Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #112295

Larissa M. Jennings, BA MHS¹, Nabeel A. Ali, BA MA², Peter Winch, MD MPH¹, Ishtiaq Mannan, MD MPH², Abdullah H. Baqui, PhD MPH¹, M. Habibur Rahman Seraji, MD MPH², Rowshan Jahan, BA MA², and Khaleda Ahkter, BA MA². (1) Department of International Health/Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, 410-598-9281, ljenning@jhsph.edu, (2) Public Health Sciences Division, International Center for Diarrheal Disease Research, Bangladesh, Mohakhali, Dhaka, Bangladesh

Background: Effective interpersonal communication in counseling and negotiation is essential in promoting behavior change. Community-health workers (CHWs) conduct counseling on newborn care during home visits at 12-16 and 32-34 weeks gestation in the Projahnmo project, a community-based project in Sylhet, Bangladesh that aims to improve maternal and neonatal care practices. Methods: Data for this presentation comes from semi-structured interviews (n=18) and focus-group discussions (n=2) with CHWs and their supervisors to explore experiences in counseling and negotiation during antenatal household visits. Pregnant women (n=17) who received birth and newborn care (BNCP) visits were also interviewed to evaluate messages, and project reports on formative research and CHW communication were reviewed. Responses from interviews and focus group discussions were categorized according to a model of the implementation process for BNCP. Results: Factors facilitating successful negotiation include sharing positive experiences of other women and local stories, use of newborn dolls and BNCP cards to show danger signs, and emphasizing expertise from previous training. Reported constraints to effective counseling were reluctance of mothers to discuss danger signs, constant arrival and departure of household members and the value placed on traditional practices by mother-in-laws. Messages building upon existing practices and cultural understandings of newborn care were more readily valued than practices outside existing norms or that incur additional financial costs. Conclusions: Programs aiming to change maternal and newborn care practices may employ qualitative research to identify effective methods of communication. Improvement of implementation requires iterative in-depth investigation into culturally-informed counseling techniques.

Learning Objectives: At the close of the session, participants will be able to

• Assess the value of effective communication as a tool for increasing awareness in birth and newborn care preparedness
• Examine strategies employed by CHWs to negotiate expected change areas
• Identify at least two challenges for CHWs in counseling in resource-poor communities
• Discuss program components which are applicable in other settings

Keywords: Community Health Promoters, Infant Health

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.