*Y.C.* Words of Witness: Digital Stories of Maternal Health
Principle idea:
The global health community knows the major causes of maternal mortality (many of which are preventable) as well as the solutions needed to bring down maternal deaths. Why then is it that one woman dies every minute because of complications during pregnancy and childbirth? Because despite this knowledge, gaps remain. One such gap is inadequate access to information and health services that could otherwise prove critical in saving these lives. When coupled with powerful social norms that underestimate the strength and capability of women, communities become hard-pressed to change their behavior or improve maternal health.
For these reasons, changing behaviors regarding maternal health represents a significant challenge. This innovative project uses digital storytelling as a creative and dynamic tool to engage communities in discussion around these social norms with the hopes of improving access to information and maternal health services. This goal will be accomplished by: 1) producing stories about the issues of maternal mortality and reproductive health, 2) stirring discussion in communities about the causes of maternal death and reproductive health practices, and 3) creating a learning network of best practices among service providers that promote healthy women and mothers.
Digital storytelling is the process of telling personal narratives by using a mix of images, video, recorded audio, art and music. Digital stories offer a non-threatening environment in which an individual can tell his or her personal story and become engaged in every aspect of the story-creation process. Digital storytelling for maternal health captures the tradition of oral history to bring silent voices to the forefront of dialogue; voices that were previously overlooked will be heard, championing individual and collective change.
The Strength of Using the Digital Storytelling Tool:
Digital storytelling is a tool designed to tap into the strength of the community itself. This initiative offers participants to share their stories and to become the creators of their stories, engaging them on a journey of discovery and growth. The use of digital media builds upon the traditions of oral history and personal testimony to create a participatory art piece that can be used to attract non-traditional actors, including men and policymakers, to address maternal mortality. Digital media also serves as a hook for adolescents who are often left out of reproductive health programming. Many adolescents around the world are engaged in some form of technology, a growing field for which basic digital literacy can be an entry point for a young generation, especially in low-income areas.
Using ‘playbacks’ of digital stories in a community setting opens the door for candid discussion about maternal mortality, barriers to care and information, and broader reproductive health issues. Playbacks can be used as a method for evaluating and assessing the maternal health situation in a given community by exploring overall needs and individual understanding of maternal health.
I have adopted the following are principles of digital storytelling, developed by those in the digital media field. The philosophy of digital storytelling can offer a powerful force of change within the maternal health field:
1. Everyone has a compelling story to tell. Using digital storytelling can give voice to those unheard. There is value to each person’s experience, and as a community, we can all learn from this collective sharing of experience.
2. Listening can be hard. Listening to the stories of women can be particularly difficult in areas where they, along with other vulnerable populations including adolescents, are marginalized. However, women are the foundation of these communities, and their voices must be heard.
3. Individuals see, hear and perceive the world in different ways. Digital storytelling can illuminate the perspectives of women, men and adolescents to open the door for understanding and change.
4. Creativity lies within us all. Like Ashoka’s emphasis on creativity and innovation, this project frees us from the notion that we lose the creative spirit. Using digital storytelling in a structured way can help participants confront issues surrounding maternal health and releases them from the idea that they cannot create. Often times, this self-expression can stir change within ourselves and our community.
5. Technology is a powerful tool for creativity and change. While technology can feel overwhelming to someone just learning computer skills, digital storytelling offers a simple platform to introduce digital literacy and opens the door to a bigger world of interconnectivity and sharing. Using a digital media platform, the storytelling tool can encompass the use of other art forms including music, tactile art, acting, photography, and film.
6. Sharing stories can lead to positive change. Supporting groups in a process of learning and creating digital media projects about maternal health will transform the storyteller and has the potential to harness the energy of a captivated audience. By reflecting about their own experience or speaking out about injustices, the storyteller can embrace healing. Sharing these stories with the larger community will create dialogue about the gaps in access to information and services and will initiate change within powerful social norms that prevent women from getting critical and life-saving reproductive health services, including emergency obstetric care (EmOC) and contraception.
