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Health Education Access in Local Languages (HEAL) Program

Comprehensive Sexual Education in local dialects to train and empower illiterate IDP women and girls in ex-Katanga province, in DRC.

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What specific problem(s) are you trying to address?

70% of the Congolese live in rural areas, where 25 % of women and girls are illiterate (DHS II 2014) and cannot access limited available basic health services promoted only in French and Swahili. Thus, rural youths do not know about SRH services and are exposed to risky behavior and practices related to STI and HIV. Early sex (43%), unsafe abortions, miscarriages, unwanted pregnancies, etc. are common coin. Talking about sex in families or among peers is a taboo. That situation is sustained by different pro-masculinity socio-ecological factors, and exacerbated by on-going conflicts, which move thousands into camps where (i) SRH services are not a systematic agenda and (ii) aid dependency and unsafety fuel vulnerability to SGBV.

What are some of your unanswered questions about the problem(s) you are working to address?

Can illiterate IDP adolescents look for and access SRH services if they are appropriately informed and educated in their own dialects and through images? Can they demand for context-friendly SRH services if they are empowered? Can sex dialogue be integrated within their families? Is it possible to shift current harmful social and gender norms to foster a responsible culture within illiterate indigenous populations of the former Katanga?

Explain Your Idea

SAFEKA wants to provide comprehensive sexuality education to nearly 50000 illiterate internally displaced women and girls from remote rural linguistic minorities, namely Twa or Pygmies, Luba, Tabwa and Kalanga. Those women and girls suffer double vulnerability as to their origin and the IDP status. They experience daily severe gender based violence which exposes them to serious sexual and reproductive health issues. Communicating easily in their local dialects, the illiterate IDP women and girls cannot access basic available SRHR services simply because they do not understand French or Swahili, two common languages used in IDP camps and neighboring cities for information and service delivery. For the sake of inclusiveness and universality values, SAFEKA will scale up its current club-based SGBV prevention and SRHR promotion programming by using two components: (i) local dialects as medium of communication during all program activities (survey, training, sensitization, etc.) and (ii) CSE fixed panels fixed in camp key areas with photos and images, which teach SRHR basics without any writings on them. Thanks to the support of UNHCR and AmplifyChange, SAFEKA is using a community mobilization approach through youth clubs since 2014. After being piloted in schools, the approach has proven effective and is now working in and out of IDP camps. The method is done through a role play, called participatory theatre, in which comedians develop a specific SGBV or SRHR issue.

Name the three most important ways that your idea will address your identified problem(s).

First, both baseline and endline survey will be conducted among 5 IDP camp communities to get fresh data against which intended outcomes will be measured. Surveys will focus on KAP and social norms. Second, 100 selected illiterate adolescent boys and girls will be trained in SGBV, SRHR and participatory theaters so that they can be able to sensitize their own communities. Finally, sensitization activities: mass meetings in open air; fixed CSE Panels; and advocacy. Therefore, illiterate IDP women and girls will become aware of the importance and availability of SRH services and start using them; a free dialogue space around sexuality will be created among adolescents and parents; and negative attitudes sustaining SGBV will be improved

How is your idea unique?

Our idea is very unique in terms of the target people and the format of the communication medium. Particular characteristics are inclusiveness, equity, and empowerment. The idea is inclusive in that it reaches out to the social layers left behind for decades. Although different projects have been implemented in ex-Katanga area, none of them had had a clear focus on the minority who were expected to tune to the rule of majority. Either, teaching and sensitizing illiterate indigenous communities in their dialects and images is not only an innovation but also a foothold, which enables them to make use of available or demand for new SRH services that are only accessible to their literate counterparts. Finally, this idea is transforming the illiterate women and girls into community educators or change makers so that, henceforth, they can be considered as partners in each program targeting them.

What are some outstanding concerns or questions that you have regarding your idea?

