Community-Based Interventions: Tanzania
The potential value of parenting interventions has been recognized in several countries in sub-Saharan Africa, by NGOs, researchers and some governments. Following results of the MEMA kwa Vijana trial, a needs assessment in rural northern Tanzania found that parents were concerned about their children’s sexual risks but felt inadequate to protect them, due to: lack of sexual health knowledge; believing their own experiences no longer relevant; and not knowing how to engage with their children about sex (Remes et al., 2010).
From 2006-11 we developed a parenting intervention to promote positive sexual norms and behaviors at a community level. Mema kwa Jamii (‘Good Things for Communities’) is designed for parents of 10-14 year olds. It is derived from theories of diffusion of innovation, collective efficacy, the role of gender and power in relationships, and ‘learning-by-teaching’ (reinforcing and internalizing learning through active dissemination). The programme is delivered through a cascade of peer-facilitated training, starting with opinion leaders and continuing to successive waves of peer groups. Each parent is meant to both actively participate in training and subsequently deliver the course to others.
Mema kwa Jamii was piloted in four contrasting villages: road-side, fishing, mining and remote rural. A formative evaluation focused on the strategy of using opinion leaders, factors affecting the reach of the programme, fidelity, gendered participation and the suitability of the content. In the remote rural village pre- and one year post-intervention surveys with dyads of parents and their 10-14 year old children was conducted to investigate effects on intermediate outcomes. Initial analysis suggests few effects can be attributed to the intervention, but this might reflect poor fidelity in its implementation.
Remes P, Renju J, Nyalali K, Benedict J, Medard L, Kimaryo M, Changalucha J, Obasi A, Wight D. Dusty discos and dangerous desires: community perceptions of adolescent sexual and reproductive health risks and vulnerability and the potential role of parents in rural Mwanza, Tanzania. Culture, Health & Sexuality 2010;12:279-92pubmed