Participatory Communication and Reproductive Health

The role of participatory communication -- specifically, participatory video -- in promoting better reproductive health is vividly illustrated by Communication for Change's experiences of the past several years. Working with local organizations, Communication for Change has provided training not only in the use of small format video equipment, but also interviewing skills, planning communication strategies, critical viewing and facilitating community screenings. As community members gain new skills, their confidence grows. Once they show their programs to their peers and other members of their community, they discover the importance of self-representation and often community members take action to influence the life options available to women and men. The examples that follow will illustrate this approach and its potential for improving reproductive health.

Communication for Change, a New York-based not for profit organization, has formed long term partnerships with leading NGOs in several countries, including Action Health in Nigeria, the Self Employed Women's Association (SEWA) in India and Banchte Shekha in Bangladesh. Their work demonstrates that participatory video activities can play an important role in meeting the reproductive health needs of adolescents, improving women's economic status, opposing violence against women, elevating the status of women in society, and enabling women to become decision-makers in their lives as well as leaders in their communities. The global debate, culminating in the International Conference on Population and Development, endorsed these same goals as critical to reducing global population growth and achieving reproductive health. With this redefinition of reproductive health and the lessons learned through this project, the significance of participatory communication as a reproductive health strategy takes on greater definition.

How are the community video activities of Action Health, SEWA and Banchte Shekha helping to achieve reproductive health goals?

"In particular, information and services should be made available to adolescents that can help them understand their sexuality and protect them from unwanted pregnancies, sexually transmitted diseases ... This should be combined with the education of young men to respect women's self-determination and to share responsibility with women in matters of sexuality and reproduction." (Programme of Action of the United Nations International Conference on Population and Development)

• Action Health's video project helps to meet the reproductive health needs of adolescents

At Action Health in Lagos, young people have been producing video programs for their peers since 1992. To our knowledge, Action Health is the only producer of such material in Nigeria. Programs by, for, and about Nigerian teens have a strong impact according Nike Essiet, Director of Action Health. The team produces video programs on many teen reproductive health issues (e.g. STDs, AIDS, teen pregnancy, pubertal changes) and on related issues like communicating with parents and alcohol consumption.

Young people respond positively to the relevance and honesty of Action Health programs because they present the real issues and problems confronting teenagers. Lively discussions follow screenings, and word is spreading among teens about the Action Health programs. Action Health has found that youth are coming to the center for the first time to request playbacks of specific Action Health video tapes.

Participatory video has built leadership and communication skills among the teens directly involved with the program. By mastering a technical skill, showing their work to their peers and facilitating discussions, the video team members -- girls as well as boys -- gain confidence. Young women are becoming better communicators with or without the video camera and they are growing stronger and willing to take on tough issues such as rape and STDs.

Action Health's video unit is headed by two recent high school graduates, a young woman and man. Their leadership and the Action Health tapes model positive attitudes and behaviors between young men and women. This is especially important given the prevailing negative norms found in the Nigerian media and the culture overall.

Action Health's video project has made significant contributions to their teen health program. Their video programs act as a magnet attracting many teens to Action Health's center. Given the high level of civil unrest and frequent school closings, it would have been extremely difficult for Action Health's program to grow and deepen without the excitement, motivation and energy that their participatory video program has generated. Nike Esiet, the director of Action Health, attributes the dramatic increase in attendance during 1992-93 at Action Health's center in large part to their video programs.

"Achieving change requires policy and programme actions that will improve women's access to secure livelihoods and economic resources...." (Ibid.)

• The participatory video work of SEWA and Banchte Shekha helps to improve women's economic status

At SEWA and Banchte Shekha, organizing begins with the economic issues of poor women. The programs of these two NGOs improve the income levels and increase the standard of living of their members. Among other benefits, this allows their members to better care for and further educate their children.

Each organization has a video team whose activities support these aims. Their tapes are used to help mobilize members and train organizers and group leaders. At SEWA Academy and at Banchte Shekha headquarters, the training of staff and group leaders incorporates their video programs. The tapes bring issues and experiences to life in ways that other training materials cannot. The trainees gain exposure to areas and situations that would otherwise be difficult to access. Video is also used in training of trainers to give valuable and non-judgmental feedback. Successful training of organizers leads to greater impact in the field.

Members at the community level both contribute to and benefit from video programs that draw on their experience. SEWA and Banchte Shekha have produced many tapes that enrich training in income-generating skills and new techniques, including chicken rearing, beekeeping, handicrafts, and forming a cooperative. When women see a video about improved chicken rearing techniques that have been successfully used by women like them, they are more receptive to the new ideas and more likely to try them. Our partners in Asia find that video can facilitate the horizontal exchange of experience among villagers. Their members are more open to ideas coming from their peers and they understand and trust things they can see more readily. Because of these benefits, Video SEWA uses the slogan, "Seeing is Believing."

Banchte Shekha's and SEWA's health programs teach new ideas and practices to their members. These programs benefit from participatory video activities in ways similar to the economic programs. Their programs about immunization, the causes of diarrhea and reproductive health assist health training and reach audiences in villages and slums.

Through Banchte Shekha's and SEWA's economic and health programs, the well-being of their members is increasing, thereby enabling poor women and their daughters to make different choices about their own health, education and their family's size.

"Violence against women, particularly domestic violence and rape, is widespread .... Active and open discussion of the need to protect women, youth and children from any abuse, ... must be encouraged and supported..." (Ibid.)

