C-Change Picks - Focus on Reproductive Health, Maternal Health, and Malaria

C-Change Picks #13 - Focus on Reproductive Health, Maternal Health, and Malaria
Information about Social and Behaviour Change Communication, sponsored by C-Change
June 2010

From The Communication Initiative (The CI) and the United States Agency for International Development (USAID)'s C-Change programme

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C-Change Picks is an e-magazine supported by C-Change and implemented by The Communication Initiative on social and behaviour change communication (SBCC) case studies, reports, analyses, and resources in the health sector (HIV and AIDS, family planning and reproductive health, malaria, and maternal and antenatal health) and the environment sector. If you have received this newsletter from a friend or colleague and would like to subscribe, please contact cchange@comminit.com

C-Change Picks #13 opens with a highlight on SBCC strategies for addressing women's reproductive health, including improving access to family planning among young married couples, delaying first births, healthy spacing between births, and using the LAM method. Evaluations of four maternal health-focused SBCC projects, from the Middle East to East Timor, follow. A section on malaria spotlights IEC tools recently developed by C-Change for a malaria prevention campaign in Ethiopia, a comic book and social mobilisation campaign in India, and two reports on other SBCC strategies for addressing malaria prevention in Ethiopia and globally. The issue concludes with three upcoming events.

C-Change recently assisted the Government of Kenya in its efforts to revitalise family planning with a launch of the national reproductive health strategy and related guideline documents. C Change is providing technical assistance to implementing partners in the design and implementation of communication interventions in family planning programmes, with the overarching goal of assisting individuals to make informed decisions and determine their own reproductive intentions based on what is best for their families.

With funding from the U.S. President's Malaria Initiative (PMI), C-Change is working with the regional Oromia government in Ethiopia to educate and assist families to carry out actions to prevent and treat malaria. This includes providing training to government health staff that in turn assist families and communities to improve their malaria prevention knowledge using C Change developed materials. Working together, a health worker helps a family to monitor progress in carrying out specific actions to prevent malaria under the Model Families Program and use the Malaria Protection Scorecard to verify compliance. Visit the C-Change website for additional information about C-Change programmes and activities.

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In this Issue of C-Change Picks...

FAMILY PLANNING AND COUPLES

MATERNAL HEALTH

MALARIA

EVENTS

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FAMILY PLANNING AND COUPLES

1. A Couples' Reproductive Health Communication Model from India

Using data from PRACHAR, a project in Bihar, India, this January 2010 paper, "A Reproductive Health Communication Model That Helps Improve Young Women's Reproductive Life and Reduce Population Growth," from Pathfinder International, shows that culturally- and community-focused interventions geared to adolescents and youth can help to: increase age of marriage and first birth, increase contraceptive use among young couples, provide vulnerable populations with better access to reproductive health (RH) services, and reduce population growth. Sample PRACHAR activities include: newlywed couples are given "infotainment" parties; young married women are visited by female workers who provide information on the benefits of delaying childbearing and spacing of pregnancies; and meetings are held with young married males, parents and in-laws, and influential community members. The impact of PRACHAR interventions was assessed at both Phase 1 (2002-2005) and Phase 2 (2005-08), with a summary of the findings included here.

2. Linking Marriage, Family Planning, and Adaptation to Climate Change in Ethiopia

This October 2009 document, "Linking Population, Fertility and Family Planning with Adaptation to Climate Change in Ethiopia," from Population Action International, details a study exploring how communities in Ethiopia react to and cope with climate variation, which groups are considered most vulnerable, what resources communities need to adapt to climate changes, and the role of family planning and reproductive health in increasing resilience to climate change impacts. Researchers found that, while awareness of family planning is high, 34% of currently married women want to postpone childbearing for 2 or more years or stop entirely, but they are not currently using contraception. In the Southern Nations, Nationalities and People's region, a rural community member remarked that "...if a family has limited children, he will have enough land for his kids and hence we can protect the forests....In earlier years, we had a lot of fallow lands, but now, as a result of population growth, we don't have adequate fallow land. Therefore, limiting the number of children will help us to cope with the change in climate."

