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Evaluation report

1999 Oman: Voices from the Community in the Sultanate of Oman: Local Women's Perceptions of Community Support Group Volunteers



Executive summary

Background

Community Support Groups (CSG) were first created in the Sultanate of Oman in 1992 by the Ministry of Health as part of the UNICEF-supported Baby-Friendly Hospital Initiative (BFHI). They represent an innovative means of tapping community initiative and channeling it into an effective organizational structure. Female volunteers selected from the community and trained to assist other women in breastfeeding and complementary feeding now serve as a vital link between health care providers and health care recipients in the community. With support and nurturing, the CSG movement has grown into a wide network throughout the country and is burgeoning into a multi-purpose support system. Their roles are being expanded through additional training on a variety of maternal and child health issues which they, in turn, transmit to other community members. This joint Ministry of Health/UNICEF study was planned as the third in a series of assessments of the dynamics of interaction among Community Support Group volunteers, the local women with whom they interact, and the health service staff who support and facilitate such interactions. Following on previous analyses of the perceptions of health professionals and volunteers, the current study focussed on the perceptions of local women who are beneficiaries of the volunteers' services.

Purpose / Objective

The aim was to record local women's perceptions of volunteers and incorporate these into a broader assessment of volunteer effectiveness based on the degree to which volunteers have correctly assimilated a number of health and nutrition messages, and the manner in which they are communicating these to community members.

- To record perceptions of the quality and effectiveness of volunteer interaction with community members from the perspective of women who have been beneficiaries of volunteer support services
- To further assess the nature of volunteer interactions with local women through extended interviews and field observations at various sites
- To conduct a preliminary assessment of the degree to which volunteers have correctly assimilated the health and nutrition information they are expected to transmit to others, and the counselling skills that they should be applying in their work

Methodology

Five health regions were selected with a focus group of around 24 local women beneficiaries held in two different districts in each region. At least three observations of interactions between volunteers and local women were conducted in each of the five study regions. Volunteers were given a knowledge-based test on the major categories of training volunteers received. Additional information was gathered from interviews with key health personnel, volunteers and local women. As a further input for analysis, routine monitoring forms for volunteer activities were developed by the Ministry of Health and distributed to all regional health directorates.

Key Findings and Conclusions

Most women (over 80%) reported having contact with many volunteers, and nearly two thirds (65%) reported that such contacts occurred frequently. Over half of the women reported that the volunteers initiated first contact. Topics of discussion most frequently reported by women included breastfeeding (92.4%), complementary feeding (85.6%), and birth spacing (85.2%) though notable regional variation in these proportions exist. Discussions of hygiene were reported by around three quarters of women overall while just over 60% reported discussion issues related to CDD/ARI/EPI and growth monitoring.

Women in each locale voiced overwhelmingly positive impressions of the volunteers known personally to them. Volunteers are especially valued because they are able to articulate health messages in a simple and informal manner easily understood by all. Such ease of communication was seen by many women to be in direct contrast with difficulties in communication with health staff. Volunteers were also contrasted positively with medical professionals in terms of the time and patience they accorded women and their availability and outreach efforts. Almost half of the women perceived information provided by volunteer and health staff working together to be more beneficial than information provided solely by one or the other.

The women felt that volunteers should be encouraged through continued support and follow-up, and greater recognition for their efforts. Women in each region evoked the need for more training for the volunteers and for new and improved training materials. They also stressed the need for more volunteers as a means of extending coverage to more remote areas and different populations such as children and men.

Observations conducted at diverse settings revealed both strengths and weaknesses in volunteers' interactions with local women. Variations in the quality of interaction seemed to be due in part to varying levels of training, experience and ability on the part of volunteers; in part to the choice of activity deemed most appropriate for volunteers to carry out; and in part to the nature of the partnerships established between volunteers and health workers. Knowledge tests had high scores overall with an average of 86.1% correct answers in all. However, significant variations were found by region and topic. On a regional basis, average test scores ranged from 72.2% in South Batinah to 92.9% in Dhofar. Topic wise, the highest overall scores were for complementary feeding and breastfeeding while the lowest scores were recorded for nutrition and growth monitoring.

The main conclusion to be drawn is that volunteers can and do provide a useful service to their communities in disseminating important health and nutrition messages. With appropriate training and support, they function effectively as enthusiastic auxiliaries to the health services and as links between local community and government health providers.

Recommendations

The current findings point to the need to provide continuous training and appropriate training materials to volunteers to enable them to correctly carry out their burgeoning functions. A system needs to be developed to ensure basic training of volunteers new to the movement; periodic refresher trainings; and trainings for all on the new topics volunteers are increasingly beginning to tackle.

Attempts to expand coverage by the movement will depend on enlisting more volunteers who will then, in turn, depend on strengthened structures for their organization and training. There may be scope to diversify the target population. Overall, continued official recognition of, and support for, volunteer contributions will help spur volunteer motivation and enthusiasm, and maintain the success of this important movement.



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Report information

Date:
1999

Region:
MENA

Country:
Oman

Type:
Evaluation

Theme:
Training

Partners:
Ministry of Health

PIDB:

Follow Up:

Language:
English

Sequence Number:
1999/003

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