The Obulamu Wheel of Good Practices...
A VHT-led negotiated counseling guide

The Obulamu Wheel of Good Practices...

What does happiness mean to you? Is it hitting that desired weight goal? Could it be seeing your loved ones healthy?

Well, at USAID SBCA, we believe that at the heart of every family's journey lies the pursuit of happiness and wellness. With this perspective, our integrated #Essanyu (happiness) Family Health Campaign was born.


About the campaign:

The Integrated Family Health #Essanyu (happiness) Campaign is a national-level campaign addressing factors that affect the uptake of health behaviors for HIV/AIDS, TB, Nutrition, WASH, Malaria, Maternal, Newborn & Child Health (MNCH), Family Planning/Reproductive Health (FP/RH), COVID-19 and the Global Health Security Agenda.?The #Essanyu campaign uses a variety of social and behavior change strategies to promote healthy behaviors at the household level, targeting mainly four stages in a person's life:

  • Stage 1- Adolescents.
  • Stage 2 - Young adults in a relationship.
  • Stage 3 - Pregnant couple.
  • Stage 4 - caretakers of children under 5.

Understanding that sustainable change requires a comprehensive approach, we developed and utilized a number of #sbc approaches and tools, including the Obulamu Wheel of Good Practices, which serves as an important resource for Village Health Team (VHT) led negotiated counseling at the household level.?

Speaking of the Catalyst for Change: The Wheel.

Village Health Team (VHT) member utilizing the Obulamu wheel of good practice to engage in a conversation with an expecting mother. They discuss essential health indicators as he provides guidance on a healthy pregnancy.
Facilitating this transformative process are the remarkable Village Health Teams (VHTs). These passionate individuals continue to serve as educators and mentors, visiting households through engaging discussions, skills demonstrations, and personalized guidance. This has empowered households with the knowledge and skills necessary to adopt and sustain positive health behaviors.

The Obulamu Wheel of Good Practices is a comprehensive resource that has led to many success stories in the communities where we have implemented our campaign: guiding families through essential behaviors crucial during pregnancy, the first two years of a child's life, and everyday practices.?

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The first visit to the newly profiled home involves the VHTs discussing the promoted behaviors with the family members in their homes. The discussions are a negotiation after a thorough explanation of why the behaviors should be adopted and of what benefit it would be to the entire family. The negotiations are done with the help of the counseling guide (another SBC tool) and the Obulamu Wheel of Good Practices chart that is given to each household to help keep track of their progress.

Some of the behaviors promoted in these homes include but are not limited to; early and regular antenatal care visits, male/partner support, WASH, proper nutrition for both the mother and the developing baby, exclusive breastfeeding, and immunization. By empowering these families with this knowledge, we are fostering a proactive approach to preventive health.

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Beyond the specific stages of pregnancy and early childhood, VHTs also address everyday practices that contribute to the overall health and hygiene of families. This includes promoting good handwashing practices, safe food preparation and storage, proper sanitation and waste management, and the prevention of common illnesses through hygiene education. By targeting these everyday behaviors, we create an environment that supports the health and well-being of families on a day-to-day basis.

How the wheel is spun!

Through the negotiated counseling by the VHTs and households, commitments are made: for example, if a family commits to constructing a toilet as an action to address the WASH challenge at hand, the VHT records this commitment in their #Obulamu register. Subsequent visits allow the VHT to refer to the register, reviewing the progress, and discussing any challenges faced by the household. This process ensures that ongoing support and guidance are tailored to address the specific needs of each family.

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Before (left): Herbert and his family were using a hole as their toilet, which was both hazardous and contributed to the spread of disease-causing organisms through flies transferring pathogens between feces and food. After (right): Following an engagement with VHT Acen in Auwa village, Ochelakur SC, Kalaki district, Herbert and his family constructed a pit latrine. This adoption of the Wheel of Good Practice resulted in a safer sanitation facility, reducing health risks associated with open defecation and minimizing the transmission of pathogens by flies.

As families continue to adopt these key health behaviors, they become change agents within their communities. This ripple effect amplifies the impact of Social and Behavior Change programming, leading to healthier communities where positive behaviors are celebrated and nurtured.

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Awilli Stella, a 22-year-old resident of Atheder North village in Gulotworo Parish, Magamaga Sub County, Abim district, carrying her 7-month-old infant.
Thanks to the consistent support and negotiated counseling sessions by the Village Health Team (VHT), Awili successfully breastfed her baby exclusively (only on breast milk) for the first 6 months. Additionally, she introduced her baby to soft foods such as porridge and soup. Stella has two other children, aged 4.5 and 2 years, both of whom have received complete immunization. After engaging in extensive counseling sessions with the VHT, Stella gained a thorough understanding of the potential risks associated with not adopting modern family planning methods. Consequently, she took the proactive step of initiating Depo as a contraceptive in April 2023.

Have you heard about or been directly affected by any of our Obulamu interventions? Please share your experience below.

#obulamu #vhts #behaviorchange #EmpoweringHouseholds #healthyfamilies #transformingcommunities #essanyu #publichealth

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