InsideThis Issue

• Consultative Research

• SOMA-Net gets Support from CCNY

  • Database of who is doing what where?

• Advocating for Health Social Sciences

• SOMA-Net in Francophone Africa

• The 4^th International Health Social Sciences Conference and 10^th Anniversary Celebrations

• The Place of Social and Health Sciences in Institutions of Higher Learning

• Improving Health in Africa: What is the role of Social Science?

• Transdisciplinary or interdisciplinary research? The Debate

• Which other Networks are working in HSS in Africa?

• Transnational and Collaborative Research activities

• Widening Networking

  • SOMA-Net facilitates formation of an Organ Transplant Network

SOMA-Net Circle

Is Edited and published biannually by the Social Science and Medicine Africa Network (SOMA-Net)

P.O. Box 20811, Nairobi-Kenya
Tel (+254-2) 560569
Fax (+254-2) 567577
E-mail: somanet@africaonline.co.ke

Consultative Research: An Innovative Approach to Intervention Research

Participants of the Consultative research workshop in Mombasa, Kenya

SOMA-Net has recently been involved in an extensive training of multi-
disciplinary research teams of scientists and programme managers in
consultative research. Focusing on those working in nutrition and nutrition related programmes and with support from the United States Agency for International Development (USAID), through the Academy for Educational Development (AED) and Sustainable Approaches to Nutrition in Africa (SANA), SOMA-Net aims to strengthen its capacity in responding to the regional needs for technical assistance through this project.

In consultative research, important scientific data and key cultural and personal concerns are examined and changes in behaviour negotiated. The programme beneficiaries thereby play an active role in identification of feasible, acceptable and effective strategies for improvement of health related behaviour. Trials of improved practices (TIPs) technique is used at the stage of testing the feasibility and acceptability of the various recommendations at the household level prior to incorporating them in programmes.

TIPs involves the following steps: -

1. an interview with the beneficiary on knowledge, attitudes, practices and behaviour towards the specified problem,

2. analysis of the information and identification of possible aspects, problems and constraints,

3. preparation of a list of recommendations that address the specific problems and are considered feasible to the beneficiary,

4. a counselling visit when the beneficiary is presented with recommendations and through negotiations, is asked to try out a few of them,

5. a follow up visit to find out whether the recommendations were tried out, the beneficiary's experiences and willingness to continue and

6. discussions on the recommendations with other stakeholders in the community and programme personnel and their subsequent incorporation in programmes.

A three-week workshop was held at Whitesands Hotel, Mombasa, Kenya in

February 1998 to train a multi-disciplinary group of twenty-three participants drawn from eight African countries. It was expected that at the close of the workshop, the participants would be equipped with knowledge and skills to enable them deal with problems of child feeding at the grassroots and to negotiate behaviour change with mothers and other caretakers.

Support from the Danish International Development Agency (DANIDA) and the Ministry of Culture and Social Services in Kenya enabled the participants to have hands on experience in the Community Based Nutrition Project in Majajani Village, Kilifi.

By the close of the workshop, the participants had developed proposals on improving child feeding in their respective countries. Zimbabwean, South African, Malawian and Ethiopian teams developed proposals aimed at improving complimentary feeding of infants and small children. The Kenyan and Tanzanian teams' proposals focused on improving exclusive breastfeeding. The Ghanaian team looked at breastfeeding among working women while the Ugandan team's project was on Improving Feeding Practices among Sick and Convalescing Children aged 6-24 months.

The teams were provided with seed funds to enable them initiate projects in their own countries.

SOMA-Net has worked very closely with various institutions in the countries involved in these projects. During supervisory visits, Dr. Anne Pertet, the SOMA-Net Coordinator and Ms. Debbie Gachuhi, the SANA regional advisor, provided technical assistance and made courtesy calls to the hosting institutions and to UNICEF and USAID offices where the projects were discussed. Much interest in the projects was evident and it is anticipated

that other activities will develop as offshoots of this project.

South Africa

The South African team's project was based in a low-income area in Witbank District, Mpumalanga Province. Since community nutrition is still at its infancy in South Africa, this project was significant. The team trained nineteen grass-root personnel, thus expanding its human resource in community nutrition.

