Through EDEAN, Communities “Come Together to Strengthen Child Spacing”

Have you ever seen a performance or movie that you couldn’t stop talking about–one that you discussed for days with friends and family, or one that made you think about something in a new way?

In the Karamoja region of Uganda, rapid cultural transitions are happening, and these shifts offer an opportunity introduce new health information, like fertility awareness, in an engaging way.

The FACT Project’s Emorikinos Daadang Etogogogitoth Alatanakithi Ngidwe (EDEAN) intervention – which means “Let’s Come Together and Strengthen Child Spacing” – uses community-wide theater performances to spread fertility awareness, or actionable information about fertility throughout the life cycle that people can apply to their own circumstances and needs. Ultimately, EDEAN’s goal is to reduce unintended pregnancies and improve reproductive health outcomes.

In partnership with Save the Children, the Georgetown University Institute for Reproductive Health is testing the effectiveness of a community theater approach to diffuse fertility awareness throughout the community, providing information that individuals can share with their social networks and apply to their own lives. Save the Children’s Early Childhood Care and Development Centers serve as the entry point for working with local communities to introduce EDEAN. Communities nominate young men and women to participate in EDEAN Peer Groups. Peer Moderators work in pairs to lead Peer Group Meetings and direct the Peer Group in enacting community theatre performances. Community theatre performances depict people learning and discussing new reproductive health information, and couples using this information to make decisions for their families. The performances foster community reflection on social and gender norms around fertility and address common misconceptions about menstruation, fertility, and family planning.

What’s involved: EDEAN’s components

EDEAN is made up of five components to share fertility awareness in a culturally meaningful way:
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Peer Group Meetings
Peer Group Members learn core fertility awareness content in four topic areas – couple communication, menstruation, fertility, and family planning – during a series of meetings. Based on information that made clear the importance of sensitivities around these topics, EDEAN peer group meetings include one single-sex and one mixed-sex meeting on each topic.
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Community Theatre Performances
Peer Group Members enact Community Theatre Performances to share the information throughout their communities. Some performances follow a standardized storyline that emphasizes core fertility awareness information, while others are developed by group members. During each performance, the Peer Moderator engages the audience in question and answer sessions to help ensure that the core content is properly understood and encourages dialogue on these topics.
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Linkages to Health System
Village Health Team members and Health Center Family Planning Providers are invited to attend EDEAN activities to give information on family planning methods. A family planning invitation card is distributed at community theatre events to encourage interested attendees to visit providers to learn more about family planning methods. These cards are collected by Village Health Teams or Family Planning Providers if those individuals seek services.
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Engaging Community Leaders
Individuals who may influence the behavior of young people—such as community leaders, religious leaders, and elders—attend orientation meetings held by Save the Children to learn about EDEAN and are encouraged to support intervention activities. In regular reflection meetings, they identify actions they will take to support EDEAN.
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Training and Support
Community Development Officers, who work closely with communities in their districts on a range of community development projects, train Peer Moderators to facilitate Peer Group Meetings and direct Community Theatre Performances, and provide ongoing support and coaching to the Peer Moderators through regular calls and visits.

What people are saying about EDEAN

Community members have been very receptive to EDEAN. Audience members of community theatre performances report that they appreciate seeing such things as couples discuss how many children to have and how the menstrual cycle works, as such discussions are not common in their communities. After being encouraged by friends to attend performances, they say that they plan to share what they have learned with their friends, partners, and families.

“I came because the last time when my friend came to watch the performance she told me I missed a lot and so I said I should come and find out for myself… I like that part where the friends of the woman gave her very good advice and am sure that advice can help her build her family well. I was very impressed on the ability of friends sharing their experiences with each other. It was beautiful. I liked it.” – 26 year-old woman

“The last time I was here I learned a lot of things. It was my first to know about couples talking to each other about their family, so I came again so maybe I could learn how to speak to my husband… Today I learned that we women can make our families better if we learn to share information with our husbands. It also builds trust and respect among the two. [I learned] that one can find all the answers about family planning from the hospital and couples should discuss and agree on the number of children they would want to have. ” – 30 year-old woman

“I heard about the performance from people within the manyatta [homestead] I am from and I too wanted to come and witness what was going to happen. I had also been to a previous performance and it had good information for people of my age especially on how to talk to our wives.” – 25 year-old man

What’s Next

EDEAN is wrapping up a proof of concept phase, and endline research will be conducted to assess the effectiveness and potential scalability of the intervention. A mix of qualitative and quantitative methods will be used to understand participants’ experience with EDEAN, perceptions of EDEAN in the community, and whether the EDEAN was successful at increasing fertility awareness levels throughout the community.

Are you interested in including fertility awareness in your own work? EDEAN lesson plans and dramas can easily be incorporated into the ongoing group activities, such as youth, mothers’ or livelihoods groups. The EDEAN package will be revised based on project results and made available online in 2017.

Stay tuned for EDEAN’s results, fertility awareness resources, and a video of a fertility awareness drama!