Culture Matters: Incorporating culture into effective

RMNCH health programming

By: Maggie Woo Kinshella

Introduction

Who am I?

– Recent Cuso International volunteer

What is this about?

– Experience sharing and learning

What's the key message?

– Culture matters in health

Overview

Step 1 – Assessment review

Step 2 – Collaborative action planning

Step 3 – Training workshops and discussions

Step 4 -Community research

Step 5 – Translating knowledge into practice – 4 examples of end-products

Step 1: Health Education Assessment Review

4 case studies

Waiting room health education

Inconsistent programming, esp. with larger facilities

Challenges of RMNCH Health Education in Benishangul-Gumuz

Step 2: Action Planning Meeting between partner, Cuso International

program manager and volunteer

Systems strengthening

Trainingworkshops

Developmaterials

Understanding local contextvia community research

Key topics: ● Family

planning● Maternal

and child nutrition

● 4th ANC visit● RMC ● Institutional

delivery

Step 3: Training workshops

3 workshops conducted- 143 trained

Updating health education communication, cultural awareness, faciliation skills

Theory in action

Some activities of the workshops

Developing fun participatory learning ideas like this ball game to promote Focused Antenatal Care!

Iceberg model is SOOOO Canadian! We made Ethiopian cultural models!

Key training messages

Giving information is not enough

Need environments that support healthy behaviours

Importance of culture and community

“You can lead a horse to water but you can't make it drink” - providing health information is not enough but rather need to also understand the participants goals, expectations and desires for their wellbeing

Culture 101 Culture is

a shared set of norms, values and practices that is flexible and dynamic

We all have culture:

Cuso International culture, Canadian medical culture, Westcoast culture...

What is valued? What makes us who we are? What are our assumptions and expecations on how the world works and how we should act?

“Fish discover water last”Because we live with our own culture all around us, we may not realize our own expectations and assumptions that we bring to a situation.

Step 4: Community Research

Procedure:

Extensive literature review and planning

Putting together a local team

11 days of fieldwork

Debrief team

Data analysis and report writing

Applying findings in health promotion campaign

Research Results

Successes:

Exclusive breastfeeding, uptake of institutional delivery/ at least 1 ANC visit, community health workers connecting well

Challenges:

Complementary feeding, malnutrition,family planning, ANC 4th visit

Culture Matters in Health!

Food and identity are closely interconnected

Family planning is NOT seen as only a HEALTH issue

Multiple gender identities and norms

Step 5: Translating knowledge into practice

RMNCH Health Education package

“I believe in family planning” campaign

Respectful Maternity Care campaign

Breastfeeding

community event

The Pregnancy Juggle Educational Game

Promotion of Focused ANC – going to at least 4 ANC visits throughout pregancies

Active learning to promote prevention and demonstrate challenge of compounding risks

“I believe in family planning” campaign:Real quotes from real people

** All posters also translated into Amharic**

Nutrition poster with a local focus

Local views of meals focus on the bulky starch filler

Local foods, pictures from local Assosa market

Respectful Maternity Care

● A 7 poster series featuring local patients and health professionals

● Working with Assosa Hospital to improve the experience of mothers and their families

Summary of presentation

Experience sharing of a process of working with a local partner to develop evidence-based community health promotion programming

Demonstrate the importance of culture and community to be more effective in Cuso International's health work

Thank you! Questions?

A few discussion questions to start us off:

1) What are some of the ways you/your volunteers have incorporated culture into health programming?

2) How, in your opinion, can we go beyond thinking of culture as simply “harmful traditional practices” and how can this be beneficial to program success?

3) Do you have any examples/stories on how cultural sensitivity has made your program more effective?