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

UNICEF 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

UNICEF 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

UNICEF 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

UNICEF 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

UNICEF 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

UNICEF 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

UNICEF TOOLS Transect Walk and Community Home Visits Role Plays - Explore Gender Dimensions of ITN Use

UNICEF 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

UNICEF 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

UNICEF 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

UNICEF 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

UNICEF 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

UNICEF SOME MEASURABLE OUTCOMES

UNICEF 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