Respect for “Do No Harm principle” will be challenging in order toe ensure a safe and violence free space for all. Most SRH key terms will need translation. Choosing between iron and wood for making fixed panel is critical: iron might be costly; timber misused as firewood. The integration of comprehensive SRH services within Camp-based clinics or health centers deserves deep rethinking. Finally, parents and opinion leaders may resist being allies in fighting their own cultural norms.

Who are your end users?

1. We are primarily targeting illiterate women and girls who are IDPs in 8 camps. Within this group, care shall be taken to include all indigenous minority groups as well as those living with disability and survivors of sexual violence; 2. Since SRH is a gender issue, men and boys will be involved as well. we will identify male agents of change who can model positive gender attitudes and behaviors, thereby challenging discriminatory social norms. Men exclusion may create room for domestic violence; 3. Parents and opinion leaders have a great influence on adolescents’ behavior and need be considered as allies in delivering this idea; 4. Most camps are near host communities which will indirectly be exposed to this idea too

Where will your idea be implemented?

  • Democratic Republic of Congo

What is the primary type of emergency setting where your innovation would operate?

  • Armed conflict
  • Prolonged displacement

Tell us more about the emergency setting that you intend to implement in

DRC is facing a humanitarian crisis affecting more than 7.3 million people. The former Katanga alone counts 2.3 million IDPs living in protracted camps with very limited access to basic social services and livelihood. Most harmful social norms resume. Men become jobless; most indigenous illiterate women and girls do casual labor in host communities, what often leads to sexual abuse and related SRH problems for which they have very limited, if not no information.

What is your organization's name?

Sauve la Femme et la Jeune Fille du Katanga, SAFEKA

Tell us more about you.

Created in 2013, SAFEKA exists to end violence against women and girls and promote SRHR in the former Katanga, in DRC. SAFEKA’s activities are geared to preventing and providing holistic support to women and girls at risk and survivors of GBV; improving socio economic conditions of women and girls; promoting peace and nonviolence in conflict-torn communities; educating and training women and girls in women's human rights, entrepreneurship, sexual reproductive health and rights, gender equality and women’s leadership and promoting the education of the vulnerable girls. Member of Protection Cluster, SAFEKA has got both expertise and experience of working in emergencies with specific attention to vulnerable groups.

Organizational Characteristics

  • Women-led organization
  • Youth-led organization
  • Locally/community-led organization

What is the current scale of your proposed innovation?

  • Community - 1+ communities within 1 country

Experience in Implementation Country(ies)

  • Yes, for more than one year.

Expertise in Sector

  • Yes, for more than a year.

Organization Location

SAFEKA is headquartered in Kalemie, Tanganyika province, with a sub-office in Lubumbashi, High-Katanga province, in DRC.

What is your organizational status?

  • Registered non-profit, charity, NGO, or community-based organization.

What is the maturity of your innovation?

  • Early Stage Innovation: exploring my innovation, refining, researching, and gathering inspiration.

Website

We do not have a website yet. Facebook: safeka asbl

How has your idea changed based on feedback?

1. Role playing has been welcomed as not only an information tool but also a psycho-social adventure, especially when it is done in one's mother tongue. To be effective, role plays will be designed in order to comply with the user journey approach so that the community can be brought from experienced problem to feasible contextualized solution. 2. Upon fruitful exchange, we have agreed with the beneficiaries to cancel the radio program as, like 95% of IDPs, the indigenous minorities do not own radios to listen to. 3. Images are very powerful in conveying targeted messages if they are well drawn and framed. otherwise, they may be confusing and misleading. Thus, we will need a designer from the target communities. 4. Fixed CSE panels will not be enough! They will be complemented by 10 Image kits in which each image would be a user journey on a precise issue. Common SRH issues has been listed and each will be considered as a topic to illustrate by user experience map.

Who will implement this idea?

