Expressing collective voices of mothers on children's health to inform supply side managers: photovoice exploration with mothers of young children from the Indian Sundarbans
Summary:
The Indian Sundarbans is marked by inhospitable terrain and frequent climate change, which increases the burden of malnutrition and communicable diseases among children. Community members specially women have few means to communicate their concerns regarding social determinants of childrens health and nutritional conditions to local decision makers. Photovoice is one way in which communities can voice their local challenges with decision makers. Photovoice action research was conducted in three blocks (administrative units) in the Sundarbans region of West Bengal, India involving eight groups of eight to ten mothers. They received training on photo documentation and ethical concerns before taking two rounds of photographs within 6 months. Photographs and key messages were communicated to local decision makers to the state policy managers. Mothers photos and narratives focused on specific determinants of child malnutrition and health, like agriculture and fisheries; malnutrition of mother and child, water and sanitation; recurrent non-communicable diseases; service inaccessibility, which led to positive outcomes across all social determinants. The action research where the locus of control of generating evidences rested with mothers have resulted in self-identification of social determinants by respondents initiated a behavior change at family and community level. An expected outcome of this transformational project, photovoice examined gendered social power in understanding determinants of child malnutrition and health in geo-climatically vulnerable region. More overarching outcomes traced in the framework include a rise in understanding of the dynamics of community care delivery system by mothers and other civil society workers that needs to tapped.
Background/Objectives:
The Indian Sundarbans is marked by inhospitable terrain and frequent climatic shocks which jointly hinder access to health care. Community members, and women in particular, have few means to communicate their concerns to local decision makers. The community based participatoey action research study Photovoice is one way in which communities can raise their local health challenges with decision makers. This study unlocks mothers' voices on the determinants of their children's health to inform local level decision-making on child health issues in the Indian Sundarbans.
Description of Intervention and/or Methods/Design:
Photovoice action research was conducted after through research of the participatory SBCC in remote regions under climate distress in three blocks in the Sundarbans inlands of West Bengal, India. The project involved eight groups of eight to ten mothers who had at least one child below 6 years of age across four villages. The mothers received training on photo documentation and ethical concerns before taking two rounds of photographs within 6 months, interspersed by fortnightly group meetings facilitated by researchers. Photographs and key messages were communicated to local decision makers during block and village level interface sessions with the mothers and researchers.
Results/Lessons Learned:
Mothers' photos focused on specific determinants of health, such as watsan; health status, like malnutrition and non-communicable diseases; service accessibility; climate conditions; and social issues such as early marriage and recurrent pregnancy. Some issues were not captured by photos but were discussed in group meetings, including domestic violence and the non-availability of medical practitioners. We found differences by mother's educational status, livelihood and caste identity in the extent and nature of photographs taken. As a result of the mother's interface with community decision makers, which included showcasing a selection of their photos, efforts to improve road infrastructure and human resource availability in the primary health centres and local government were realized.
Discussion/Implications for the Field:
Photovoice has the potential to express the voices of vulnerable communities regarding their health needs and can help them dialogue with local decision makers to inform community health policy and planning. More needs to be done to understand how social differences among photovoice participants influences how they engage with the methodology. As an expected transformational social outcome of the project, photo voice examined gendered social power in understanding determinants of non-communicable diseases in geo-climatically vulnerable Sundarbans. The more overarching outcomes traced in the framework include a rise in understanding of dynamics of community care system by women and other system.
Abstract submitted by:
Shibaji Bose
Upasona Ghosh
The Indian Sundarbans is marked by inhospitable terrain and frequent climate change, which increases the burden of malnutrition and communicable diseases among children. Community members specially women have few means to communicate their concerns regarding social determinants of childrens health and nutritional conditions to local decision makers. Photovoice is one way in which communities can voice their local challenges with decision makers. Photovoice action research was conducted in three blocks (administrative units) in the Sundarbans region of West Bengal, India involving eight groups of eight to ten mothers. They received training on photo documentation and ethical concerns before taking two rounds of photographs within 6 months. Photographs and key messages were communicated to local decision makers to the state policy managers. Mothers photos and narratives focused on specific determinants of child malnutrition and health, like agriculture and fisheries; malnutrition of mother and child, water and sanitation; recurrent non-communicable diseases; service inaccessibility, which led to positive outcomes across all social determinants. The action research where the locus of control of generating evidences rested with mothers have resulted in self-identification of social determinants by respondents initiated a behavior change at family and community level. An expected outcome of this transformational project, photovoice examined gendered social power in understanding determinants of child malnutrition and health in geo-climatically vulnerable region. More overarching outcomes traced in the framework include a rise in understanding of the dynamics of community care delivery system by mothers and other civil society workers that needs to tapped.
Background/Objectives:
The Indian Sundarbans is marked by inhospitable terrain and frequent climatic shocks which jointly hinder access to health care. Community members, and women in particular, have few means to communicate their concerns to local decision makers. The community based participatoey action research study Photovoice is one way in which communities can raise their local health challenges with decision makers. This study unlocks mothers' voices on the determinants of their children's health to inform local level decision-making on child health issues in the Indian Sundarbans.
Description of Intervention and/or Methods/Design:
Photovoice action research was conducted after through research of the participatory SBCC in remote regions under climate distress in three blocks in the Sundarbans inlands of West Bengal, India. The project involved eight groups of eight to ten mothers who had at least one child below 6 years of age across four villages. The mothers received training on photo documentation and ethical concerns before taking two rounds of photographs within 6 months, interspersed by fortnightly group meetings facilitated by researchers. Photographs and key messages were communicated to local decision makers during block and village level interface sessions with the mothers and researchers.
Results/Lessons Learned:
Mothers' photos focused on specific determinants of health, such as watsan; health status, like malnutrition and non-communicable diseases; service accessibility; climate conditions; and social issues such as early marriage and recurrent pregnancy. Some issues were not captured by photos but were discussed in group meetings, including domestic violence and the non-availability of medical practitioners. We found differences by mother's educational status, livelihood and caste identity in the extent and nature of photographs taken. As a result of the mother's interface with community decision makers, which included showcasing a selection of their photos, efforts to improve road infrastructure and human resource availability in the primary health centres and local government were realized.
Discussion/Implications for the Field:
Photovoice has the potential to express the voices of vulnerable communities regarding their health needs and can help them dialogue with local decision makers to inform community health policy and planning. More needs to be done to understand how social differences among photovoice participants influences how they engage with the methodology. As an expected transformational social outcome of the project, photo voice examined gendered social power in understanding determinants of non-communicable diseases in geo-climatically vulnerable Sundarbans. The more overarching outcomes traced in the framework include a rise in understanding of dynamics of community care system by women and other system.
Abstract submitted by:
Shibaji Bose
Upasona Ghosh
Source
Approved abstract for the postponed 2020 SBCC Summit in Marrakech, Morocco. Provided by the International Steering Committee for the Summit. Image credit: Shibaji Bose via SlideShare