COMMUNITY EDUCATION AFTER INTEGRATED CAMPAIGNS

PROMOTING ITN USE IN GHANA

Mark Young/Melanie Renshaw

Ghana/ NYHQ

UNICEF

EFFECTIVE COMMUNICATION

• Enables people to reach a common position amongst themselves

• Enables people to negotiate on an equal basis with those who control resources and hold authority

• Develops capacity of marginalized people to participate in decision-making

• Creates the social conditions in which individual behaviour change is possible

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COMMUNICATION ENGAGEMENT “BASKET OF METHODOLOGIES”

• Use multiple entry points (build on what is already available: CHWs, schools, rural banks)

• Use multiple communication techniques that are participatory in nature (see basket below) but include supportive mass communication

• Basket of methodologies:– Participatory Rural Appraisal – Participatory Learning and Action – Participatory Hygiene and Sanitation Transformation – Community-Based Management of Information Systems – Community participatory theatre– Community dialogue

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COMMUNITY DIALOGUE

• Participatory technique to develop village action plans based on the priorities of community members and others, including local government officials

• Draws on knowledge and experience of all participants to reach consensus around joint actions

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GHANA INTEGRATED CAMPAIGN NOVEMBER 2006

• Integrated campaign: Polio (5 m children), Measles (3.9 m children), Vitamin A (4.5 m children), LLINs (1.9 m children <2)

• Communication during campaign included:– use of mass media: radio, leaflets, newspapers– Interpersonal communication

• Survey found health workers were the main source of information about the campaign (42%), followed by radio (36%).

• Post campaign, UNICEF trained development workers on community dialogue to sustain correct utilisation of ITNs

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COMMUNITY DIALOGUE

• Participants trained by specialists in communication for social change

• Facilitators from Ministry of Women’s and Children’s Affairs, Ghana Red Cross, Christian Mother’s Association, Department of Community Development

• Trainers worked with networks of mother’s clubs, mother-to-mother support groups and community-based agents: – e.g. 2 Christian Mother’s Association facilitators reach 5248

women belonging to 238 organised associations

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TRAINING IN COMMUNITY DIALOGUE

Focused on:• Ensuring accuracy of

information (malaria transmission and prevention)

• Steps of community dialogue:– situation analysis via

participatory learning methods – dialogue and discussion with

community members– action planning and monitoring

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COMMUNITY DIALOGUE: SITUATION ANALYSIS

• Development workers learn to ask and listen

• Community-level situation analysis helps uncover beliefs, barriers and attitudes around malaria and ITN use

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TOOLS

• Transect Walk and Community Home Visits

• Role Plays - Explore Gender Dimensions of ITN Use

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COMMUNITY DIALOGUE: MALARIA AND ITNs

• Picture cards portray two families: users and non-users of ITNs

• Problem-posing rather than message-giving: pictures and open questions invite dialogue on malaria, its causes and effects (comparing existing beliefs to scientific knowledge), costs to a household of net use or non-use

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COMMUNITY DIALOGUE FOR ITN USE

• Successes: end-of-workshop evaluations positive; participants consistently engaged; critical thinking skills improved

• Lessons Learned: post-workshop application and monitoring requires more engagement of organization leadership; some participant’s traditional “teaching” habits hard to change

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COMMUNITY DIALOGUE: NEXT STEPS

• Identifying more NGOs in target regions with whom to work; and their capacities, needs and resources around behaviour change

• Lessons learned will inform design of support to existing and new partners with the goal of increasing effectiveness and efficiency

• Will extend beyond ITNs to other High Impact Rapid Delivery interventions

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PREVIOUS EXPERIENCES: PARTICIPATORY TOOLS MOZAMBIQUE

• Nurse Felicidade: health priorities • Signs and symptoms/ Risk groups• Pocket Chart: treatment-seeking

behaviours - duty bearers, capacity gaps, priority actions

• Identifying and Blocking the routes of malaria transmission

• Community mapping: monitoring and planning tool

• Sad/happy child: identifies duty bearers etc

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USE IN DEVELOPMENT, EMERGENCY/POST-EMERGENCY

• Zambezia: 350 community councils reaching >400,000 people

• Gaza: Malaria Participatory tools used in support of the distribution of ITNs to flood affected families in 2001, reaching > 250,000 people in 3 months

• Tete: Malaria, diarrhoea and nutrition tool kit reaching 50,000 families in 3 months

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SOME MEASURABLE OUTCOMES

Comparison of impact: participatory approaches (PA) and drama

PA

Af ter 1 year

Drama

Af ter 6 months

% still possessing the net 98 80

% on nets in good condition 94 80

% sleeping under the net last night 95 80

% children sleeping under the net last night

89 62

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ACHIEVING SCALE AND IMPACT

• Increase the impact of communication by synchronizing community engagement with mass media communication and advocacy/policy development – Stimulate as much community dialogue as possible, using

community groups, networks and methodologies– Use mass media approaches to amplify key issues stimulating

discussion at community district and national levels– Create channels for government and development agencies to

respond to the issues, leading to improved service delivery and policy