How It Will Work:
The beauty of using the digital storytelling tool is that it can compliment any ongoing community-based maternal or reproductive health program. Whether a complimentary or stand-alone project, digital storytelling can address maternal health issues by targeting the following populations to participate:
• Mothers who have had complications in pregnancy or childbirth
• Pregnant women
• Men who are involved in and care about maternal health
• Adolescents or peer educators who are interested in reproductive/maternal health
• Health providers at the community level who are able to talk about their service and how these services will make a difference in women’s lives. Their stories can also be used for facility advocacy by underscoring the importance of referral systems in places where EmOC services are not available.
Stories from patients, community leaders, adolescents and health providers will be used to build a learning network so community members can learn about the services available to them, and health providers can learn more about the needs of women and better provide services for their community.
The project sequence is as follows:
1. Form a community steering committee that includes reproductive health service providers, experts, community leaders, women and youth
2. Assess the needs/conduct baseline survey of current behaviors and beliefs related to maternal health
3. Plan program with steering committee and community leaders
4. Set up refurbished computers and maternal health information in a Digital Storytelling Center, housed within a community center, NGO or health service provider
5. Train initial group on maternal health, reproductive health, digital media, and principles of behavior change communication/community change
6. Create discussion guide to compliment screening of stories; this guide includes key messages for preventing maternal deaths
7. Implement digital media creation and play-backs in this community and create action plans from the facilitated discussion that includes what the community would like to do to change the status quo
8. Follow-up with an assessment of how the program went and evaluate any changes that may need to be made in the training, playbacks and discussion guide
9. Identify digital media and maternal health leadership team who will help facilitate the next training
10. Evaluate possible entry into public policy arena to use digital stories for health system strengthening and women’s health advocacy
11. Use internet platform to share stories globally and open story archive for use by any organization working on maternal health
12. Plan for next training with identified digital media and maternal health leaders.
About You
Section 1: About You
First Name
Erika
Last Name
Larson
Website
Organization
Country
United States, DC
Are you an individual between the ages of 18 and 35 who would like to apply for a nine month Young Champions Program mentored by an Ashoka Fellow?
Yes
Section 2: About Your Organization
Organization Name
Organization Website
Organization Phone
Organization Address
Organization Country
The information you provide here will be used to fill in any parts of your profile that have been left blank, such as interests, organization information, and website. No contact information will be made public. Please uncheck here if you do not want this to happen..
Your idea
Name Your Project
*Y.C.* Words of Witness: Digital Stories of Maternal Health
Country your work focuses on
Describe Your Idea
Principle idea:
The global health community knows the major causes of maternal mortality (many of which are preventable) as well as the solutions needed to bring down maternal deaths. Why then is it that one woman dies every minute because of complications during pregnancy and childbirth? Because despite this knowledge, gaps remain. One such gap is inadequate access to information and health services that could otherwise prove critical in saving these lives. When coupled with powerful social norms that underestimate the strength and capability of women, communities become hard-pressed to change their behavior or improve maternal health.
For these reasons, changing behaviors regarding maternal health represents a significant challenge. This innovative project uses digital storytelling as a creative and dynamic tool to engage communities in discussion around these social norms with the hopes of improving access to information and maternal health services. This goal will be accomplished by: 1) producing stories about the issues of maternal mortality and reproductive health, 2) stirring discussion in communities about the causes of maternal death and reproductive health practices, and 3) creating a learning network of best practices among service providers that promote healthy women and mothers.
Digital storytelling is the process of telling personal narratives by using a mix of images, video, recorded audio, art and music. Digital stories offer a non-threatening environment in which an individual can tell his or her personal story and become engaged in every aspect of the story-creation process. Digital storytelling for maternal health captures the tradition of oral history to bring silent voices to the forefront of dialogue; voices that were previously overlooked will be heard, championing individual and collective change.
The Strength of Using the Digital Storytelling Tool:
Digital storytelling is a tool designed to tap into the strength of the community itself. This initiative offers participants to share their stories and to become the creators of their stories, engaging them on a journey of discovery and growth. The use of digital media builds upon the traditions of oral history and personal testimony to create a participatory art piece that can be used to attract non-traditional actors, including men and policymakers, to address maternal mortality. Digital media also serves as a hook for adolescents who are often left out of reproductive health programming. Many adolescents around the world are engaged in some form of technology, a growing field for which basic digital literacy can be an entry point for a young generation, especially in low-income areas.
