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Towards Effective Community Involvement in Sexual and Reproductive Health Educational Programmes for Youth in Egypt

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Towards Effective Community Involvement in Sexual and Reproductive Health Educational Programmes for Youth in Egypt TOWARDS EFFECTIVE COMMUNITY INVOLVEMENT IN SEXUAL AND REPRODUCTIVE HEALTH EDUCATIONAL PROGRAMMES FOR YOUTH IN EGYPT By MERVAT ESHAK MA HEALTH MANAGEMENT, PLANNING AND POLICY August, 2008 Nuffield Centre for International Health and Development Leeds Institute of Health Sciences DECLARATION “This dissertation has been submitted in partial fulfilment of the requirements for award of (add the name of the relevant degree). The examiners cannot, however, be held responsible for the views expressed, nor the factual accuracy of the contents”. Signed ................................................................................................ Programme Director The University of Leeds Declaration of Academic Integrity I declare that in the attached submission I have not presented anyone else’s work as my own. Where I have taken advantage of the work of others, I have given full acknowledgement. I am aware of and I understand the University rules on cheating and plagiarism as published in the Taught Student’s Handbook, and also any more detailed rules specified at School or module level. I also declare that the document submitted electronically to the Nathan Bodington Building is the same document as the hard copies submitted to the Department Signed: Mervat Eshak Date: 22 August 2008 FORMAT TYPE OF STUDY Programme review √ and/or plan Research proposal In-depth study OUTPUT Action plan Draft article Research proposal Recommendations √ Dissemination √ action plan Preliminary pages DEDICATION To dearest Basem my husband who encourages me all the time…. he is always the secret of my success. To my beloved sons Peter and Andrew who supported me and dealt with my absence amazingly Dedications i Preliminary pages ACKNOWLEDGEMENTS First and foremost, to my Lord for granting me strength, grace and many blessings. Indeed, I felt God’s hands supporting me … I am genuinely thankful. Though I wish to sincerely thank all who have contributed in completion of this study; yet I will acknowledge few on behalf of all. My sincere gratitude to my supervisor and mentor Dr. Nancy Gerein for her guidance and genuine support to me. Her thoughtful comments guided me to deliver this piece of work. She inspired me with real, honest understanding especially when I was feeling down. My special thanks to my Programme Director, Dr. Ricky Kalliecharan for his encouragement throughout the course. Thanks to my personal tutor, Philippa Bird for her support. I really appreciate the efforts done by Leeds University, Institute of Health Science’s teaching and administrative staff as well. My true gratefulness to Ford IFP programme, my sponsoring agency which gave me the opportunity to pursue this Master’s degree. Sincere appreciations and praises to my mother and my mother-in-law; I could not do it without their love, kind support and prayers. A profound thank you to my brother Magdy and my sister-in-law Elham as they were there, looking after my children. I am indeed indebted to my friends and my colleges in Egypt who supported me by their prayers, telephones and emails and restored my confidence. They were always there for me. Indeed, I am really grateful to my colleague Sonia for being the true friend I gained this year. We studied, travelled, cried and laughed together. I will always cherish those memories. My special thanks go to all my friends here in UK; they have been shown abundant care since I came and throughout the year. Thanks to my colleagues in the Institute of Health Science MA HMPP, MPH and HM, I learned a lot from their invaluable experiences. Finally, to my family members and my friends in all the world who supported me, encouraged me and shared with me their precious experiences, I thank you deeply from my heart. Indeed, I hope that this piece of work will be an added value to CDS, the place I work in and I learned a lot from. Acknowledgements ii Preliminary pages TABLE OF CONTENT DEDICATION ------------------------------------------------------------------------------------------------- i ACKNOWLEDGEMENTS-----------------------------------------------------------------------------------ii LIST OF DIAGRAMS AND TABLES-------------------------------------------------------------------- viii KEY TO ABBREVIATIONS -------------------------------------------------------------------------------- ix EXECUTIVE SUMMARY----------------------------------------------------------------------------------- 1 CHAPTER 1: INTRODUCTION --------------------------------------------------------------------------- 2 1.1 Why sexual and reproductive health (SRH)?