Eastern and Southern Africa Regional Office

Eastern and Southern Africa Regional Office

HEALTHY

PREGNANCY

HEALTHY

CHILD

GUIDE FOR SOCIAL MOBILISATION

HEALTH MOBILISERS

PREFACE

Why social mobilisation?

Why Mobilise around Child and Maternal Health?

A child, when born, comes into the world without the ability to eat or drink, move or speak on their own. Newborns, infants, and children depend on those around them for proper care.

As caretakers, we have the pleasure of seeing the children in our communities grow up to understand how to walk, how to talk, how to follow the footsteps of those that have come before them. It is up to us to do everything in our power to give them a healthy start to life.

Sometimes, the caregiver of one child has not had access to the same knowledge as the caregiver of another. But does this give that one child less of a right to life than the other? Whether or not it is your role to bring children into this world, as an influencer in your community you have the power to honour the chances of these unborn children.

You hold in your hands guidelines for how we might contribute in helping to save the lives of infants, newborns and children by sharing the knowledge that modern medicine has brought to us. This guideline is a tool to support sharing information on maternal, newborn and child health and nutrition (MNCHN) and to assist you in mobilising communities to work together in helping to save and improve lives of mothers, newborn and children.

Across Eastern and Southern Africa, too many women and infants die in the natural act of giving life:

Health Mobilisers Can Contribute to Helping a Child Live a Healthy Life!

You do not need to be a mother or a health worker to save the life of a child. As a health mobiliser, you play a crucial role in saving children’s lives.

In this kit, you will find suggestions for how you might share this health advice to save lives in your community or constituency.

The mobilisation activities described in the following pages are to be used as guides, taking into consideration your community context to contextualise the information as required. But it is crucial that the technical content of the health messages in this kit are maintained for accuracy and consistency. It will make a significant difference in a child’s likelihood of survival if mothers and families have access to the accurate health messages in this guide.

CONTENTS

You can make a difference

As a health mobiliser, one of your key roles is to help to reduce infant deaths and improve the health of mothers and their children in your community.

In order to mount a sustainable intervention, you have to ensure that your own words and messages will persist long after your initial visits or sessions are done. The key to achieving this is to concentrate on people: your work will be sustained through the coalitions and allies you manage to build. Therefore, when working in any community, your first step should always be to identify existing social influencers who may be potential allies, such as those identified in the preface: local NGOs and CSOs, health workers, school teachers, community leaders, religious leaders, and so on.

The following guide will provide you with a starting point and a basic set of information that will help you to approach potential allies, build effective coalitions, and teach individual mothers and caregivers delicately and with respect.

TABLE OF CONTENTS

2 Why social mobilisation?

3 Health Mobilisers can make a difference in MNCHN

4 What can you do?

5 Session 1: Door-to-door visits

6 Session 2: Presentations and events

7 Session 3: Working with community groups

8 Session 4: General advocacy

9 General Tips

10 Health Messages

TACTICS

What can you do?

In the following pages, you will find concrete examples of MNCH health information and ways to engage audiences in conversation regarding these concrete health facts.

For each action you take, try to keep your audience in mind. Think about the mothers and caregivers whom you would like to see adopt these practices, and how you can create an enabling environment where everything around them is working positively towards their health and knowledge. Creating a system of allies and support will help individuals to understand

rationale and take action themselves. Here are several guidelines that hold true irrespective of your audience group:

1. Respect the experience and knowledge of your audience

These messages do not need to replace other practices, unless they directly contradict one another. Each one provides an additional opportunity for mothers or caregivers to protect themselves and their children from harm.

2. Be as clear, complete and simple as possible with your instructions

Use the index in this document for basic messages. You may choose to consult online resources to find print and online resources that can facilitate your explanations and program development.

3. Listen carefully to your audience members; encourage them to ask questions Dialogue is crucial as a tool for individuals to learn and adopt new behaviours. Keep in mind that these practices could be new/scary for mothers or caregivers, who may need to be reassured that you are listening to their concerns.

4. Keep the confidentiality of the mothers and caregivers who you speak with This may allow them to trust you and to speak much more freely with you, allowing you to help them in a much more profound way.

5. Remember your purpose and communicate that incentive clearly

The value of these activities is the impact you will have on your constituents. If you yourself have some questions or concerns about certain health messages, consult with a health worker before communicating them.

6. Use stories and examples of role models whenever possible

In door-to-door visits or community meetings, bring up stories of women who have successfully delivered in hospitals and role models who are following all the protocols and have healthy babies as a result. Such stories are the most effective way to help your audience understand the true value of your advice.

SESSION 1

Door-to-door visits

1. Develop your plan of which homes you will visit, and what you will focus on:

– Consider health topics that you know are particular issues for maternal, newborn and child health and nutrition in your community

– Think about the situation of the household you are visiting, and focus on the most relevant information for that audience

2. Remind yourself of all of the key health messages at the back of this booklet before your visit.

3. Find out any information you may need to know about this issue, such as:

– The availability of supplies at the closest dispensary or health centre

– The rates of sickness or fatality of individuals in your community

– The other resources available to pregnant women and mothers/caregivers

4. Assemble any other materials that you can bring to help people to understand your teachings, including flipcharts, illustrated guides, etc.