3. Mobilizing Married Youth in Nepal to Improve Reproductive Health

This report evaluates the 2-year Reproductive Health for Married Adolescent Couples Project (RHMACP), implemented in Nepal in 2005 by the ACQUIRE Project in association with CARE Nepal and with funding from USAID. The project utilised an ecological model to improve health outcomes for married adolescents in the 2 target districts (Parsa and Dhanusha). In close collaboration with District Public Health Offices, the RHMACP established a peer education network to disseminate reproductive health information to married couples; supported local health facilities to provide youth-friendly services; and fostered an enabling environment among parents, in-laws, and influential community members to increase married adolescents' access to, and use of, health services. "The ecological model successfully accommodated an expanded project focus that embraced peer initiatives in community development, local governance, and citizens' rights - all of which strongly supported the core project goal of effective access to quality reproductive health services for all married adolescents."

For more information about the RHMACP project, please click here.

4. Lactational Amenorrhea Method Family Planning Tools and Resources

a) Counseling Guide for Teaching Women How to Use LAM and Informational Client Card: LAM Lactational Amenorrhea Method: A Family Planning Method for Breastfeeding Women

This Counseling Guide is designed to help family planning counsellors explain when and how to use the Lactational Amenorrhea Method (LAM) of birth control. The Informational Client Card is a smaller format describing the same information and using the same illustrations as the Counselling Guide, but addresses women who have given birth and are breastfeeding their infants.

b) Repositioning the Lactational Amenorrhea Method: Benefits for Women, Children and Programs

This document intends to give guidance to providers about how LAM can be repositioned in their programmes so that they can better address the needs of postpartum women. The document first describes the benefits of the method, citing World Health Organization (WHO) recognition of its importance, and then recommends use of strategic steps for repositioning LAM as an introductory family planning method.

Also see the Consensus Statement on Rationale for Operationalizing LAM Criteria.

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MATERNAL HEALTH

5. White Ribbon Alliances in Asia and the Middle East Make it Happen for Maternal Health and Family Planning

This July 2009 publication, entitled "Time to Deliver on Maternal Health and Family Planning Best Practices: White Ribbon Alliances in Asia and the Middle East Make it Happen," examines White Ribbon Alliances (WRAs), which have been established across Asia and the Middle East as advocates for evidence-based strategies to reduce maternal mortality. This brief highlights the achievements of alliances from Bangladesh, India (Orissa), Indonesia, Pakistan, and Yemen. The 5 case studies demonstrate the alliances' strategies for strengthening commitment to and active promotion of maternal and child health, as well as for designing country-specific action plans to scale up evidenced-based FP/MNCH best practices, including best practices in SBCC.

6. Postpartum Care Survey Results from Sub-Saharan Africa

Based on a model developed in 2005 by the Extending Service Delivery Project and CATALYST for the Asia and Near East region, the postpartum case survey from the ACCESS Program on family planning (FP), ACCESS-FP, was created to identify, document, and share information on the status of postpartum care (PPC) services implemented by USAID cooperating agencies. This report describes the purpose and scope of the survey, and presents results from 37 sub-Saharan African projects surveyed. SBCC best practices, lessons learned, recommendations, and potential barriers are all identified here.

7. Evaluations of Two USAID-supported Maternal, Newborn and Child Health Programmes in Pakistan

This is a 2008 evaluation of both the Pakistan Initiative for Mothers and Newborns (PAIMAN) maternal and newborn project, led by John Snow Inc. (JSI), and the Improved Child Health Project (ICHP) implemented by Save the Children. Conducted in June-July 2008 through the Global Health Technical Assistance Project, these evaluations assessed whether the projects were achieving intended results, reviewed their organisational structures and technical approaches, and formulated recommendations for future directions. During field visits to selected project sites, the team interviewed a broad range of stakeholders, including health managers, service providers, trainees, and community members. Findings related to SBCC within each project are included in this report.

For more information about the PAIMAN project, click here.
For more information about the ICHP project, click here.

8. Improving Maternal and Newborn Health in Timor Leste

This evaluation report explores the initial 4-year cycle of the Child Survival and Health Grants Program (CSHGP), which was carried out by Health Alliance International (HAI) in 7 Districts in the Democratic Republic of Timor-Leste. Launched in September 2004, the intervention combined community-level health promotion activities and health system strengthening. The strategies focused on training, behaviour change, materials development, and community outreach. Best practices, lessons learned, and recommendations are indicated in this report.

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MALARIA

9. Tools Developed for a Malaria Prevention Campaign in Ethiopia

These 3 graphic tools, designed by C-Change for the Malaria Prevention Campaign in Ethiopia, focus on small, "doable actions" that families can carry out to protect themselves against malaria. The tools include: 1) Malaria Protection Scorecard; 2) Essential Malaria Actions Flipchart; and 3) Malaria Prevention Sticker.

