Acceptability, Comprehensibility and Reported Influence - BRAC ...

(29). A community member who felt that they did not understand or could not
remember a message could ask a peer for clarity.
Factors such as the degree of privacy, time selected for encounters, comfort, and
waiting time can also inhibit or enhance individual/group-provider interaction (29).
Results reveal that messages did not effectively reach secondary audiences such as
men and elderly due to their unavailability in the household at the time of visit of the
SSs and SKs and because of the persistence of traditional beliefs and attendant
resistance to modern healthcare systems. There was little evidence that men and the
elderly engaged in peer support. In Tanzania, under the KINSHAI project, eight peer
support groups were established to provide HIV/AIDS education to the community.
Each group consists of 25 members aged at least 60. From each group four
individuals were trained by KINSHAI. Members of the groups have reported reduced
stigma from their communities and a greater sense of hope and well-being (32).
MNCH programme may arrange group meeting with both the mother-in-law and
daughter-in-law about their role and relationship in pregnancy and delivery care.
Flash cards including men’s role in pregnancy and delivery care of his wife,
importance of ANC, delivery preparedness can be distributed to increase men’s
comprehensibility in these issues. There is also room for more targeted
communication with older members of the community.
Effective communication programme could explore new ways to use peer groups to
convey messages and also reinforce the practice of the key messages in their real
life. However, depending on intervention site, peer educators are often illiterate, which
especially in our study areas where there was discrimination against lower status and
poorly educated SSs and SKs could be considered to be a disadvantage to the peer
education method (33).
It was found that community had a perception of SSs and SKs as poorly educated
and of low status. To overcome this perception, programmes should give importance
of effective training which may increase rapport-building, communication and
negotiation skills. While SSs and SKs are given foundation or some basic training on
MNCH and essential healthcare. Regular refresher training is also given for one day
every month. If they are adequately trained and exposed to identify health problem,
they will have adequate skills to assess, manage and take right decisions to save
mother and newborn lives. However, the technical medical skills listed should be
buttressed by further training in assertive communication. There are many
programmes that report successful training of CHWs (34, 35). Soloman et al. found
that in the Ghananian community health volunteer’s drug management skills were
good, the response of the community was positive. In Ghana, community volunteers
were trained for 7-18 days on diagnosis of trachoma, the use of azithromycine, and
side effect of the drugs. After training, each volunteer was asked to examine the
member of household in the presence of doctor and ophthalmic nurse (35).
24 RED Working Paper No. 21