Project

Sorry I haven't been keeping updated... I'm so so busy! but this is a little sample of what we've been working on: the introduction to our program manuel and the first session of which I am the team leader...
Overview of the Maternal Health Education Program

Rwanda Village Concept Project (RVCP) and GlobeMed GWU, two student organizations from the National University of Rwanda and The George Washington University respectively, have partnered together to form a maternal healthcare education program that is to be held at the Huye Health Center in the Huye Sector. In the summer of 2009, RVCP and GlobeMed surveyed 201 women attending the Huye Health Center to determine the scope of the women’s knowledge concerning maternal health related issues. In compiling these results, the team determined the following:

78.1% received prenatal care at the Huye Health Center, 46.3% of women surveyed drank alcohol while pregnant, 58.6% ate only starches and vegetables while pregnant, 48.3% do not use contraception, 67.7% received education about proper nutrition practices while pregnant.

Thus, the team established five areas of focus for substantial improvement, as follows: nutrition & alcohol consumption, women’s empowerment, knowledge of risk factors and dangerous behaviors, prioritization of prenatal care, and contraception use. These areas were formatted into a six-session education program with an emphasis on empowering the women in the village community of Butare to view their own health and the health of their children as an important facet of their lives. The program thus begins with a discussion-based session for the women to explore the role that they play within their community and family. The women are taught to uphold the saying, “umugore ni umutima w’urugo,” meaning, “a woman is the heart of the family.” The following sessions explore more specifically the aspects of maintaining a healthy pregnancy and infancy period, with a final session focused on instilling the importance of a safe motherhood. In the final session, each woman will verbally commit to being a safe mother, for the benefit of herself and her children. A minimum of two RVCP members will be conducting each session. The sessions will be held biweekly over a period three months. RVCP will then conduct an evaluation of the program by surveying both the women in attendance and the instructors for the sessions.

Two target groups for this program have been determined. Working with the Huye Sector Office, the team contacted pregnant and nursing women in the village to meet with us at the Huye Health Center. RVCP and the nurses from the Health Center indexed the malnutrition status of the women’s children, and prioritized the initial target group based on this information. 48 women were selected from this group. A second target group consisting of health workers in the village was contacted; we have asked them come to our sessions in order to be advocates for our program. It is our goal to expand this target group over the coming years.

The ultimate goal of the partnership between RVCP and GlobeMed is to enhance the health and well being of the villages surrounding Butare. We see this program as an integral part of this aim. We hope that in our evaluation of the women’s knowledge at the end of this program, we will find significant improvement in their general knowledge and habits regarding health and safety issues.

Session I
The Place and Value of Women
Traditions, Beliefs, and Taboos


Aims
• Encourage participants to think about their place and value in society and empower them to become advocates of safe motherhood
• Encourage participants to realize how social roles and traditional practices affect a mother and child’s health during pregnancy

Objectives
• Define difference between sex and gender
• Emphasize importance of equal role of husband and wife in family planning
• Promote spirit of mutual understanding between husband and wife
• Emphasize importance of women educating their children (both boys and girls) about sex, contraception, etc.
• Make women aware of why they are the targeted group and how they can be empowered through safe motherhood
• “Umugore ni umutima w’urugo”

Recommended Teaching Methods
The purpose of this first session is to open the conversation on the importance of maternal health. It should be conducted as a discussion rather than a lecture. Because we are not direct members of the targeted women’s community, we cannot define the “place and value of women” for them, nor can we make assumptions about “beliefs, traditions, and taboos.” Thus, it would be best to incite the women to discuss their opinions and grievances about their community and empower them to work towards improvement. Overall, when discussing their place and practices in their community, women should decide what they want to keep, what they should avoid, what they should change, and what should remain.

1. It is recommended that five (5) RVCP volunteers participate in this session.
2. Women should be separated into five (5) groups – one group per RVCP volunteer. Each RVCP volunteer should focus on one (1) of the first five (5) objectives.
3. Groups are divided based on each of the first five (5) objectives. Discussion should take place in each group for about twenty (20) minutes. When a discussion has finished, RVCP volunteers should rotate so that they introduce their objective to a new group. When each RVCP volunteer has facilitated discussion with each of the five (5) groups of women, the women should reconvene into one (1) group for the conclusion of the session. The conclusion is based on the last objective: “Umugore ni umutima w’urugo.”
4. Each RVCP volunteer should encourage discussion about traditional practices before, during, and after pregnancy and inform women of which practices may be harmful to their health and which practices are safe. He/She should encourage discussion about what women wish to change in their community and how they may go about achieving this change. Most importantly he/she should relate this topic back to maternal health and empower women to make safe decisions for the well being of themselves, their children, and their community as a whole.


The Place and Value of Women

Define the difference between sex and gender: begin by asking the women to define the difference themselves. Then give a more formal definition.
• What jobs do men traditionally hold? What jobs do women traditionally hold? Do you think you could perform the same jobs as men?
• What is the biggest difference between men and women in your community?
• Formal definition of sex vs. gender: Sex is a biological category determined at conception. Gender is a culturally constructed category that is not fixed and varies from culture to culture. Gender is a category that can be redefined through empowerment.



Importance of equal role of husband and wife in family planning: start by asking women what role they currently play in family planning. Then explain that it is important to a woman’s maternal health to play an active role in family planning.
• How involved have you been in decisions about family planning?
• How many children would you like to have in your lifetime? Have you discussed this with your husband?
• Are you more likely to let male or female children attend school? Why? Emphasize the importance of education for girls in order to become productive members of society and escape poverty
• Have you thought about how your economic situation should influence your decisions in family planning?


Promote spirit of mutual understanding between husband and wife: ask women about their role within their households. Then help them decide how they might achieve equality in the home.
• Do you communicate about how to manage your family?
• Do you make economic and health related decisions together with your husband?
• How many times per week do you discuss your concerns regarding issues of family management, economic situation, and health with your husband?
• Does your husband accept your ideas and opinions?
• How might you make your husband receptive to your ideas and opinions?


Importance of women educating their children about sex, contraception, etc.: start out by asking women if they received sex education from their parents. Then explain why educating their children will improve their children’s health and well-being. Encourage women to think about how their situation might be different had they been educated before engaging in sex.
• Did your mother educate you about sex? Do you perceive this education as important? Was it helpful in planning for your future?
• If your mother did educate you about sex what were the benefits and what were the drawbacks?
• Will you educate your own children about sex?
• Emphasize importance of educating both boys and girls about sex and the benefits this will have regarding the health of their children.


Why these women were included in the target group and how they can be empowered: start by asking women about their practices in the home and how they share tasks with their husbands. Encourage women to seek equality as mothers in their community.
• Do you share tasks with your husband and children in your home?
• How many hours/days per week does your husband help with housework? Would you like it if he helped you more often?
• How would you like your husband to help you?
• How can you encourage your husband to share household tasks with you?


Conclusion: “Umugore ni umutima w’urugo .”: ask women to make a general conclusion based on what they have discussed.
• What could you change and what could you continue doing in order to live in accordance with this saying?
• Give a general conclusion of how women’s empowerment can help achieve a safe and healthy motherhood.