Training of Roma Health Mediators in Reproductive Health

‣ How many children do you have?
‣ At what age did you have children?
‣ What is the number of children a woman can have without risks for her health?
‣ What is an appropriate age to have children?
‣ What is the optimal interval between childbirths?
Based on their answers, conduct a group discussion, emphasizing the importance of the
relationship between maternal and child mortality and the high-risk factors (“too young,
too old,” “too many”, “too close”). Use the trainer document Relationship between
maternal and child mortality and high-risk factors to provide explanations.
V-VI. BARRIERS TO FAMILY PLANNING; AND HEALTH MEDIATOR ROLE
IN FAMILY PLANNING (40 minutes)
Tell a story of a woman from our community and her interest in getting services. (see
Trainer document Story: Barriers to Family Planning)
The story should bring out common individual factors (ignorance, denying the risks, fear),
but also certain social obstacles (traditions, religion).
While you tell the first part of the story, hold the large "motivation" sign in front of you.
Each time the woman in the story experiences an obstacle, tear a piece of the paper
indicating that the client has lost a little of her motivation to practice FP.
Among the obstacles may be the fact that the client is obliged to make a visit to the family
doctor’s cabinet for receiving FP services. In this case, discard what remains of the first
paper and hold the second (which is half the size of the first, indicating that the woman is
less motivated, that she has been discouraged). Continue with what happens to the woman
during the visit, tearing a part of the "motivation" paper each time the woman confronts
other obstacles (long period of waiting, judicative attitude of medical personnel,
impossibility to receive the method which is her first choice, small amount of contraceptives
received).
After the visit to the family doctor, the woman talks with friends about the contraceptive
method she received, and finds different information than the information given by the
doctor. As the story continues, discard the remainder of the second paper and hold the 3 rd
(smaller one) and tear away the sign/paper as the obstacles tear away the woman's
motivation for using contraception.
Ask the group:
‣ What are the barriers to the motivation of the woman? What has been the effect of
each one on her motivation of using contraception?
Note responses on a flip chart.
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RFHI/JSI Romania Training of RHMs in Reproductive Health Session 2: Basic Principles of RH & FP