Communication for Childbirth
This issue of the Drum Beat focuses on childbirth and the role of communication in antenatal preparation and postnatal practices related to maternal, child, and family health. The summary sampling addresses: 1) who are the influencers on local socio-cultural beliefs and practices related to childbirth; 2) how to reach and engage them; 3) how to communicate healthy childbirth practices as norms; and 4) how to measure the reach and results of such communication.
- A selection of summaries on ANTENATAL KNOWLEDGE AND PRACTICES.
- Vote in a POLL on e-Health initiatives.
- A focus on FAMILY INVOLVEMENT.
- BLOG with The CI.
- POSTNATAL CARE: A selection of projects and strategies.
by Samuel E Anya, Abba Hydara, and Lamin ES Jaiteh
This report is the result of a study conducted to examine the provision of information and education in antenatal clinics from the perspective of pregnant women attending these clinics. According to the authors, educated women have better pregnancy outcomes compared with uneducated women. Literacy among women in many developing countries is low, and there are socio-cultural beliefs and practices with adverse effects on pregnancy and birth - even among educated women. The report suggests that information, education, and communication during antenatal care in the largest health division are inadequate. Pregnant women are ill-equipped to make appropriate choices, especially when they are in danger. This contributes to the persistent high maternal mortality ratios in the country.
by Catherine Toth
This case study examines the rationale, strategy, and impact of World Vision's child survival project, Pragati, carried out in 3 districts of Uttar Pradesh, in north-central India. Pragati strove to improve health outcomes and change behaviours related to women's and children's health, and to ensure that pregnant women and new mothers had ready access to information about and methods of birth spacing and family planning. That is, behaviour change communication (BCC) on health, nutrition, and family planning was timed to a woman's stage of pregnancy, the age of her infant, and/or the fertility intentions of the couple. It sought to engage all decision-makers in the family, including but not solely limited to the individual who might accept a contraceptive method.
3. Community Consultation on Child Health Practices in Timor-Leste
This document provides results from a 2007 consultation conducted by the Timor-Leste Integrated Maternal and Child Health Care Project (TAIS), jointly implemented by USAID/BASICS and USAID/IMMUNIZATIONbasics to learn more about key preventive and care-seeking health practices related to child health. The community exercise consisted of focus group discussions (FGDs) in 5 districts on the context of behaviour change, such as the range of household tasks that mothers perform and their level of independence. This was followed by in-depth interviews and trials of improved practices (TIPs) in 13 communities. In the TIPs, mothers were asked to try out new, improved practices for a trial period, after which interviewers returned to seek feedback on what people did, as well as the benefits they perceived and difficulties they encountered during the trial period. Communication-related next steps towards the desired behavioural changes in maternal practices included making a birth plan, making at least 4 antenatal visits, and breastfeeding exclusively for 6 months, among others.
mothers2mothers (m2m) is a non-governmental organisation (NGO) that uses a peer mentorship model to provide health and HIV/AIDS information and support to pregnant women and new mothers living with HIV/AIDS. The programme is designed to empower mothers and reduce the number of babies born with HIV by training mothers living with HIV to counsel others. m2m has over 340 sites at hospitals, antenatal clinics, maternity wards, and post-natal clinics across South Africa, Lesotho, Kenya, Zambia, Swaziland, Malawi, and Rwanda, and is looking to expand into more provinces across South Africa throughout 2008. m2m's main communication strategy is peer education. The programme trains and employs mothers living with HIV, who have themselves benefited from m2m's services, to become "Mentor Mothers". The mentoring team is comprised of caregivers and educators who help counsel and advise new and expectant mothers.
In general, e-Health initiatives are:
- Lifesaving - in remote places where there are no alternatives and/or where providers are not adequately trained or are in short supply, these services are crucial and need to be supported through training, funding, and research and development (R&D).
- Dangerous - the evidence is not yet clear as to the viability of guiding physicians to provide care from a distance.
