The persistent recurrence of drought forces nomadic and semi-nomadic communities to keep moving. Searching for water and pastures is the norm for them.
Some droughts might be so severe that even camels, hardy as they are, may not survive long enough until the onset of the next rains.
Wajir and Mandera counties are some of the most affected whenever drought sets in. These counties have a population of 780,000 and 867,000 respectively, according to the 2019 population census.
The small ruminants that many women and girls are compelled to shepherd are sheep and goats. Men might be away from their temporary shelters for extended periods, tending camels and cattle in environments experiencing searing heat.
These frequent movements sometimes deter the uptake of family planning services. Community Health Volunteers (CHVs) have been out to reverse this trend. They are working under the Nomadic Health Project (NHP) that Save the Children International is implementing, in conjunction with the Centre for Behaviour Change and Communication (CBCC).
CBCC Africa NHP programme manager, Phillip Kinyota, said, as a result of the mostly nomadic lifestyle of, “The inhabitants of the two counties find themselves perennially underserved by conventional health systems because they keep moving away from health services.”
Save the Children NHP programme manager Abdullahi Mohammed said initially, in the highly patriarchal society he belongs to, family planning was seen as a measure of controlling the population.
The attitude is gradually changing. “I am proud to say that family planning is being promoted in community gatherings unlike before, where it was a taboo to do so,” he said.
One of the over 190 CHVs who’ve been trained on the Social and Behaviour Change module is Aden Hussein. He’s also one of the over 170 CHVs who’ve been consistent in conducting household visits. He’s been seeking to become an effective agent of behaviour change.
Hussein’s role is crucial in encouraging his community to embrace ideal health practices. He’s been mobilising women to attend peer-to-peer support group open-air meetings at Machine Ben in Tarbaj subcounty, Wajir. Most of these women fall under the reproductive age bracket of 15-49 years. A few are in their 60s or 70s.
They are not being dissuaded from having many children. This might go against the cultural norms of this pastoralist community that views children as a form of wealth.
We’re encouraging them now to space their children for at least two years, so that children and their mothers can be healthier
SOLAR-POWERED DEVICE
A number of audio materials in the form of radio dramas and radio sermons by religious leaders were developed to be relayed to audiences using a radio-like portable device known as DigiSolar.
It’s recharged using solar power and is pre-loaded with dramas and sermons, which can be listened to wherever the pastoralists are.
CBCC Social and Behaviour Change (SBC) communications officer Abdi Mohammed said, “We’re encouraging them now to space their children for at least two years, so that children and their mothers can be healthier.”
Hussein has been assigned a number of households to regularly interact with. His wife, Maryan Hellow, is mostly present when her husband delivers health talks. She’s taught alongside other women about the various modern family planning methods available.
More than 1,600 SBC materials have been printed and disseminated.
Armed with the CHV’s manual, Hussein unpacks the five keys concept. Besides child spacing, he addresses child health care; taking care of women during pregnancy, delivery and post-natal care; provision of good nutrition and practice of good hygiene and sanitation.
Other than the manual he uses, he’s equipped with a DigiRedio. This solar-powered device is loaded with pre-recorded messages in the Somali language.
The project attracted the interest of local religious leaders from the Islamic faith. Kinyota said, “A number of these religious leaders signed pledge forms to support child spacing using modern methods.” Their commitment was contingent on the non-violation of Islamic values.
After Hussein concludes his talks at the peer-to-peer group session, a Duksi teacher takes over. This is a Muslim religious leader identified within the project sites. He too has been taken through the Social Behaviour Change module. His manual and DigiRedio contain health messages in the Somali language from the Islamic perspective.
CHVs commit a considerable amount of time each week conducting house-to-house visits sensitising men and women about modern child-spacing methods to increase their uptake.
SATISFIED USERS
While at his home, Hussein strives to practice what he teaches. After each session at the peer-to-peer group meeting, He and his wife recap what was discussed.
At the time of visiting him, the couple had a baby who was hardly two months old. Their eldest child had just turned 16 years old.
“She’s just had an implant,” Hussein said, referring to his wife, Hellow, “since she has a new baby. The implant is for five years.”
“I have had 11 children,” Hellow said. “I began practising family planning after our seventh child. I was put on pills.”
Hellow feared she would forget taking her pills. She had to switch to the five-year implant.
While the peer-to-peer discussion conducted by Hussein is going on, there might be another gathering parallel to it elsewhere, one exclusively for men.
Sabdow Baka Bule is one of the CHVs tasked with caring for the men’s baraza. He’s adopted some ingenuity to his approach.
In the midst of the men here is a ram draped in an anti-mating apron. This, according to him, symbolises family planning. As people who value livestock, he knows that if his community’s herds were not controlled, especially during drought, heavy losses due to lack of pastures would arise. The losses would in turn adversely affect them, too, especially if their population was high.
RESOLUTION MAKING
Having understood the messages that have been conveyed, a resolution is presented. The men pledge to support modern child-spacing methods.
A number of couples are satisfied with the family planning methods they’ve been exposed to. Maryan Abdi and her husband Farah Garane weren’t spacing their children.
“We have seven children,” Garane said, “The spacing among the first five was one year. CHVs educated us about the importance of child spacing.”
His wife said, “I opted for the implant. I had it for a while until my last child began walking. I’m now pregnant again.”
Isnino Ibrahim, a mother of four, chose the implant. She said, “I’ve succeeded in spacing my children.”
As pastoralists tend their livestock in Wajir and Mandera counties, they often move further away from static health services. Nonetheless, due to the four-year Nomadic Health Project, which began being implemented in 2017, the nomadic life hasn’t blocked the residents of these counties from accessing services related to family planning.
