CDFU staff detailing IEC Materials used for campaigns.

Healthy Timing and Spacing of Pregnancies was the theme for this year’s Safe Motherhood Day Celebrations, organized by the Ministry of Health in conjunction with Mayuge district and stakeholders involved in Safe Motherhood activities.

The celebrations took place at Kigandalo Sub County, Mayuge district on October 30, 2009. The chief guest was the Minister of Health, Hon. Dr. Stephen O. Malinga who emphasized the issue of appropriate age for one to start having children. He said  people should take into account when to start giving birth.

He cautioned that giving birth early (below 18 years) leads to too frequent births, leading to too many children, “breeding” health complications in women’s lives. He emphasized the need to focus on the unmet need for family planning.

On his part, the LC5 Chairman of Mayuge urged men to support their wives to practice family planning. He said there can never be a healthy mother without a responsible father. He further pointed out the lack of male involvement in family planning, the desire for many children and water scarcity as the three major problems affecting the health of women in Mayuge district.

Over 20 organizations graced the event by providing services and products in their respective exhibition stalls that promoted health for mothers and the entire community. CDFU displayed materials produced for different campaigns and projects promoting Safe Motherhood. The materials displayed included; Flip Charts, Posters,   Comic books, Flyers and trigger video CDs.

Other activities of the day included:

• Cervical cancer screening (by the Uganda Cancer Institute).
• Provision of Health Communication materials (Fact sheets, leaflets and posters) to the public.
• Enter-educate activities such as music, dance and drama performances with messages related to family planning. 

Peer educators sensitizing people during a community event.

CDFU provides strategic communication support focusing on network based community mobilization and Behavior Change utilizing peer educators (also known as Popular Opinion Leaders in some communities). The peer educators are selected by the community. They usually belong to some network and are therefore able to pass on information to peers.

The objective of the peer education intervention is to bring about significant and sustained positive change in behaviours and practices through the efforts of peer educators who encourage positive change. They further promote use of specific health products and services among groups of peers.

CDFU develops training guides specifically designed to empower peer educators with skills and knowledge to: initiate discussions with peers in communities, use social events and “conversational” approaches to talk about health issues and mobilize people for individual and social change. Our experience has shown that interpersonal communication is powerful in stimulating behaviour change among individuals and the communities they live in.

The process involves working with districts to select community based organizations to partner with so they can monitor and directly supervise the activities; meetings with the community to select the peer educators; training of trainers to build capacity at the district level and training of the community volunteers. The innovation of working through existing community structures addresses sustainability and ownership of the intervention. Our approach emphasizes use of informal interactions in order to provide information and skills necessary for one’s well-being.

Who is a Peer Educator?

A peer educator is an ordinary person selected from already existing social networks in a community like: Village Health Teams, farmers’ groups, women groups and Post Test Clubs. In other cases, people respected as “opinion” leaders can also be selected as peer educators.

Characteristics of a good Peer educator

A peer educator should be;

• A good listener and communicator
• An advocate of health and development issues
• A role model in the community
• A trusted source of information within the community and respected by the community because they benefit from the person’s experience and knowledge
• Approachable and talks to other community members
• Willing to work as an unpaid volunteer because he/she values contributing to the community
• A resident of the specific area of intervention

Why is Peer Education important?

Peers are very successful in passing on information because people identify with them. Their peers also consider them as credible sources of information. Peer education has allowed free discussion of sensitive matters in communities especially on health issues. It is empowering for those involved because they develop leadership skills, gain respect of their peers, and improve their own knowledge base and skills. It is an efficient and sustainable way of reinforcing learning through already existing networks in the communities.

Margaret’s  Story

Margaret says she was very delighted to be selected as a peer educator because she is interested in programmes that help her community. She mobilizes her community for health and development issues, in addition to her responsibilities as a house wife and mother.

“Talking to my community members about health issues has not interrupted my other duties because I do that whenever I get chance. The health issues we talk about are everyone’s concern.” explains Margaret. She admits that her family has also benefited a lot. She says after the training, she managed to talk to her 19 year old daughter about the challenges of HIV and reproductive health. “I also find it easy to discuss health issues with my husband. He has ‘confessed’ that I changed my way of looking at things after the peer educator training,” she adds.

Margaret has discussed with fellow women the importance of timing and spacing births. She also talks about prevention of malaria among other health topics. She uses opportunities like attending church services and group meetings to talk to her peers. Women have called her to talk to them about family planning and their major concerns are around myths, misconceptions and side effects. On some occasions, she uses the radio to pass on messages.

Margaret lives in an area near a slum with unhygienic conditions. She says many of her community members take infections like HIV “for granted” and are not aware of the available health services. She has taken on the role of helping direct her community members to services; “When I talk to my neighbours and friends about the health issues and refer them for services, I feel I am rendering a very important service to the community” Margaret says with a smile. She is happy to be a helpful person in her community.

For her, it has been over 15 years’ of voluntary work so people in the community appreciate what she does. 

How behavior change is achieved

Our experience has revealed that the peer educators decide to practice what they advise others to do. Many of them have made some positive changes that they also encourage their peers to adopt. In other cases, some people have been able to change their behaviors and practices after receiving correct information from the peer educators. Sometimes, information is passed on to members of a group who after trying out new behaviours, promote them among their peers.

NOTE: Margaret is a pseudo name

Some of the community members during the dialogue session

CDFU is a partner in the AFFORD Project and continues to offer support for the Popular Opinion Leader (POL) intervention funded under the AFFORD Project/Uganda Health Marketing Group (UHMG). The POL intervention is being implemented on behalf of UHMG in 17 districts.

POLs are volunteers based in local communities who support the Good Life communication campaign. CDFU works closely with District Health officers, Community leaders and Community Based Organizations to implement the POL intervention.
 
CDFU works closely with 36 Community Based Partner Organizations (CBPOs) in 17 districts.  The POLs sensitize their community and network members on HIV and AIDS, Malaria, Family Planning and Child Health. They also participate in district based health events and those of the CBPOs to which they are attached. Some of the POLs are members of the Village Health Teams in their localities.

A community dialogue discussing health issues amongst Nsabwa community members, local leaders, the District Health Educator (DHE- Mukono district) and a CDFU representative was held on 11th August, 2009. In total, 60 community members participated in the dialogue i.e. (35 females and 25 males).

The community utilized participatory approaches to explore health challenges they face. A question and answer session was also held to address key health questions that they had.

The community identified the following as the priority Health Areas:

• Malaria
• Pneumonia
• Respiratory Infections
• STIs including, HIV infection; AIDS
• Skin diseases
• Diarrhea
• Pregnancy related complications

Next Steps

• Undertake a simple baseline to determine knowledge, attitudes and practices before the intervention.
• Design health education interventions based on the baseline findings
• Design consultative/ needs assessment meetings while clustering different populations for example conduct FDGs with particular target groups.