Addressing healthy settings in Malawi
Under trees, inside churches and halls in hot and dusty Chikwawa district during March, communities gathered together to discuss their thoughts about the daily challenges they face that prevent them from leading healthy lives and accessing local health services. Sitting together with their peers: leaders, elderly and marginalized people, male and female youth and other men and women they openly discussed issues ranging from marriage to education, climate change to lack of drugs, gently prompted by staff from SCHI.
In total 144 focus groups from 18 villages near to Mfera Health Centre catchment area and 6 control villages in nearby Maperera discussed issues close to their hearts. Some were keen to share their thoughts others less so; several young men commented that it made a change to be called for a meeting and be able to air their views, usually the chiefs only call on them to help with physical tasks.
More often than not the anonymous discussions were animated and resulted in a long list of priorities to be addressed from better sex education for male youths to more boreholes so women don’t spend their days having to wait in long queues. After they ran out of issues and the discussion dried up the facilitator handed each group member a wooden scale “the Schutte scale” so that they could rank from 1-11 how important each issue was to them.
Now that all of this information has been written up and analysed the team will spend two weeks with the communities going through the information with each group so that they can work together to draw up a community action plan addressing the most pressing issues in turn.
The Healthy Settings approach is all about community participation. To ensure the project is community owned from the start the SCHI project team has put great emphasis on listening to people’s views about the social and economic factors that determine their health, in addition to the Schutte scale and focus group discussions the team has carried out transect and household surveys and village mapping. All of this rich qualitative and quantitative data will be shared with community members.
“I have noted that SCHI has spent more time in knowing our problems than other organisations. Other organisations come […] but they do not ask comprehensively about our problems. We hope this project will help us in our problems”.
Chief Chinkole, Group Village Headwoman