Contribution of Community Volunteers/Positive Peer Couples in Uptake and Coverage of Health Timing and Spacing of Pregnancy (HTSP) in Burundi - Case Study: Cumba Zone, Muyinga Commune, Muyinga Province in 2014-15

Abstract

“Irondoka rijanye n’amagara meza” is Kirundi for “health timing and spacing of pregnancy". (HTSP) is an intervention that focuses on healthy fertility to help women and families delay, space and limit their pregnancies to achieve healthiest outcomes for women, newborns, infants and children and essential in achieving MDG 4,5, 6 and it was the focus of this article. The purpose of the research was to assess the contribution of community volunteers/positive peer couples in uptake and coverage of healthy timing and spacing of pregnancy (HTSP) in Cumba Zone. The Positive Peer Couples (PPC) approach, as used by World Vision International Burundi rests upon the observation that in communities throughout the world, there are a few individuals whose uncommon behaviors or practices enable them to find better solutions to problems than their neighbors with whom they share the same, or lesser, resource base. The operational research helped to analyze barriers, develop and evaluate solutions for these barriers, improve program performance (including logistics, access, quality and impact), and facilitate program scale up and sustainability. By embedding research into the HTSP program, we generated lessons learned; optimized program performance, which will inform other programs and countries with similar challenges. The research determined that community members (couples) who participated in Positive peer couples for HTSP, adopted positive change towards new born, child health, safer sexual.

This study explored the impact of Positive Peer Couples (PPC) in uptake and coverage of Healthy Timing and Spacing of Pregnancy (HTSP) in Gashoho commune. It covered 132 PPCs. They were chosen randomly. The study reveals that there are uncommon practical behaviors that enabled Positive Deviants (PDs) to outperform and enhance massively to adherence to contraceptive methods by community members: Those include: effective implementation of PPC, sensitization of community members using Household to household approach, involvement of Men in Family planning (the men accompanied his wife to Antenatal Care service (ANC), closer follow up and monitoring by PPCs, PPCs are role models at community level, Regular Health education at sub hill level by PPCs living in the same area, equity, and the solutions come from the community not from experts, deep respect of the community, its members and its culture and focus on interactive engagement, expends existing networkers and create new ones, creating more space for innovative solutions to emerge. Positive deviance enhances local research capacity for controlling problem in relevant, affordable, sustainable ways.

The approach reveals at least partial solutions today to challenges rather than waiting for long term development; it introduces a generic approach for local problem solving. Indeed, intervention communities commonly launch parallel activities, such as participation in common community works for instance local road construction or successfully demanding social services.

Keywords: community, spacing, pregnancy