Designing Behaviorally Informed Health Interventions: Adherence to Micronutrient Treatment in El Salvador

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Aug 2020
This Technical Note describes the process of designing a behavioral intervention to help reduce the prevalence of anemia in children in El Salvador. It first describes a traditional micronutrient distribution program for rural households. The analysis shows that although implementation was relatively successful, and take-up high, adherence to the full treatment of micronutrients was much lower. To explain this gap, the analysis employs a design methodology based on the “caregiver journey.” This methodology is a sequential analysis of the decisions taken by caregivers and the factors affecting each of these decisions. The Technical Note then explores the behavioral barriers to each of these decisions by examining relevant literature and conducting semi-structured interviews in the field. Drawing on these findings, ideas and designs are proposed for interventions to overcome these barriers, prioritized based on three factors: impact, feasibility, and ability to be evaluated. The process highlights the relevance of using behavioral sciences to address issues of take-up and adherence that go beyond traditional approaches used in public health.