Increasing male involvement in Maternal Neonatal and Child Health (MNCH): Trained Health Surveillance Assistants are effective in using gender responsive SBCC in Chitipa and Kasungu Districts in Malawi
Summary:
Along with government partners, Plan International's Integrated Pathways for Improving Maternal, Newborn and Child Health (InPath) project developed a SBCC roadmap to guide community awareness activities on gender responsive MNCH. The finalized, pretested messages resulted in a matrix of message options for project SBCC activities. MOH's Health Surveillance Assistants (HSA) and community volunteers were trained to engage with women and their partners during home-visits during pregnancy and after birth, supported by trained district supervisors. Training included interpersonal communication (IPC), facilitation and public speaking skills, differentiation of message and approaches to engage women, men, adolescents and community gatekeepers, and building their understanding of effects of GE barriers on MNCH outcomes. Actual HIS data is used to adjust messaging to ensure HSA's are addressing the most pressing place and situation specific behaviors. Midterm assessment results showed that the proportion of men involved during HSA's ANC and PNC home visits as well as male accompaniment to ANC visits improved. Plan International's approach to bolster HSA's skills on gender sensitive SBCC and IPC has been successful in increasing male partner involvement in MNCH by addressing underlying GE discrimination and barriers to information. As home births, and subsequently maternal and neonatal deaths remain high in many regions and misconceptions on the importance of male support to ANC, birth and PNC are still persistent, long term investment supporting continued engagement through home visits, community sensitization events and use of various communication channels, is paramount for ensuring adaptation of healthy GE and MNCH behaviors.
Background/Objectives:
Despite demonstrable advances in newborn and child health, maternal mortality remains high in Malawi, with 439 maternal deaths per 100,000 live births. Along with government partners, Plan International's Integrated Pathways for Improving Maternal, Newborn and Child Health (InPath) project developed a SBCC roadmap to guide community awareness activities on gender responsive MNCH. Messages are delivered through community sensitization events, open- and market days (OD-MD), community radio, and interpersonal communication/ household visits to position pregnancy as a special period in a woman' life and increase the sense of responsibility for MNCH among husbands/male partners, family members and community gatekeepers.
Description of Intervention and/or Methods/Design:
Through a consultative process with the Ministry of Health (MOH), the project applied a gender equality lens and adapted SBCC messages from Malawi's National Health Communication Strategy to aim for better MNCH outcomes. The finalized, pretested messages resulted in a matrix of message options for project SBCC activities. MOH's Health Surveillance Assistants (HSA) and community volunteers were trained to engage with women and their partners during home-visits during pregnancy and after birth, supported by trained district supervisors. Training included interpersonal communication (IPC), facilitation and public speaking skills, differentiation of message and approaches to engage women, men, adolescents and community gatekeepers, and building their understanding of effects of GE barriers on MNCH outcomes. The mix of stakeholders and interventions, from household visits, drama groups and edutainment during MD and OD, radio spots, and HSAs leading public and panel discussions reinforced the key GE- MNCH behaviors.
Results/Lessons Learned:
Recent assessment data suggests MNCH and GE messages are reaching men: the importance of accompanying their spouse on ANC visits; involvement in child care; sharing household chores and birth spacing. Midterm assessment results showed that the proportion of men involved during HSA's ANC and PNC home visits improved from respectively 6% to 58% and 6% to 24% in Chitipa and from 6 to 36% and 26% in Kasungu. On average at midterm, 82% of the women in Kasungu and 54% in Chitipa were accompanied by their male partners to ANC at least once. However, barriers to increased MNCH service utilization persist, and male engagement is still being negatively influenced by traditional and social beliefs.
Discussion/Implications for the Field:
Plan International's approach to bolster HSA's skills on gender sensitive SBCC and IPC has been successful in increasing male partner involvement in MNCH by addressing underlying GE discrimination and barriers to information. As home births, and subsequently maternal and neonatal deaths remain high in many regions and misconceptions on the importance of male support to ANC, birth and PNC are still persistent, long term investment supporting continued engagement through home visits, community sensitization events and use of various communication channels, is paramount for ensuring adaptation of healthy GE and MNCH behaviors.
