Human Resources for Health in Maternal, Neonatal and - HRH ...
Human Resources for Health in Maternal, Neonatal and - HRH ...
Human Resources for Health in Maternal, Neonatal and - HRH ...
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<strong>and</strong> benefited from essential care at health units. Despite these successes it is important to<br />
note that many community members who distribute MNRH commodities are also driven by<br />
their own personal agendas <strong>and</strong> <strong>in</strong>terests <strong>in</strong> gett<strong>in</strong>g ahead <strong>in</strong> life. This can be at odds with the<br />
goals of the MNRH programme. <strong>HRH</strong> knowledge of distributors motivations can help to<br />
provide more realistic expectations from such programmes <strong>and</strong> improve relationships<br />
between the two (Kaler 2001).<br />
Partnerships with fathers<br />
A key component of the MNH Program which commenced <strong>in</strong> 1998 <strong>in</strong> Indonesia was the<br />
community partnership developed through the SIAGA campaign. This programme began<br />
with as a mass media campaign that focused on <strong>in</strong>creas<strong>in</strong>g the husb<strong>and</strong>‘s role <strong>in</strong> prepar<strong>in</strong>g <strong>for</strong><br />
delivery. The success of the programme led to an enlarged remit <strong>in</strong>clud<strong>in</strong>g <strong>in</strong>terventions to<br />
reduce post partum haemorrhage. SIAGA (an acronym <strong>for</strong> ready, take transport, be on guard)<br />
became associated with the concept of shared responsibility which is central to the<br />
Indonesian value of Gotong Royong or self help (Palmer 2004). The village midwife was<br />
promoted as a skilled friendly provider who was will<strong>in</strong>g to help. The BIDAN SIAGA<br />
campaign encourages pregnant women <strong>and</strong> their husb<strong>and</strong>s to consult a bidan <strong>for</strong> maternal<br />
health services <strong>and</strong> encourages the bidan to proactively approach the community to offer<br />
support. An evaluation of the programme found that the campaign played an important role <strong>in</strong><br />
mak<strong>in</strong>g Indonesian women, their husb<strong>and</strong>s, <strong>and</strong> their communities more prepared <strong>for</strong><br />
complications dur<strong>in</strong>g pregnancy <strong>and</strong> delivery.<br />
Summary<br />
Experiences from LMICs highlight a number of factors that contribute to the strengthen<strong>in</strong>g of<br />
relationships with communities which facilitates a partnership approach to the delivery of<br />
MNRH care <strong>and</strong> services. This <strong>in</strong>cludes the need <strong>for</strong> a motivated health workers who are<br />
cultural competent <strong>and</strong> will<strong>in</strong>g to engage with exist<strong>in</strong>g community structures. Likewise, <strong>HRH</strong><br />
depend on communities that are well organised with strong leadership that can mobilise local<br />
women <strong>and</strong> traditional power holders. The co-production of health outcomes <strong>in</strong> LMIC,<br />
there<strong>for</strong>e, is a shared responsibility between health workers <strong>and</strong> communities <strong>and</strong> enabled by<br />
HRM systems with mechanisms to support this community engagement. Despite much<br />
documentation that describes the need <strong>for</strong> participatory approaches there is little description<br />
of actual health worker experience apply<strong>in</strong>g these approaches <strong>and</strong> the strategies applied when<br />
faced with various obstacles.<br />
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