changing behavior with women, girls, boys, and men: how gender and sbc connect_gillian mckay_5.6.14
TRANSCRIPT
Gillian McKayBehaviour Change & Gender Officer
GOAL Ireland
Global Health Practitioners Meeting“Health Starts at the Community”
Silver Spring, Maryland May 5th -9th 2014
GOAL’s Work in Kutum, North Darfur, Sudan Integrated Programme
Primary Health Care
Community Health
Nutrition
Livelihoods
WASH
REFLECT (Regenerated Frerian Literacy Through Empowering Community Techniques)
GOAL & Gender GOAL is committed to gender equality throughout the
organization and in addressing the basic rights and needs of vulnerable populations throughout the developing world by focusing on gender issues across the full range of sectors within existing policies, development strategies and priorities.
Mainstreaming of Gender across organisation
Consideration of Women, Girls, Boys and Men
The DBC Framework The DBC Framework is an Evidence Based Behaviour
Change Planning Technique
Uses Barrier Analysis Formative Research to Discover the Barriers and Motivators of Behaviour Change
Helps Us to Choose Activities That Directly Address Those Barriers and Motivators
Can be Done Quickly, Cheaply and At Any Stage in the Project Life-Cycle
The DBC FrameworkBehaviour PriorityandInfluencingGroup
Description
SignificantDeterminants BridgestoActivities Activities
OutcomeIndicators:
ProcessIndicators:
The Problem Women in Kutum are not empowered to be involved in
decision making about themselves or their children to visit the health care facility in times of illness.
The Behaviour Women in REFLECT Circles in Kutum are
contributing to decision making concerning health seeking behaviour.
Determinants of BehaviourDeterminant
Self – Efficacy / Access (transport, money)
Social Norms (Neighbours, Aunts/Uncles approve, Grandparents disapprove)
Action – Efficacy (high likelihood of negative effect, effect will be severe if do not contribute)
Bridges to ActivitiesDeterminant Bridges to Activities
Self – Efficacy/ Access (transport, money)
• Increase the perception that women can control household money
• Increase the ability of women to access health services
Social Norms (Neighbours, Aunts/ Uncles approve, Grandparents disapprove)
• Increase the perception that Neighbours and Aunts/Uncles approve of them contributing to decision making
• Increase the perception that Grandparents approve of contributing to decision making
Action – Efficacy (high likelihood of severe, negative effects)
• Increase the perception that not contributing to decision making can result in a high likelihood of serious effects on health
ActivitiesBridges to Activities Activities
Increase the perception that women can control household money
Village Savings and Loan Associations• “Social Funds” to access emergency care• Control of own money earned through IGADiscussion Fora• Role play how to discuss accessing the clinic• Invite key influencers to participate in
discussions
Increase the ability of women to access health services
ActivitiesBridges to Activities Activities
Increase the perception that Neighbours and Aunts/Uncles approve of contributing to decision making
• Follow up Focus Groups with these identified influencing groups to discover their true feelings on the behaviour
• Discussion fora with influencers and Priority Group members to create space to hear opinions and develop solutions
• Women supported to identify their “support person” who they can go to in the event they require support in contributing to decision making
• “Hands Up Approval” in Community Meetings• Training of Community Leaders
Increase the perception that Grandparents approve of contributing to decision making
ActivitiesBridges to Activities Activities
• Increase the perception that not contributing to decision making can result in a high likelihood of serious effects on the health of the children
• Sharing of Most Significant Change stories• Creation of Contrast Stories by the women in
the Circles for sharing• Discussion fora with local health extensionist• Training of REFLECT facilitators by health
extensionist on prompt care-seeking• REFLECT manual reviewed and additions
made by the Endemic Sickness Unit
Next Steps Identified activities to address barriers are being
integrated into a number of ongoing GOAL projects
REFLECT Circles
NIPPs Circles
We are planning to trial Care Groups in Kutum and will integrate DBC activities.
Framework is considered when we are developing new projects to show evidence-base of our selected activities
Early Results Increase from 30% to 50% of REFLECT circle women
who contribute to decision making
VSLA activities have improved the perception of women that they have the emergency funds to make the decision to access care.
Pre/Post Test increase from 5% to 75% of community leaders who report their approval of women contributing to decision making for care seeking following training
DBC’s Added Value No more assumptions!
Building the evidence base for how to increase access and control for women
Respecting the time of our target population
More emphasis on influencers
Lessons Learnt Challenging to come up with innovative activities to
address barriers
Support from Global Tech Team
Global Community of Practice
Integration of activities requires buy-in from all levels of in-country team