Friday, April 15th, 2016
Nnenna Ike, MannionDaniels’ Behaviour Change Communication Specialist, spoke at the MSH Anniversary Event in Abuja, Nigeria.
The event was held to celebrate the work on health system strengthening and community health interventions carried out by a variety of partners in Nigeria.
Nnenna’s talk focused on how to promote behaviour change in the community. Based on MannionDaniels’ experience with the PATHS2 programme in Nigeria, we identified three key strategies:
- Inclusion: If we want people to adopt healthy household behaviours, we have to involve some otherwise ignored informal players in the health sector such as traditional healers, traditional birth attendants and other key influencers in the community. They can feel intimidated by BCC that promotes early care-seeking because it threatens their livelihood. We have brought them into the program as partners – rather than rivals – by taking their advice, by integrating their responses, and then by linking them to health facilities. When they have a positive attitude towards health facilities, they promote early care-seeking to their clients. This has increased the acceptance and utilisation of health facilities.
- Acceptability: Different states in Nigeria have different cultures. When trying to improve the adoption of healthy household behaviours, we need to work respectfully and sensitively within those cultures and existing traditional structures. This includes considering the language; in the North, we communicate the intervention in Hausa but have some PhD students in Bayero state University translating it into Arabic to make it more widely accessible. In the South, messages have been translated into Yoruba and Igbo languages. We even have products in Pidgin English and Egun language (predominant in western Nigeria). It also involves considering the cultural norms around men and women – for example, in the North, men and women meet separately, whilst in the South they can meet together for community meetings. Also, we incorporate BCC activities into to existing structures like the ‘August meetings’ and the women fellowships or pregnant women support groups in churches and mosques in the southern states.
- Involving men: Men are the main decision-makers when it comes to maternal and reproductive health – so they are a very important group to promote early care-seeking to. The volunteers in the Northern States we work in are largely men, they act as drivers, blood donors and manage the communal purse dedicated to obstetric emergencies. In the South, there are male leaders in churches who are given responsibilities, for examples they pray with the women in the pregnancy support groups in churches; and women who go to health facilities with their husbands get a special mention by the health providers.