In this blog post we highlight a successful experience around community engagement in CMAM in Northwest Nigeria. This has happened in the context of a CMAM programme supported by IMC that, since the very beginning, made important efforts to involve a wide range of community actors in the definition and implementation of the programme itself. Here we present some of best practices identified and lessons learned.
Since 2013, International Medical Corps has been supporting the implementation of a CMAM programme in the two Local Administrative Areas of Wamakko and Binji, in the North-western state of Sokoto. In late 2014, a SQUEAC assessment
in the combined area found particularly good levels of performance and quality of care. What lies behind this good result? It is likely to be a combination of factors, and the close engagement of the programme with the community is probably the most important one.
The programme started with a strong community component: meetings with community groups and discussions about their opinion of the programme. These were completed with a transfer of responsibilities to the community: not only was community engagement achieved by building positive opinions about the programme or inviting local figures to discuss its objectives; rather, involving people’s concerns about the functioning of the programme and asking them to solve problems encountered proved to be a much more effective approach.
This has been a key element in Binji and Wamakko. Groups of model mothers for healthy food demonstrations and community groups conducting sensitisation campaigns have not been regarded as supporting actors, but rather as responsible for key aspects of the programme’s success. Simultaneously, the programme team holds frequent consultative meetings with influential leaders regarding the programme’s progress and challenges. This does not reduce the role of the supporting NGO; rather, it transforms it into a monitoring and guidance role that rests upon local organisations: mothers care groups, community volunteers handpicked by the community and strong involvement of local leaders.
On that regard, IMC encouraged the formation of mothers care groups based on a simple model: a group of 10 to 15 mothers who regularly meet together with community health volunteers for training, supervision and support. Care groups could achieve complete and consistent coverage of the wider project area thanks to a relatively low ratio of households per volunteer. This made it possible for the volunteer to interact with each household more frequently and develop deeper personal relationships for promoting behaviour change compared to models using a higher ratio of households to volunteers.
Such practices have proven to improve community engagement whilst empowering women, and also increasing demand for other health services: through better community outreach and a good CMAM programme performance, mothers are able to see visible improvements in the health and wellbeing of their children. This in turn, creates demand for other important services such as antenatal care and routine immunisation.