This idea will be implemented by SAFEKA in closer collaboration with the communities through 4 local clubs to be made from the 100 minority trainees. Indirectly, we will be interacting with other actors through the local OCHA-led clustered coordination mechanisms aimed at avoiding duplicity of interventions on the field. The Project Leader, the Field Assistant and the M&E Assistant will be working full-time for this idea whereas the trainer, the translator, the designer and the painter will work part-time, i.e. for the timely activities following the defined schedule. All the staff members are located in former Katanga province, precisely in Kalemie and Lubumbashi cities.

Using a human-centered design approach, you may uncover insights that lead to small or foundational changes to your organization’s existing strategy or processes in order to unlock the potential of your idea. How would your organization go about making such changes?

SAFEKA is a community-based organization open to everyone. New members apply for membership and pay a once-off fee, followed by agreed monthly subscription. All SAFEKA interventions are nourished by needs identified in and proposed by the communities we serve. At SAFEKA, decisions taken by the General Assembly or the Board of Directors reflect the will of the target populations. Compared to the human-centered design, we do discover that our approach goes hand in hand with the inspiration and the implementation phases, overlooking the IDEATION phase. Henceforth, we will have to ensure that during our programming process we take time to test in the communities the effectiveness of proposed strategies for change so that time is set for review, adjustment and refinement.

What challenges do your end-users face? (1) What is the biggest challenge that your end-users face on a day-to-day, individual level? (2) What is the biggest systems-level challenge that affects your end-users?

Common SRH challenges faced daily in life become more complex during emergencies: (1) On individual level, the biggest challenge is made of lack of knowledge, misinformation, myths, stigma, and shame. (2) On the systems-level, the biggest challenge is two-fold: (i) Sexual and Reproductive Health, particularly ASRH, is not a priority, while DRC laws and policies criminalize abortion and restrict service access to sexually active adolescents. (ii) Socio-cultural and religious factors condemn open discussion around SRHR simply because adolescent sexuality is supposed to be disapproved

Tell us about your vision for this project: (1) share one sentence about the impact you would like to see from this project in five years and (2) what is the biggest question you need to answer to get there?

(1) By 2022, 250.000 illiterate IDP women and girls from remote linguistic minorities will have accessed comprehensive sexuality education, information and basic SRHR services through HEAL Program. (2) Which key messages do we have to develop and logically deliver to the communities while empowering the latter for owning the program?

What is it that most attracted you to Amplify instead of a more traditional funding model?

The Amplify's approach is very unique and stimulates people into deep thinking so that to come up with tested realistic innovation. Most traditional donors stick to predefined sectors for decades; but here published challenges cover all areas of life. Most importantly, traditional donors assess proposals against predefined solutions, but here no model solution exists before hand: Only creativity counts.

Do you intend to implement your Amplify idea in refugee camps / temporary settlements?

  • We aim to implement our Amplify idea in support of displaced populations, but not in a refugee camp / temporary settlement.

How long have you and your colleagues been working on this idea together?

  • Less than 6 months

How many of your organizations’s paid, full-time staff are currently based in the location where the beneficiaries of your proposed idea live?

  • Between 5-10 paid, full-time staff

Is your organization registered in the country you intend to implement your idea in?

  • We are registered in all countries where we plan to implement.

My organization's operational budget for 2016 was:

  • Between $100,000 and $500,000 USD

What do you need the most support with for your innovation?

  • Understanding User and/or Community

5 comments

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Team

Hi NDUME ELIYA NDUELIB and Team -

We’re excited to share feedback and questions with you from a set of experts that are supporting this Challenge.

We encourage you to think about this feedback as you continue to improve your idea, whether that’s refining it or adding more context. You are welcome to respond in the comments section and/or to incorporate feedback into the text of your idea. Your idea and all associated comments will all be reviewed during the final review process, but all critical information should be in the body of your contribution somewhere.