Using ‘playbacks’ of digital stories in a community setting opens the door for candid discussion about maternal mortality, barriers to care and information, and broader reproductive health issues. Playbacks can be used as a method for evaluating and assessing the maternal health situation in a given community by exploring overall needs and individual understanding of maternal health.
I have adopted the following are principles of digital storytelling, developed by those in the digital media field. The philosophy of digital storytelling can offer a powerful force of change within the maternal health field:
1. Everyone has a compelling story to tell. Using digital storytelling can give voice to those unheard. There is value to each person’s experience, and as a community, we can all learn from this collective sharing of experience.
2. Listening can be hard. Listening to the stories of women can be particularly difficult in areas where they, along with other vulnerable populations including adolescents, are marginalized. However, women are the foundation of these communities, and their voices must be heard.
3. Individuals see, hear and perceive the world in different ways. Digital storytelling can illuminate the perspectives of women, men and adolescents to open the door for understanding and change.
4. Creativity lies within us all. Like Ashoka’s emphasis on creativity and innovation, this project frees us from the notion that we lose the creative spirit. Using digital storytelling in a structured way can help participants confront issues surrounding maternal health and releases them from the idea that they cannot create. Often times, this self-expression can stir change within ourselves and our community.
5. Technology is a powerful tool for creativity and change. While technology can feel overwhelming to someone just learning computer skills, digital storytelling offers a simple platform to introduce digital literacy and opens the door to a bigger world of interconnectivity and sharing. Using a digital media platform, the storytelling tool can encompass the use of other art forms including music, tactile art, acting, photography, and film.
6. Sharing stories can lead to positive change. Supporting groups in a process of learning and creating digital media projects about maternal health will transform the storyteller and has the potential to harness the energy of a captivated audience. By reflecting about their own experience or speaking out about injustices, the storyteller can embrace healing. Sharing these stories with the larger community will create dialogue about the gaps in access to information and services and will initiate change within powerful social norms that prevent women from getting critical and life-saving reproductive health services, including emergency obstetric care (EmOC) and contraception.
How It Will Work:
The beauty of using the digital storytelling tool is that it can compliment any ongoing community-based maternal or reproductive health program. Whether a complimentary or stand-alone project, digital storytelling can address maternal health issues by targeting the following populations to participate:
• Mothers who have had complications in pregnancy or childbirth
• Pregnant women
• Men who are involved in and care about maternal health
• Adolescents or peer educators who are interested in reproductive/maternal health
• Health providers at the community level who are able to talk about their service and how these services will make a difference in women’s lives. Their stories can also be used for facility advocacy by underscoring the importance of referral systems in places where EmOC services are not available.
Stories from patients, community leaders, adolescents and health providers will be used to build a learning network so community members can learn about the services available to them, and health providers can learn more about the needs of women and better provide services for their community.
The project sequence is as follows:
1. Form a community steering committee that includes reproductive health service providers, experts, community leaders, women and youth
2. Assess the needs/conduct baseline survey of current behaviors and beliefs related to maternal health
3. Plan program with steering committee and community leaders
4. Set up refurbished computers and maternal health information in a Digital Storytelling Center, housed within a community center, NGO or health service provider
5. Train initial group on maternal health, reproductive health, digital media, and principles of behavior change communication/community change
6. Create discussion guide to compliment screening of stories; this guide includes key messages for preventing maternal deaths
7. Implement digital media creation and play-backs in this community and create action plans from the facilitated discussion that includes what the community would like to do to change the status quo
8. Follow-up with an assessment of how the program went and evaluate any changes that may need to be made in the training, playbacks and discussion guide
9. Identify digital media and maternal health leadership team who will help facilitate the next training
10. Evaluate possible entry into public policy arena to use digital stories for health system strengthening and women’s health advocacy
11. Use internet platform to share stories globally and open story archive for use by any organization working on maternal health
12. Plan for next training with identified digital media and maternal health leaders.
Website URL
Innovation
What makes your idea unique?