Abstract submitted by:
Carolien Albers - Plan International Canada
Aaliya Bibi - Plan International Canada
Mathews Chavunya - Plan International
Rudy Broers - Plan International Canada
Janani Vijayaraghavan - Plan International Canada
Along with government partners, Plan International's Integrated Pathways for Improving Maternal, Newborn and Child Health (InPath) project developed a SBCC roadmap to guide community awareness activities on gender responsive MNCH. The finalized, pretested messages resulted in a matrix of message options for project SBCC activities. MOH's Health Surveillance Assistants (HSA) and community volunteers were trained to engage with women and their partners during home-visits during pregnancy and after birth, supported by trained district supervisors. Training included interpersonal communication (IPC), facilitation and public speaking skills, differentiation of message and approaches to engage women, men, adolescents and community gatekeepers, and building their understanding of effects of GE barriers on MNCH outcomes. Actual HIS data is used to adjust messaging to ensure HSA's are addressing the most pressing place and situation specific behaviors. Midterm assessment results showed that the proportion of men involved during HSA's ANC and PNC home visits as well as male accompaniment to ANC visits improved. Plan International's approach to bolster HSA's skills on gender sensitive SBCC and IPC has been successful in increasing male partner involvement in MNCH by addressing underlying GE discrimination and barriers to information. As home births, and subsequently maternal and neonatal deaths remain high in many regions and misconceptions on the importance of male support to ANC, birth and PNC are still persistent, long term investment supporting continued engagement through home visits, community sensitization events and use of various communication channels, is paramount for ensuring adaptation of healthy GE and MNCH behaviors.
Background/Objectives:
Despite demonstrable advances in newborn and child health, maternal mortality remains high in Malawi, with 439 maternal deaths per 100,000 live births. Along with government partners, Plan International's Integrated Pathways for Improving Maternal, Newborn and Child Health (InPath) project developed a SBCC roadmap to guide community awareness activities on gender responsive MNCH. Messages are delivered through community sensitization events, open- and market days (OD-MD), community radio, and interpersonal communication/ household visits to position pregnancy as a special period in a woman' life and increase the sense of responsibility for MNCH among husbands/male partners, family members and community gatekeepers.
Description of Intervention and/or Methods/Design:
Through a consultative process with the Ministry of Health (MOH), the project applied a gender equality lens and adapted SBCC messages from Malawi's National Health Communication Strategy to aim for better MNCH outcomes. The finalized, pretested messages resulted in a matrix of message options for project SBCC activities. MOH's Health Surveillance Assistants (HSA) and community volunteers were trained to engage with women and their partners during home-visits during pregnancy and after birth, supported by trained district supervisors. Training included interpersonal communication (IPC), facilitation and public speaking skills, differentiation of message and approaches to engage women, men, adolescents and community gatekeepers, and building their understanding of effects of GE barriers on MNCH outcomes. The mix of stakeholders and interventions, from household visits, drama groups and edutainment during MD and OD, radio spots, and HSAs leading public and panel discussions reinforced the key GE- MNCH behaviors.
Results/Lessons Learned:
Recent assessment data suggests MNCH and GE messages are reaching men: the importance of accompanying their spouse on ANC visits; involvement in child care; sharing household chores and birth spacing. Midterm assessment results showed that the proportion of men involved during HSA's ANC and PNC home visits improved from respectively 6% to 58% and 6% to 24% in Chitipa and from 6 to 36% and 26% in Kasungu. On average at midterm, 82% of the women in Kasungu and 54% in Chitipa were accompanied by their male partners to ANC at least once. However, barriers to increased MNCH service utilization persist, and male engagement is still being negatively influenced by traditional and social beliefs.
Discussion/Implications for the Field:
Plan International's approach to bolster HSA's skills on gender sensitive SBCC and IPC has been successful in increasing male partner involvement in MNCH by addressing underlying GE discrimination and barriers to information. As home births, and subsequently maternal and neonatal deaths remain high in many regions and misconceptions on the importance of male support to ANC, birth and PNC are still persistent, long term investment supporting continued engagement through home visits, community sensitization events and use of various communication channels, is paramount for ensuring adaptation of healthy GE and MNCH behaviors.
Abstract submitted by:
Carolien Albers - Plan International Canada
Aaliya Bibi - Plan International Canada
Mathews Chavunya - Plan International
Rudy Broers - Plan International Canada
Janani Vijayaraghavan - Plan International Canada
Source
Approved abstract for the postponed 2020 SBCC Summit in Marrakech, Morocco. Provided by the International Steering Committee for the Summit. Image credit: One Drop