Simavi aims to provide an integrated package of interventions best suited to the local context. We do that by strengthening the organisational, thematic and lobby & advocacy capacities of our local partner organisations. Our local partners empower people to improve their health through interventions related to all three components of our Theory of Change: informed decision-making, a supportive and enabling environment, and sustainable quality services. Below we describe how we translate each component of our Theory of Change into action on the ground.
Informed decision-making – ‘I know how to and I want to’
Obviously, to make free and informed decisions, you need information. So, the first thing we do is to strengthen knowledge of individuals so that they can make informed decisions about their health and bodies. For example, we train local residents to serve as peer educators on SRHR and WASH. They serve as role models in the community or school and can be approached for help, information and advice. They are key people in the empowerment process. In addition to providing training, we often use mass media to convey messages on SRHR and WASH and hold large awareness-raising events in schools and communities.
Examples of our awareness-raising and education activities include providing existing community health workers with information on prenatal screening for pregnant women to identify life-threatening pregnancy complications. The community health workers can refer women to health clinics for testing. At schools, Simavi partners provide youth clubs with essential comprehensive sexuality education to pass on to their peers at school. And Simavi partners give information on menstrual hygiene management (MHM) to both mothers and fathers to ensure their daughters have access to sanitary pads and MHM friendly toilets so that they can still go to school when they are having their periods. Education and awareness-raising are key steps in effecting behavioural change, such as visiting a prenatal care provider or using a latrine.
A supportive and enabling environment – ‘I am allowed to’
Second, for people to put their health and hygiene choices into practice, the social environment in which they live must allow them to do so, and ideally should actively encourage them to do so. We create a supportive environment in which the rights and needs of individuals are respected and upheld by relevant stakeholders. We also engage with government health and WASH providers to inform them about national laws and regulations and make them fully aware of their roles and responsibilities.
We support civil society in influencing and strengthening the capacity of local, district and national institutions to deliver SRHR and WASH policies, planning and practices. By establishing local advocacy and social accountability mechanisms we make citizens’ voices heard by those who bear the duty to provide the services. This is a powerful instrument in promoting dialogue and accountability between the people who use these services, civil society organisations, government agencies, and public and private service providers. Because advocacy is crucial for sustainable change but often escapes easy quantification, we dedicate section 2.4 to an in-depth discussion of our SRHR and WASH advocacy efforts in 2016.
Sustainable quality services – ‘I have access to’
Finally, we work with people to gain access to sustainable, high-quality services provided by the responsible bodies. Joining with governments and end users, we facilitate the construction of WASH facilities in schools and health centres, strengthen the capacity of service providers and create sustainable access to sanitation, drinking water and hygiene facilities. We also encourage local health clinics to provide youth-friendly services to ensure adolescents are not denied access to contraceptives or SRH services, or too ashamed to ask for them.
Sustainable and accessible SRHR and WASH services in communities promote better health. For example, improved SRHR services give women and girls better access to information and enable them to adopt safe sexual and reproductive health practices, leading to less maternal mortality and morbidity. Access to and use of safe sanitation and drinking water reduces the incidence of diarrhoea, and handwashing facilities improve hygiene and block the spread of diseases.
In addition to creating access to these services, we ensure they are properly used. We also improve their quality by training health workers and other community members (including youth). This stimulates awareness and spreads information and knowledge on SRHR and WASH, which helps the community demand the quality it deserves.
We identify actions that lead to solutions that match the community’s priorities. We then implement and evaluate these solutions. This strengthens communities’ capacity to organise themselves, to understand their health problems, to know how to reduce health risks, to articulate their needs and demands, and to manage communal SRHR and WASH facilities so that they are maintained for a long time to come.