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FIELD ACTION REPORT
Open Access

When Knowledge Is Not Enough: Applying a Behavioral Design Approach to Improve Fever Case Management in Nigeria

Faraz Haqqi, Angela Acosta, Sriram Sridharan, Emily Zimmerman, Temitope Ogunbi, Eno’bong Idiong, Uwem Inyang, Foyeke Oyedokun-Adebagbo, Jose Tchofa, Nene Diallo, Emma Mtiro, Chukwu Okoronkwo and Bolatito Aiyenigba
Global Health: Science and Practice December 2022, 10(6):e2200211; https://doi.org/10.9745/GHSP-D-22-00211
Faraz Haqqi
aBreakthrough ACTION, ideas42, New York, NY, USA.
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  • For correspondence: faraz{at}ideas42.org
Angela Acosta
bBreakthrough ACTION, Johns Hopkins Center for Communication Programs, Baltimore, MD, USA.
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Sriram Sridharan
aBreakthrough ACTION, ideas42, New York, NY, USA.
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Emily Zimmerman
aBreakthrough ACTION, ideas42, New York, NY, USA.
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Temitope Ogunbi
cBreakthrough ACTION, Johns Hopkins Center for Communication Programs, Abuja, Nigeria.
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Eno’bong Idiong
cBreakthrough ACTION, Johns Hopkins Center for Communication Programs, Abuja, Nigeria.
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Uwem Inyang
dU.S. Agency for International Development, Abuja, Nigeria.
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Foyeke Oyedokun-Adebagbo
dU.S. Agency for International Development, Abuja, Nigeria.
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Jose Tchofa
dU.S. Agency for International Development, Abuja, Nigeria.
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Nene Diallo
dU.S. Agency for International Development, Abuja, Nigeria.
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Emma Mtiro
eU.S. President’s Malaria Initiative, Abuja, Nigeria.
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Chukwu Okoronkwo
fNigeria National Malaria Elimination Programme, Abuja, Nigeria.
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Bolatito Aiyenigba
cBreakthrough ACTION, Johns Hopkins Center for Communication Programs, Abuja, Nigeria.
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    FIGURE.

    Building Behavioral Design Interventions Into the Fever Case Management Process

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    TABLE 1.

    Monitoring Data for Behavioral Design Interventions to Improve Fever Case Management in Nigeria

    Month 1Month 2Month 3
    Facilities, No.Facility Adherence,a%Facilities, No.Facility Adherence,a%Facilities, No.Facility Adherence,a% 
    Primary care centers9929104999
    Hospitals2423923122
    • ↵a Average facility adherence was calculated as the ratio of artemisinin-based combination therapy regimens prescribed to the positive malaria test results.

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    TABLE 2.

    Provider Knowledge and Attitudes Test Results Before and After Behavioral Design Interventions to Improve Fever Case Management in Nigeria

    Correct or Desirable Responses to Knowledge Questions
    Before Pilot, No. (%)
    (N=207)
    After Pilot, No. (%)
    (N=127)
    Poor (hot) storage conditions can cause RDTs to give false negative results (false)24 (12)29 (23)
    Malaria RDTs can miss malaria in febrile children if the child has low parasite levels (false)76 (37)72 (57)
    Number of children with malaria has decreased in the past 10 years (true)98 (48)94 (74)
    Any laboratory scientist who knows how to use a microscope can diagnose malaria (false)33 (16)32 (25)
    Your colleagues believe that positive RDT results can be trusted (yes)177 (86)121 (95)
    Your colleagues believe that negative RDT results can be trusted (yes)124 (61)97 (76)
    • Abbreviation: RDT, rapid diagnostic test.

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Global Health: Science and Practice: 10 (6)
Global Health: Science and Practice
Vol. 10, No. 6
December 21, 2022
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When Knowledge Is Not Enough: Applying a Behavioral Design Approach to Improve Fever Case Management in Nigeria
Faraz Haqqi, Angela Acosta, Sriram Sridharan, Emily Zimmerman, Temitope Ogunbi, Eno’bong Idiong, Uwem Inyang, Foyeke Oyedokun-Adebagbo, Jose Tchofa, Nene Diallo, Emma Mtiro, Chukwu Okoronkwo, Bolatito Aiyenigba
Global Health: Science and Practice Dec 2022, 10 (6) e2200211; DOI: 10.9745/GHSP-D-22-00211

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When Knowledge Is Not Enough: Applying a Behavioral Design Approach to Improve Fever Case Management in Nigeria
Faraz Haqqi, Angela Acosta, Sriram Sridharan, Emily Zimmerman, Temitope Ogunbi, Eno’bong Idiong, Uwem Inyang, Foyeke Oyedokun-Adebagbo, Jose Tchofa, Nene Diallo, Emma Mtiro, Chukwu Okoronkwo, Bolatito Aiyenigba
Global Health: Science and Practice Dec 2022, 10 (6) e2200211; DOI: 10.9745/GHSP-D-22-00211
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