Empowering rural Women Leaders for health: Test of an innovative teaching method

Purpose: Rural women need to be empowered to make better decisions about home health behaviors. Where women's health needs are greatest, they are usually least empowered: so how to support the critical transition from disempowered to empowered? We tested one hypothesis with women leaders from rural Andean communities of Peru with operations research project “Between Us (Women): Sharing Pregnancy Histories as Part of Community Education for Maternal and Neonatal Health,” in which processes used to train women leaders are designed to empower them as change agents. Method: In a cluster-randomized controlled trial, half the communities' women leaders were trained using innovative methods; for the other half of matched randomly-assigned communities traditional health promoter teaching methods were used. Results: Qualitative- In the experimental group, rural women learned faster after sharing their experiences and learning from their mistakes. They: acquired confidence hearing other women tell their stories and difficulties, overcame nervousness, fear, and shame of speaking in public, and became more communicative and able to teach other women. They used the same method in their own communities to generate trust among women by telling their stories and asking mothers to tell theirs. Quantitative- Baseline versus final survey results showed positive impact on maternal health knowledge and behaviors comparing intervention and control communities. Pre and post-tests for each training module showed improvements. Recommendations: Methods used to train rural female change agents have significant impact on learning, performance and impact. Facilitator manuals were produced on six MCH topics for use in scaling-up the methodology.