Using Magnet Theater to engage high risk communities in communicating bio-medico-social research: Experiences in Kenya. International Public Engagement Workshop 3-5 th December, 2008 African Center for Health and Population Studies, Somkhele, Northern KwaZulu Natal, South Africa Oby Obyerodhyambo., Family Health International, Kenya.

Introduction to Magnet Theatre. Magnet Theatre evolved out of an urgent need to find an engaging community (initially youth) forum for discourse that would lead to debating, choosing and rehearsing healthier behavior change options. MT is: a) target audience specific, b) static or location specific, c) interactive and participatory and, d) provides a forum for behavior change rehearsal and magnification.

Magnet Theatre evolved out of an urgent need to find an engaging community (initially youth) forum for discourse that would lead to debating, choosing and rehearsing healthier behavior change options.

MT is: a) target audience specific, b) static or location specific, c) interactive and participatory and, d) provides a forum for behavior change rehearsal and magnification.

The MT ‘Dilemma’ a safe space for discourse. Magnet theatre creates space for discourse by presenting in juxtaposition the diametrically opposed desired behavior and the ‘ issue ’ which is a barrier to the adoption of the desired behavior. The public are invited to create the bridge between the ‘ issue ’ and the desired behavior by debating the dilemma faced by the dilemma holder a personae in the theatre.

Magnet theatre creates space for discourse by presenting in juxtaposition the diametrically opposed desired behavior and the ‘ issue ’ which is a barrier to the adoption of the desired behavior.

The public are invited to create the bridge between the ‘ issue ’ and the desired behavior by debating the dilemma faced by the dilemma holder a personae in the theatre.

The MT Process. The theatre derives its engagement force from the specificity of the ‘issue’ and dilemma to the target population. The self implication or self-identity created in the MT session creates cognitive dissonance in the audience that seeks resolution in re-enactments and rehearsals of ‘solutions’ to the dilemma. The dissonance and reevaluation of held beliefs creates the first step in the journey of behavior change; questioning the unquestioned .

The theatre derives its engagement force from the specificity of the ‘issue’ and dilemma to the target population.

The self implication or self-identity created in the MT session creates cognitive dissonance in the audience that seeks resolution in re-enactments and rehearsals of ‘solutions’ to the dilemma.

The dissonance and reevaluation of held beliefs creates the first step in the journey of behavior change; questioning the unquestioned .

Examining of behavior options Through role play, role reversals, ‘ hot seating ’ the audience examine behavioral choices and test their efficacy as behavior change options in situ . Subliminally, the collective/communal endorsement or disapproval of tried choices allows the individual to examine behavioral options open to them. The enactment tests the efficacy of the choice before the community thus providing reassurance of acceptance upon adoption.

Through role play, role reversals, ‘ hot seating ’ the audience examine behavioral choices and test their efficacy as behavior change options in situ .

Subliminally, the collective/communal endorsement or disapproval of tried choices allows the individual to examine behavioral options open to them.

The enactment tests the efficacy of the choice before the community thus providing reassurance of acceptance upon adoption.

Bio-medical research findings Vs Culture and Traditions Cultural tolerance and acceptance of polygamy in the face of RH and HIV research that shows that polygamous unions carry a higher risk than monogamous unions. Cultural tolerance for Female Genital Mutilation as a rite of passage in the face of bio-medical research that shows that the practice increases the risk of gynecological and obstetric complication including fistula.

Cultural tolerance and acceptance of polygamy in the face of RH and HIV research that shows that polygamous unions carry a higher risk than monogamous unions.

Cultural tolerance for Female Genital Mutilation as a rite of passage in the face of bio-medical research that shows that the practice increases the risk of gynecological and obstetric complication including fistula.

Bio-medical research findings Vs Culture and Traditions Early marriage of the girl-child in the face of medico-socio research that shows that longer/ higher exposure to education for the girl-child improves health. Early initiation into sexual intercourse against the bio-medical research that shows greater vulnerability to infections when sexual activity is initiated early as well as risk of early pregnancy (elective traditional abortions) and child bearing.

Early marriage of the girl-child in the face of medico-socio research that shows that longer/ higher exposure to education for the girl-child improves health.

Early initiation into sexual intercourse against the bio-medical research that shows greater vulnerability to infections when sexual activity is initiated early as well as risk of early pregnancy (elective traditional abortions) and child bearing.

Bio-medical research findings Vs Culture and Traditions Condom non-acceptance in the face of bio-medical research finding that condoms provide protection from HIV and STIs MMC in non-circumcising communities when bio-medical research has evidence that MMC reduces chances of infection by 60% margin.

Condom non-acceptance in the face of bio-medical research finding that condoms provide protection from HIV and STIs

MMC in non-circumcising communities when bio-medical research has evidence that MMC reduces chances of infection by 60% margin.

Emerging Medico-legal issues versus public health concerns Needle exchange for IDU where drug use is both abhorred as a crime and moral malfeasance yet a well documented prevention strategy for IDU for HIV and Hepatitis infection prevention. Promotion of condom among sex workers seen as support or tolerance of sex work when bio-medical research has evidence that higher condom use by sex workers leads to reduced infection when there is a generalized epidemic.

Needle exchange for IDU where drug use is both abhorred as a crime and moral malfeasance yet a well documented prevention strategy for IDU for HIV and Hepatitis infection prevention.

Promotion of condom among sex workers seen as support or tolerance of sex work when bio-medical research has evidence that higher condom use by sex workers leads to reduced infection when there is a generalized epidemic.

Conclusion. MT has been used in diverse populations in Kenya to open public discourse on issues formerly seen as taboo like sexual orientation, inter-spousal adoption of condoms, drug dependence, culture and traditions supported by bio-medical research. MT has empowered communities to name and discourse around bio-medical/ ethical issues, test community acceptance of adopted behavior, advocate for such behavior to be accepted as social norms.

MT has been used in diverse populations in Kenya to open public discourse on issues formerly seen as taboo like sexual orientation, inter-spousal adoption of condoms, drug dependence, culture and traditions supported by bio-medical research.

MT has empowered communities to name and discourse around bio-medical/ ethical issues, test community acceptance of adopted behavior, advocate for such behavior to be accepted as social norms.

Conclusion Contextualization through public discourse of the bio-medical research as a response to issues and dilemmas faced by communities is a viable way of engendering engagement between science and communities in an empowering way.

Contextualization through public discourse of the bio-medical research as a response to issues and dilemmas faced by communities is a viable way of engendering engagement between science and communities in an empowering way.

Finally. Thank you very much.

Thank you very much.