The team has networked with UNICEF and USAID who are keen to render further support particularly to facilitate documentation on the TIPs approach. SOMA-Net worked in collaboration with the Medical Research Council, Pretoria University, Witbank Hospital and Mpumalanga provincial administration in this project.

Malawi

The Malawi team had plans to carry out the research in the low-income area of Kawale in Lilongwe urban area. However at the time of going to press, the team had not started fieldwork. The Population and Nutrition office of USAID at Lilongwe was keen on the project.

Zimbabwe

The Zimbabwean team received both human and material support as a result of several meetings held with various relevant government officials. The project area was in Makoni district, a low-income rural area. The project was housed by the Nutrition Department of the Ministry of Health and was conducted in close collaboration with the Blair Research Institute.

Tanzania

SOMA-Net is working closely with Tanzania

Food Nutrition Centre (TFNC) and Community Health Department, College of Health Sciences, Dar-es-salaam and the National Medical Research Institute on the country team's project. Mbagala Division, Dar-es-salaam was the study area.

Uganda

The Ugandan team has been working in a low-income urban area in Iganga district. After getting acquainted with the Tips approach from the project,

the UNICEF office has considered using it in developing the Integrated Management of Childhood Illness' (IMCI) community component. The Child Health and Development Centre in Kampala hosted the project.

Kenya

The team in Kenya has been working in the urban slums of Kibera in Nairobi, while being hosted by the Centre for Public Health Research, of the Kenya Medical Research Institute (KEMRI). It is anticipated that KEMRI and the Ministry of Health in Kenya will use the experiences gained in this project in their programmes.

Ghana

The impact of constraints confronting breastfeeding mothers working outside the home must have spurred the Ghanaian team in the choice of their research proposal. Hopefully through it new insights will be gained

Dr. Radol and Dr. Ellen Piwoz SANA Project manager

on how to promote breastfeeding among working women. The project is based in Madina in the Ayawasa District of Ghana and is housed by the Department of Geography, University of Ghana.

  Ethiopia

It is unfortunate that this team which had worked extremely hard to produce an excellent proposal appears not to have progressed further. Speculation is that civil unrest may be responsible for the total breakdown of communication that has occurred. The team had planned to carry out the project in Endarta District of Tigray, Ethiopia and was working under the umbrella of Tigray Development Association (TDA).

Susan Mujanganja receives her certificate of participation from Dr. B.N. Muia Ministry of Health Kenya

Ripple effect

Already some ripple effects have been experienced. The training given to country level personnel working at the grassroots level by country teams who attended the training workshop is one such effect.

In addition, the Applied Nutrition Unit in Food Science Department of the University of Nairobi, intends to encourage students to prepare thesis using the consultative research approach. Some NGOs working at the grassroots in nutrition related activities have made enquiries on the approach.

SOMA-Net plans to market the consultative research methodology widely. Its suitability in tackling other health challenges such as condom use in relation to HIV infection or bed-net adoption to prevent malaria and psycho-social development and early childhood education. The Network also plans to use the training guide that was developed for skills

building amongst community based NGOs and other public institutions who wish to improve programmes through influencing behaviour change.

SOMA-Net gets
support from
Carnegie Corporation of
New York

The Third three-year phase in the growth of SOMA-Net has gained momentum thanks to the continued support from the Carnegie Corporation of New York, which has availed funding to the Network since the Network's inception. The current grant goes towards organizational and financial sustainability of the network.

Database of who is doing what, where

Some of the Carnegie Corporation of New York's financial support is being used to build and update SOMA-Net's directory of individuals and institutions in Health Social Sciences (HSS). The directory has enabled identification and extensive utilization of the talent and skills existing in HSS in Africa thus highlighting the wealth of experience existing in the area. More Africans and Africanists are encouraged to update their Biodata and forward them to the secretariat for incorporation in the updated Directory.

Advocating for Health Social Sciences

In pursuit of its mission of promoting and advocating for social sciences approaches in improving health, SOMA-Net has set in motion various strategies. One of these strategies is to

compile an inventory of donor interests in order to guide the Network members on critical research areas that have a good chance of capturing donor support. This task too is benefiting from Carnegie Corporation of New York's support.

