East Africa Toolkit: AYSRH Demand Generation
Community dialogues are an interactive participatory communication process that brings together different generations – typically the older generations and millennials – to dialogue to gain a better understanding of each other with the goal to ultimately address some barriers that youth are facing related to their access to reproductive health information and services.
Why Use Community Dialogues in AYSRH?
- Creates a platform for a shared understanding as well as dissemination of new information on family planning
- Improves access to reproductive health information and services for young people at the community level
- Helps the community gain insights into the benefits of sexual and reproductive health care for adolescents and youth
- Allows for an opportunity to express different views and overcome common cultural and religious barriers to youth’s access of reproductive health information and services
- Helps secure community participation, support and commitment to problem solving for sustained positive reproductive health behavior change among adolescents and youth
Within Tupange Pamoja, youth advocates and community health assistants (CHAs)/community health extension workers (CHEWs)/village health teams (VHT) are used to identify priority issues within the community to be addressed. As of May 2020, over 180 community dialogues have been conducted reaching various stakeholders with accurate information on AYSRH as well as the community coming up with their own solutions
In Uganda, community gatekeepers have been organizing community dialogue meetings to discuss and challenge the socio-cultural norms and religious beliefs that hinder adolescents and youth from accessing and utilizing SRH services. These dialogues are often held in conjunction with integrated outreaches to drive referrals and access to quality contraceptive services.
“We work with the religious leaders in churches and mosques to mobilize adolescent and youth for our community sexual reproductive health outreaches. They make announcements immediately after church service or mass and this has helped us to get more numbers of adolescents and youth accessing services. As a result, there have been reduced myths and misconceptions around family planning and adolescent sexuality, stigma by adolescents from seeking for reproductive health services including contraception services,” explains Sr. Nangobi Zikula Midwife from Bugono HC IV in Iganga District.
Guidance: How to Conduct a Community Dialogue
- Engage with key stakeholders within the health facility for buy-in and effective community-led dialogue preparation.
- Plan with the Community Health Assistants (CHAs)/Community Health Extension Workers (CHEWs) on dates for the community dialogue, involve the local administrative units and community gatekeepers. During the planning meeting identify common issues preventing young people’s access to reproductive health information and services in the community, e.g., increased rates of teenage pregnancy, myths on contraceptives, etc.
- Mobilize the target audience based on the issue identified (this could be parents, community gatekeepers, first- time mothers, husbands, boda-boda riders, among others) using community health workers and public announcements. It is important to be strategic about who is invited to take part in the dialogue. It often helps to have multiple perspectives on the issues. For example, the perspective from a government official, religious or traditional leader, community member (parent or service provider), and youth may vary but helpful to having rich conversation.
- The facilitator engages the participants in a discussion, using the facilitator’s guide, to enable participants to share their opinions, experiences, views, stereotypes, narratives, norms and values in an interactive and participatory manner. The sessions should facilitate an ease of expression without fear of judgment and intimidation.
- Identify solutions where there is a commitment or resolution by the participants to embrace AYSRH/family planning. It may also bring about additional information, issues, and ideas that the community may wish to act on.
- Develop an action plan together in accordance with their cultural practices and traditional values. The process is most effective when the participants are actively involved in the resolution that may eventually lead to increased support and acceptance of AYSRH/FP.
- After successfully conducting a dialogue session and the evaluation, express appreciation to all participants for their time, contribution and resolve. This should be done regardless of the dialogue outcome.
- Community units commit to work on AYSRH despite sensitivity surrounding youth sexuality.
- Agree on the date for the next follow-up meeting.
- Use youth networks and collaborate with existing groups to engage youth comfortable in speaking on behalf of youth.
- Conduct the dialogue in a language that is easily understood by all. It is advisable to use the local dialect of all participants.
- Sitting arrangement should be in a semi-circle.
- Each dialogue should have a chairperson/facilitator and a note taker, who should be respected members of the community.
- An ideal community dialogue should have 15-30 members. In case there are more than 30 members, break the meeting into two and appoint different facilitator and note takers.
- If you have an individual who is outspoken, you might suggest continuing the conversation after the meeting or pulling them aside.
- Remember to take pictures of the dialogue meeting.
- Continuous engagement with participants may be necessary to ensure changes in mindset, attitude and beliefs as well as follow-up on progress made towards solutions discussed during the dialogue.
- Changes in practices, knowledge, attitude and beliefs towards FP/AYSRH services
- Supportive/enabling environment for provision of quality FP/AYSRH services
- Monitor outcomes of community dialogues conducted (i.e., action plans developed)
- Monitoring of the dialogues to gauge if it is reaching the intended audiences
- Monitoring the attitudes of the community towards AYSRH/FP
- Increased knowledge and awareness of AYSRH/family planning in catchment areas Increased approval of uptake of SRH/family planning services by adolescents and youth by community members
- Increased number of women, men and young person’s receiving family planning or contraception services
- Increase involvement of youth in the design, implementation and monitoring of adolescent & youth-friendly services (AYFS)
- Increased awareness of FP and AYFS by young people in the community
- % of women ages 15-19 and 20-24 who perceive the presence of social support for family planning in their community
- Meeting costs
- Mobilization of community members
- CHA/CHEW/VHT lunch / snacks (optional)
- CHA/CHEW/VHT transport (optional)
- Venue hall hire (optional)
- Inclusion of family planning demand generation activities in the annual work plans
- Inclusion of community dialogues in existing community forums e.g., chief/community Barazas and community savings groups, etc.
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