This project is innovative because it combines participatory digital media and digital literacy with the powerful realities of maternal and reproductive health. This combination is compelling because it draws on the strength of the community itself, creating locally led change from within. Amplifying community voices leads to concrete change both individually and collectively to prevent maternal deaths and to support quality maternal health services.
In addition to bringing digital literacy skills and strengthening community voices, the digital storytelling approach uses a participatory angle to address the three delays: seeking care, identifying and reaching a medical facility and receiving adequate and appropriate treatment. Using digital storytelling as a tool of transformation, both within the storyteller and the audience, this project 1) addresses the behavior and socioeconomic factors associated with deciding to seek care, 2) bridges service providers with the community members through community playbacks of stories from service providers (accessibility), and 3) improves the quality of care by illuminating the needs of communities and engaging service providers to address these needs.
Do you have a patent for this idea?
Impact
This Entry is about (Issues)
What impact have you had?
This project is in the idea phase. However, I hope to impact the decisions of pregnant women in seeking care and accessing transportation and facilities with skilled personnel. This project also aims to explore social norms that prevent women, men, and adolescents from seeking reproductive health services, including family planning.
To work towards this goal, the digital storytelling project will:
• provide information to pregnant women seeking care before, during and after pregnancy
• provide young people with information about quality RH services and where to access them
• provide information to those who wish to delay childbearing
• advocate for debate and dialogue within the community and within the country by using the voices of women, young people and service providers who have been affected by maternal deaths or maternal health complications.
Problem
Eighty percent of all maternal deaths are due to five major causes: hemorrhage, sepsis, unsafe abortion, hypertensive disorders and obstructive labor. While we know how to prevent many of these deaths, U.N. Secretary General Ban Ki Moon characterized maternal mortality as the “most off-track of all the Millennium Development Goals”. How can this be when interventions to reduce maternal mortality are neither complex nor costly?
Nearly 536,000 women die every year from pregnancy-related causes, and gaps remain in current maternal health interventions. Meeting the need for contraception would reduce up to 1/3 of maternal deaths. Yet an estimated 200 million women would like to use contraceptives but lack access. Access to quality contraception and emergency obstetric care is essential to reducing maternal mortality. Digital storytelling connects communities with quality maternal and reproductive health services and facilitates discussions of social norms that may discourage women from accessing services even where available.
Actions
Approximately 150 words left (1200 characters).
Results
Approximately 150 words left (1200 characters).
What will it take for your project to be successful over the next three years? Please address each year separately, if possible.
Year 1: Appointment of community leaders in steering committee; completion of baseline survey and initial rounds of digital storytelling production and playbacks; collaboration with maternal health/reproductive health service providers; and development of digital storytelling archive.
Year 2: Continuation of story production and playbacks; introduction of exceptional leaders from trainings in Year 1 to serve as training teams for other communities; development of digital storytelling creators network; and collaboration with national and local maternal health and reproductive health advocacy organizations to use the stories for policy advocacy.
Year 3: Continued development of digital storytelling network and transfer of leadership to exceptional local digital media creators, trainers and maternal health community leaders.
What would prevent your project from being a success?
Additionally, disinterest in the community would prevent this project from taking off, since the philosophy of this project is rooted in the energies and passions of those on the ground and in these communities. Without the acceptance and leadership from within the community, this project would be difficult to develop. However, because this project firmly stands on a foundation of partnership with key community members who promote maternal health, disinterest will be easier to overcome.
How many people will your project serve annually?
101‐1000
What is the average monthly household income in your target community, in US Dollars?
Please select
Does your project seek to have an impact on public policy?
Yes
Sustainability
What stage is your project in?
Idea phase
Is your organization a
Not registered
Is your initiative connected to an established organization?
If yes, provide organization name.
How long has this organization been operating?
Please select
Does your organization have a Board of Directors or an Advisory Board?
Does your organization have a non-monetary partnerships with NGOs?
Does your organization have a non-monetary partnerships with businesses?
Does your organization have a non-monetary partnerships with government?
Please tell us more about how these partnerships are critical to the success of your innovation.
Approximately 150 words left (1200 characters).
What are the three most important actions needed to grow your initiative or organization?
