Community Media/CLP/PartII

Part II - Programme Design

SW approach -- Notes from an exercise

1. Got the money
2. bring together the key groups:
   1. Community
   2. Radio
   3. Health groups

Key points:

1. Health is not a bio-medical issue
   1. 13 million people & 75 doctors

1. Behaviour change is as much a societal issue as

1. Reasons for maternal mortality
   1. Hemmorrage
   2. Infection
   3. Obstructed labour
2. They can all be addressed by visits to clinic and many at home

Issues to do with MH - Get people to brainstorm the ideas

1. HIV/AIDS
2. Nutrition
3. Smoking
4. Drinking
5. Family planning
6. Malaria
7. Prenatal care
8. Gender relations
9. Illiteracy
10. Poverty
11. Infrastructure
12. Information
13. Safe delivery
14. Working conditions
15. Abortion

Focus on nutrition

What are the positive behaviours?

1. Eating balanced meal
2. Having enough good food
3. Washing hands
4. Extra food for pregnant women
5. Clean drinking water
6. Nurses giving information on healthy foods

What are the negative behaviours?

1. Not eating good food
2. Eating only nsima (maize) (fast food)
3. Not giving women what they need

What are the benefits of positive behaviour?

1. Healthy mother, healthy baby
2. Women are well informed

What are the consequences of negative behaviour?

1. (poor nutition) Maternal death
2. Low birth weight
3. (smoking and drinking)
   1. uses us family income (consequence: poverty)
   2. impact on baby

What things will help positive actions

1. informing women on consequences (informed decisions)
2. public policy
3. substitutions
4. emotional support

Gender relations: (never split by men/women)(or in cases with healthworkers, about good or bad HCWs)

Negative behaviour (consequences)

1. domestic violence (suicide, miscarriage)
2. men not involved / excluded (withdrawal)
3. forced sex (trauma, unwanted pregnancy, STIs)
4. women denied access money, mobility
5. women lack decision making power (women feeling inferior, do not to take responsibility, dependence; community is missing half the inputs & loses out)
6. men refuse to wear condoms
7. lack of capacity development
8. women being submissive
9. preference for boys (girls discriminated against)
10. early pregnancy (maternal death; emotional consequences: young girls not ready to parents)

Positive behaviour (benefits)

1. Men and women sharing responsibilities for pregnancy & parenting (healthy families, good parenting)
2. Special care: resting and eating well (healthy mothers, healthy babies)

Notes: Takes days because you go through all, add more issues, etc.)

Issues: How do you get health care workers on board and agree to the process

Pre-natal care

Negative behaviour (consequences)

1. Nurses yelling at pregnant women (women not going back)
2. Long cues/clinics closed
3. Health staff drunk
4. People believing myths (poor healthcare, risky decisions)
5. System does not provide adequate care
6. Women going to late to clinic
7. Nurses underpaid, undervalued, overworked

Positive behaviour

1. Nurses being supportive (esp. young people), non-judgement
2. Men supporting clinic visits
3. Couple testing for HIV
4. Good counselling

Create characters and stories based on the behaviours The stories are almost written in the process

1. Good
2. Bad -- one eating only nzima, storing food badly, etc.
3. Swing

Other benefits:

• Also a way to gauge the community dynamics...
• A way to get the content out of a group, start the process
• Yields a key product (put it on the wall of the studio)
• Also a key process

Points:

• Stay close to people's lives
• Get back to what is happening and what people are doing
• Trained the radio makers on how to deal with conflict, e.g. child died and hospital blamed; how to deal with the conflict

Questions:

• How do you do this in a resource-poor community?
  • Get individuals in the radio trained to run the process
  • Can the radio do it in the course of their work?

Introduce the formats

• Drama
• Magazine

Magazine

• Interviews (including handing issues sensitively)