- Potentially useful, but prohibitively costly.
VOTE and COMMENT click here.
This illustrated material is designed to address behaviours of young men who are about to be fathers or are planning in the future to have children. It briefly explains the effects of male smoking, alcohol use, and "easy sex" on family life, women, and children. It also focuses on alerting men to the genetic dangers of marrying a cousin and the advantage for future family life of marriage to a woman who has finished high school and is of adult age. It gives brief instructions for care of a wife before, during, and after pregnancy, with the goal of improving mother and infant health.
This report details a study nested in a project entitled "Projahnmo: Community-Based Interventions to Reduce Neonatal Mortality in Bangladesh". In order to foster behaviour change, Projahnmo drew largely on interpersonal communication (IPC) in or near the household level, with an emphasis on involving the entire range of decision-makers in the lives of pregnant women. The interventions included BCC to improve maternal knowledge and practices, promotion of services focusing on birth and newborn care preparedness (BNCP), safe and clean delivery, essential newborn care, and management of serious neonatal illness. For example, community mobilisers (CMs) work with women's and men's groups in the community to encourage and educate them on appropriate home care techniques for both mother and newborn, the need for a birth and newborn preparedness plan for every expectant mother, and their rights as a community to adequate health care.
The Mabrouk! ("Congratulations!") Initiative was designed to raise awareness and discussion among young married couples in Egypt around pre-marital/newlywed counselling, antenatal care, safe delivery, postpartum care (maternal and child health and family planning), and infant health, and to create sustainable social change related to health practices across the stages of family life. Part of the Communication for Healthy Living (CHL) project, the Mabrouk! Initiative combined a multimedia campaign with interpersonal and community empowerment approaches to reinforce programme effects. The initiative identified marriage as a strategic entry point for family health messages, as married couples make many health and behaviour decisions that will have lifelong effects on family health.
by Rachel Scheier
Published by Women's eNews, this article outlines a strategy being used by clinics in the Jinja district of Uganda to encourage men to be involved in the prenatal care and reproductive health of their wives. When a woman visits a clinic alone, after her consultation she is given a brief letter for her husband, signed by the local district health director, which includes some basic information and a polite request to come to the clinic in person to discuss health matters, such as: HIV testing; what to expect during the delivery; and how to care for a pregnant woman. According to one man interviewed for the article, this letter encouraged him to take the time to come to the clinic to find out what the couple could expect in the time leading up to the birth of their child.
This report describes maternal-newborn care practices and care of infants aged 2-4 months (feeding practices, morbidity status, immunisation status, and nutritional status) in urban slum dwellings of Indore city, Madya Pradesh (India). Also discussed in this report are reasons for following these practices, what facilitates and what hinders following optimal practices, and potential programme options for their improvement. Strategies for supporting mothers and newborns through antenatal care include:
- Encourage families and/or pregnant women to join a health savings fund group from which they can draw money if needed for health care.
- Train 'Basti' Community Based Organisations (BCBOs) through pictorial and group discussion, accommodating literacy issues, to monitor behaviours of mothers and assess their progress.
- Establish telephone links of slum-based birthing huts with public or private medical facilities that can offer support.
- Engage in collective dialogue with mothers-in-law (MILs), elder ladies of the community, and traditional birth attendants (TBAs).
The Ministry of Health (MOH) in Kenya increased both the recommended timing and content of postnatal services a women and her infant should receive to at least 3 assessments within the first 6 weeks after childbirth. This orientation package not only expanded the existing content of postnatal care (PNC) to incorporate comprehensive care for both mother and baby, but also provided opportunities to deliver appropriate family planning (FP) advice and methods at several points in time. The package was introduced and evaluated at one hospital and 4 health centres in Embu district, Eastern Province, between 2006 and 2008.