• The video projects of Banchte Shekha and SEWA help combat violence against women

Banchte Shekha's legal aid unit demonstrates the potential of participatory video to expose and combat violence against women. The team has documented cases of domestic violence, shown the tapes to stimulate discussion in villages, and used the videos to gain justice through traditional courts. Now, the threat of being exposed on a Banchte Shekha video program is becoming a deterrent to violence and abuse. No one wants to be embarrassed in front of his neighbors and village leaders. Tolerance of spousal abuse has declined in the areas where Banchte Shekha is working.

Chandrikaben, a SEWA member and participatory video trainee, has decided to use the power of local video to oppose forced marriages in her village. She herself was forced to marry, and the marriage subsequently failed. By Chandrikaben's estimation, her status in her village has dropped and her options have diminished. Her experience is typical. Chandrikaben believes that video will be a potent way to raise this issue in her community. As she works for women's human rights, her leadership capability and status increase.

Access to powerful communication tools, such as video, combined with effective communication skills and outreach strategies has enabled SEWA and Banchte Shekha to more successfully oppose violence against women and their children. Not only are these organizations bringing the problem into the open and creating deterrents, but they are gaining justice for victims as well.

"Experience shows that population and development programmes are most effective when steps have simultaneously been taken to improve the status of women." (Ibid.)

• SEWA's and Banchte Shekha's video activities elevate the status of women in society

Participatory video strengthens women's status in their communities by lending greater power to their voices. This increased power enables women to organize, train and take collective action.

One example of this is women's performance giving testimony in court. SEWA members must often turn to the courts to settle their disputes with contractors or to establish their right to a minimum wage. SEWA members attend the hearings and give evidence. The outcome usually depends on the women's testimony. "The atmosphere is very intimidating for me," explained Renana Jhabvala, Secretary of SEWA. "So you can imagine what it is like for the SEWA members. The lawyers try to cut their evidence into pieces and call them liars. This is very difficult for the women to deal with and they usually change their statements."

Now, when SEWA members prepare to testify, Video SEWA records the rehearsals. The women and their lawyer review and discuss the tape. This process helps build their confidence and prepare them to stand up for themselves in court. Like athletes who visualize their performance before a critical contest, these women, thanks to the video rehearsal, create a positive image of themselves performing under pressure.

The tapes produced by the participatory video teams at Banchte Shekha and SEWA are important. Of equal importance however, is the effect of the participatory production experience on the team members and, by association, on their sister members. Learning the use of a camcorder, gaining the interpersonal skills to approach and interview community members and local leaders, and acquiring the technical skills to plan and produce a program -- these build the self-confidence of individual team members. Moreover, being seen as capable of using video equipment, of presenting video programs to others and being perceived as part of an organization that produces its own programs, these factors affect community perceptions of what women are capable of achieving and contribute to their greater status in the eyes of others.

Efforts to improve women's status in society must include helping women to speak out on all issues that touch them. This work entails advocacy at many levels of society. Video SEWA has effectively supported organizational efforts on local, national and even international levels. Video SEWA's tapes have been used to negotiate with municipal authorities and to represent the concerns of self-employed workers to national leaders in India and to labor leaders around the world. SEWA also uses video to advocate for their member's issues and mobilize public support. For example, SEWA succeeded in revising the Indian census to include a much broader range of economic and social activity. For the first time, the contribution of the self-employed, who constitute 89% of the labor force, was to be enumerated. However, some of the census questions were not easily understood by the census takers and were difficult for grassroots people to grasp. In 1991, Video SEWA produced a fifteen minute program entitled, "My Work, Myself," which reached an audience of approximately half a million women in Gujarat through local video cassette playbacks and was broadcast on state television three days before the census was taken. This program informed the public on the importance of being counted in the census and illustrated, through lively role plays, some of the problematic questions.

"Improving the status of women also enhances their decision-making capacity at all levels in all spheres of life, especially in the area of sexuality and reproduction." (Ibid.)

• The video projects of Banchte Shekha, SEWA and Action Health enable women to become decision-makers in their lives and leaders in their communities

Participatory video enables women to represent their own experiences and express their concerns. Self-representation is empowering for grassroots women who are often invisible or misrepresented in the mainstream media. And self-expression is a strong desire among adolescents who are seeking to define their distinct identities.

To viewers of the tapes, the messages are believable and carry great weight because they vividly portray the viewers' experience. Videos created by peers that present new ideas and options can support and encourage new decisions. For example, if an adolescent identifies with the teens on an Action Health video program, she is more likely to seek counseling about sex and contraception. If a village woman, thanks to an immunization program on a Banchte Shekha video tape, believes that her children are more likely to survive to adulthood she will consider different decisions about the size of her family. If a SEWA member has increased her income, she may decide that she can afford to educate her daughters, as her peers on the video program have.

The links between self-expression, decision-making and leadership skills are mutually reinforcing and vital. Women involved in the participatory communication activities of SEWA, Banchte Shekha and Action Health gain confidence, benefit from exposure and learn to exercise leadership. When they learn to make a meaningful and compelling video program, to master a new and sophisticated tool or to facilitate a group discussion after viewing a relevant video program, they increase their visibility in the community. Exercising communication skills to effect change requires vision and strategy. The participatory video team members have a strong strategic sensibility -- another key element of leadership. Strategic thinkers and communicators are important and valuable assets, not only to their organizations, but to their communities and nations as well. They are the ones who will ask challenging questions and inspire others to make changes to improve their lives.

For the NGO community to fulfill its central role in implementing the goals of ICPD they -- and through them their members -- require powerful communication tools and skills with which to represent themselves and their concerns. Communication for Change's role has been to build these skills among leading NGOs and to demonstrate their potential for creating change.