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Community Dialogues Stimulate Interest in Long-Acting Family Planning Methods

Ahmed Nuriye knows all too well the issues facing his community—Melaki Kebele, in Ethiopia’s Amhara Region, where he has lived for all 38 years of his life. Having served as a community health volunteer for nine years, he believes that family planning is a key solution to the community’s problems.

“My community is suffering due to high fertility and land shortage,” he says. “Food shortage is a common problem, along with child malnourishment and death. Women are also dying because of high fertility and limited access to family planning services. Seeing these problems motivated me to try to serve my community by promoting family planning.”

Working under the supervision of an EngenderHealth partner, the Amhara Development Association, Ahmed leads regular community discussions on family planning and other development issues. He also conducts home visits to counsel couples about family planning.

Ahmed was among 250 community volunteers who were trained by the Amhara Development Association and EngenderHealth to provide family planning information to women and men in the community. The training, in April and May 2010, focused on long-acting and permanent methods of contraception (LA/PMs), such as the intrauterine device (IUD) and male and female sterilization. The Federal Ministry of Health, with support from EngenderHealth’s Access to Better Reproductive Health Initiative (ABRI), is expanding contraceptive options throughout Ethiopia.

The training also covered new communication guidelines and tools developed by EngenderHealth to help community volunteers like Ahmed promote family planning more effectively. One of the new communication tools is designed to help volunteers engage community members in genuine dialogue about family planning—instead of giving a traditional, one-sided health talk or “lecture.” These community dialogues explore people’s views about the benefits of family planning, the barriers that limit their use, and ways to overcome these challenges. Volunteers like Ahmed are encouraged to invite satisfied family planning clients, who share their own experiences with other participants in the community dialogue.

Since the training, Ahmed has organized community dialogue sessions with various groups in his community: older married women, young married women, and married men. Ahmed says the new approach and tools have helped him become a better communicator.

“My style of teaching and communication has completely changed,” he reflects. “In the past, the communication between me and the community was only one-way communication. Now I let the community have the floor. They themselves discuss their problems, share their experiences, and try to solve their problems in their own ways. My involvement is only to play a facilitation role.”

Ahmed says that the new approach is making a difference in people’s attitudes about and interest in family planning, particularly LA/PMs. “The tools create the room for sharing of experiences among those clients using long-acting and permanent methods, and those who are not. This has contributed to increased awareness of the community towards those methods. Misconceptions are decreasing, and uptake is increasing.”

Service statistics at the nearby health center confirm Ahmed’s observations: LA/PM caseloads in June 2010 were more than three times higher than the average monthly caseload during the previous six months.

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