Method for transfer of experience

8. PLAN FOR PHASE TWO

8.5 Method for transfer of experience

It is vital that the plans and initiatives are integrated in the planning and budget cycle – at district, ward and village level.

Importance of local culture and traditions

The team observed during our visit to Pangani that issues related to maternal health seem to be strongly related to traditional cultural attitudes and values where local civil society informal organisations and leaders play a key role. In the case of child birth, the team was told that women traditionally went home to their mothers or mothers in law to give birth. Despite the fact that an increasing number of women now prefer to give birth at a health facility, some women prefer to deliver with TBAs or family members because they are shy to undress in front of health workers that are younger than themselves. Some people also believe that a husband is stingy if he does not send his wife to her mother for delivery. Fear of stigma may therefore compel men to send their wife to their mother for delivery rather than to hospital.

The district administration cannot change traditional cultural attitudes to child birth, but it can influence the choice women make by providing safe quality facilities and services at a reasonable price (the need to bring rubber gloves and clothes for delivery at hospital was also mentioned as something that made women choose other, cheaper, alternatives).

Focus on civil society and religious organisations

The importance of traditional cultures in matters related to maternal health implies that phase two must have a strong focus of civil society, informal as well as formal.

This implies that civil society organisations and religious organisations must play a leading role. This is particularly important in Pangani where few members of the district administration staff are from the district. At present, none of the Head of Departments are from Pangani (although a woman from Pangani was recently acting Head of Community Development and is now a senior Community Development Officer). Most of the staff seems to be from Kilimanjaro and Arusha. This is a consequence of the high level of education in those areas, but it is nevertheless a challenge for the cooperation between the district administration and the

communities.

At a practical level, the above will imply that at least 50 percent of the persons involved in phase two exchange visits and seminars should represent elected representatives (councillors, including women special seats), as well as NGOs, CBOs and FBOs.

Focus on women

Maternal health is very much seen as a women's issue. This implies that approximately 50% of the persons involved in phase two exchange visits and seminars should be women. The team believes that women who participate in the project will have a greater chance of reaching women for mobilisation than men.

Methods for transfer of knowledge

Study visits between districts do not in it self necessary lead to transfer of knowledge, or the implementation of new knowledge. Even if information, experiences or ideas are received by the council members or others, they will not automatically be transmitted to the villages or the communities. It will be important to integrate a focus on this through a process of planned steps, based on mutual commitment, clear plans, realistic actions and systematic assessment of how the information and activities are being brought down to the local level.

At village level, the project should be anchored in the village government and its health committee. At the sub-village level, sub-village chairpersons (who are also members of the village government) should arrange separate meetings for men and women, led by a male and female village health worker respectively.

Planning and documentation of learning

When it comes to the use of twinning, exchange visits do of course – in themselves – not guarantee learning or later implementation.

Before any exchange visit, the visiting district will be asked to discuss and describe–

in specific not general terms:

- what they see as problematic regarding the present

- what kind of things they would be interested in seeing and learning - how they are planning to use this knowledge.

After the visit, the visiting district will be asked to describe:

- what they saw and learnt - how this will be implemented

After a number of months the district will be asked:

- whether they were able to implement any of the new ideas - if yes – how?

- if no, why not?

8.6

8.7

Way forward The first steps are the following:

1. PMO-RALG and RNE will clarify the urgent issues o ensure PMO-RALG ownership and capacity o clarify institutional arrangements

o coordination with other Ministries o clarification of budget

2. PMO-RALG- with the possible assistance of the consultant team – elaborate the information package for the selected districts

3. PMO-RALG sends out an invitation letter and the information package to the selected districts

Activities and time timetable

The table below provides an overview over objectives, activities, time frame, and budget needs for the study, completing Phase 1 and Phase 2. Most of the budget items are to be elaborated by PMO-RALG and/or the Royal Norwegian Embassy.

Objective Activity Time Budget

PHASE 1

Discuss draft report phase 1 and discuss plans for phase 2.

General workshop with all 4 district, key NGOs, PMO-RALG, Ministries, Development partners

May 2007 Budget to be elaborated by PMO-RALG

May 2007 Budget to be elaborated by RNE based on Moshi test study Int. consultants 2 x 2 man weeks

National consultants 2 x 2 man weeks

Finalize report phase 1 and plans for phase 2

Distribution of final report 1 and final plan for phase 2 Elaborate material to be

used in phase 2 districts –– as well as in

Budget to be elaborated by RNE

regarding maternal

Budget to be elaborated by RNE