Maternal and Child Health Campaign

• Project Overview
• Objectives and Strategies
• Activities and Highlights

PROJECT OVERVIEW

The maternal health and child immunization statistics in Guinea are among the worst in the world, with an estimated 528 women dying for every 100,000 live births, and only 30% of the children in Haute Guineé completely immunized.

The PRISM MCH campaign involved 107 health centers and covered a population of 2 million. The main programmatic aims were to mobilize women and their families to prepare for obstetrical emergencies through the development of “birth plans” and to fully immunize their children. Community-based talks and training sessions were designed to provide health personnel, community leaders, youth mobilizers, and demba nyouma (“good mothers”) with the knowledge and skills needed to influence their own behavior and that of their communities. Growing families were encouraged to join mutual health insurance organizations (MURIGAs) to help them prepare financially for obstetrical emergencies.

Partners for the Maternal and Child Health Campaign included the Ministry of Health, Ministry of Youth, Ministry of Education, Ministry of Women Affairs, Save the Children, Africare, PSI, the Guinean Family Welfare Association (AGBEF), and the Adventist Development Relief Agency (ADRA).

OBJECTIVES/STRATEGIES

The MCH Campaign aimed to increase the percentage of:

• Women who know that pregnant women should make a birth plan covering pregnancy, labor, delivery and post-natal health care;
• Women who can correctly list 3 components of a birth plan;
• Men and women who understand and have joined a local MURIGA;
• Women who can correctly list two danger signs for a woman who is pregnant or in labor and two for a post-partum woman indicating that she should seek help from a trained health care provider;
• Women who can correctly list two risk factors for pregnant women;
• Women who are currently using a modern family planning method;
• Community members who state they believe that health center and community accountability has increased since the campaign began; and
• Children aged 0-12 months who have an immunization card and are fully vaccinated against the six major childhood diseases.

ACTIVITIES AND HIGHLIGHTS

Community-Centered Activities

Community-Health Center Dialogue: Discussions in health centers brought health center workers and traditional birth attendants face-to-face with community leaders, religious and appointed leaders, representatives of women’s groups, parents, and youth mobilizers. First-round talks assessed key maternal and child health concerns and brainstormed solutions. Future rounds of discussions shared the campaign’s key messages, motivated people to join and participate in MURIGAs (community health insurance groups), and helped the community to develop and implement action plans. These dialogues were integrated into ongoing community meetings, such as those facilitated by Africare in Dinguiraye.

Demba Nyouma: Women in each community who practiced key maternal and child health behaviors and had developed “birth plans” were identified and honored as Demba Nyouma (“good mothers,” or “model women”). They received badges and were encouraged to pass health information on to friends and relatives. The Demba Nyouma strategy enabled women to reach their peers through informal encounters while fetching water, at baptisms, and during mamayas (gatherings of one or several women’s groups to socialize through singing and dancing).

Sports Activities: Highly attended sports matches were used to reach the women who attended these matches, as well as men, with key campaign messages.

Theater Presentations: Sketches and street shows were developed to encourage dialogue and accountability between the health center personnel and people in the community. The roles and responsibilities of both parties were presented by eight youth and three adult theater troupes with a touch of humor and reality. IEC Groups played a key role in sensitizing the community prior to the theater presentations.

Campaign Launches: Mini-campaign launches were held in each prefecture to deliver key messages and promote health workers participating in a “new partnership” between the community and the local health center. IEC Groups were central to the organization and implementation of these community launches.

Working with Men. Through the health centers/CPN sections, men who supported their wives’ use of modern contraception were identified and used to reach other men within the community. These men were given special recognition in the community and encouraged to share their experiences with other husbands.

Campaign Materials

Promotional logo materials: Promotional materials (including a limited number of T-shirts, commemorative cloths and pins) with the campaign logo and key messages were distributed. They helped promote recognition and understanding of the campaign’s key messages among illiterate populations. IEC Groups helped develop, pre-test and distribute these materials.

Simple print materials: Highly visual and easy-to-follow print materials were developed to help health workers and community members remember and share key campaign messages – particularly the key elements in a birth plan, pregnancy/childbirth risk factors, and danger signs.

Leaders’ brochure: A concise leaflet outlining the campaign’s key messages and interventions was prepared in collaboration with key community and religious leaders.

Skills Development and Training

Health Worker Training: PRISM/JHU provided refresher training in maternal health topics and immunization to health center staff. In addition to imparting key technical knowledge, the training explained the Demba Nyouma approach, strengthened counseling skills, and promoted participation in community dialogue meetings and MURIGAs. Issues related to poor treatment of clients and the community’s low regard for health center services were addressed through participatory training in counseling and technical skills for providers. The training of health center personnel, as well as TBAs and community-based distributors of health products (CBDs), was coordinated with MSH.

Youth Mobilizer Training: Youth mobilizers were trained to continue conducting community outreach and referral activities. Their training and work reinforced the work carried out by the health center personnel, TBAs and CBDs. A series of training sessions was carried on in all eight prefectures by a local consultant, together with the IEC Resident Advisor, and key members of the IEC Group.

Traditional Birth Attendant Training: PRISM/MSH trained and supported five traditional birth attendants per health center in the prefectures of Kankan, Kerouané and Faranah in the areas of prenatal care health center referrals, childbirth, hygiene, and recognition of danger signs.

Community-Based Distributors Training: PRISM/MSH trained and supported more than 300 district-based CBD agents in the areas of family planning, dehydration prevention, HIV/AIDS and, in Dinguiraye, vitamin A distribution.

School-Based Activities

Child-to-Child Strategy. PRISM supported the Child-to-Child Strategy by identifying, training and monitoring teachers in schools who were promoting immunization using fifth grade students.

Radio

Radio Spots: Testimonials were aired on rural radio by community members and health workers on: (i) positive experiences at the health center, (ii) benefits of participating in a MURIGA, and (iii) correct prices for services, including immunization (free, following the purchase of an immunization card).

Distance Learning Program: The Agents de santé, Amis des clients radio distance learning program was developed and broadcast on rural radio. Thirteen 15-minute episodes aired weekly, educating health workers and informing the community about the new, quality services provided by the health centers.

Radio Announced Competition: Rural radio announcements promoted a competition among the different sérés and regularly announced the most outstanding séré -- based on the number of members who have come to the health center for maternal and child health needs – particularly for immunizations and deliveries.