*Thoughtfully designed solution that is equitable and inclusive. The solution also builds off of an established program with proven success. The scale up strategy is well thought out.
*One area of strength is this is a tested model that is going to be scaled up and focuses on adolescent girls, an often underserved population.
*We’d like to learn more about how men and boys will be engaged, not at the expense of women and girls.
*Focusing on IDPs demonstrates that they are addressing the needs of women and girls affected by conflict and they have considered the risks in working in these contexts.
*Role playing and learning clubs are not novel interventions by themselves. However, as applied to SRHR challenges, they are likely to very effective, as they have been in other contexts.
*How do you plan to measure any social norm change? It may be important to consider how much a short programme can influence social norm change while recognising the role in collective efforts to change traditional attitudes and behaviours.

In case you missed it, check out this Storytelling Toolkit (ideo.to/OZznV4) for inspiration on crafting strong and compelling stories as well as the recorded Office Hour (ideo.to/Gf1Cs6). Storytelling is an incredibly useful tool to articulate an idea and make it come to life for those reading it. Don’t forget - the last day to make changes to your contribution on the OpenIDEO platform is October 26 at 11:30PM PST.

Have questions? Email us at amplify@ideo.org

We look forward to reading more, and thank you for the important work that you are doing!

Photo of NDUME ELIYA NDUELIB
Team

Thank you so much for your valuable feedback from which I have deducted three main questions for which I provide answers here-under. You will also note that some more information has been added in the body of the challenge.

1) The success of our idea relies on the participation of all community members since SRHR and SGBV are public issues. Although men and boys have been, for decades, portrayed as perpetrators of violence against women and girls, field experience has, however, shown that, apart from being survivors themselves, many men and boys have the capacity to be partners and allies. Taking into consideration feedback from community members, we will identify male agents of change who will be individually strengthened in terms of knowledge and skills so that they can model positive gender attitudes and behaviours, challenging discriminatory social norms. Either, both boys and girls will be part of the clubs so that community education on gender equality, masculinity, etc. is promoted. Be tough, be strong, fight, do not cry, show no emotions, do not back down, don’t access healthcare unless it is serious, have sex, have multiple partners, don’t use condoms, ... are some of key messages most boys and men get from their peers, families, communities, and societies about masculinity, what puts women and girls at greater risks of violence and health problems, especially in emergency settings. The resulting wrong perception is more rigid in indigenous communities and must be addressed from within by men and boys as well as by women and girls.

2) Working in emergencies is risky for the project itself, the beneficiaries, and the staff. In some areas, the security situation may be fragile. Some times, local authorities may refuse to facilitate activities or get involved. Either, IDPs may expect to get some payments as they are living miserably. In order to deal with the identified risks, following measures are anticipated: Respect of DO NO HARM principle; consider security threat levels as provided by UNDSS; non-discrimination; clear and public presentation of the project; signed agreements with authorities and other stakeholders involved in the project to insure their full implication. Though addressing safety and security in an emergency setting would require a specific project, from feedback phase we have learnt that safety audits can be conducted as part of evidence collection to inform the sensitization topics during drama. The goal is not only to raise awareness about possible risks that may be encountered when accessing services but also to advocate for a safer physical environment on the way to and around public latrines and showers, water points, distribution sites, etc.

3) Social norms are shared beliefs that shape mutual expectations about appropriate behaviours. They are about TYPICAL and APPROPRIATE behaviours within reference groups. In order to identify and measure social norm change we will make use of specific questions and metrics compared to the ones used for measuring individual attitudes and behaviour. We will go beyond the KAP survey in order to uncover the beliefs about others. Concrete questions will focus on the reference group whose opinion matters to the target group; whether a given behaviour is perceived as typical or appropriate; whether the majority of people would act in a given way even if others disagree; etc. Furthermore, we will make use of both qualitative and quantitative research methods with, respectively, social approval/disapproval indicators on the one hand, and, on the other, proportion of men or women who agree with.... or believe that....or do this....To that end, a baseline and endline survey will be conducted.

At SAFEKA we are conscious that complete change in social norms needs requires much time. However, a well designed human-centered short intervention can at least show preliminary symptoms of change on which a longer programme can build.

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