Mapping the evidence on social, behavioural and community engagement for reproductive, maternal, newborn, child and adolescent health

This brief combines the findings from the evidence gap map on adolescent, sexual and reproductive health and the social behavioral and community engagement interventions map for reproductive, maternal, newborn and child health. The World Health Organisation commissioned this brief to highlight the main findings and common limitations related to both subjects and identify possible areas for future research.

Context

Over the last few decades, there have been significant improvements in the health and well-being of women, adolescents and children, however, gains have been uneven and inequalities persist.

Social, behavioural and community engagement (SBCE) interventions address the capabilities of individuals, families, communities and health providers to better identify and respond to health needs. Such interventions are considered fundamental to realising improved health and well-being for women, children and adolescents. SBCE interventions include interpersonal communication and health education activities, delivery of health messages, engagement through mass and social media, interventions that address financial barriers (including cash transfers) and interventions to formalise community participation in health planning and programming.

To support the implementation of effective and sustainable programmes and direct research funding to where it is most needed, decision makers need access to existing high-quality evidence on intervention effectiveness. 3ie has recently produced two evidence gap maps (EGMs) that cover SBCE interventions across a spectrum of reproductive, maternal, newborn, child, and adolescent health.

To bring the findings of these two projects together, the World Health Organisation (WHO) commissioned 3ie to produce a policy brief. The brief highlights the main findings and common limitations related to SBCE interventions across the two EGMs and summarises areas for future research.

The brief pulls together findings from the following two EGM reports:

• Social, behavioural and community engagement interventions for reproductive, maternal, newborn and child health: evidence 
  gap map
• Adolescent sexual and reproductive health evidence gap map report: In this report, SBCE interventions are examined within a broader framework of interventions. This report was produced by 3ie.

Main findings from the RMNCH and ASRH gap maps

We find that while a considerable amount of evidence already exists for SBCE interventions for RMNCH and ASRH, there are still critical gaps in the impact evaluation and systematic review evidence bases.

We identified a number of limitations common across studies in this literature. These should be considered in the design and reporting of future impact evaluations and systematic reviews to help improve and advance research on SBCE interventions:

• Studies rarely report on outcomes related to the enabling environment, such as health provider attitudes and communication skills, or social norms;
• Analysis of how SBCE intervention effects vary by vulnerable or marginalised populations  is frequently missing;
• M-health and other ICTs play an increasingly stronger role in SBCE programming, but there is limited evaluation evidence available;
• The usefulness of studies is often limited by inadequate reporting, including in descriptions of context of the evaluation, interventions and study design;
• Few of the studies included qualitative components or process evaluation
• It was rare for studies to include information on cost or cost effectiveness analysis;
• There are very few evaluations of interventions in francophone African countries, despite evidence of SBCE programming in this region; and
• A significant share of the systematic review evidence base has methodological limitations. These limitations include unclear inclusion criteria for interventions and health topics, no use of independent screening or data extraction, missing risk of bias assessments of included studies and use of vote-counting approaches.

Use the links below to access 3ie’s interactive EGM platform

Explore the evidence gap maps on 3ie’s interactive platform
ASRH evidence gap map 
RMNCH evidence gap map

To explore the EGMs by health area:
Reproductive health evidence gap map
Maternal health evidence gap map
Newborn health evidence gap map
Child health evidence gap map

Key publications
Download the 3ie ASRH EGM report
Download the 3ie brief on SBCE interventions