eprintid: 10107699 rev_number: 17 eprint_status: archive userid: 608 dir: disk0/10/10/76/99 datestamp: 2020-08-13 14:54:51 lastmod: 2021-12-13 02:04:13 status_changed: 2020-08-13 14:54:51 type: article metadata_visibility: show creators_name: Hill, Z creators_name: Scheelbeek, P creators_name: Hamza, Y creators_name: Amare, Y creators_name: Schellenberg, J title: Are We Using the Right Approach to Change Newborn Care Practices in the Community? Qualitative Evidence From Ethiopia and Northern Nigeria. ispublished: inpress divisions: UCL divisions: B02 divisions: D01 note: © Hill et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-19-00410 abstract: Changing behaviors is usually a core component of the role of community health workers (CHWs), but little is known about the mechanisms through which they change behavior. We collected qualitative data from 8 sites in Ethiopia and northern Nigeria where CHWs were active to understand how they change newborn care behaviors. In each country, we conducted 12 narrative interviews and 12–13 in-depth interviews with recent mothers and 4 focus group discussions each with mothers, fathers, grandmothers, and CHWs. We identified 2 key mechanisms of behavior change. The first was linked to the frequency and consistency of hearing messages that led to a perception that change had occurred in community-wide behaviors, collective beliefs, and social expectations. The second was linked to trust in the CHW, obligation, and hierarchy. We found little evidence that constructs that often inform the design of counseling approaches, such as knowledge of causality and perceived risks and benefits, were mechanisms of change. date: 2020-07-24 date_type: published official_url: https://doi.org/10.9745/GHSP-D-19-00410 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1807144 doi: 10.9745/GHSP-D-19-00410 pii: GHSP-D-19-00410 lyricists_name: Hill, Zelee lyricists_id: ZEHIL36 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner full_text_status: public publication: Global Health: Science and Practice volume: 8 number: 3 event_location: United States issn: 2169-575X citation: Hill, Z; Scheelbeek, P; Hamza, Y; Amare, Y; Schellenberg, J; (2020) Are We Using the Right Approach to Change Newborn Care Practices in the Community? Qualitative Evidence From Ethiopia and Northern Nigeria. Global Health: Science and Practice , 8 (3) 10.9745/GHSP-D-19-00410 <https://doi.org/10.9745/GHSP-D-19-00410>. (In press). Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10107699/1/GHSP-D-19-00410.full.pdf