From Concern Worldwide: Paving the Way for Behavior Change in Tahoua, Niger

Next up in our series of Posts from Concern Worldwide is a look at some of the education services they provide in Niger. The program concentrates on improving maternal and child health by education on health and basic care for babies. Concern's Health Adviser Jenn Weiss traveled to Niger last summer to participate in the program.

This summer, I traveled from the Concern US office in New York City to Tahoua, Niger, leaving the heat of the city behind and arriving to much hotter weather (130 degrees!) on the dusty and barren edge of the Sahel. In the Tahoua region, which is about 400 kilometers north of Niamey, Niger’s capital, Concern is in the second year of its child survival programs.

Over the last decade, these programs, funded by USAID have been recognized for their impact, improving maternal and child health in Bangladesh, Rwanda, Burundi and Haiti through low-cost, community-based solutions.

Concern Niger’s Lahiya Yara (‘Life of a Child’) program aims to reach approximately 300,000 mothers and children under five years old with proven life-saving interventions to address diarrheal disease, malaria, pneumonia, and malnutrition by strengthening the health system, and by investing in intensive community-level activities to promote sustained behavior change.

Behavior change is one of the key strategies of Concern’s child survival programs. In simple terms, it means helping people make simple, yet life-saving actions part of their daily routines. It’s a sustainable, low-cost methodology to ensure that mothers are equipped with the knowledge and skills to improve their child’s health.

Some of the specific behaviors the Lahiya Yara Project is trying to promote include washing hands before eating, seeking care for a fever within 24 hours, and giving sick children as much or more food and liquid than usual. These may seem like obvious behaviors that we all practice in the U.S, but in Tahoua, a lack of basic necessities such as clean water, soap, and food, and long distances from the health center are barriers that mothers encounter on a daily basis.

The purpose of my trip to Tahoua was to work with the Lahiya Yara team to develop behavior change messages that will teach mothers how to realistically implement healthy behaviors. In order to make sure our messages would be relevant and accepted, we first asked mothers why they weren’t able to implement the healthy behaviors we recommend. Based on their answers, we designed tailor-made messages that take into account the formidable barriers mothers face.

For example, Concern will be encouraging mothers to provide their children with clean drinking water. One of the barriers women cited as a barrier to providing clean water to their children is that they don’t have the money to purchase a water filter. Concern will therefore focus on teaching women that boiling is also an effective way to treat water.

This is an easy, low-cost solution that could save the lives of many children by preventing diarrheal diseases. It may seem simple, almost intuitive to us, but we have been inculcated with these types of messages through health education in schools and the mass media, benefits not available to most Nigeriens.

Another behavior that Concern is promoting is exclusive breastfeeding until the child is six months old. When Concern asked why some mothers do not feed their babies with breast milk only, many replied that they believed it wasn’t possible or healthy for a mother to breastfeed when she is sick.

Sick mothers would instead feed their babies water or other liquids. Concern will therefore focus its messages on teaching women that most illnesses do not affect breastmilk and that it is healthy and safe to breastfeed even when the mother is sick.

Now that we have our behavior change messages finalized, we will begin to spread messages urging mothers to adapt these specific behaviors through a variety of channels: one-on-one counseling with Health Officers and Community Health Workers, radio messages, and even text messages. By reaching women through multiple channels with consistent, tailor-made messages; Concern’s behavior change activities will equip mothers with the knowledge and skills they need to improve the lives of their children.