In Rustiro, Health Behavioral Change through SFH’s CBOs is Real

Globally, most international and national organisations engaged in the fight against diseases are challenged to sustainably combat them. As the English adage goes; ‘Prevention is better than cure”, those that have vested more emphasis on prevention to change people’s health behaviours have proven more effective on ground. Usaid Rwanda provides financial and technical support to Society for Family Health (SFH) Rwanda to run the Rwanda Social Marketing Program (RSMP) built on a strong foundation of Behavioural Change through Behavioral Change Communication (BCC) for healthier life. It focuses on developing tailored messages and approaches to enhance positive behaviors; promote and sustain individual, community and societal behavior change; and maintains appropriate behaviors. One such approach is the use of Community Based Organisations (CBOs) as an outreach strategy to disseminate SFH’s social marketing programs and activities. John Bosco Kwizera, the Deputy Health Programs Senior Manager at SFH reports that there are currently over 60 CBOs across the five regions the organisation operates nationwide. CBOs are legitimate member-based associations or cooperatives. “Ubuzima Burakomeza” Cooperative, loosely translated as “Life goes on”, is a CBOs of 99 members of whom 76 are women and 23 are men. It operates in four sectors of Rustiro District, namely; Musasa, Gihango, Ruhango and Mulunda. It is hardly a year since the cooperative started working with SFH and the results thus far are amazing. “It all started in July 2013 when fourteen (14) of our members were selected and trained. We were equipped with knowledge about the socially marketed products (of SFH), those are; Prudence, Plaisir, Sur Eau, P&G and a variety of Family Planning products like Confiance”, recounts Uwayezu Charlotte, the President of the Cooperative. In the district, Charlotte reports, “our outreach activities targets group of 5 different categories: Female Sex Workers, MSM (Men having sex with Men), People living with HIV/AIDS, Tracker Drivers and Moto Drivers” ”. Rustiro is among the six districts of SFH Western region, others are; Muhanga, Ruhango, Nyanza, Karongi and Ngororero. Alphonse Hategikimana is the Western Regional CBOs Program Coordinator of the region. He reports that Rustiro alone has 5 active CBOs of; Motorists, Former Sex Workers, People living with HIV and Men having Sex with Men (MSM)—the key focus groups by SFH in HIV prevention term as Key Populations (KPs). In a live demonstration, the President (Charlotte) and other members picked randomly displayed excellent knowhow on condom use, use of Sur Eau and P&G and Family Planning products. Unique to the cooperative, they also innovatively composed their own songs and a play (drama) with key messages on the use various SFH products. It indeed demonstrates how communities at grassroots have owned up health programs. The cooperative urges SFH to support it in its art and entertainment endeavors by buying them dancing costumes. Testimonies Charlotte and husband, Nzeyimana Desire, aged 48 both tested for HIV last year. They live at Mburamazi (cell), Mulunda Sector in Rustiro District. Incidentally, Charlotte tested Positive but husband negative. “It was bizarre. We tested three times to confirm and the results were consistent”. She says they were thoroughly counseled at Rustiro healthy centre to continue as a family but start using a condom. “This advice came at the right time because in our cooperative SFH gives us enough condoms (Prudence and Plaisir) we normally use in social marketing”. The whole village now knows her as infected. “At first it was really hard for me. People were hesitant as I and my team sensitized them on HIV and use of condoms but now it is no more. In fact many more members have joined lately. Ntizibanze Charles, aged 55 is also member of the cooperative. He too is a family man with a wife and three children. “Diarrhea was on the verge of wiping out my family, everybody frequently got a running stomach, and sometimes it became difficult to nurse them, because I was also suffering a similar fate. Diarrhea alternated with scabies at plaguing them. This blight hit any body part, and scratching oneself unconsciously is what usually followed, causing unnecessary embarrassment sometimes,” he says. “We of course knew the cause—it was dirty water we fetch from in the valleys fed by Nyabarongo River. Access to clean, safe water in Rustiro is a challenge. But with these SFH products; Sur Eau and Pur (P&G) I no longer have to worry about such water borne diseases. Where I used to spend over Rwf 30, 000 a month on medication only I now spend literally nothing,” he adds.