first results and lessons learned from a community …...first results and lessons learned from a...
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Firstresultsandlessonslearnedfroma
communitydialogueinterven4ontoimprovematernalhealthinSouthSudan
KorriedeKoning,MaryElario,JohnAkile,MaryseKok
andMarylineNyaboga
AlaraconferencePretoria,2015
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Context
SouthSudan–NorthernandWesternBahrelGhazalStatesHighestmaternalmortalityintheworld(2056/100.000livebirths)TradiRonal,patriarchalsociety
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Mul4-facetedinterven4ons
Qualityofservicedelivery:• UpgradingfaciliRes
• Capacitybuildinghealth• workers
• Communityempowerment
• AcRonresearch
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Objec4vesAim:Improvehealth-seekingbehaviorformaternalhealthCare:CommunityacRonon:socialandgendernormsandrelaRons.TradiRonalpracRcesduringpregnancyanddeliveryBirthpreparedness
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Ac4vi4es1. StakeholdermeeRngs
2. Leadfacilitators(CPOs)
3. 4communityfacilitators(CFs)and40communityparRcipants
4. CommunitybaselineconsultaRon
5. FivedialoguesessionsandacommunitymeeRng
6. Followup
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Fivedialoguesessions• CommunicaRonbetween
generaRonsandmenandwomen
• ReflecRngonthelivecyclesofwomenandmen
• Learningaboutdangersduringpregnancyanddelivery
• ReflecRngonbarrierstoaccessservices
• Sharingpledgesandagreeingonsuggestedchanges
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PreliminaryresultsSofarimplementedin16villagesintwostates.Changesobservedinbothstates:• CommunicaRonbetweengeneraRonsandsexes:increasedrespect,girlsandwomenspeakinginpublic.
• PledgesandacRonson:– GirlseducaRonandearlymarriage– UseofcontracepRves– GenderrelaRons– TradiRonalpracRcesaroundpregnancyanddelivery– Responsibilityofmenandbirthpreparedness
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• Follow-upmeeRnginNBeG• ParRcipantexplainingaboutcontracepRvesforyouth• ConfirmaRonofchiefaaerwards
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Similari4esanddifferencesinNorthernandWesternBahrelGhazal:NyamlelandWau
• Differentcontext:Waudiverseculturesandbiggerinfluenceoftown;Nyamlelmoreremoteandcowfarming
• MakingcontracepRvesavailabletoyoungpeoplewasmoreacceptableinWau
• LessopposiRontouseofbirthspacinginWau• Supportforbirthpreparednessandfacilitydeliverywasenhancedinbothareas
• CommunitydemandforhealthfacilityinremoteareaswasiniRatedinbothareas.
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LessonslearnedTheapproachempoweredwomenandyouthandcreatedownershipforchangeamongoldermen.SRrightssupportedbythegovernment.SelecRonofCFincludingyoungunmarriedgirlsandpotenRaltospeakoutinpublic.CreateownershipthroughstakeholdermeeRngsandregularfeedbackbyparRcipantstothelargercommunity
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LessonslearnedImportanttotrainfacilityStaffonyouthfriendlyservices,includingcontracepRvesfortheyouth7daysfacilitatorstrainingisaminimumtointroducecriRcalquesRoningandgetawayfromgivingmessages.ObservaRonsandfeedbackbytrainedsupervisorsisimportanttoensurequality
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Furtherques4onsandresearch
• MostsignificantchangeevaluaRon
• HMISuRlizaRonrecords
• IsitethicaltostartacommunityempowermentprogrammeinareaswithnohealthfaciliRes?
• Sustainabilityofcommunitydialogue