ACCESS and the Centre for Development and Population Activities (CEDPA) are implementing an operations research project in selected blocks of Dumka district of Jharkhand. The aim is to demonstrate that the delivery of lifesaving skills by auxiliary nurse midwives (ANMs) - combined with BCC activities for surrounding communities - improves the access to and use of key maternal and neonatal care services. The ultimate goal is to contribute to improved health outcomes and reduced morbidity and mortality of mothers and newborns. Interpersonal communication and capacity building are central to these efforts to support the Government of India's Ministry of Health and Family Welfare initiative to increase skilled attendance at birth.
by Martha Morrow, Prarthna Dayal, Jia Zhen, Garth Luke, Anueja Gopalakrishnan, and Sue Ndwala
This report explores strategies that have been proven to be effective in reducing maternal, newborn, and child deaths as part of the effort to meet Millennium Development Goals (MDGs) 4 and 5 by 2015. The first portion of the document presents evidence that low-income countries could indeed substantially reduce the number of maternal, newborn, and child deaths by implementing a limited number of cost-effective interventions at specific points in time. A key theme characterising successful maternal, neonatal, and child health (MNCH) interventions is provision of a continuum of care during the period before and during pregnancy, through birth and the neonatal stage, and then through early childhood (up to 5 years of age). Other directives include: developing systematic approaches to planning and monitoring; training and retaining sufficient health staff to provide effective services at the community and district level; reducing inequalities; and actively engaging communities in programmes.
This planning model, from the United States Agency for International Development (USAID)-supported ACCESS-FP Program, "illustrates the relationships between postpartum family planning, maternal health, newborn health, and prevention of mother-to-child transmission of HIV/AIDS through the first year postpartum. The framework illustrates the relationships as they commonly exist in programmes. Dotted lines indicate those services are more theoretical than actual. In family planning, emphasis is placed on integrating family messages in antenatal care, then immediate postpartum family planning for long-acting and permanent methods as available, with the greatest emphasis on the six-week postpartum visit..."
by Sarla Chand and Jacqui Patterson
This brief highlights the contribution of faith-based organisations (FBOs) to health care by focusing on 4 FBO programme models that, despite multiple challenges, have been effective in improving maternal and newborn health (MNH) outcomes. The programme models are based on FBO health networks, community health behaviour change programmes, congregation-based health programmes, and comprehensive health care programmes. Using project examples mainly from Africa, the document shows how these models can strengthen and expand health services and contribute to the achievement of the health-related MDGs. The brief concludes with recommended actions for all stakeholders - FBOs, policy makers, and donors.
This web-based toolkit from the Change Project contains approaches and tools for behaviour change interventions for maternal survival. According to the Change Project, the set of tools have been designed for effective and locally appropriate behaviour change and have been field-tested in Kenya, Guinea, and Bangladesh. The kit's Maternal Survival framework organises behaviour change interventions into 3 areas: seeking skilled care, birth preparedness, and providing skilled care. These are interventions at the household, community, and health facility levels that begin with information gathering on attitudes and beliefs about skilled care and include lessons learned and global programme experience from a project called the Safe Motherhood Initiative.
Carried out from 1999 to 2006, this LINKAGES programme piloted the integration of infant feeding and HIV counseling and testing (CT) in maternal and child health (MCH) and community services in Ndola District, Zambia. NDP is based on the notion that integrated improved counselling - face-to-face sharing of information - on infant feeding, maternal nutrition, and antiretroviral (ARV) prophylaxis in health care and community services can enable women to make informed choices and to act effectively to feed their infants optimally in the context of HIV prevalence. NDP drew on interpersonal communication, printed materials, partnership, and research in an effort to have an impact on CT uptake and to facilitate the introduction of ARV prophylaxis. Activities included involvement of provincial health offices in planning and implementation, the introduction of a group counselling model, streamlined data collection, additional human resources for CT, and development of messages and materials to support CT.
This issue of the Drum Beat was written by Julie Levy.
The Drum Beat seeks to cover the full range of communication for development activities. Inclusion of an item does not imply endorsement or support by The Partners.
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