COMMUNITY EDUCATION AFTER INTEGRATED CAMPAIGNS PROMOTING ITN USE IN GHANA

1. COMMUNITY EDUCATION AFTER INTEGRATED CAMPAIGNS PROMOTING ITN USE IN GHANA Mark Young/Melanie Renshaw Ghana/ NYHQ

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

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

10. 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

11. 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

12. 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

13. 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

14. 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

15. SOME MEASURABLE OUTCOMES

16. 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