Celebrate Solutions: Storytelling for Health and Empowerment

By Smita Gaith, Women Deliver

PeruPregnancyHistories.jpg Future Generations’ “Between Us (Women): Sharing Pregnancy Histories as Part of Community Education for Maternal and Neonatal Health” is about far more than just telling stories.

The innovative program—which is currently being tested in Peru by Future Generations—is designed to help women share their voices and experiences with others to save the lives of mothers and newborns living in some of the remotest regions in the Latin American country.

According to the World Health Organization, Peru’s maternal mortality is 98 deaths per 100,000 live births, and infant mortality is as high as 15 deaths per 1000 live births, both greater than the average regional rates. Figures are estimated to be even higher in remove villages in the Andes mountain range, where Future Generations and Between Us (Women) are operating.

The project, adapted from one in Afghanistan, seeks to empower rural Peruvian women by educating them on healthy behaviors, build women leaders, and, ultimately, reduce maternal and newborn mortality.

Women begin by electing other females from their community as community health promoters, also known as “women leaders.” Then they are asked to share stories about their own experiences with pregnancy, child birth, post-partum periods, breastfeeding, and much more. These women leaders discuss what they did, how they felt, and what they experienced after they asked for help in managing their specific maternal and newborn health concerns. By sharing these stories, women identify cultural practices and perceptions underpinning certain behaviors, have the opportunity to learn from each other, and realize they can ask for help.

Future Generations has tested this approach in a cluster-randomized trial, with one set of communities using this innovative method (experimental group) and the other half using standard health promoter teaching methods (control group). Future Generations then conducted several workshops where women leaders could share their experiences; these included pregnancy, childbirth and postpartum, newborn health, breastfeeding, infant diarrhea, and infant pneumonia. After conducting surveys, researchers leading the trial were able to assess attitudes towards the women leaders and determine the level of learning among the women.

Future Generations found that although control communities had more improvements in levels of maternal health knowledge, “experimental communities had greater changes in maternal behaviors including a significant decrease in the prevalence of child diarrhea.” Women in the experimental group also learned faster after sharing experiences, were more confident, and were more effective communicators. Future Generations emphasizes that any training of women leaders is an effective way to transform them into agents of change. The Sharing Pregnancy Histories project was also an effective and simple way to include illiterate female health promoters.

Since the trial, Future Generations has developed six facilitator manuals to help guide conversations during workshops. The project is now being tested further in another region of Peru, until 2014, and will be scaled up to reach more mothers, babies, and communities.

This first pilot in the Peruvian Andes was supported in part by Maternal Health Task Force and the Bill & Melinda Gates Foundation.

More information about the project is available here.

Flickr photograph via Ianr.

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