5. On the day of your visit, keep these guidelines in mind:

– Respect the experiences and knowledge of your audience

– Be as clear, complete and simple as possible with your instructions

– Listen carefully to your audience members, and encourage them to ask questions

– Keep the confidentiality of everyone who you speak with

– Remember your purpose and communicate it clearly

– Use stories and examples of role models whenever possible

– Engage your audience deeply through questions, invitations, and eye contact

6. Try to ask questions as well as delivering information, in order to get a picture of what their current health practices are and whether they already knew any of the information you are sharing with them.

7. Leave the home with a clear articulation of next steps: when you will come to visit them next, and what they should do next.

8. Make sure that you are engaging in rigorous monitoring of which houses you visit, when, and what you teach each time so as to determine any further actions that are required and track changes in the community’s health learning as a whole.

SESSION 2

Presentations and events

1. Identify where you might have the opportunity to present or perform.

2. Prepare by reminding yourself of the full set of health messages at the back of this booklet.

3. Think about creative ways you might articulate these messages to a large group. Consider:

– Dances, skits, plays, songs that highlight the key messages in a memorable way

– Stories or testimonies of role models who have followed health messages successfully

– Data or statistics that show how these messages can have a positive impact

4. Identify several health messages which are most crucial to the health of your community.

– Consult with the health workers and other mobilisers in your area to identify the most urgent issues for your community

5. On the day of your presentation, remember that you do not have to share every health message at once, but you do have to impress upon your audience how important it is for each of them to follow the messages and to follow up for more information.

6. Focus on practical ways that each of you can contribute to shifting the practices of your community. Remember:

– Role modelling and positive examples can help to shift behaviours and social norms

– Community members need to have access to the health messages in this book from sources they understand as the most reliable and credible

– Creating spaces for pregnant women and caregivers to openly share the barriers that they face to good health can help leaders to identify new and innovative solutions

7. Act confident and proud. Know that you are a community expert, and that if you trust yourself, others will be more likely to trust you.

8. Conclude your presentation with opportunities for follow-up. Make sure that your audience members know where to go for more information and guidance.

SESSION 3

Working with community groups

1. Identify women’s groups, or other engaged groups in your community that may have an interest in improving the community’s maternal, newborn and child health status.

2. Organise a meeting to learn their perspectives and discuss these specific health messages, or join a meeting they have already organised.

3. Define your goals for the meeting. These may include:

– Sharing the health messages in this booklet and discussing which ones are not often followed in your community

– Discussing why this issue is pressing for the entire community, not only new mothers

– Defining what you – and they – have done and would like to do to change the situation

– Discussing how you might make a measurable change in the health of your community by promoting these maternal, newborn and child health tactics

4. Explain to them the value of carefully following the health messages contained in this booklet, and compare these messages to what members of the group already knew.

– Share positive stories from your work as a mobiliser

– Ask if any of the group members have already worked on maternal and child health issues

5. Maintain a hopeful tone, and offer your knowledge in a spirit of collaboration.

6. Turn the group focus to concrete actions:

– Discuss how members of this group can be positive role models

– Suggest that they could develop spaces and meetings where individuals with positive stories and examples can share testimonials

– Reinforce that members of the community should support one another for this cause

7. Ensure that they have access to the resources and knowledge they need to understand and spread accurate health messages.

8. Coordinate a strategy for follow-up:

– Ask if they are open to planning regular meetings on this subject

– Find ways to monitor whether these meetings influence the overall health of your community

– Advise them to visit the closest health facility to answer any further questions

SESSION 4

General advocacy

1. Be prepared to speak on the messages at the back of this booklet at any point in time, whether or not you are officially engaged in health mobilisation at that moment.

2. Practice answering unexpected questions about the issues with fellow mobilisers, or with your mentors.

3. Seek out conversations about maternal, newborn and child health – with your friends, with your family, with co-workers and neighbours.

4. Ensure that you know the most important facts for your particular community, or have them on hand to share in case someone approaches you. These should include:

– Detailed information about the nearest health centre

– The most pressing issues in maternal, newborn and child health for your community

– Essential health information, such as the number and timing of ANC/PNC visits, etc.

5. Consider arranging meetings with religious and community leaders that you know personally to try to encourage them to champion this issue:

– Share your knowledge with them, and encourage them to take a stand

– Ask whether they would bring up maternal, newborn and child health messages in their own meetings and services

6. Share your own story about how you began as a health mobiliser as often as you can, to help people understand how important this mission is to you.

7. Check back with those you talk to later on, to see if they have made any changes as a result of your conversations and to check if they still remember what you have taught them.

TIPS

TIP #1 : IDENTIFYING YOUR AUDIENCE

When determining your target audience, think beyond the obvious. Maybe teens are the best audience for teen health messages, but maybe not. You should always consider:

A. Who is actually influencing the behaviour you are trying to change?

B. Who do you, as a health mobiliser, have the strongest ability to influence?

TIP #2 : FRAMING MESSAGES FOR EACH GROUP

This booklet contains basic messages that all prospective mothers, mothers and children should follow. But as a health mobiliser in your community, you are best positioned to decide how to frame each message.

To decide how to deliver these messages to each group of people you deal with, consider:

A. Level of literacy, current knowledge level and existing ways of receiving health information

B. Other information or environmental factors that would need to be in place prior to adoption

C. Degree of incentive to learn and adopt these directives, and what will increase that incentive

TIP #3 : PLANNING AHEAD

If you plan your session well ahead of time, you will:

A. Have time to gather audience members and collaborators, such as health workers

B. Have a chance to develop engaging/participatory methods for conversation and learning