Essential Family Practices: real behavioural change at community level

In Niger, in response to high rates of mortality and morbidity (198 per 1,000 and 646 per 100,000 respectively), UNICEF embarked on a drive to promote the survival and the development of children through a promoting behaviour with high impact on mother and child health. Thus SNV Niger and UNICEF signed a Memorandum of Understanding for the implementation of a programme to promote Essential Family Practices in five municipalities in the regions of Maradi and Zinder over a one-year period from December 2011 to December 2012.

Village women at a programme sensitisation session

The aim of the programme is to contribute to the reduction of child mortality by the end of 2012 through the adoption of good practices in key areas for children survival and development at family and community level.

A multi-stakeholder approach based on capacity building actions and communication was adopted and a localisation dimension was integrated through working with two local capacity building organisations - Tattali in Maradi and Al Umma in Zinder. SNV advisors, with support from the UNICEF communication team, assisted in the installation of operational teams composed of 37 facilitators, 5 supervisors and 717 community volunteers.

SNV support consisted of training the key actors in the ownership of the process; improved interpersonal communication through a network of community trained/equipped volunteers; communication for social change through the stimulation of community participation; building partnerships and networks with traditional leaders, professional associations and the non-governmental sector; and advocacy, so that the voices of the community will be better heard by decision makers.

The programme has already achieved real behaviour change in communities, both individually and collectively. Notable results include:

• 180 villages have created action plans to ensure better sanitation combined with Community Led Total Sanitation activities;

• 82.71% of households now wash their hands with soap and water, especially school children; 77.14% of households apply exclusive breastfeeding;

• 57.26% of covered households undertake supplementary feeding for children aged 6-24 months;

• The ownership of the Essential Family Practices approach by the two NGOs in the conduct of activities;

• The enthusiasm of the population and the quality of debate in educational sessions on health issues: a monthly average of 14,241 people (4,475 men and 9,767 women) participate in sessions led by the volunteers, and 12,668 people (4,849 men and 7,820 women) participate during general meetings.

Though significant outcomes have been achieved, a number of difficulties have had to be overcome during programme implementation, such as the absence of Essential Family Practices database, baseline and tools to collect and measure the results of the programme, and a lack of synergy between the various actors involved in the implementation of the programme.

The Essential Family Practices programme has been a rewarding experience, as it has provided lessons during implementation. For future programmes, it will be in the interest of the implementers and the beneficiaries to involve the local health technical services in order to promote the visibility and integration of the practices. Although the method has brought different actors together, the multi-stakeholder approach is not complete and more involvement of community leaders, populations and local media in the process is needed to create a more real and efficient dynamic at the relay level.

The Essential Family Practices programme creates a synergy between the Health and Sanitation & Hygiene sectors. The involvement of basic communities and local capacity building organisations also enforces the ownership of the methodology by the local population and ensures sustainability of the whole process. All these factors make the porgramme’s approach worth sharing for improvement and upscaling, but we note that the approach requires significant human and financial resources.