Behavioural Insights Drive Public Health Innovation in Four African Countries

A pioneering initiative to embed behavioural sciences into public health systems has successfully concluded in four African countries. The project, Mainstreaming Behavioural Insights into Public Health in the African Region, has equipped Burkina Faso, Namibia, Tanzania and Zambia with the tools to design and implement people-centred health interventions rooted in behavioural science.

Spearheaded by the World Health Organization’s (WHO) Behavioural Insights Unit at headquarters, in collaboration with the Health Promotion and Social Determinants of Health Unit at the WHO Regional Office for Africa and the respective country offices, the initiative sought to address the persistent challenge of bridging the gap between health knowledge and actual behavioural change.

Supported by funding from the Rockefeller Foundation, the project ran from January 2023 to December 2024. Its core aim was to embed behavioural evidence into public health systems and foster collaboration between health authorities and academic institutions.

According to Elena Altieri, Head of the Behavioural Insights Unit at WHO headquarters, the importance of this project stems from the increased attention behavioural sciences have received in recent years. However, she pointed out that challenges remained.

“Over the past decade, we have seen a growing interest in integrating behavioural sciences into public health among governments and institutions. However, the COVID-19 pandemic highlighted significant practical and technical challenges in adopting these approaches. We face limitations in capacity, funding and time. There is also a lack of confidence among policymakers about the impact, sustainability and replicability of behavioural interventions. This project was designed to tackle these issues by offering robust, evidence-based strategies to practitioners to test and develop people-centred policies and interventions,” she said.

Concrete Outcomes in Education, Health Systems and Data

One of the key achievements of the project has been the integration of behavioural sciences into academic institutions. Universities in Burkina Faso, Namibia and Zambia introduced behavioural science modules into their health promotion curricula. Namibia went a step further by launching a postgraduate diploma in behavioural science. Meanwhile, the University of Pretoria incorporated behavioural science capacity building and evidence generation into its terms of reference as a WHO Collaborating Centre.

At the institutional level, ministries of health across all four countries were supported to apply behavioural approaches in specific health strategies and action plans. Zambia piloted the use of behavioural insights in its routine antenatal care data collection, signalling a major shift in the way health information systems can support targeted interventions.

These achievements respond to the commitments made under the World Health Assembly Resolution WHA76.17 on Behavioural sciences for better health, adopted in May 2023. The resolution encourages Member States to make better use of behavioural evidence in designing public health interventions and policies.

Building Cross-Country Collaboration and Knowledge Exchange

Doris Kirigia, Team Lead for the Health Promotion and Social Determinants of Health Unit at the WHO Regional Office for Africa, emphasised the regional benefits of the programme.

“The connections we have created between universities, ministries of health, WHO country offices, the Regional Office for Africa and headquarters are already bearing fruit and will be highly beneficial moving forward. There is growing interest in behavioural science in the region. As an organisation, we will focus on supporting other countries in establishing behavioural insights functions, providing technical support to initiate projects, and leveraging our pool of experts and trainers at the country level to sustain capacity-building efforts,” she said.

The initiative has informed several ongoing efforts. Countries are applying behavioural insights in areas such as risk communication, community engagement, and health promotion. For instance, Mauritius is integrating behavioural science into its campaigns to reduce noncommunicable disease risk factors. In Burkina Faso, Tanzania and Zambia, insights are being used to promote people-centred sexual and reproductive health services.

Moreover, a wave of new behavioural research has emerged. These include studies promoting healthy eating in Zambian schools, examining harmful skin-lightening practices in Gabon and increasing the uptake of parenting programmes in Tanzania.

Lessons for the Future

As the project concludes, several lessons have emerged that may guide future efforts to institutionalise behavioural science in public health. These include:

• Promoting active collaboration between universities and ministries through joint projects and training programmes.
• Facilitating cross-country knowledge exchange to build regional expertise and share experiences.
• Prioritising capacity building via diverse formats, such as in-person national and sub-national trainings and online courses.
• Showcasing practical applications of behavioural insights, including success stories and pilot projects, to enhance visibility and credibility.
• Avoiding overly complex or rushed pilot interventions that risk undermining stakeholder trust and long-term impact.

The WHO has called on African countries to deepen their integration of behavioural science into public health strategies. By learning from successful pilots and scaling up promising approaches, countries can improve the relevance and effectiveness of their health interventions.

As this initiative has demonstrated, investing in behavioural insights is not just about changing individual actions. It is about building resilient, people-centred health systems that respond to the real-world behaviours and needs of communities.

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