Changing Behavior with Women, Girls, Boys, and Men: How Gender and SBC Connect_Angie Brasington_5.6.14
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Changing Behavior with Women, Girls, Boys, and Men: How Gender and SBC Connect_Angie Brasington_5.6.14

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Changing Behavior with Women, Girls, Boys, and Men: How Gender and SBC Connect_Angie Brasington_5.6.14 Presentation Transcript

  • 1. MCHIP/Egypt: Community-based SBC and GenderInterventions forMaternal, Newborn and Child Health Angie Brasington, Community Health and Social Change Advisor, MCHIP/Save the Children o n be half o f MCHIP/Eg ypt te am , e spe cially: Dr. IssamEl Adawi, Chief of Party Samah Said Helmy, Gender Advisor
  • 2. MCHIP/Egypt Context  2-year funding to address high rates of malnutrition and newborn mortality  Atmosphere of political turmoil, rise in religious conservatism.  Unable to work with Ministry of Health (post revolution)  Deep experience working with local Community Development Associations (CDAs) BUT, CDAs from the neediest places had limited experience, especially in MNCH-focused programming. Start-up - November 2011 Community-based Implementation starts – November 2012 CB-implementation ends – Nov/Dec 2013 Endline survey – Jan/Feb 2014
  • 3. 1 Umbrella CDA / District 5-10 Local CDAs / Umbrella CDA 12 CHWs / Local CDA (Total ~1,200 CHWs) 6 Governorates 12 Districts (2 per Governorate) Egypt 120 Villages (1 Village /CDA = ~15-20,000 pop) Target Population = 2,041,725 Pregnant Women = 57,168 U2 = 112,295 Newborn = 51,043 Maternal Nutrition and Birth Preparedness Newborn Health Child Spacing Infant and Young Child Nutrition MCHIP Technical Support SBC and referral by CDA-trained and supported Female CHWs Capacity Strengthening of CDAs Technical Focus Transformativegender-focusedstrategies Core Approach Geographic Coverage
  • 4. CHWs provide IPC focused on the 1,000 day period. Home visits and group antenatal and birth preparation classes for all pregnant women PPhome-visits for counseling and referral Community GMPfor 6- 23 month olds (bi-monthly), followed by nutrition-focused home visits and classes. Dialogue sessions with men and women on the influence of gender and social norms on key health practices – Fam ily So lidarity Mo dule s 4 MCHIP’s key CB-MNCHInterventions
  • 5. FamilySolidarity- new & appealing  Sessions interwove popular media - Egyptian movies & songs, sayings and mottos that reflect culture  Critical incidents sparked reflection on local customs and discussion about connection between gender, human rights and health  Health messages and gender concepts interlinked social roles and health, including violence against girls and women. 5
  • 6. Hot Topics Participants liked discussing: Islam and gender Gender and leadership Women’s dress codes - changes over time and how dress reflects one’s identity. Shifts in gender and social norms over time. 6
  • 7. Roll out process 1. MCHIP trained and supported CDA board members and staff to conduct Gender Analysis that informed their program strategies and Family Solidarity Modules (Nov 2012) 2. Gender Advisor developed FSMs (Dec 2012) 3. MCHIP supported CDAs to train CHW trainers on FSM content and facilitation skills (Jan – March 2013) 4. CDAs trained and supported CHWs to conduct FSMs, focusing on engaging mothers, fathers and grandmothers of children under two (April – Nov 2013) 7
  • 8. 81.9 55.7 70.9 65.2 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 Endline Endline Endline Endline Intervention Comparison Intervention Comparison Upper Egypt Lower Egypt Husbands went to doctor with their wives for ANC 41.9 22.9 44.9 38.3 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 Endline Endline Endline Endline Intervention Comparison Intervention Comparison Upper Egypt Lower Egypt Men received advice on Spacing Results fromendline survey UpperEgypt LowerEgypt Men participated in group sessions 31.8 19.3
  • 9. Results fromendline survey 52.3 45.8 30.6 28.6 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 Endline Endline Endline Endline Intervention Comparison Intervention Comparison Upper Egypt Lower Egypt Knowledge of atleast three newborn danger signs
  • 10. 38.5 16.4 17.9 15.1 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 Upper Lower Upper Lower Men who participated Men who did not participate Knowledge to breasfeed more during diarrhea 40.1 12.9 20.9 16.9 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 Upper Lower Upper Lower Men who participated Men who did not participate Joint decision on purchase and selling of animals Results fromendline survey
  • 11. Learning  CHWs found Family Solidarity content relevant to their outreach work and their own lives  Implementation strategies varied based on levels of religious conservatism  Family Solidarity delivered mid-cycle, + and –  Some sessions conducted jointly, but mainly conducted for women and men separately. 11
  • 12. Learning  Build trust in communities -- he alth as a no n- co ntro ve rsiale ntry po int – then start FSMs  Be flexible and rely on local organizations to refine process and activity plans  Work closely with Village Health Committees  Invite participation of religious leaders – and be prepared for their inputs  Train and support male and female facilitators  Develop women’s leadership skills 12
  • 13. 13 ThankYou