COMMUNITY EDUCATION AFTER INTEGRATED CAMPAIGNS PROMOTING ITN USE IN GHANA

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COMMUNITY EDUCATION AFTER INTEGRATED CAMPAIGNS
PROMOTING ITN USE IN GHANA

• Mark Young/Melanie Renshaw
• Ghana/ NYHQ

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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 lt2)
• 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 Womens and
  Childrens Affairs, Ghana Red Cross, Christian
  Mothers Association, Department of Community
  Development
• Trainers worked with networks of mothers clubs,
  mother-to-mother support groups and
  community-based agents
• e.g. 2 Christian Mothers 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 participants
  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
  gt400,000 people
• Gaza Malaria Participatory tools used in support
  of the distribution of ITNs to flood affected
  families in 2001, reaching gt 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
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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