Lessons Learned in Programming and Implementing the Religious Leaders RH/FP Programme: A Case for Dadaab Refugee Camp

This 16-page report, published by the Extending Service Delivery (ESD) Project of the United States Agency for International Development (USAID), presents the lessons learned from engaging religious leaders in promoting health behaviours in reproductive health and family planning (RH/FP) services in Dadaab refugee camp in Northern Kenya. According to the report, there was increased demand for RH services from women during the programme year, including antenatal care, postpartum care, and sexually tranmitted infection (STI) diagnosis and treatment. Anecdotal evidence also suggests that community members' attitudes towards RH seem to be changing.

The initiative was implemented over a 1-year period and involved building the capacity of religious leaders to address RH/FP through four key activities: development of relevant materials; creation of a core group of leaders who could also function as trainers and mentors; training of camp-based religious leaders to support efforts to improve the health of families; and strengthening community outreach by religious leaders through the mosque and other community education activities.

Participants were generally satisfied with the training, reporting that they had gained new knowledge on RH and community health, and that the training was unique and different from previous trainings they had attended. The participants also felt that their expectations were met. According to participant observations following the training, there were no major issues of concern that surfaced. However, trainees expressed reluctance to use the term "family planning" as it is widely perceived as a method of population control; they were more in favour of using the term "child spacing."

According to the report, organisers learned several major lessons:

• Project duration and funding levels must be taken into consideration if results are to be realised with behaviour change programmes, especially in an amorphous setting like the Dadaab camps.
• The over-reliance on the literature alone (e.g. reports) for planning purposes is likely to result in programme gaps, duplication, and miss-targeting of interventions. There is a need for a comprehensive site assessment that focuses on the proposed programme.
• Recognising the most appropriate entry point for an RH/FP intervention can determine the level of acceptance and potential reach of information and services. For example, in Dadaab, the use of the concepts of safe motherhood and “healthy families” as the way to teach others about how using family planning improves maternal and newborn and child health, was most effective and valued by religious leaders who would otherwise have opposed FP, which is commonly viewed as a population control measure among an already endangered community.
• In a humanitarian setting, the mobility of refugees, insecurity in camps, emerging health issues, and inter-group conflicts have significant implications on the pace of programme implementation. These factors need to be considered in the programme design, and contingency measures should be put in place to ensure minimal disruption.
• Religion and culture play an important role in the behaviour of any community and refugees are no exception. Introduction of a controversial health intervention such as RH/FP in a religiously conservative community requires careful assessment of the environment and careful planning for its introduction.

The report concludes that the lessons learned and presented can assist different agencies and stakeholders working in refugee camps to more successfully implement health and development programmes that involve influential members of the community, such as religious leaders. To ensure activities reach the right people who can effectively champion RH/FP information and services to community members, the key factors that will contribute to success include being prepared, responsive, and resourceful.

For more information contact:
Extending Service Delivery (ESD) Project
ESDMail@ESDProj.org