SOMA-Net in Francophone Africa

Constraints of distance and language have kept a stumbling block in the way of adequately covering Francophone Africa. With the help of Carnegie Corporation of New York's funding, SOMA-Net has established a Liaison office for the region in Yaounde, Cameroon. Housed by the Network for Medical Anthropologists, NAMA, the functions of the Liaison office are benefiting from moral support and goodwill of Prof. Paul Nkwi. The office will replicate SOMA-Net's activities in Francophone Africa.

The 4^th International Health Social Sciences Conference and 10^th Anniversary Celebrations

It is time yet again for SOMA-Net's biennial conference. Plans are already underway to hold the conference in September 2000. This will coincide with celebrations of the 10^th anniversary of what can be proudly described as a successful indigenous African Network.

The local organizing committee in Botswana, in collaboration with various African institutions has been carrying out the necessary tasks to make the conference a reality. SOMA-Net is relying on its collaboration with Networks and agencies such as, COHRED, NAMA/PAA, Carnegie Corporation of New York, International Development Research Centre (IDRC), Ford

EXCO members and the Local Organising Committee for the 4th International conference during a meeting in Gaborone, Botswana

Foundation, Rockefeller Foundation, Swedish Agency for Research and Corporation (SIDA), World Health Organization (WHO), UNICEF and International Health Policy Programme (IHPP) in organizing the conference, while at the same time encouraging new development partners.

The objective of the conference is to facilitate exchange of experiences on social science interventions that have been used in research, programmes, projects and policies in the past with the aim of expanding on the lessons learned and drawing up best practices for improving health in the next millennium. There is a Call for Abstracts under the banner theme of "African Health at Crossroads: Challenges for the next Millenium (successes, failures, constraints and way forward)". The main health areas intended for focus at the conference are; Special Health Care Concerns, Population Based Health Care Initiatives, Health Sector Reforms, Emerging and Re-emerging Infections and the Recently Adopted New approaches for improving health care.

It is hoped that the donor agencies will take this opportunity to share their experiences especially in health programmes they have supported in the past.

Members wishing to present papers are encouraged to contact SOMA-Net in good time.

The Place of Social and Health Sciences in Institutions of Higher Learning

SOMA-Net is in the process of collecting and analyzing curricula and training materials from medical schools and faculties of social sciences in some selected African universities to determine their health social sciences content. The aim of this exercise is to identify gaps, weaknesses, strengths and opportunities that will enable the Network to advocate for more health social sciences content in the curricula where necessary. This task is also benefiting from Carnegie Corporation of New York's support.

Improving Health in Africa: What is the role of Social Science?

SOMA-Net is in the process of commissioning case studies that demonstrate how social sciences have been used to improve health in

Transdisciplinary or interdisciplinary research? `The Debate'.

Debate has at times raged regarding the definition of transdisciplinary research as opposed to interdisciplinary research. Some SOMA-Net members have come forward and formed a team to review studies described as transdisciplinary in order to clarify the issue.

Which other Networks are working in HSS in Africa?

SOMA-Net is collecting information on other agencies, which share similar views and mission. This information would assist in building SOMA-Net's capacity in inter-agency Network building and collaboration.

Transnational and Collaborative Research activities

SOMA-Net has been successful in its objective of initiating transnational comparative research. The equity project funded by the WHO which aims at developing tools to describe inter-country

inequities in health status using demographic health survey data is one such project. The other main one is the nutrition project described earlier funded by USAID through AED/SANA. Discussions are going on with major donors to seek support for projects in other critical areas of interest such as behavioural aspects of HIV/STI and nutrition.

Widening Networking

SOMA-Net has been represented in several African and international meetings where its vision and mission have been discussed and further thrusts in Networking been made. The President has made several visits abroad during which he has used the chances to discuss the Network's activities. The Coordinator/CEO has also represented SOMA-Net in many African meetings.

SOMA-Net facilitates formation of an Organ Transplant Network

A group of Kidney transplant beneficiaries have joined together in forming an organization named Kidney Transplant Recipients Organization (KITRO), under the auspices of the Network. The new organization's objectives include awareness, support, education and advocacy. They also aim to offer education on other problems associated with kidney disease such as diabetes and hypertension and hope to influence policy regarding all forms of organ and tissue donation and transplantation.

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