---------------------------------------- 2 1.2 SRH problems overview:------------------------------------------------------------------ 2 1.3 Egypt overview: ----------------------------------------------------------------------------- 2 1.4 Egypt and ASRH problems---------------------------------------------------------------- 3 1.5 Aim:--------------------------------------------------------------------------------------------- 4 1.6 Objectives:------------------------------------------------------------------------------------ 4 1.7 Methodology:-------------------------------------------------------------------------------- 4 1.8 Author’s role --------------------------------------------------------------------------------- 5 1.9 Outputs:--------------------------------------------------------------------------------------- 5 1.10 Stakeholders: -------------------------------------------------------------------------------- 5 1.11 Outline of dissertation: ------------------------------------------------------------------- 5 1.12 Dissertation limitations ------------------------------------------------------------------- 6 1.13 Conclusion ------------------------------------------------------------------------------------ 6 CHAPTER 2: ASRHEPS; ARRAY OF PROGRAMMES AND DIVERSITY OF ACTORS---------- 7 2.1 Why ASRHEPs? ------------------------------------------------------------------------------------ 7 2.2 Types of ASRHEPs in developing countries ------------------------------------------------ 7 2.2.1 Curriculum-based programmes -------------------------------------------------- 8 2.2.2 Community-based programmes ------------------------------------------------- 8 2.2.3 Health facility-based programmes----------------------------------------------- 9 2.2.4 Workplace programmes------------------------------------------------------------- 9 Table of contents iii Preliminary pages 2.2.5 Mass media programmes ---------------------------------------------------------- 9 2.3 Methodology for conducting ASRHEPs ----------------------------------------------------10 2.4 ASRHEPs in Egypt --------------------------------------------------------------------------------10 2.5 Community involvement, definitions and concepts -------------------------11 2.5.1 What is community?-----------------------------------------------------------------11 2.5.2 What are communities?------------------------------------------------------------11 2.5.3 What is community involvement/ participation? ---------------------------11 2.5.4 What is community empowerment? -------------------------------------------12 2.5.5 What is social capital?--------------------------------------------------------------13 2.5.6 What are gatekeepers, stakeholders and positive deviants? --------13 2.5.7 Health and community participation -------------------------------------------14 2.6 Community involvement in ASRHEPs ---------------------------------------------14 2.6.1 Key actors-------------------------------------------------------------------------------14 2.6.2 Meaningful community participation in ASRHEPs------------------------15 2.7 Conclusion: ------------------------------------------------------------------------------------15 CHAPTER 3: PROBLEM ANALYSIS, PROGRAMMES AND INTERVENTIONS TO ADDRESS ----------------------------------------------------------------------------------------------------------------16 3.1 Problem in-brief: -----------------------------------------------------------------------------16 3.2 Problem tree -----------------------------------------------------------------------------------16 3.3 Actors’ involvement; significance, problem analysis and positive experiences:-----------------------------------------------------------------------------------------18 3.3.1 Youth the indispensable actor: -----------------------------------------------------18 3.3.1.1 Youth involvement, challenges and problems ----------------------18 3.3.1.2 Experiences: programmes and interventions -----------------------20 3.3.1.3 Youth roles: --------------------------------------------------------------------------22 3.3.2 Parents --------------------------------------------------------------------------------------23 3.3.2.1 Parents involvement, challenges and problems------------------------23 3.3.2.2 Experiences: programmes, interventions and roles --------------23 Table of contents iv Preliminary pages 3.3.3 Religious leaders ---------------------------------------------------------------------24 3.3.3.1 RLs involvement, Challenges and problems ------------------------24 3.3.3.2 Experiences: programmes, interventions and roles --------------24 3.3.4 Community Leaders -----------------------------------------------------------------25 3.3.4.1 CLs involvement, Challenges and problems ----------------------------25 3.3.4.2 Experiences: programmes, interventions and roles ------------------26 3.4 Conclusion: ------------------------------------------------------------------------------------27
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