Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for...
Transcript of Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for...
![Page 1: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/1.jpg)
1
Mobilising communities for sexual and reproductive
health promotion.
Professor Catherine Campbell,
Health, Community and Development GroupInstitute of Social PsychologyLondon School of Economics
WHO, Geneva, 27 April 2011Global Health Histories Webinar Series
![Page 2: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/2.jpg)
2
Campbell, C, Cornish, F (2010) Towards a ‘fourth generation’ of approaches to HIV/AIDS management: Creating contexts for effective community mobilization. AIDS Care. 22(2): 1569- 1579.
Campbell, C, Cornish, F (accepted) How can community health programmes build enabling environments for transformative communication? Experiences from India and South Africa. AIDS and Behaviour.
Campbell, C, Maimane, S and Sibiya, Z (2005) The impact of social environments on the effectiveness of youth HIV prevention. AIDS-Care. 17 (4).
![Page 3: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/3.jpg)
3
1. Introduction
![Page 4: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/4.jpg)
4
Contrasting case studies: both used peer education as starting point for community mobilisation – through involving highly marginalised women in HIV/AIDS management.
Entabeni: rural South Africa – home nursing skills
Sonagachi: Kolkata, India – HIV prevention and condom distribution
![Page 5: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/5.jpg)
5
• HEALTH ENABLING SOCIAL ENVIRONMENTS:
i.e. social contexts that enable and support the possibility of health- enhancing attitudes and behaviour change
![Page 6: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/6.jpg)
6
Campbell, C, Maimane, S and Sibiya, Z (2005) The impact of social environments on the effectiveness of youth HIV prevention. AIDS-Care. 17 (4).
3 dimensions of context
– Symbolic
– Material
– Relational
![Page 7: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/7.jpg)
7
Symbolic:Meanings, ideologies, worldviews through
which people understand selves, others, activities they are engaged in
Honneth’s theory of recognition:Person or group’s worth, dignity, concrete
achievements, legal rights
![Page 8: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/8.jpg)
8
Material:
Resource-based agency
Concrete opportunities for people to act in ways that reflect agency
![Page 9: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/9.jpg)
9
Relational:
Democratic and accountable leadership
Bonding and bridging social capital
![Page 10: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/10.jpg)
10
Spivak (1988): ‘strategic alliances’
![Page 11: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/11.jpg)
11
2. Case studies
![Page 12: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/12.jpg)
12
2.1 Sonagachi Project
![Page 13: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/13.jpg)
13
Sonagachi Project
![Page 14: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/14.jpg)
14
![Page 15: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/15.jpg)
15
![Page 16: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/16.jpg)
16
2.2 The Entabeni Project
![Page 17: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/17.jpg)
17
Project: Three Strategies
1. Strengthen existing volunteer team through skills building
2. Strengthen local support structures for volunteers
3. Build partnerships with outside agencies in public and NGO sectors
![Page 18: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/18.jpg)
18
Building volunteer skills?
![Page 19: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/19.jpg)
19
Mobilising local support for volunteers?
![Page 20: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/20.jpg)
20
Building bridges between volunteers and external partners?
![Page 21: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/21.jpg)
21
3. Entabeni vs Sonagachi?
Sonagachi managed to facilitate-symbolic-material-relational changes that supported effective
community mobilisation in ways that Entabeni did not
![Page 22: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/22.jpg)
22
3.1 Creating symbolic contexts for transformative communication?
![Page 23: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/23.jpg)
23
What symbolic factors facilitated programme success?
Entabeni – stigmatisation of-AIDS (immoral, shameful)-caring (just ‘women’s work’)-volunteering
![Page 24: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/24.jpg)
24
Sonagachi: managed to frame HIV as an occupational health issue
Sex workers seen as successful and legitimate workers who needed to unite to secure their rights
![Page 25: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/25.jpg)
25
Very different political contexts – West Bengal vs traditional rural South Africa
![Page 26: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/26.jpg)
26
• Symbolic power of External Change Agents
![Page 27: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/27.jpg)
27
Funders’ willingness to see empowerment as a fundable outcome
![Page 28: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/28.jpg)
28
Entabeni funders did not see empowerment of poor as ‘a deliverable of value to the US government’
![Page 29: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/29.jpg)
29
Sonagachi: managed to ‘sell’ empowerment as a legitimate thing to fund-worked hard to build its public image, this filtered thro to funders
Growing influence on national and international AIDS policy
![Page 30: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/30.jpg)
30
3.2 Material contexts for transformative communication?
Resource-based agencySon: peer educators get small paymentEntabeni: no luck in securing stipends
![Page 31: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/31.jpg)
31
Experiential-based agency (small wins)Son: successful peer ed experience used
as first steps to promoting wider experiences of empowerment
![Page 32: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/32.jpg)
32
Ent: no opportunities for women to export their new experiences of agency from peer ed to other contexts
![Page 33: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/33.jpg)
33
Income generation
Son: co-operative bank
![Page 34: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/34.jpg)
34
• Ent: less success here – because there was no economic gain associated with involvement, project failed to resonate with peoples’ economic aspirations
![Page 35: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/35.jpg)
35
![Page 36: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/36.jpg)
36
3.3 Relational contexts for transformative communication?
![Page 37: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/37.jpg)
37
Leadership and decision-making
Son: gradual involvement of women in organisational decision-making and leadership
![Page 38: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/38.jpg)
38
Ent: strong resistance to any aspect of female empowerment
![Page 39: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/39.jpg)
39
Son: careful management of power relations
![Page 40: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/40.jpg)
40
Bridging social capital: building outside support for project activities
Ent: success with small NGOs-immediately responsive-individuals-shoestring budgets
![Page 41: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/41.jpg)
41
• Ent: Despite monumental efforts, project failed to establish long- term partnerships with local government bodies, including health, welfare and municipality
![Page 42: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/42.jpg)
42
Son: build excellent productive links with relevant groups – pimps and madams; media, politicians, funders etc – all of whom saw they had something to gain from project involvement
![Page 43: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/43.jpg)
43
4. Conclusion
![Page 44: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/44.jpg)
44
• How can social development projects best create social environments that enable transformative communication?
![Page 45: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/45.jpg)
45
Last word ……..
1. Improvisation vs blueprint
Son: long-term, improvisational approach, evolved in organic way, built on small achievements
Ent: followed a pre-determined project proposal (albeit rooted in 12 months of research and consultation)
![Page 46: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/46.jpg)
46
2. Providing incentives for potential allies
Son – shrewd incentivising, and gradualist approach
Captured personal, political and economic interests of relevant groups in quite a shrewd, almost calculating way – leading to meaningful support for the project and the women
The challenge of creating conditions where • the poor have voice, and • where relevant social groups are willing to listen,may often involve real-politik rather than mutually
respective dialogue
![Page 47: Mobilising communities for sexual and reproductive health … · 1. Mobilising communities for sexual and reproductive health promotion. Professor Catherine Campbell, Health, Community](https://reader033.fdocuments.in/reader033/viewer/2022051902/5ff17955e510526a53627cb3/html5/thumbnails/47.jpg)
47