Percent of audience who practice the recommended behavior
Among those in the target audience, the percent who practice the recommended behavior. “Audience” is defined as the intended population for the program. “Behavior” refers to the desired result the program is trying to achieve among members of the intended population. Examples include: seeking antenatal care (ANC), going for HIV testing and counseling, or using a modern method of family planning.
For the respective behavior of interest, evaluators may have to define what meets the criteria for practicing a recommended behavior. For example, if seeking ANC is the practice being promoted for pregnant women, evaluators should determine if one ANC visit suffices, or if women must have attended a minimum of four ANC visits, as recommended by the WHO, in order to be counted for this indicator. Programs must define the reference period during which the behavior was practiced (e.g., at last sex or in the past day/week/month; duration of pregnancy).
Depending on the need for a yes/no response, or if the responses lend themselves to more flexibility, evaluators may want to use a five-point Likert scale to decide whether to combine “always practice” with “sometimes practice” to arrive at the total percentage practicing the desired behavior.
This indicator is calculated as:
(Number of audience members who report practicing the recommended behavior/Total number surveyed in intended audience) x 100
Confirmation that the recommended behavior is or is not being practiced among the intended audience
This indicator can be disaggregated by audience characteristics (age, sex, geographic location, rural/urban status, or other characteristics of interest to the program).
National, regional, or local sample surveys with members of the intended audience; focus group discussion; in-depth interviews; direct observation
This qualitative outcome indicator measures the effectiveness of a social behavior change communication strategy. When looking at the process of behavior change and the Stages of Change Continuum (FHI, 2004), practicing the recommended behavior represents one of the later stages in effecting social change.
This is a follow-up indicator to other BCC indicators related to intent, such as, Percent of non-users who intend to adopt a certain practice in the future.
Behavior change is a long process and it may take several years of program implementation before actual changes occur. Also, it is difficult to measure behavior change accurately and verify if the respondent is indeed practicing the recommended behavior, so in most cases responses must rely solely on individuals’ honesty, which could be influenced by response bias if those in the target population are familiar with the behavior and want to give a favorable answer.
Even when evaluators conduct baseline, midline, and endline surveys, it is still difficult to link program activities to observed behavior change because of other outside influences (FHI, 2004).
FHI. Monitoring HIV/AIDS Programs: A Facilitator’s Training Guide. Module 6: Monitoring and Evaluating Behavior Change Communication Programs. 2004.