First results and lessons learned from a community …...First results and lessons learned from a...

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First results and lessons learned from a community dialogue interven4on to improve maternal health in South Sudan Korrie de Koning, Mary Elario, John Akile, Maryse Kok and Maryline Nyaboga Alara conference Pretoria, 2015

Transcript of First results and lessons learned from a community …...First results and lessons learned from a...

Page 1: First results and lessons learned from a community …...First results and lessons learned from a community dialogue intervenon to improve maternal health in South Sudan Korrie de

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


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