10. A Primer for PMI Communication and Social Mobilisation

This short-form document presents summary guidelines to assist in the development, implementation, and monitoring and evaluation (M&E) of programmes to influence behaviours and mobilise communities to create long-term behaviour change around the President’s Malaria Initiative (PMI) interventions: correct and consistent use of insecticide-treated nets (ITNs); acceptance of indoor residual spraying (IRS); and adherence to treatment and prevention therapies, particularly during pregnancy. The guidelines are structured as a planning framework. They explain how to: establish goals and objectives, review existing data and conduct a rapid assessment, develop a strategy with a budgeted plan of activities, and monitor and evaluate the process.

Also see the PMI Communication and Social Mobilization Guidelines.

11. Malaria Awareness Comic Book-based Campaign in India

An India-based content and design service provider, Chillibreeeze, has produced a comic book called "A Tale of Two Magic Potions" to spread awareness about hazards of malaria. The comic book is designed to engage Indian children, who can then go on to educate their families about the disease. An associated campaign implemented through school curricula, a contest, and participatory online social networking tools such as Facebook are broadening distribution and supporting social norms change.

For more information about "A Tale of Two Magic Potions", please click here.

12. Involving Communities in the Fight Against Malaria in Ethiopia

Published by the African Medical and Research Foundation (AMREF) in 2009, this case study shares the experience of the organisation's Malaria Prevention and Control Programme in the Afar region of Ethiopia, which comprises mostly pastoralist communities. The main activities of the programme included training health care service providers, equipping health centres, training mother coordinators, distributing insecticide treated nets (ITNs), and sensitising local leaders on malaria prevention and control. According to AMREF, as a result of this programme, the skills of over 200 health care service providers on diagnosis and treatment improved. There was a 34% increase in knowledge about transmission of malaria, 62.5% increase in ITN possession, and 48% increase in treatment seeking behaviour at the community level. The case study suggests that the programme demonstrated a reasonable and replicable model of malaria prevention and control by strengthening and linking the different segments of health systems in pastoralist communities.

13. Nets + Hang Up Campaign: The Winning Formula to Beat Malaria

Published in mid-2009, this International Federation of Red Cross and Red Crescent Societies (IFRC) World Malaria Day report discusses the organisation's experiences with distributing insecticide treated nets accompanied by "hang up" campaigns to ensure the nets are used. According to the report, there is growing scientific evidence to demonstrate that combining mosquito net distribution with follow-on "hang up" campaigns carried out by trained local volunteers significantly reduces incidence of malaria, particularly among those living in remote areas, refugees, and people affected by stigma and discrimination.

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EVENTS

14. Women Deliver 2010 (June 7-10 2010) Washington, DC, United States

15. Global Health Council's Annual Conference - Dateline 2010: Global Health Goals & Metrics (June 14-18 2010) Washington, DC, United States

16. Global Maternal Health Conference 2010 (August 3 – September 1 2010) India Habitat Centre, New Delhi, India

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Communication for Change (C-Change),implemented by AED, is USAID's flagship programme to improve the effectiveness and sustainability of social and behaviour change communication programmes, activities, and tools. C-Change works with global, regional, and local partners to incorporate knowledge about the social determinants and underlying causes of individual behaviours and takes into account research and lessons learned from implementing and evaluating activities. Employing innovative and tested methods, C-Change works to meet the continuing challenges posed by evolving health issues that require a behaviour change communication approach. C-Change also works to strengthen the capacity of local organisations to plan, implement, and manage programmes, thus ensuring sustained local knowledge and skills. Please visit the C-Change website. To contact C-Change, please email cchange@aed.org

The Communication Initiative (The CI) network is an online space for sharing the experiences of, and building bridges between, the people and organisations engaged in or supporting communication as a fundamental strategy for economic and social development and change. It does this through a process of initiating dialogue and debate and giving the network a stronger, more representative and informed voice with which to advance the use and improve the impact of communication for development. This process is supported by web-based resources of summarised information and several electronic publications, as well as online research, review, and discussion platforms providing insight into communication for development experiences. Please see The CI website.

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This publication is made possible by the support of the American people through the United States Agency for International Development (USAID) under the terms of Agreement No. GPO-A-00-07-00004-00. The contents are the responsibility of the Communicative Initiative and the C-Change project, managed by AED, and do not necessarily reflect the views of USAID or the United States Government.

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