{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T07:07:08Z","timestamp":1777100828102,"version":"3.51.4"},"reference-count":46,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,1,18]],"date-time":"2025-01-18T00:00:00Z","timestamp":1737158400000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["AID-OAA-A-17-00018"],"award-info":[{"award-number":["AID-OAA-A-17-00018"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,1,2]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This paper examines the outcomes of the public sector capacity strengthening (PSCS) approach and how they contribute to the promotion of maternal, newborn, and child health, and nutrition (MNCH+N), family planning (FP) and malaria prevention-related outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>The qualitative study implemented from July to August of 2022 used the outcome harvesting methodology and key informant interviews to elicit information including most significant change (MSC) stories to evaluate project outcomes over 5 years (2017\u20132022).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was conducted in Sokoto, Kebbi, Nasarawa, Bauchi and Ebonyi states of Nigeria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The study focused on public sector stakeholders who were exposed to the PSCS intervention and were selected from government agencies. Nine study participants were engaged per state, bringing the total number of participants to 45. Data were analysed thematically and elicited MSC stories were analysed for content.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The PSCS approach empowered stakeholders at the individual level to disseminate MNCH+N, FP and malaria prevention messages, monitor health and social and behaviour (SBC) activities and increase the demand for health services. At the organisational level, the approach facilitated coordination of SBC activities, enabled training cascades and promoted adherence to health service guidelines. At the system level, it strengthened ward development committees to address health challenges. Challenges hindering stakeholders\u2019 application of PSCS-acquired skills include inadequate workforce, negative attitudes of health workers, funding constraints, cultural barriers, lack of government ownership and limited accessibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study shows that the PSCS approach is an effective model to scale up capacity for SBC in MNCH+N, FP and malaria prevention programmes. In response to documented supply-side challenges impeding the application of gained knowledge and skill, we recommend inclusive health worker recruitment, sensitisation programmes for health workers, government ownership, improved security, healthcare infrastructure and transportation systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-089214","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T21:37:44Z","timestamp":1737409064000},"page":"e089214","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Improving health outcomes by strengthening public sector capacity in social and behaviour change programming in Nigeria: a qualitative study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7201-4899","authenticated-orcid":false,"given":"Adetayo","family":"Adetunji","sequence":"first","affiliation":[{"name":"Population Council, Abuja, Nigeria"},{"name":"Department of International Health and Sustainable Development, Tulane University Celia Scott Weatherhead School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bright","family":"Addo","sequence":"additional","affiliation":[{"name":"Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dele","family":"Abegunde","sequence":"additional","affiliation":[{"name":"Population Council, Abuja, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Kalamar","sequence":"additional","affiliation":[{"name":"Population Council, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nrupa Jani","family":"Tulsiani","sequence":"additional","affiliation":[{"name":"Population Council, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pooja","family":"Sripad","sequence":"additional","affiliation":[{"name":"Population Council, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Foyeke","family":"Oyedokun-Adegbabo","sequence":"additional","affiliation":[{"name":"USAID, Abuja, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Augustine","family":"Ankomah","sequence":"additional","affiliation":[{"name":"Population Council, Accra, Ghana"},{"name":"Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,20]]},"reference":[{"key":"2025121220540059000_15.1.e089214.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12936-018-2427-x","article-title":"Factors associated with caregivers\u2019 consistency of use of bed nets in Nigeria: a multilevel multinomial analysis of survey data","volume":"17","author":"Babalola","year":"2018","journal-title":"Malar J"},{"key":"2025121220540059000_15.1.e089214.2","doi-asserted-by":"crossref","DOI":"10.1186\/s12936-018-2249-x","article-title":"Correlates of social behavior change communication on care-seeking behaviors for children with fever: an analysis of malaria household survey data from Liberia","volume":"17","author":"Awantang","year":"2018","journal-title":"Malar J"},{"key":"2025121220540059000_15.1.e089214.3","unstructured":"Lamstein S , Stillman P , Koniz-Booher A , et al . 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