG is also supporting a series of online sessions to gather input from communities, caregivers, and frontline health workers on what they view as key barriers to reaching zero-dose and under-vaccinated children and potential solutions for addressing them, including in urban, rural remote, and fragile settings.