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Reports: Training on Community Mobilization and Advocacy for PMTCT in Bayelsa State, Nigeria

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Posted: 09 Jan 2009 09:08

REPORT OF SMAT TRAINING ON COMMUNITY MOBILIZATION For Prevention of Mother-to-Child Transmission (PMTCT) of HIV

CONTENTS

Introduction
Project goal
Project objectives
The project team & participants
Project activities & outcome
Key achievements & challenges:
Recommendations
Conclusion

INTRODUCTION

Bayelsa State Ministry of Health in collaboration with United Nations Children Fund (UNICEF), organized a 3 day SMAT training workshop on Community Mobilization for PMTCT of HIV.

This elaborate training took place in the NUJ House, Azikoro Road, Yenegua and lasted from the 21^st to 24^th of May 2007.

The workshop was anchored by Rev. (Mrs.) Gloria Uchefuna of HEALIN and her crew; other facilitators were Mrs. Orukari and Mrs. Alagoa both from the Bayelsa State Ministry of Health.

The training drew 45 participants from 33 communities of Ologoama catchment area of Nembe Local Government Area of Bayelsa State.

Resource persons present at the training were Mrs. Wumi Falana of CHEDCOM, Dr. Abigail Ndisika of UNILAG, Dr. Biodun Oduwole of Benson Associates Ibadan and Dr. Wale Olaitan of OAU University.

PROJECT GOAL:

The goal of the SMAT training workshop on community mobilization for PMTCT of HIV was to enhance and facilitate community ownership to carry out prevention of HIV strategies in the communities, especially MTCT.

Project Objectives

To train and empower the Social Mobilization Action Team (SMAT) to carry out prevention of HIV strategies in the communities, especially MTCT.
To enhance and build the capacity of the community health workers and stakeholders.
To develop the capacity of collaborating CBOs for on-going community mobilization.
To further enhance and facilitate community ownership of the Project.

THE PROJECT TEAM & PARTICIPANTS:

A total of 45 persons representing 33 communities in Ologoama catchment area participated in the training workshop.

The breakdown of the Participants included 33 SMAT Chairperson, 5 CBO representatives and 7 Health Workers, totaling 45 participants.

Resource Persons

Dr. Abigail Ndisika - (Lagos)
Dr Wale Olaitan - (Ibadan)
Dr Biodun Oduwole - (Ibadan)
Dr. Wumi Sina-Falana - (Lagos)

FACILITATORS

Rev. Gloria Uchefuna - (Health & Life Int’l)
Mrs. Esther Onyiriro - (Health & Life Int’l)
Mrs. Caroline Orukari - (Ministry Of Health, Bayelsa State)
Mrs. Diepreye .E. Alagua - (Ministry Of Health, Bayelsa State)

PROJECT ACTIVITIES & OUTCOME

A. Mobilization of Social Mobilization Action Team:

Mobilization included sending out notifications of training start and end dates to SMAT members, selected health workers, stakeholders and community leaders/chiefs some of whom were SMAT members.

B. Training workshop:

The workshop included plenary presentations, group work and roll plays.

The workshop which ran for three days, built the capacity of participants in core skill areas required for promoting PMTCT at community level.

1. DAY ONE

OPENING:

Participants arrived at about 9.00am and registered for the workshop and were provided with writing materials and programme schedule. There was an opening prayer by a participant and a welcome address by Rev. Gloria Uchefuna who explained to participants the importance of the workshop and the commitment of UNICEF and Bayelsa State Ministry of Health towards improving on the health of their communities, especially those of children and mothers in the phase of HIV/AIDS. She also highlighted the need for community participation in the eradication of HIV/AIDS in their communities, hence the need to train their community-based Social Mobilization Action Teams (SMAT) for prevention of mother-to-child transmission of HIV.

Participants introduced themselves, and they set ground rules to guide participation and facilitation of the workshop. Rapporteurs were also appointed among participants who were charged with responsibility of reviewing and summarizing activities and key learning for each day.

Pre-test Questionnaires were then administered to assess participants’ understanding and to serve as a baseline for their knowledge base on in the areas of HIV/AIDS transmission and prevention, Voluntary counseling and testing, advocacy, community mobilization, team-building, etc.

Workshop objectives were shared with participants after their expectations were elicited by facilitator, and opening events and pre-training activities were concluded with the taking of group photograph by participants and facilitators.

SESSION 1:

Following tea break, the first training session was facilitated by Dr. Wunmi Falana on an Overview of HIV/AIDS. The session covered basic facts on HIV & AIDS including:

Meaning HIV & AIDS
Modes of transmission
Scope and prevalence of the pandemic
Risk factors and vulnerable groups
Modes of Prevention

Dr. Wumi then concluded the session with a question and answer session where misconceptions were cleared and issues clarified.

SESSION 2:

The 2^nd training session was on “Advocacy”, facilitated by Dr. Abigail Ndisika. The session covered:

Conceptual definition of advocacy
Skills in advocacy
Elements of Advocacy
Processes in advocacy
Expected outcome of advocacy
Rules/guidelines for advocacy

SESSION 3:

Following lunch break, the third training session was facilitated by Dr. Biodun Oduwole as a follow-up to the 2^nd session. The session covered:

Target audiences for advocacy in PMTCT
Strategies and Channels for Advocacy in PMTCT.

The day’s activities ended at about 6.00pm with a 2^nd tea break.

2. DAY TWO:

OPENING:

Participants arrived at about 7.30am and the session commenced at about 8.00am and attendance for the day was taken. There was an opening prayer by a participant and review of day one by rapporteur.

