TY - JOUR
T1 - Rewarding behavior change in rural communities
T2 - Pathways for a sustained inclusive change for child health
AU - Ali, Shazwin Syed
AU - Tabassum, Farhana
AU - Delawalla, Zayaan
AU - Asim, Muhammad
AU - Memon, Mehwish Asad
AU - Mirani, Mushtaq
AU - Khatoon, Sana
AU - Padhani, Zahra Ali
AU - Sheikh, Imtiaz
AU - Jamali, Muhammad Khan
AU - Mangi, Khan Muhammad
AU - Bhutta, Zulfiqar A.
AU - Das, Jai K.
N1 - Publisher Copyright:
© 2025 Ali et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2025/12
Y1 - 2025/12
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/105023875559
U2 - 10.1371/journal.pgph.0005273
DO - 10.1371/journal.pgph.0005273
M3 - Article
AN - SCOPUS:105023875559
SN - 2767-3375
VL - 5
JO - PLOS Global Public Health
JF - PLOS Global Public Health
IS - 12 December
M1 - e0005273
ER -
