Participatory Approaches Empower Communities
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In Senegal a group of villages makes a public declaration to renounce female genital cutting and child marriage. Such events help to change social norms and can get news coverage, which widens impact. Photos: © 2007 Tostan
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When community members help design and guide a health or development program, the community gains problem-solving skills and ownership of the program. These two important elements contribute towards sustainable results (27, 47, 227). The process has been called participatory communication. It has at least three elements:
- Through dialogue communities and BCC programmers reach a shared understanding of the community’s problems and needs,
- Community members participate in planning and implementing social programs, and
- The community makes decisions (128, 211).
In their purest form participatory approaches seek to strengthen the overall capacity of a community to address its own health and social issues beyond the life of a particular project. Changing specific health behavior or reaching a specific health objective is less important (128). Behind this approach lies the philosophy that communities have the right to decide what matters most and are in the best position to know (77, 128, 211).
Under this framework the solution to a health or social problem may not involve communication. Finding the solution, however, involves communication—among community members and between the community and programmers. Techniques include dialogue, community meetings, workshops, and participatory analysis techniques such as community mapping and modeling (community members draw a map of the community in order to identify what programs they need most and where).
Participatory approaches tend to focus on social change such as community empowerment, social cohesion, and leadership. In contrast, conventional BCC approaches tend to focus on individuals’ behavior and related factors such as knowledge, attitudes, and skills (60, 128).
The gap between the two approaches is narrowing (60, 128, 211). For example, in 2002 a diverse group of communication scholars and practitioners developed an integrated model of “communication for social change” that combines these two frameworks. The model includes both individual behavior change outcomes as well as social change outcomes (60). The appropriate mix of communication approaches depends on the nature of program goals and community needs (128).
In practice some BCC programs have employed participatory approaches without losing focus on health objectives and behavior change. Community participation in BCC programs has ranged from involvement in formative research to identifying the health and social needs to be addressed to some degree of involvement in directing and carrying out the program, such as a community advisory committee or review board (76, 118, 152, 170).
Participatory Approach Motivates Communities to Stop Female Genital Cutting
Through community-based education, Tostan, an international NGO based in Senegal, has had considerable success in empowering communities in six African countries to abandon female genital cutting (FGC). Since 1997, 2,336 villages in Senegal, 298 in Guinea, and 23 in Burkina Faso have renounced this harmful practice (49, 194).
Tostan uses a participatory approach to community-based education called the Community Empowerment Program. In the first phase of the program, a village sets up a committee to adapt and manage the program. In the second phase a group of villagers receives training and education in hygiene, women’s health, human rights, and problem-solving. Training emphasizes enabling participants, who are mostly women, to analyze their own situation and find the best solution. In the third and fourth phases, each trainee shares what she is learning with one other person, and the group begins to organize public discussions. The public discussions concern issues identified by the trainees. Participants serve as discussion leaders and seek the consensus of the community in renouncing certain harmful practices such as FGC. In the fifth phase, if communities express support, community members reach out and spread educational activities to neighboring villages where family ties exist. Finally, a group of villages organizes a public declaration to indicate their collective intention to renounce harmful practices (49, 76).
Tostan started activities in 1988 in 20 villages in the Kolda Region of Senegal, where nearly 88% of women had experienced FGC. By 2001 the program had expanded to 90 villages in the region (76). Program staff evaluated the Community Empowerment Program approach in this region. They compared 20 villages that undertook the community-based education and 20 control villages that did not (49).
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In Senegal Tostan, an international NGO, uses community-based education to bring about social change. Participatory approaches help communities develop a sense of ownership in programs, which contributes to sustainable results. Photos: © 2007 Tostan
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The evaluation found that Tostan’s Community Empowerment Program has brought about social change within communities, enabled villagers to improve living conditions, and increased respect for human rights and women’s health. Specifically, the program has helped reduce community support for and practice of FGC. Prevalence of FGC among daughters of both program participants and residents of the comparison communities was high before the start of the education program (87% of daughters among program participants and 93% in the comparison communities). Prevalence remained high after the program ended, but it had dropped significantly among daughters of the participants (to 79%). The four percentage point decrease among daughters of women from comparison villages was not statistically significant.
In particular, 68% of participants’ daughters ages newborn to four years had not been circumcised before the start of the program. Two years after the program ended, this percentage rose significantly to 78%. In contrast, in the comparison group, the percentage of daughters in the same age group who had not been circumcised did not change significantly.
Even greater percentages of participants said they did not intend to have their daughters circumcised in the future. Before the program started, 7 women of every 10 said that they wanted to have their uncircumcised daughters circumcised in the future. This proportion fell to about 1 woman in every 10 among those who participated in the program, while more than 5 women of every 10 in the comparison villages expected to have their daughters circumcised in the future (49). Tostan’s FGC-focused programs have empowered participants, particularly women, by enabling them to raise important issues in the community and to lead a process of community decision-making (49, 117).
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