As one of the planned activities of the MCH programme in 2009, the COMBI (Communication-for-Behavioural-Impact) training was held on 23rd-26th June in Chengdu city, Sichuan province. Besides the trainee from the health sector, 9 persons from family planning side who are related to this program have participated, including 3 from CPDRC, the executing agency of this program, 6 FP service providers of 6 pilot counties where ethnic minority live, namely LeiShan county and Congjiang county of Guizhou province, Luxi city and Longchuan county of Yunnan province, Hualong county of Qinghai province and Gongbujiangda county of Tibetan autonomous region.
The following are some details of the whole training.
Part A: The Content of COMBI Training
Focusing on narrowing the gap between the knowledge of health and people’s healthy behaviour, this training tried to popularize the COMBI mode proposed by WHO, to help the local service providers master the approach and have the ability of drawing operational, specific and behaviour-infect communication strategy, which in turn can influences people adopt and maintain the recommended healthy behaviour.
The ten key procedures of making a plan of COMBI were mentioned in detail during the training. These include: 1)setting a overall objective of behaviour change;2) specific behaviour objective/objectives also should be fixed;3)analyze the marketing situation related to specific behaviour objective; 4) drawing a communication strategy which could have behaviour-change effect and is fatal to achieve the specific behaviour target; 5) working out an operating plan of COMBI; 6-7)settling how to manage and monitor this action pla;8) establish the method and resource of evaluation on combi plan; 9)scheduling working timetable;10) Budgeting.
Participatory method was applied during the entire training process. Trainees have their discussion and presentation all in groups. Through training, the trainees learned about the meaning of combi, which means to promote family and individual adopt good healthy behaviour by implementing carefully designed social mobilization and communication suit to local social-cultural characteristics.
During training, the trainees from FP system choose increasing the percentage of informed choice of contraception as an overall objective based on the index of the SPAIN FUND MCH/FP programme. And we fixed specific behaviour targets, drawing detailed communication strategy and action plan. After the interview, the communication strategy and action plan were revised accordingly. Next, the pilot counties will continue to probe into how to make COMBI plans which fit local situation well and how to promote informed choice of contraception in ethnic minority areas.
Part B: Problems in Training and Suggestions for Further Development
l Wording in material and lecture is too obscure to be understood, especial for the trainee from county level;
Partly because it is the first COMBI training in internal China and the material is translated from some related handbook published by WHO, the wording in material is too obscure to be understood, especially for the people from county level and under-developed area. If the trainer can localize the words of material during lecturing, it would be another approach to solve the problem mentioned above. But actually she didn’t. As a result, most of the trainees felt difficult to understand whether in reading the material or listen to the trainer. So it will be easier for the trainees to accept if the wording used in training is localized and popularized and this is beneficial for them to master the skill and apply.
l Having no significant reference because the content of training lack of examples directly related to FP service
Since the staff from FP side are required to attend this training, they have the expectation to receive some information can benefit them to promote the FP/MCH service-delivery. But it turned out that the training is almost focused on how to draw a combi plan on MCH, including the content and examples the trainer mentioned. We could not find out a single case directly related to FP service, not mention the informed choice of contraception which is a key index in this MCH program. In addition, the trainer lack of understanding of the working-field and the way of FP service, so this training has no significant reference to the trainees as FP service providers and could not inspire their interests. The 9 trainees from FP side had to work on their own to finish every procedure of drawing the combi plan according to the lecture.
l Hadn’t gotten equal opportunity for voicing and presentation
Most of the time, our 9-person-group is on the last one to present our discussion result. Sometimes when time was too limited, we couldn’t get the chance to present and to listen to the very trainer’s comment on our work product. Therefore we had no chance to know whether our work on drawing the plan of COMBI was right or not and to make development.
l The training is not time-efficient and key points stressed.
It is impossible to mention every detail of the 10 procedures of drawing combi plan in a 3 and half days training, so some parts of the material should have the priority to be mentioned, especially the part the trainees are confused and hard to understand, to make the training is time-saving and effective. During the training, the information taught is too much for the trainees to assimilate. Sometimes they didn’t know which part is important and what should pay special attention. It is suggested to use material and lecture-time jointly. Leave the content in material that could be understood by reading alone to the trainees, and the lecturer should mainly focus on the part related to operation and hard to understand by reading alone.
l The work of training-organization need to be improved
According to the procedures of formulating a combi plan, doing a marketing situation analysis is required. In the field-investigation, the organizer only contacted two women in reproductive age for interview. We couldn’t get a whole picture of the true situation and the factors infecting the level of informed choice of contraception. For this reason, the combi plan is not so target-oriented.
In addition, at the beginning of training, it is said that the courseware will distributed to every participant as a CD-ROM, later it changed to send by email, and the problem is that most of the trainees who came from remote area have no email address. The solution given by the organizer is giving a single CD to each group, the group has to work out the way to secure everyone got the courseware. Having no option, we had to look all around to buy the CD and make copies. If the organized can take the real situation, the working conditions of these remote areas into account, we will be appreciated.
l It is not instrumental for this programme to separate people from health sector and FP sector during training.
During training, the participants were divided into 5 groups, four groups are people from health sector, and the last one is from FP sector. The meal also served in this way. In our opinion, this is not good for the interaction between the participants and learning from each other for the programme, all in all ,the target of this program is to promote the MCH、FP service by the efforts jointly by health sector and FP sector.
