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African leadership for child survival . 16-18 January 2013 Addis Adeba Rocio BERZAL Ethiopie C4D Specialist Niger . Promoting social and behaviour change for Child survival. Setting the basis - (from 2006 to mid-2008)
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African leadership for child survival 16-18 January 2013 AddisAdebaRocio BERZAL Ethiopie C4D Specialist Niger
Promoting social and behaviour change for Child survival Setting the basis - (from 2006 to mid-2008) • Research LANCET, pilot design, secure resources (HR and financial) • Identify & develop coordination mechanisms (national and local) • Social & Behaviour change communication • IPC / community workers + participatory communication for individual change (proximity and traditional media, cinema, theatre, community radios…) • Community empowerment / participation for collective change (community learning, community-led design, implementation and M&E of action plans) • Social Mobilization • Creation of partnership and networks (trad. chiefs, women, youth) • Media campaigns • Advocacy • Local (imams, traditional chiefs) and national levels (partners)
Community empowerment From Collective learning… Introduce approach, build trust …To Collective action: Participatory community assessment Village plan of action Meetings to discuss the progress Annual celebration of champions Community advocates
Scaling up: communities, agents of change Communityassesment ANALYSIS • Celebration of progress • Certification «communauté Modèle» Promotion KFP DIFFUSION SITAN ACTION CONTACT PLAN • Amplication horizontale et verticale PLAN DIFFUSION ACTION Community plan of action ANALYSIS SITAN CONTACT Identify acteurs Establish trust relationships Using stimulus guiding dialogue Community self- diagnosis
Facilitators/ volunteers Supervisors (NGO) Traditional Mass media/ actors of change Modern Mass media Community Dialogue Constraintes and external support • Step 1 • Identification of problem • Step 2 • Involving leaders and participants • Step 3 • Clarification perceptions Training • Etape 4 • Expression of individualsand collectifs needs(census/ cartographie) Step 5 • Evaluation current situation • Vision • Establish’ objectifs • Reaching consensus about activities Catalyseurs Step 6 Analyse and action plan Collective action Step 7 Sharing responsabilities (relais, village chief and religious Step 10 Communitybased monitoring system Step 11 Participatoryassessment Step 12 Recognition of model families and villages Step 8 Social Mobilisation Step 9 Implementationactivities Changements individuels • Individual Changes • Competencies • Ideation : Knowledge, Self- Confidence, Risk Perception, subjective Norms, self Image, Emotions, Self-efficiency, Social Influence, personal advocacy • Intentions • Behavior • Social Changes • Leadership • Level and equity of participation • Information equity • Collective Self-efficiency • Ownership • Social Cohesion • Social norms Societal impact
Analyse data on KFP and community interaction withhealth system Community-based monitoring form allows gathering data on KFP adoption and sharing /discussing indicators with health workers at village level. The purpose of the village action plan is outline different actions to help the practices adoption. A problem of supply/resource issues could be outlined in the action plan to stress this issue and find solutions, included advocacy actions. Monitoring tool.pptx
SCALING UP FROM 140,000 TO 2 MILLION FAMILIES Scaling up in 5 regions with 6 NGOs (from mid-2009) Scaling up through other programme entry doors (from mid 2011) WASH, EDUCATION, CASH TRANSFER
Results accelerated in individual & social change (INS Survey and LASDEL study in 2012) Individual behaviour changes are supported and accelerated Social change: increased participation, sense of ownership, change of social norms (EBF, assisted delivery..), the community enters in a dynamic of change (various initiatives related to hygiene, education..)
Empiricalevidences Public sanitation days
“Social cohesion”: The village had created a “food bank,” solidarity system organized to invest in nutrition activities
Young leaders Organization of transportation of pregnant women to the health centers Husbands more supportive of health facility attendance The “community cart” gives community members access to health services
“You can see the change by looking at the health of our children. I think I can convince the others. When women saw my baby recently they all commented on how healthy my baby looked”.
Local media trained in KFP becomes spokespersons and organizes public broadcasts with population
Volunteers create demand for products and health services among the population Volunteersgenerateknowledge and information about care-seekingand monitor behaviours Volunteers assist the health staff of the health center by holding communication sessions for patients
Approaches for scaling up in 2013: consolidating gains and increasing impact Increasing alliances to scale –up coverage focused on ICCM, nutrition and social safety nets: • MDG Initiative atlevel of 8 health districts supported by EU • Modelling a community-based nutrition program to reduce and preventchronic malnutrition • Safety nets: Cash transfer + KFP in 1,000 villages • Alliance with WFP in 1200 CRENAMs and 29 Health Districts • Alliance with UNFPA, Mens involvement initiative « Schools for husbands » in 1 region
Evidence: Almost 60,000 children’s lives saved in 2009!Proportion of child lives saved in 2009, by intervention or risk factor reduction (List JHU team)
Bibliography LANCET series 2003, 2004 Proposal for Spanish Government : Fomentar la incorporacion de practicas familiares a fin de promover la supervivencia del niño en Niger, Unicef Niger, 2008 KAP study on KFP, KONE Mariatou, Niger, juillet 2008 EDSN MICS III 2006, EDSN MICS IV 2012. INS NIGER Narrative of an Action Research project in Communication for Social and Behavior Change, in five municipalities of Maradi and Zinder, Niger. Manuela Varrasso Enquête quantitative sur les Pratiques Familiales Essentiels. INS, Niger. Avril 2012. La promotion des Pratiques Familiales Essentiels au Niger, LASDEL-Avril 2012. Figueroa M.E., Lawrence Kincaid D., Rani M., Lewis G., Communication for Social Change: An Integrated Model for Measuring the Process and Its Outcomes, Communication for Social Change Working Paper Series I, The Rockefeller Foundation and Johns Hopkins University Center for Communication Programs, New York, 2002 LANCET. Reduction in child mortality in Niger: a Countdown to 2015 country case study AgbessiAmouzou, OumarouHabi, KhaledBensaïd, and the Niger Countdown Case Study Working Group Qualitative research to identify solutions to local barriers to care-seeking and treatment for diarrhoea , malaria and pneumonia in Niger. Juliet Bedford, 2012 Review/analysis of UNICEF Community-Led Total Sanitation and Essential Family Practices Communication for Development Interventions in Niger. Karen Greiner 2012