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Exploring community participation in project design: application of the community conversation approach to improve maternal and newborn health in Zambia

BACKGROUND: The United Nations Development Programme (UNDP) has adopted an approach entitled Community Conversation (CC) to improve community engagement in addressing health challenges. CCs are based on Paulo Freire’s transformative communication approach, in which communities pose problems and crit...

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Autores principales: Mutale, Wilbroad, Masoso, Chisala, Mwanza, Bisalom, Chirwa, Cindy, Mwaba, Lasidah, Siwale, Zumbe, Lamisa, Barbara, Musatwe, Dennis, Chilengi, Roma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364664/
https://www.ncbi.nlm.nih.gov/pubmed/28335751
http://dx.doi.org/10.1186/s12889-017-4187-x
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author Mutale, Wilbroad
Masoso, Chisala
Mwanza, Bisalom
Chirwa, Cindy
Mwaba, Lasidah
Siwale, Zumbe
Lamisa, Barbara
Musatwe, Dennis
Chilengi, Roma
author_facet Mutale, Wilbroad
Masoso, Chisala
Mwanza, Bisalom
Chirwa, Cindy
Mwaba, Lasidah
Siwale, Zumbe
Lamisa, Barbara
Musatwe, Dennis
Chilengi, Roma
author_sort Mutale, Wilbroad
collection PubMed
description BACKGROUND: The United Nations Development Programme (UNDP) has adopted an approach entitled Community Conversation (CC) to improve community engagement in addressing health challenges. CCs are based on Paulo Freire’s transformative communication approach, in which communities pose problems and critically examine their everyday life experiences through discussion. We adopted this approach to engage communities in maternal and newborn health discussions in three rural districts of Zambia, with the aim of developing community-generated interventions. METHODS: Sixty (60) CCs were held in three target districts, covering a total of 20 health facilities. Communities were purposively selected in each district to capture a range of rural and peri-urban areas at varying distances from health facilities. Conversations were held four times in each community between May and September 2014. All conversations were digitally recorded and later transcribed. NVivo version 10 was used for data analysis. RESULTS AND DISCUSSION: The major barriers to accessing maternal health services included geography, limited infrastructure, lack of knowledge, shortage of human resources and essential commodities, and insufficient involvement of male partners. From the demand side, a lack of information and misconceptions, and, from the supply side, inadequately trained health workers with poor attitudes, negatively affected access to maternal health services in target districts either directly or indirectly. At least 17 of 20 communities suggested solutions to these challenges, including targeted community sensitisation on the importance of safe motherhood, family planning and prevention of teenage pregnancy. Community members and key stakeholders committed time and resources to address these challenges with minimal external support. CONCLUSION: We successfully applied the CC approach to explore maternal health challenges in three rural districts of Zambia. CCs functioned as an advocacy platform to facilitate direct engagement with key decision makers within the community and to align priorities while incorporating community views. There was a general lack of knowledge about safe motherhood and family planning in all three districts. However, other problems were unique to health facilities, demonstrating the need for tailored interventions.
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spelling pubmed-53646642017-03-24 Exploring community participation in project design: application of the community conversation approach to improve maternal and newborn health in Zambia Mutale, Wilbroad Masoso, Chisala Mwanza, Bisalom Chirwa, Cindy Mwaba, Lasidah Siwale, Zumbe Lamisa, Barbara Musatwe, Dennis Chilengi, Roma BMC Public Health Research Article BACKGROUND: The United Nations Development Programme (UNDP) has adopted an approach entitled Community Conversation (CC) to improve community engagement in addressing health challenges. CCs are based on Paulo Freire’s transformative communication approach, in which communities pose problems and critically examine their everyday life experiences through discussion. We adopted this approach to engage communities in maternal and newborn health discussions in three rural districts of Zambia, with the aim of developing community-generated interventions. METHODS: Sixty (60) CCs were held in three target districts, covering a total of 20 health facilities. Communities were purposively selected in each district to capture a range of rural and peri-urban areas at varying distances from health facilities. Conversations were held four times in each community between May and September 2014. All conversations were digitally recorded and later transcribed. NVivo version 10 was used for data analysis. RESULTS AND DISCUSSION: The major barriers to accessing maternal health services included geography, limited infrastructure, lack of knowledge, shortage of human resources and essential commodities, and insufficient involvement of male partners. From the demand side, a lack of information and misconceptions, and, from the supply side, inadequately trained health workers with poor attitudes, negatively affected access to maternal health services in target districts either directly or indirectly. At least 17 of 20 communities suggested solutions to these challenges, including targeted community sensitisation on the importance of safe motherhood, family planning and prevention of teenage pregnancy. Community members and key stakeholders committed time and resources to address these challenges with minimal external support. CONCLUSION: We successfully applied the CC approach to explore maternal health challenges in three rural districts of Zambia. CCs functioned as an advocacy platform to facilitate direct engagement with key decision makers within the community and to align priorities while incorporating community views. There was a general lack of knowledge about safe motherhood and family planning in all three districts. However, other problems were unique to health facilities, demonstrating the need for tailored interventions. BioMed Central 2017-03-23 /pmc/articles/PMC5364664/ /pubmed/28335751 http://dx.doi.org/10.1186/s12889-017-4187-x Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Mutale, Wilbroad
Masoso, Chisala
Mwanza, Bisalom
Chirwa, Cindy
Mwaba, Lasidah
Siwale, Zumbe
Lamisa, Barbara
Musatwe, Dennis
Chilengi, Roma
Exploring community participation in project design: application of the community conversation approach to improve maternal and newborn health in Zambia
title Exploring community participation in project design: application of the community conversation approach to improve maternal and newborn health in Zambia
title_full Exploring community participation in project design: application of the community conversation approach to improve maternal and newborn health in Zambia
title_fullStr Exploring community participation in project design: application of the community conversation approach to improve maternal and newborn health in Zambia
title_full_unstemmed Exploring community participation in project design: application of the community conversation approach to improve maternal and newborn health in Zambia
title_short Exploring community participation in project design: application of the community conversation approach to improve maternal and newborn health in Zambia
title_sort exploring community participation in project design: application of the community conversation approach to improve maternal and newborn health in zambia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364664/
https://www.ncbi.nlm.nih.gov/pubmed/28335751
http://dx.doi.org/10.1186/s12889-017-4187-x
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