As a new idea, this project hinges on the training of community leaders and those interested in developing leadership in both maternal health and digital media. Additionally, fundraising will likely be needed as the initiative expands to purchase refurbished, low-cost media tools to use in other communities.
The Story
What was the defining moment that you led to this innovation?
I will never forget the moment, as child, when my mother’s friend walked into our house in Botswana and told us she had tested positive for HIV. This was before HIV treatment was widely available, and she had come to say goodbye. I grew up in a community that fought against HIV and used oral history and storytelling to inspire resilience. That experience has led me to this project.
Since my childhood, my primary interest has been reproductive health in crisis-affected communities. Many of the worst maternal health indicators are in countries ravaged by war. The reproductive health of women living in conflict is often forgotten, yet these women often carry the burden of war.
I have also taken an interest in local leadership. I believe that local responses to these pressing issues are often more holistic in nature, the way women themselves experience them. Because many local groups know community sensitivities, they are well-positioned to provide services and reach out to community members in a relevant and meaningful way.
The RAISE International Conference fostered my belief in the strength of local leadership. At the conference, I supported local partners in the development of their presentations and personal stories. They were eager to tell their stories, and the audience was eager to hear them. I realized that digital storytelling could be a powerful tool in transforming the storyteller and transforming the audience, who are often keen to learn about the local realities.
Development and relief initiatives often overlook the potential for creativity in reaching their goals. Creativity within the community has led to many effective and locally-led art, music and theater groups. Capturing and pairing this creativity with critical maternal health messages can open the door to accessing quality maternal and reproductive health services for women and their communities.
Tell us about the social innovator behind this idea.
My role in this project is to be facilitator. Offering digital media to these communities enhances the innovation they hold within their community. Solutions to maternal health may be different for each context. While this approach can be used in different communities around the world, the discussion around each story is unique and offers unique transformation fitted particularly for the community.
The heart of the matter is in the communities themselves and my role in this project is to bring these stories to the foreground, bringing transformation at the grassroots level.
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Comments
Erika,
I really like your idea to connect communities globally with the use of digital media and storytelling, which can be such a powerful and dynamic learning tool. I am curious to hear more of your thoughts on a few things. First, what communities would you begin working in first, and how would you create demand for joining the community steering community and participating? Second, what communities would you target (E.g. size, urban vs. rural, regional/ country focus, demographics)? Third, how would you overcome global language barriers to sharing stories among communities? Fourth, have you considered engaging fathers in storytelling about their experiences supporting their partners through pregnancy and childbirth? This might be a powerful tool to also engage men as partners and spread positive messages about fathers' involvement in healthy pregnancies.
I really like your idea and would be interested in hearing more about it.
Thanks for your comment, Jessica. All great points.
I'll try to address your questions, but feel free to respond--it's great to have a conversation about these ideas.
1) I really want to underscore the importance and strength of organizations on the ground. When you talk about shifting gender norms or other societal norms, change happens slowly, so the work must continue beyond a short period. Because of funding restraints, it's often these local NGOs that can carry it on after interest or funding has died on the part of INGOs. Creating demand for such programs can be tough, but I think engaging leaders who are already working on these issues would be the first level of demand creation. The first step is reaching out to their networks and then building from there.
2)As far as a target community--I think that's one thing I really like about this framework; it can be adapted for any target community, from a small town in Cameroon to Chicago. There are obviously different barriers and strengths in each community, so the approach should be adapted to the context, but the backbone to tell and share stories and human experience remains the same.
3)Language barriers are definitely a challenge, especially in sharing these stories globally. Translation would likely be needed for the narration, but I would also stress that even a quiver in the voice, images or music alone have the power to stir.
4)Engaging fathers is a great idea, and certainly one that I have considered. As I said in my proposal, technology and media can be powerful hooks for those who might not otherwise participate. I often think that the role of men during pregnancy and childbirth often is underplayed, but these fathers and their stories can be powerful agents of change, especially in places where access to care for women is decided by their male counterparts. There is a lot of work to be built on in this area; organizations like the White Ribbon Campaign and EngenderHealth have done extensive work with men as partners, especially in addressing HIV/AIDS and sexual violence.
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