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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.

Nenna Ike MSH Talk

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:

  1. 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.
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  3. 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.
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  5. 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.

MSH Anniversary Event Nigeria group talk

 


A new 5-year Health Sector Programme for Nepal

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The new 5-year Nepal Health Sector Programme (2015-2020) will draw on the policy directions outlined in the recent National Health Policy (2014), as approved by the Cabinet.  The NHSP-III is emphasising the need for greater output-based and decentralised planning and budgeting for the sector.  The plan will also indicate the importance of ensuring financial protection for the poor and give more attention to improving quality of services across all areas of the health system.  NHSP-III will aim to build financial sustainability, better coordination and strengthened partnership with non-state partners. The MoHP will be looking at stronger regulation of the sector including measures to ensure quality of care through commercial and not-for-profit health providers. The rise in non-communicable diseases in Nepal poses a big challenge for the Ministry and in response the new plan will include components on promoting healthy lifestyles and working to create healthy environments.  An emphasis will be put on the importance of good information and self-responsibility  for health.  MannionDaniels is supporting the NHSP-III building on its earlier involvement in the Mid-Term Review of the current NHSP-II. The work on the new sector programme is on-going.

 


The MannionDaniels team, led by Director David Daniels, conducted the Annual Review of the Delivering Increased Family Planning Across Rural Kenya (DIFPARK) programme in January 2014.  With funding from DFID, DIFPARK is designed to respond to the needs of the Government of Kenya in reducing unmet need and increasing the contraceptive prevalence rate. Its overall goal is to increase FP uptake in Kenya with the impact of reducing maternal and newborn deaths. The programme intends to increase new users of family planning, primarily through the private sector, utilising a total market approach and providing complementary support to the public sector to ensure the provision of quality FP services. It has been designed with specific emphasis on increasing access to family planning by rural women and young adolescent girls (15-19 years of age).  The programme is managed by a consortium led by the Futures group and includes Jhpiego, JHU-CCP, Save the Children, Exp Social Marketing and Well Told Story.  The programme operates across 23 counties.  The annual review assessed progress under the first phase of programme implementation and provided an overview of progress as well as recommendations to the programme management agent.


In March 2014, MannionDaniels was part of a study on “Sustainability Outcomes of donor-funded programme in the health sector in Kenya”, commissioned as part of the Private Sector Innovation Programme for Health (PSP4H) initiative.  This is an action research project to explore the markets in which poor people pay for-profit providers for healthcare.  Sustainable outcomes is seen as central to the Making Markets Work for the Poor approach and focuses on how market systems can function effectively in the long term rather than focusing on short term gains in impact.  The purpose of this study was to undertake primary research to assist the PSP4H team to assess the sustainability outcomes of prior donor-funded health care programmes in Kenya, particularly those offering grants and subsidies to partners in the public sector, not-for-profit sector, and commercial sector. The study also aimed to provide inputs for future PSP4H interventions.

The MannionDaniels team, led by Director David Daniels, conducting in-depth interviews with representatives from donor agencies, government, and private sector providers from Non-Govermental Organisations (NGOs), Faith-Based Organisations (FBOs) and For-Profit providers.  As part of the study a field visit was conducted in Embu County to meet with private for-profit providers who were also involved in social franchising and insurance programmes.

The study report is available from the PSP4H website:   

http://psp4h-public.sharepoint.com/SiteAssets/reports/research-reports/A%20Study%20on%20Sustainability%20Outcomes%20of%20Donor-funded%20Programmes.pdf


Strategic Advice to FP2020

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MannionDaniels worked with FP2020 in 2014, providing strategic advice on several issues including reporting and development of the Rapid Response Mechanism of small grants. This new mechanism to support smaller advocacy grants to accelerate update of family planning launched on 11th July 2014.

FP2020 is ‘a global partnership that supports the rights of women and girls to decide, freely and for themselves, whether, when and how many children they want to have’.  FP2020 stems from the 2012 London Summit on Family Planning, where more than 20 governments made commitments to improve access to contraceptive supplies and information.  FP2020’s aim is to enable 120 million more women and girls use contraceptives by 2020.  More details of FP2020’s work are available on www.familyplanning2020.org