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

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

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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