SESSION 4:

Following the presentation of previous day’s review, the fourth training session on the Nature of Community Mobilization was facilitated by Dr. Wale Olaitan. The session covered:

The purpose of community mobilization
Resource multiplier
Capacity building
Benefits of Community Mobilization
Features of Community Mobilization
Steps in Community Mobilization
Targets for Community Mobilization

SESSION 5:

Following tea break, the fifth training session on Issues in Community Mobilization for PMTCT was facilitated by Dr. Biodun Oduwole & Dr. Wunmi Falana. The session covered:

The nature and magnitude of Mother-to-child transmission
Low ANC attendance
Denial
Stigma & Discrimination
Resource Mobilization
Rights of PLWHAs (especially in relation to PMTCT)
Male Involvement
Community Support structures
Teambuilding
Information sharing & transparency
Social Challenges

The session was facilitated using PowerPoint presentations, and participants were allowed to ask questions and clarify issues around the presentations.

SESSION 6:

Following lunch break, the sixth training session on Target Audiences for Community Mobilization in PMTCT was facilitated in follow up to the previous session by Dr. Biodun Oduwole. The session covered:

Target audiences for Community Mobilization in PMTCT
Strategies & channels for Community Mobilization in PMTCT

This session also examined strategies for oprationalising and applying SMATs in PMTCT at community level, including:

Definition of roles and responsibilities
Assignment of roles & responsibilities
Building Capacity of SMAT Members
Coordination of Reviews
Periodic review & Adjustments

The session also explored “education within the context of community mobilization” through the use of drama, comics, road shows, music and dance.

Challenges of community mobilization were also explored including difficulties in adaptability, cost effectiveness and precise measurement of outcomes.

The roles of networking, partnership and negotiation in community mobilization were also emphasized in relation to PMTCT.

The day ended with a group task for participants to be presented on day 3.

Group Task:

Participants were divided into 3 groups and assigned to work on the following task:

Choose a specific community
Identify an issue in PMTCT
How would you carry out advocacy and community mobilization in that community?

3. DAY THREE:

OPENING:

Participants arrived at about 7.30am and the session commenced at about 8.00am and attendance for the day was taken. There was an opening prayer by a participant and review of day one by rapporteur.

SESSION 7:

Following the presentation of previous day’s review, the 7^th training session on the Community Dialogue Tools was facilitated by Dr. Abigail Ndisika, after which participants. The Community dialogue process was also explained and orientation about community dialogue examined.

GROUP WORK:

After presentations by the facilitator – Dr. Abigail Ndisika, there was group work and participants again went into groups to complete the tasks given on day 2. This continued till lunch break, after which participants made their group presentations, coordinated by Dr. Wale Olaitan.

Dr. Abigail Ndisika facilitated review of the group work, after which Dr. Wumi Falana facilitated post test assessment and evaluation of workshop to close the day.

Key Outcome of Workshop

Social Mobilization Action Teams from 33 communities in Ologoama area of Bayelsa State were trained and empowered to carry out the prevention of HIV strategies in the communities, especially PMTCT.
Five (5) CBOs and 7 Health workers were empowered for more efficient on-going community mobilization.
The training also succeeded in enhancing and facilitating community ownership of the PMTCT project.
There was Increased general knowledge of HIV/AIDS especially MTCT
Participants’ skills and capacity enhanced for advocacy, community mobilization and community dialogue as tools for creating an enabling environment for prevention of mother-to-child transmission of HIV.

EVALUATION:

The training was evaluated at two levels – a pre- and post-test evaluation showed that level of comprehension increased by over 120%, with total mean score of participants increasing from 9.7% to 21.44%. This, however, is still less than acceptable standard, but this could be appreciated against the backdrop of low literacy level of participants and didactic approach used by facilitators.

Evaluating the training environment and conditions, all participants rated welfare, accommodation, training hall and logistics as high.

KEY CHALLENGES:

It was observed that over 50% of the originally nominated SMAT chairpersons selected during the mapping exercise by Health & Life in the target communities did not attend in person, but rather sent representatives (friends and relatives) to attend on their behalf. This created challenges of communication as those sent to represent them and the communities were of low literary level and this slowed down the learning process during the workshop.
Participants were not given materials used by facilitators, and presentations were highly technical, and this further reduced comprehension. Other participatory approaches like role plays and group discussions were not used to adapt training materials to level of community-based participants, making it difficult for them step down knowledge to their respective community team members.
Due to busy nature of State ministries due to the transition process in State governance, an elaborate opening ceremony could not be organized due to logistics difficulties and non-availability of key government functionaries who were tidying up their offices for the hand-over process by end of May.
Due to security challenges and hurdles in release of funds, there were delays in the implementation schedule which created other challenges in mobilization of participants and key stakeholders.
Being the first of its kind in Bayelsa, there were challenges in gaining the support and cooperation of key State Ministry of Health Officials towards providing the needed assistance and cooperation required to make the training a success. This initially created the impression that the State did not appreciate the importance and relevance of this activity but this situation improved as UNICEF A’ field office stepped in to accelerate the implementation process.
Being the first of its kind in the State where the public and private sector carried out a donor funded activity of this sort, there were initial challenges of defining and harmonizing roles and expectations.

RECOMMENDATIONS

There is need to follow-up the SMAT training with Community Dialogue in order to avoid the need and the cost for further Advocacy and re-orientation of both the SMAT leaders and their communities.
There is need to make subsequent trainings more participatory with contents and delivery methodologies adapted to local contexts.
Participants also recommended an expansion of the training to include more healthcare workers and opinion leaders in the State.

CONCLUSION

The program was successful, and the intended goal and objectives were achieved.

It is believed that having laid this foundation, it has been demonstrated the communities are committed to this project, and there is therefore need for effective follow up, scale up and sustainability of the efforts already invested in the state PMTCT initiative through the use of Social Mobilization Action Teams (SMATs).