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Public health and healthcare management, Medical Institute, Peoples’ Friendship University of Russia , Moscow , Russia
Behavior change techniques (BCTs) represent a pivotal yet often overlooked component in the national-scale modernization of healthcare systems, particularly in resource-constrained settings where infrastructural upgrades alone are insufficient to improve clinical outcomes. The Integrated Perinatal Care Project in Uzbekistan provides a compelling case study of systematically embedding BCTs within a multi-component national initiative to strengthen perinatal services. Grounded in a comprehensive framework that addresses infrastructure, digital transformation, emergency response, and human resources, the project explicitly targets behavioral determinants at multiple levels. Provider-focused BCTs include structured training programs for medical staff in updated clinical guidelines, gender-sensitive approaches, effective communication skills, and readiness to manage complications such as violence-related issues and adolescent pregnancies. At the community level, capacity building of community health nurses equips them to influence women’s and families’ health-seeking behaviors, promoting earlier antenatal care and reducing delays in complication management. Population-level interventions comprise the development and dissemination of tailored communication materials and awareness campaigns designed to close knowledge gaps regarding pregnancy risks, climate-related threats, and service availability—directly informed by baseline survey findings. These BCTs are synergistically integrated with electronic health records enabling gender- and age-disaggregated monitoring, real-time inter-institutional data exchange, updated referral protocols, and climate-resilient infrastructure enhancements. Implementation proceeds in phased stages—from baseline assessment and planning to large-scale rollout, evaluation, and sustainability planning—offering a scalable model for integrating BCTs into national healthcare modernization. This approach underscores that sustainable quality improvement requires simultaneous investment in technical infrastructure and evidence-based behavioral interventions.
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