Programa de Comunicación en Salud Infantil (COMSAIN) - Honduras
COMSAIN is a national communication and behaviour change programme developed by the Honduran Secretariat of Health (SOH) and BASICS II in September 2000. The initiative targets mothers with low income levels in rural and peri-urban areas with memorable messages about how to improve their children's health and nutrition. Through a multi-channeled approach using radio and printed materials, this programme aims to give mothers the information and support they need to help their children survive and thrive.
Specifically, the programme is driven by the need to enhance the knowledge and skills of mothers to prevent, manage, and seek appropriate treatment for childhood illnesses. Taking into consideration the public health impact of Hurricane Mitch, planners identified five focus areas:
The centerpiece of the communication programme is a radio soap opera ("In Search of a Better World") that uses entertainment to gain the interest of the target audience. Radio soap opera episodes are typically 15 to 30 minutes long, although some have been as short as one minute long. One of the characters in this series is the single mother and orphan Maria, whose story resonates with many mothers. They are able to identify with Maria, sharing her concerns about feeding her child properly and understanding her fears when the child becomes sick. In one episode Maria takes her son Josesito to the monitora because he has a bad cold. She finds out that the child's rapid breathing is sign of pneumonia and that he needs immediate treatment.Printed materials also provide concrete guidance and reinforce behaviour change. These materials include posters; orientation cards on key behaviors for health workers to use in counseling mothers during clinic visits; take-home reminder materials for health workers and monitoras to give to mothers; informational brochures on the key behaviors for health workers, religious leaders, and maquila (factory) managers and health personnel; and advocacy tools.
Specifically, the programme is driven by the need to enhance the knowledge and skills of mothers to prevent, manage, and seek appropriate treatment for childhood illnesses. Taking into consideration the public health impact of Hurricane Mitch, planners identified five focus areas:
- growth monitoring and promotion
- breastfeeding and complementary feeding
- home management of acute respiratory infections and diarrhea (the leading causes of childhood deaths in Honduras)
- diarrhea prevention and treatment, and
- hygiene.
The centerpiece of the communication programme is a radio soap opera ("In Search of a Better World") that uses entertainment to gain the interest of the target audience. Radio soap opera episodes are typically 15 to 30 minutes long, although some have been as short as one minute long. One of the characters in this series is the single mother and orphan Maria, whose story resonates with many mothers. They are able to identify with Maria, sharing her concerns about feeding her child properly and understanding her fears when the child becomes sick. In one episode Maria takes her son Josesito to the monitora because he has a bad cold. She finds out that the child's rapid breathing is sign of pneumonia and that he needs immediate treatment.Printed materials also provide concrete guidance and reinforce behaviour change. These materials include posters; orientation cards on key behaviors for health workers to use in counseling mothers during clinic visits; take-home reminder materials for health workers and monitoras to give to mothers; informational brochures on the key behaviors for health workers, religious leaders, and maquila (factory) managers and health personnel; and advocacy tools.
Development Issues
Children, Nutrition, Health, Women.
Key Points
COMSAIN itself is one element in a larger effort to improve children's health in Honduras. It serves as the communication umbrella for the SOH's main child health strategies: AIN (Atención Integral a la Niñez), or Integrated Care of the Child at the Community Level, and IMCI (Integrated Management of Childhood Illnesses) in health facilities.
As part of a US$ 293 million reconstruction programme to aid areas affected by Hurricane Mitch in 1998, the United States Agency for International Development (USAID) funded initiatives to restore and expand critical maternal and child health services, including strengthening the Secretariat's AIN and IMCI programs. In 1999, USAID added additional funds to enable BASICS to provide further support to AIN and IMCI in the hardest-hit areas and to develop a national child health communication campaign. The result - the COMSAIN programme - became a unifying force and a collaborative model among the various organisations working in child health.
Six hundred people - including a representative of the Honduran first lady, the U.S. ambassador, the Honduran secretary of health, the director of the U.S. Agency for International Development (USAID) mission, and the managers of many local and international groups - attended the launch of COMSAIN. This kind of participation illustrates the level of concern about high rates of infant and child mortality and malnutrition in Honduras, where 42 out of every 1,000 infants die every year and about two out of five children younger than five are malnourished. It also reflects the degree of collaboration that was achieved in the design and implementation of COMSAIN. For instance, COMSAIN reinforces the AIN programme by sending messages to mothers that are consistent with those the AIN community volunteers, or monitoras, convey when they weigh babies and counsel mothers on how to keep their babies healthy and growing well.
The COMSAIN experience during its first year opened opportunities for working with religious leaders and maquila managers and health personnel. During the next phase of the programme, the partners hope to expand this type of outreach through popular faith-based radio stations and interpersonal communication in health facilities, workplaces, and communities. Several NGOs are already using their own funds to reproduce or adapt COMSAIN materials, and USAID has given about $US 100,000 to help the SOH continue the communication efforts. Prospects for sustaining the collaboration among child health organizations are also promising. The committee that coalesced around COMSAIN after Hurricane Mitch has now expanded its mandate to include AIN implementation in community and health facilities.
As part of a US$ 293 million reconstruction programme to aid areas affected by Hurricane Mitch in 1998, the United States Agency for International Development (USAID) funded initiatives to restore and expand critical maternal and child health services, including strengthening the Secretariat's AIN and IMCI programs. In 1999, USAID added additional funds to enable BASICS to provide further support to AIN and IMCI in the hardest-hit areas and to develop a national child health communication campaign. The result - the COMSAIN programme - became a unifying force and a collaborative model among the various organisations working in child health.
Six hundred people - including a representative of the Honduran first lady, the U.S. ambassador, the Honduran secretary of health, the director of the U.S. Agency for International Development (USAID) mission, and the managers of many local and international groups - attended the launch of COMSAIN. This kind of participation illustrates the level of concern about high rates of infant and child mortality and malnutrition in Honduras, where 42 out of every 1,000 infants die every year and about two out of five children younger than five are malnourished. It also reflects the degree of collaboration that was achieved in the design and implementation of COMSAIN. For instance, COMSAIN reinforces the AIN programme by sending messages to mothers that are consistent with those the AIN community volunteers, or monitoras, convey when they weigh babies and counsel mothers on how to keep their babies healthy and growing well.
The COMSAIN experience during its first year opened opportunities for working with religious leaders and maquila managers and health personnel. During the next phase of the programme, the partners hope to expand this type of outreach through popular faith-based radio stations and interpersonal communication in health facilities, workplaces, and communities. Several NGOs are already using their own funds to reproduce or adapt COMSAIN materials, and USAID has given about $US 100,000 to help the SOH continue the communication efforts. Prospects for sustaining the collaboration among child health organizations are also promising. The committee that coalesced around COMSAIN after Hurricane Mitch has now expanded its mandate to include AIN implementation in community and health facilities.
Partners
United States Agency for International Development (USAID); a broad-based coalition of local and international organisations including Programa de Asignación Familiar (PRAF), international organizations such as UNICEF and the Pan American Health Organization, the USAID-supported Quality Assurance Project, and nongovernmental organisations (NGOs) such as Aldea Global, CARE, Catholic Relief Services, Proyecto Compartir, Save the Children, Vecinos Mundiales, World Relief, and World Vision.
Sources
Letter from Kathleen Shears to the Communication Initiative sent on November 15, 2001 and BASICS site
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