Taking a closer look at the status of the health sector in the country, specifically the intervention by both the government and development partners, an impression that all is well and on track—justified by the positive progress registered by the country in the key health indicators.
According to the statistics published in the Demographic Health Survey (DHS) 2010 and Household Living Conditions Survey (EICV) 2011, Infant Mortality Rate stood at 50 per 1,000 births whereas under-five mortality was at 76 per 1000 births. HIV Prevalence Rate in 15-49 years stood at 3 per cent. Incidence of Malaria was at 61 per 1000 according to Health Management Information System. The percentage of the population with access to clean water was 74 per cent in 2010 and 55 per cent used improved and not shared latrines. But to sustain this trend, stakeholders ought to ponder sustainable health solutions that will further boost performance of the sector to achieve the set Millennium Development Goals targets by 2015. Society for Family Health Rwanda (SFH) Executive Manasseh Gihana Wandera gives more insights. Excerpts;-
Healthy Times: Could you give a brief background of SFH, particularly how it relates with Population Service International?
Manasseh: For 19 years now, Rwanda is accustomed to Population Services International (PSI)—a global brand known for the distribution of various health products including; condoms (Prudence and Plasir), water purification products, Sur’Eau and PUR for safe water, Confiance for Family Planning (which includes Injectables, Pills, Implants and Cycle beads), and outreach (health) services under the guidance and in partnership with Ministry of Health such as HIV voluntary testing and counseling, distribution of long-lasting insecticide treated bed nets and pre-packaged malaria treatment and many other quite critical services. Indeed, these efforts have saved many lives but many more still need to be saved, more expeditiously.
Our regular interactions with the communities over the years taught us far reaching experiences and lessons. Last year, SFH, a new affiliate of PSI, was born and launched by the Minister for Health, Dr Agnes Binagwaho. It was premised on the experience that the most effective and sustainable way of delivering health products is by (strongly) incorporating the function of social marketing in the distribution of health products and services of PSI.
But more important to note is that SFH comes with a local touch; a locally registered NGO, pioneered and driven by Rwandans. SFH’s main role is to enhance Behavioral Change through innovative health communication and social marketing. We strongly believe this is a sustainable way of providing health solutions to our communities, especially the poor and the vulnerable.
Healthy Times: How different is SFH’s mandate from what other health-related NGOs are doing?
Manasseh: As much as there are various organisations with interventions in the same areas, SFH stands out in a way that we are the only local organisation involved in social marketing of health products. Even more important, our health products are distributed at subsidised prices and are affordable and accessible by the majority of Rwandan people, especially the poor. We enjoy our cordial partnership with the Government of Rwanda, particularly with the Ministry of Health, in terms of distribution of health products, services and programmes.
We’re putting much emphasis on family planning, nutrition, malaria prevention to supplement government’s efforts in attaining the MDG and EDPRS targets.
We provide affordable health products to save lives and on the other we aggressively do social marketing to ensure that a big part of our community use them (health products) through influencing the change of their health behaviors.
Healthy Times: Why is it important to change people’s health behaviors?
Manasseh: There’s a common saying: Prevention is better than cure. I may also say that prevention is cheaper than treatment and obviously more sustainable. It is important to note that prevention has more to do with behavior. That brings me to the most critical aspect of Behavioural Change Communication—a noble project engineered by SFH and funded by USAID. This way, we believe that if people change their health behaviour, the renowned epidemics like HIV/Aids, malaria, (the six killer but immunisable diseases), diarrhea, etc, would be easily be combated. That is why at SFH, we focus much on disease prevention using tools and means that influence the health behaviour of our people, especially the poor with limited information and knowledge about available choices.
Healthy Times: I see you limit your interventions to only five areas, but health sector is much broader. What informs your approach?
Manasseh: With our strong research unit at SFH, we were currently reliably and evidently informed of the strategic interventions to five critical health areas, namely; malaria prevention, HIV/Aids, provision of safe water by application of the available purification products, family planning products and services, and nutrition. We would love to expand the spectrum or even cover everything in health but we’re guided and limited by the resources at hand.
Our expertise lies in area of health communications and distribution of products and provision of services through a well-studied network of community-based organisations and our well equipped and located regional SFH offices spread across the country in the five provinces.
Healthy Times: Health is a sensitive domain, how does SFH ensure efficiency and effectiveness in its cardinal role of health products social marketing and behavioral communication?
Manasseh: We are so keen and sensitive to how we relay the health messages to the communities. As though the bottom line is influencing societal behavioral change—in general terms, the packaging and communication of messages differ, depending on the targeted audience. Some of the tools commonly used by SFH include, but not limited to; mass communication through mobile van unit, road shows, radio and TV talkshows, drama and entertainment. We also use inter-personal contacts whereby through the training of trainers programme, the fommunity-based workers impart health skills, knowledge and practices to local people at the grassroots.
We have five regional offices and we are deligently and establishing and empowering community-based organisations; targeting at least one in each district of Rwanda. We are building health champions, whom we train , work closely with health workers at the lowest levels of the community—cell level to ensure effective targeted delivery.