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Abstract：
Beyond Bias was an intervention introduced in Burkina Faso, Pakistan and Tanzania, with the aim of reducing health worker bias toward young, unmarried and nulliparous women seeking family planning services. This study used qualitative methods - based on interviews with health workers who participated in the intervention, managers at health facilities that participated in the intervention, and policy and program stakeholders at the national level - to understand implementation experiences with the intervention. The results offer insights for organizations or countries seeking to implement Beyond Bias or similar programs, and point to some other key implementation challenges for multi-component interventions in lower-resource settings. The intervention, developed using a human-centered design approach, was seen as key for successful implementation but there were logistical challenges. The digital intervention was disruptive and distracting to many. In addition, the non-financial rewards intervention was perceived as complex, and some participants expressed feeling discouraged when they did not receive a reward. Beyond Bias did not sufficiently attend to the \"outer setting,\" and this was perceived as a major implementation barrier as it limited individuals\' capacity to fully achieve the desired behavior change; for example, space constraints meant that some health facilities could not ensure private services for all clients. There were scalability concerns related to cost, and there is uncertainty whether diversity of contexts (within and across countries) might constrain implementation of Beyond Bias at scale.
摘要：
超越偏见是在布基纳法索引入的干预措施，巴基斯坦和坦桑尼亚,为了减少卫生工作者对年轻人的偏见，未婚和未产妇女寻求计划生育服务。这项研究使用定性方法-基于对参与干预的卫生工作者的访谈，参与干预的医疗机构管理人员，以及国家一级的政策和计划利益相关者-了解干预措施的实施经验。这些结果为寻求实施超越偏见或类似计划的组织或国家提供了见解。并指出在资源较低的环境中，多部分干预措施的其他一些关键实施挑战。干预,使用以人为本的设计方法开发，被视为成功实施的关键，但存在后勤挑战。数字干预是破坏性的，分散了许多人的注意力。此外,非财务奖励干预被认为是复杂的，一些参与者表示，当他们没有得到奖励时感到沮丧。超越偏见没有充分关注“外部设置”，这被认为是一个主要的实施障碍，因为它限制了个人充分实现所需行为改变的能力；例如，空间限制意味着一些卫生设施无法确保为所有客户提供私人服务。存在与成本相关的可扩展性问题，并且存在不确定性（国家内部和国家之间）的背景多样性是否可能限制大规模实施超越偏见。
