In the context of low resource settings—where visiting a health center to receive counseling may be out of reach for many women in remote areas—reliance on the collective learning of the community through a group learning approach can increase acceptance of and access to family planning. Different models of group learning have been studied for health interventions, offering promising practices related to community learning and a community facilitator’s capacity to guide small groups.
In the Acholi region of Northern Uganda, Georgetown University’s Institute for Reproductive Health (IRH) and Save the Children are implementing a Group Learning approach to family planning, aimed at debunking myths and strengthening community understanding of how family planning methods work, and offering two fertility awareness-based methods (FAM). Building on findings from formative research, which used human-centered design techniques to develop a close understanding of the communities’ needs and learning preferences, WALAN (which stands for Wake ki Lago Nywal, or “Be Proud with Family Planning”) was created under the USAID-funded FACT Project.
What is WALAN?
WALAN is a community-based group learning approach that aims to increase fertility awareness, encourage family planning use and expand access to FAM, primarily among women, men, and couples 15-35 years old who learn about these topics in a group setting from trained, non-health personnel.
To implement WALAN, IRH and Save the Children are collaborating with established youth groups whose in- and out-of-school members are already benefitting from life skills, income generation and vocational skills training. Specifically for WALAN, each youth group selects two facilitators from its ranks—a man and a woman—to participate in trainings to become a WALAN facilitator in their own communities.
Youth Facilitator: What’s their Role?
Youth Facilitators receive training in group facilitation skills as well as content materials that prepare them to deliver their community learning and group counseling sessions. Using the Group Learning model, a WALAN facilitator:
leads the community members as they develop ‘body literacy’ that helps them understand their own fertility, reflect and decide on healthy spacing of their children and discuss accurate information about family planning.
Although the Youth Facilitators are not health personnel, they have received training in health or family planning-related topics, and support is essential. To support these facilitators, IRH and Save the Children rely on the existing presence of District and sub-county Community Development Officers who assist with mentoring, mobilization, and problem-solving. A set of simple job aids was specifically developed to guide community and facilitator learning. The WALAN Toolkit includes a facilitator’s guide, flipchart, activity cards, and a display board of family planning methods.
What the community is saying about WALAN
Interviews with community members who participate in Group Learning activities provided early indications on their level of comfort with the model and their satisfaction with learning to use a fertility awareness-based method.
“Because during the couple counseling sessions we share challenges and experiences so from there the non-method users can learn how the method works and the advantages. In groups we can learn new things since there will be views from different people.” (Male TwoDay user, Anaka Subcounty, Nwoya District)
“Because I have learnt so many things about me as a woman and I have also realized that the method is good since it is not painful, doesn’t need money, no need to go to hospital. You can monitor your secretions by yourself, so I feel that the method is favorable for us who are deep in the villages.” (Female TwoDay Method User, Anaka Sub County, Nwoya District)
During reflection meetings, Youth Facilitators shared their experience leading their communities in Group Learning of family planning, including counseling in FAM.
“I was very comfortable [teaching people to use FAM] because I got knowledge and above all I was talking to adults, mature people who understand about those issues.” (Youth Facilitator, Nwoya District)
“Members in my group said they liked the group sessions because they get encouraged by other members. People can get help from one another, so they preferred learning in a group.” (Youth Facilitator, Gulu District)
Looking forward: Does WALAN work?
A four-month proof-of-concept testing confirmed WALAN’s early feasibility and acceptability. Key results from this testing show that:
The Group Learning model is an acceptable intervention within the community.
Couples understand how to use the FAM method they learned through Group Learning.
Youth Facilitators develop the competency to deliver Group Learning activities but require reinforcement from their supervisors.
These findings informed the adjustments that were incorporated into the model to implement in the next pilot phase. The 12-month pilot launched in 15 villages in April 2016. Stay tuned for pilot results in May 2017, which will be used to assess the intervention effectiveness and potential scalability of WALAN.