Rewarding behavior change in rural communities

Pathways for a sustained inclusive change for child health

Bibliographic Data

ID19591886
AuthorsShazwin Syed Ali (0000-0001-9068-2700, Emory University, corresponding author), Farhana Tabassum (0000-0001-7290-8876, Aga Khan University, corresponding author), Zayaan Delawalla (0009-0009-5584-6226, Aga Khan University, corresponding author), Muhammad Asim (0000-0002-0905-0026, Aga Khan University, corresponding author), Mehwish Asad Memon, Muhammad Saleh Memon (0009-0001-7852-1207, Aga Khan University, corresponding author), Mushtaq Mirani (Aga Khan University, corresponding author), Sana Khatoon (Aga Khan University, corresponding author), Zahra Ali Padhani (0000-0003-4777-7565, South Australian Health and Medical Research Institute, corresponding author), Imtiaz Sheikh (Aga Khan University, corresponding author), Muhammad Khan Jamali (0000-0002-3486-0207, Aga Khan University, corresponding author), Khan Muhammad Mangi (Aga Khan University, corresponding author), Zulfiqar A Bhutta (0000-0003-0637-599X, Aga Khan University, corresponding author), Jai K Das (0000-0002-2966-7162, Aga Khan University, corresponding author)
EditorsFerdinand C Mukumbang (0000-0003-1441-2172)
Year2025
Volume5
Issue12
Pagese0005273
Publication date2025-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0005273
PMID41325366
OpenAlexW4416872960
LanguageEN
References cited34

Worldwide, pneumonia, diarrhea, and malaria remain leading causes of death for children under the age of five, even though these diseases are preventable and can be treated. In public health, complex behavioral change interventions are often used. These interventions employ multi-component strategies and work on domains, such as education, policy, and environmental change, to promote prevention, control, and management of childhood diseases. In Tando Muhammad Khan (TMK), the Community Mobilization and Community Incentivization (CoMIC) trial employed a complex, participatory community engagement strategy and included conditional community-based incentives and showed promising results by improving child health related behaviors. A study was conducted to explore the experiences and perceptions of community members regarding the implementation and engagement processes of the CoMIC trial. A total of 13 IDIs and 16 FGDs were conducted to understand the factors behind the community engagement and behavior change that led to the success of the CoMIC trial and its adaptability for wider scale-up. The study identified four key motives for driving community engagement: egoism, altruism, collectivism, and principlism. The community’s close-knit social structure and shared sense of collective growth played a crucial role in encouraging participation and adapting to required behaviors. The trial focused on empowering the community by reinforcing health-seeking behaviors as a community responsibility, promoting cost-sharing to ensure long-term sustainability, and creating collective ownership through active community engagement and Conditional, Collective, Community-based Incentives (C3Is). By strengthening WASH and IYCF practices, increasing immunization uptake, promoting care-seeking behaviors, the intervention aimed to reduce the burden of childhood illnesses such as diarrhea, pneumonia, and malaria, ultimately improving child health outcomes

Behavior change · Citizen journalism · Community engagement · Community health · Community organization · Incentive · Intervention (counseling) · Psychological intervention · Public health · Child Nutrition and Water Access · Community Health and Development · Global Maternal and Child Health