CBC Objectives. The results of the final KPC and interviews during the final evaluation show that mothers’ behaviors have changed regarding care seeking practices and home management, especially regarding breastfeeding, child nutrition, diarrhea and respiratory infections. New health practices are promoted through monthly AIN sessions, support groups, home visits, contacts with Health Posts and during Integrated Municipal Visits, and reinforced in the classroom and family by older children. Health fairs, puppet shows, cultural events and posters were used to communicate and reinforce new behaviors. Results of the BCC approach, as gleaned from interviews during the Final Evaluation include: ❑ Greater sharing and communication between CHWs, families and health personnel; ❑ Increased trust and acceptance of the services provided at Base Houses; ❑ Communities are empowered to implement support groups and AIN growth monitoring sessions on their own; ❑ Increased sense of health stewardship, knowledge about the community, and contacts with neighbors; ❑ Health personnel are more committed to community outreach; ❑ Increased demand for child and maternal health services; and ❑ Children share health messages with their peers, families and the community. Mass communication through radio spots and programs extended the coverage of health education to families that were not served by the project and reinforced the other BCC strategies. A video was made with assistance from Xxxxx Xxxxxxx, which shows communities implementing growth monitoring, mothers who are practicing of breastfeeding, the role of the Health Post in community health, the participation of school children, and home garden production. Short T.V. spots were made from the video and shown during key viewing hours. Other presentations were also aired on T.V. as part of local news and radio spots have been aired with messages about breast-feeding, nutrition and control of infectious diseases.
CBC Objectives. The results of the final KPC and interviews during the final evaluation show that mothers’ behaviors have changed regarding care seeking practices and home management, especially regarding child immunizations, pneumonia case management, nutrition, maternal care and family planning. The intercultural approach is promoted in women’s groups, at health fairs, and in meetings with local authorities. A workshop on cultural sensitivity was held with health personnel and covered the following topics: 1) humanization of health services, 2) concepts of health, illness, sexuality, pregnancy, and delivery from an Andean and Western medical perspective. Key results of the intercultural approach include: ❑ Increased trust and acceptance of the services provided by health personnel; ❑ Aymara obstetric practices are valued by the people and health staff; ❑ There is a greater sharing of cultural values on both sides; ❑ Health personnel are more committed to providing care that is culturally appropriate; ❑ Increased proportion of pregnant women seek prenatal care; ❑ Increased demand for obstetric care provided by health personnel; ❑ Increased demand for family planning services; and ❑ Treatment of illness includes both modern and traditional medicines. Although mass communication was not a strategy of the CS Project, a USAID funded MOH project entitled PROSIN (Proyecto de Salud Integral) made extensive use of radio communication to xxxxxx behavior change in health practices. Several soap operas (novellas) were aired that dealt with health issues, including IMCI and reproductive health. These messages supported the work done by ANs and HVs in the communities, and the new approaches being used in health centers and posts based on the intercultural approach. Some difficulties in the implementation of an effective CBC strategy include: the factor analysis outlined in the DIP was not done; educational materials are not available for all HVs; existing materials have not been updated and improved on a regular basis; work with Freedom from Hunger groups is functioning optimally in Ancoraimes, but needs to be improved in other geographic areas; there are not sufficient contacts with the population to attain lasting behavior change; if paternalistic “give-away” organizations exist in the same geographic area, people may not want to meet unless there is a material incentive.
