Community Mobilization Strategies for Increasing FP Demand and Sustainability

1
Community Mobilization Strategies for Increasing
FP Demand and Sustainability
Basics of Community-Based Family Planning
2
Who are Stakeholders?

• Who do you consider to
• be stakeholders in FP
• programs?

3
Examples of Stakeholders

• MOH (National, Provincial/Regional, District)
• Donors, CAs, Associations
• NGO/CBO partners
• Health Facility ( service providers, support
  staff, outreach workers)
• Community (chiefs, religious leaders, women
  leaders, community group leaders, community
  resource persons and traditional health workers)

4
Community Stakeholder Participation

• Why is it important to
• involve community
• members in FP programs?

5
Benefits of Community Participation

• Increased ownership, support and responsibility
  for FP, and for the program.
• More likelihood of, and sustainability for,
  behavior change due to community support
  enabling environment, role models etc.
• More cost-effective programming (project
  resources are supplemented by community
  resources).
• Better response to community needs and concerns
  because they participated in problem
  identification, prioritization and
  decision-making.

6
Benefits of Community Participation continued

• More culturally appropriate and acceptable FP
  program strategies and messages. (i.e. better
  solutions because of community input).
• Increased coverage and access to information and
  services.
• Increased community demand.
• Increased advocacy for service and policy change.
• Increased program success (results and
  sustainability).

7
Varying Degrees of Participation or Involvement

• Collective Action
• Local people set their own agenda mobilize to
  carry it out in the absence of outside initiators
  facilitation
• Co-learning
• Local people outsiders share their knowledge to
  create new understanding work together to form
  action plans with outsider facilitation
• Cooperation
• Local people work together with outsiders to
  determine priorities responsibility with
  outsiders for directing the process
• Consultation
• Local opinions asked outsiders analyze decide
  on a course of action
• Compliance
• Tasks assigned with incentives outsiders decide
  agenda direct process
• Co-option
• Token involvement of local people
  representatives chosen but have no real input or
  power

Level of community empowerment mobilization
8
Community Mobilization

• What is community
• mobilization?

9
Community Mobilization defined

• A capacity-building process through which
  individuals, groups,
• or organizations plan, carry out, and evaluate
  activities on a
• participatory and sustained basis to improve
  their health and
• other needs, either on their own initiative or
  stimulated by
• others.

From How to Mobilize Communities for Social
Change by Howard-Grabman and Snetro 20043
10
Community Mobilization continued

• Group work
• What is the level of community mobilization/partic
  ipation
• in FP in your project areas?

11
Preparing for a Community Based Program

• Collection of geographic and demographic data.
• Collection of baseline FP data review research
  and survey information.
• Contact with existing organizations and
  institutions (NGOs, CBOs, local MOH) in the
  potential target regions, for information
  sharing, discussion on possible areas of
  collaboration, joint planning and strategy
  development.
• Involve national and senior officials.

12
Channels for Reaching the Community

• NGOs
• CBOs
• Local government
• Local leaders traditional and formal
• Community Resource persons
• Special clubs or interest groups

13
Community Entry, and Gaining Effective
Participation

• Contact meetings with community leadership to
  establish interest, support and buy-in
• Community stakeholder sensitization workshops or
  meetings to discuss community participation,
  representation, involvement of men, women and any
  other specific target group, geographic and
  demographic coverage issues, outline goals,
  objectives, develop clear roles and
  responsibilities and level of commitment. (i.e
  community participation plan).

14
Key Steps in Community Action Cycle
Community Action plan development
Evaluation of process and actions.
15
Community Action Planning

• Actions should address problems discussed,
  analyzed and agreed upon by community partners.
• Actions should include strategies that
• 1. Address quality of FP services
• 2. Increase access to FP information, education,
  
• services and choice
• 3. Increase demand for FP by the population and
• 4. Increase FP coverage to address unmet need.
• 5. Clearly outline persons responsible,
  resources needed and where
• they will be obtained, timeline for
  implementation of activity, ME
• for activity.
• 6. Address skills and capacity building needs of
  community partners

16
Community Based Programs

• Group Brainstorm
• What are the different options and strategies for
  FP
• interventions at the community level?

17
FP interventions at the community level options
and strategies

• FP education, promotion and advocacy
• (peer counseling and activities, development of
  new clubs, organizing group discussion forums,
  audio-visual events, targeting men for male
  involvement, reaching youth).
• Community Based Services
• (CBD, mobile clinics, depot services, youth
  centers, referral to health services, linkages to
  other community programs)

18
Bringing Services to Hard to Reach Populations

• Types of hard to reach, underserved groups
• Remote and nomadic rural populations
• Adolescents (rural and urban)
• Migrants
• Internally displaced persons
• People who are HIV or PLWAs

19
Categories of Underserved Populations

• Those underserved because access is difficult
• Those underserved because they do not use
  services (cultural, social, economic barriers,
  and/or lack of information).

20
Effective strategies to reach underserved
populations

• Community Based Distribution
• Mobile Units
• Working through partnerships with governmental or
  non-governmental organizations
• Group work - case studies

21
Steps for designing and implementing a program to
reach underserved groups

• Identify group you intend to serve.
• Identify the groups needs for RH/FP services.
• Set Objectives.
• Identify a strategy or combination of strategies.
• Implementing and managing the strategy (group
  ideas).
• ME
• Integrating these services into the broader
  health services.

22
Challenges

• What are some of the challenges or difficulties
  in
• including community participation in programming?
  

23
Challenges

• Less control
• Things dont move as fast
• Time and cost
• Your priorities may not be the communitys
  priorities
• Project stakeholders (MOH, NGO/CBO partners,
  local government) disagree with each other or you
• Expensive (meetings)
• Community volunteer motivation
• Community skills and capacity to undertake
  project
• Selection of community participants may be biased
  by CBO or community leadership
• Contraceptive insecurity

24
Developing a Sustainability Plan

• For continued access to information, services,
  and demand creation
• For continued community capacity, involvement,
  leadership, and political support
• For continued existence of support structures
  (financial, competency and administrative).