Social and behavior change communication (SBCC), which uses communication to positively influence the social dimensions of health and well-being, is an important strategy for improving health services at the provider level. With much of the responsibility for providing health care services falling on a cadre of professional health care workers (HCWs), particularly those in lower-level facilities, SBCC strategies targeting this workforce can be an important tool for improving quality of care. To maximize the impact of SBCC activities among HCWs, program designers and implementers must first develop an awareness of factors that improve or impede HCW performance at the facility level. The purpose of this literature review is to identify the facilitators and barriers to HCW service provision in three areas: knowledge and competency barriers in which HCWs lack the skills and knowledge to provide services; structural and contextual barriers in which systemic and environmental factors affect HCWs ability to provide services; and attitudinal barriers in which attitudes and societal beliefs influence health workers’ willingness to provide services. The research confirms that HCWs experience significant barriers in all three areas, ranging from lack of training and poor management to inadequate equipment to stigma towards certain populations. The findings in this paper can be used to capitalize upon facilitators and anticipate and respond to potential barriers when using SBCC programs to improve the quality of care provided by HCWs.

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