Behavior Change
The attitude of health workers toward
information, also called the "culture of information"
is often the deciding factor in determining if information
will be valued and used in decision making. People take actions
when there are immediate consequences, either positive or
negative. In many health care systems, there are no immediate
consequences concerning information collection and so the
process is often devalued and degenerates into a burdensome
information system that does not inform rational policy development
or effective response. To overcome this situation these techniques
of behavioral science are employed:
- Identify the ideal, critical actions for community
and health staff concerning surveillance
- Determine the feasibility of these ideal actions from
the point of view of the community and health staff
- Specify the factors that either inhibit or facilitate
performance
- Work with the community and health workers to test appropriate
solutions to overcoming the barriers to performance
Behavior science gives us methods to examine
the behaviors of individuals and groups, identify the impediments
to performance, test different approaches and assess their
feasibility, and evaluate the effectiveness of approaches.
Some of the barriers to reporting
commonly cited by health workers:
- Poor communications
- Difficult forms
- Too many forms
- "No time"
- No transport
- No case definitions
The behavioral approach to surveillance
broadens our understanding as to why information either
is or is not valued and used in decision-making. This understanding
provides USAID with a new way to improve performance. The
"culture of information" is an individual and
organization trait that needs to be understood, nurtured
and monitored if infectious disease surveillance is to ever
achieve its full potential.
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