East Africa Toolkit: AYSRH Demand Generation
Community Dialogue for Family Planning and AYSRH
A champion engages with community leaders to sensitize them on benefits of family planning
Community dialogue is a forum that draws participants from as many segments of the community as possible to exchange information, share personal stories and experiences, share perspectives honestly, clarify viewpoints and jointly develop solutions to identified community health concerns/issues. These discussions can be organized by community leaders, health care providers, etc.
The composition of community dialogue will vary depending on the specific goals and objectives of the discussion. In general, a community dialogue should involve diverse groups of people, including local leaders, health care providers, religious leaders, young people, etc.
Some of the health thematic areas to be addressed during the dialogues include:
- Maternal and newborn health
- Family planning (FP) and contraception use
- Gender-based violence, including reproductive health violations
- Male engagement to support access and use of reproductive health services
- Adolescent and youth sexual and reproductive health (AYSRH) issues
Why Use Community Dialogues in Family Planning and AYSRH?
They:
- Create a platform for a shared understanding as well as for dissemination of new information on contraception.
- Improve access to reproductive health information and services for specialized groups at the community level, such as like young people, men, people living with disabilities, etc.
- Help the community gain insights into the benefits of sexual and reproductive health (SRH) care for men and women of reproductive age, including adolescents and youth.
- Allow for an opportunity to express different views and overcome common cultural and religious barriers to access to reproductive health information and services among specialized groups (men, youth, people living with disability, etc.).
- Help secure community participation, support and commitment to problem solving for sustained positive reproductive health behavior change among community members, especially among adolescents and youth.
- Breaks down the isolation and separation that many generations are experiencing by promoting positive SRH behaviors among all segments of the population.
- Provide a safe space in the community for stakeholders to engage and learn from each other to positively affect the relationship between people and their health-seeking behavior.
- Allow people to openly express their ideas and perspectives and foster a common understanding towards eliminating barriers to access to SRH services by addressing myths and misconceptions on family planning methods.
- Create ownership of programs in the community by identifying local solutions to SRH problems /concerns.
Evidence
After dialogues, TCI has witnessed an increase in dialogue participants accessing SRH services during outreaches. In particular, dialogues have enabled improved access to SRH services by adolescents and youth and other special groups, such as people living with disabilities.
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“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. |
Community Dialogue Principles
- Respect: Ensure participants treat others the way they would like to be treated. Allow each participant to air out their views on the subject.
- Caring: Create a positive, safe and honest environment where all can learn.
- Cooperation: Break down the barriers between generations so they can work together.
- Inclusiveness: All are important, and their contributions are important in the community.
- Objectivity: Aim to address a particular health concern in the community.
Guidance: How to Conduct a Community Dialogue
- Engage with key local community gatekeepers 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)/ Community Health Based Services Coordinator (CHBSC) on dates for the dialogue, involve the local administrative units and community gatekeepers. Remember to include a sign language interpreter, depending on the community in which the dialogue will be held.
- During the planning meeting, identify common issues preventing women, men, young people, and special groups, such as the physically challenged, from accessing SRH services in the community. The issues could range from myths about contraceptives, lack of male engagement, poor health-seeking behavior, among others.
- Mobilize the target audience based on the issue identified which could be parents, community gatekeepers, first-time parents, boda-boda riders, among others using community health volunteers and/or champions or through public announcements. It is important to be strategic about who is invited to take part in the dialogue. An ideal community dialogue should have at least 30 members.
- 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 Identify a chairperson/facilitator and a notetaker who should be respected members of the community.
- Conduct the dialogue in a language, preferably the local dialect that is easily understood by all participants. The sessions should facilitate an ease of expression without fear of judgment and intimidation for views on FP or contraceptive services and information.
- Identify solutions where there is a commitment or resolution by the participants based on the challenges discussed. It may also bring about additional information, issues and ideas that the community may wish to act.
- Develop a SMART action plan to address the gaps that have been identified 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 contraceptive services.
- After successfully conducting a dialogue session, express appreciation to all participants for their time, contributions and resolve. This should be done regardless of the dialogue outcome. Agree on the date for the next follow-up meeting.
Additional tips
- Use networks and collaborate with existing groups to engage any specialized groups comfortable in speaking on their behalf.
- 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, service provider, men, women and youth that may vary yet helpful to having rich conversations.
- The moderator should have people management skills to be able to guide the flow of the dialogue. If you have an individual who is outspoken, you might suggest continuing the conversation after the meeting or pulling them aside.
Key Outcomes
- Increase in number of people accessing SRH/FP services at community and facility level.
- Increased knowledge about SRH/FP services, including the various contraceptive methods that are available and where they can be accessed within the target community.
Monitoring Process
- Monitor clients accessing SRH/FP services following a community dialogue
- Monitor activities linked to and conducted after community dialogue days, e.g., outreaches/in-reaches/service delivery at facility in months with dialogue days
Success Indicators
- Increased knowledge and awareness of SRH/FP services in catchment area
- Increased uptake of SRH/FP service by community members
- Changes in knowledge attitude and practices towards SRH/FP services
Cost
- Meeting costs
- Mobilization of community members
- CHA/CHEW/VHT/CHBSC Refreshment (optional)
- CHA/CHEW/VHT/CHBSC Transport (optional) for CHMT/SCHMT/DHTS
Sustainability
- Inclusion of dialogues as part of the demand generation activities in the local governments’ annual work plans
- Integration of community dialogues in existing community functions, such as chief/community barazas and community savings
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Resources
Related Approaches
Other East Africa Program Areas
Community Dialogues in Action
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