Burkina Faso is still far from achieving the child mortality Millennium Development Goals (MDG) target. The under-five mortality rate is 188 per 1,000 live births. Data derived from the 2006 Multiple Indicator Cluster Survey (MICS). The access to sanitation is incredibly low: 13% in 2006. Community-based relays are identified as a key for supporting communication for behavioral change for Accelerated Child Survival and Development (ACSD).
During the period between 2002 and 2008, unit relays are established in 1,200 villages in Burkina Faso to ensure communication activities at the community level. A total of 6,000 community-based relays have been trained on the key family practices and reached 3.6 million inhabitants in door-to-door talks. Taking into account the existing structures in a community is instrumental to ensure the sustainability of communication activities.
Through active involvement of unit relays in villages, communication ownership at community level has been strengthened. Replication of relay units is feasible in other villages. The focus should be put on strengthening the capacity of relay units through training, provision of tools for social mobilization and materials for communication, and monitoring and evaluation.
Burkina Faso is still far from achieving the child mortality MDG target. The under-five mortality rate is 188 per 1000 live births (Multiple Indicator Cluster Survey, 2006). Resurgence of vaccine preventable diseases in 2009 (15 cases of polio and more than 53,000 cases of measles) is particularly a concern despite the reported vaccination/ immunization coverage of above 90% for several years. Although the national HIV prevalence is relatively low (1.6% in 2006, UNAIDS 2007), HIV infection is significantly higher in urban areas. Female Genital Mutilation (FGM) is in decline from 77% to slightly below 50% in 2005; source: Excision Reduction Review 1990-2006 (The National Committee Fighting Excision, CNLPE). Yet activities continue to be under-funded, particularly in relation to the sensitization information from Country Office Annual Report 2009. One MDG target that Burkina Faso might comfortably meet is the access to drinking water which has reached 72% from 34% in 1990. However, the proportion of households in the poorest quintile without access to drinking water is more than twice compared to that of the wealthiest quintile (The Situation of Childhood Poverty, UNICEF 2010). In relation to sanitation, access is still incredibly low (13% in 2006).
The experience of C4D interventions using unit relays in Burkina Faso dates back to 2002. At the beginning, they dealt with themes such as child trafficking, Female Genital Mutilation/cutting(FGM), girls' education, and Preventing Mother-to-Child Transmission of HIV (PMTCT). Most recently, community-based relays are identified as a key for supporting communication for behavioral change for Accelerated Child Survival and Development (ACSD) and are included in the African Regional Strategy. Their role is promoting the key family practices in communities. Based on this strategic shift, the National Communication Plan was developed under the leadership of the Ministry of Health.
Strategy & application
The main C4D strategies in this project are based on:
In the context of the UNICEF-Burkina Faso Country Programme and under the National Communication Plan, unit relays are established in 1200 villages to ensure communication activities in Accelerated Child Survival and Development at the community level. Each of these units is made up of five relays, including three men and two women.
Relay units were trained in running talks and activities linked with various themes such as: maternal and child health, HIV/AIDS, girls’ education, child trafficking and the worst forms of labor, Female Genital Mutilation/cutting, hygiene and sanitation. The relays tackle children-related issues with a few essential guidelines. Equipped with UNICEF-provided bikes and social mobilization material, these community-based relays travel from village to village, house to house to inform and engage in dialogues on key behavioral issues within the community.
Community participation is a central component of this project. Families, communities and populations are regarded as agents of their own development. To do this, they are involved in all communication activities in the field. The fact that communities are willing to exchange and dialogue on issues related to maternal and child health, HIV-AIDS, education, child protection has helped raise awareness and strengthen their ownership of the activities.
The multi-media approach is applied through the integration of interpersonal communication channels (door-to-door talks, forum theater, video projection, and town criers, etc) and media channels targeting communities (rural radio, community radio and television).
During the period between 2002 and 2008, 1200 relay Units have been put in place in 1200 villages and 6,000 community-based relays have been organizing door-to-door talks in villages. A total of 3.6 million inhabitants in 1200 villages have been reached by the unit relays through door to door sensitization activities. Unit relays are also ensuring the monitoring of FGM, girls’ education, and child trafficking in their communities.
Evaluating behavioral change at community level is difficult and time consuming. However, below data from the situation analysis of children suggests potential impacts of the project.
Data on the evaluation and documentation
In one of the medical districts of Bobo-Dioulasso, the second town located at the West of Burkina Faso where communication activities were implemented, the rate of HIV/AIDS test acceptance of pregnant mothers increased from 35% in 2005 to 65.51% in 2006.
In the education area, “Positive Emergency” Campaign and sensitization activities carried out by local radios and relay units contributed to the increase in the gross enrolment rate of girls; it has increased by 8.6 points from 73.2% (2006-2007) to 81.80% (2007-2008).
Sensitizing on birth registration allowed a better comprehension of families and communities of this night for evening child. To find a birth certificate for the child becomes more and more a positive reflex: the rate of birth registration of the children of less than 5 years passed from 33% in 2003 to 63.7% in 2006, (MICS 2006).
Female genital mutilation/cutting
The practice of the excision has progressively decreased: from 49.5% in 1996 to 28.1% in 2006. It should be noted that communication actions have largely contributed to raising awareness and knowledge on the risk related to FGM among population. According to the study on FGM/cutting assessment 1990-2006 carried out by CNLPE (the national committee in charge of fight against FGM/cutting), at least 81% of the surveyed population knew the risks related to the practice of the excision.