Comedy for Health
Comedy for Health (CFH) is a program aimed at healthy behavior change through educational theater entertainment. CFH is not a typical health promotion campaign. Comprised of volunteer actors, CFH tackles a variety of important health concerns and educates communities on how to address them. CFH integrates community health concerns, such as water and sanitation/hygiene, nutrition, and maternal and newborn health,, into shows to provide broad-based health messaging. Through innovative communication approaches, actors use comedy as a tool to address sensitive issues and encourage public discussion to dispel common disbeliefs. In a society where open discussion about sensitive health topics, such as family planning and HIV/AIDS prevention, is culturally unacceptable, comedy is one accepted way of approaching these issues.
Not only does CFH educate, raise awareness, and foster discussion regarding health, CFH uses existing local talent (village health volunteers, and local comedians) to build capacity and increase community participation. The participants help to develop scripts that are culturally appropriate and pertinent to the local environment. This creates a comfortable atmosphere that promotes open dialogue about pressing health concerns in the community.
Below is a brief clip from a performance by the Siem Reap Comedy for Health Team. The performance in its entirety runs about two hours, and demonstrates correct methods of breastfeeding (immediately after delivery, encouraging only breast milk for the first six months of the infant's life, and introducing complementary foods after six months), while making jokes about all of the incorrect ways to breastfeed. The show also touches on a common traditional Cambodian belief in spirits; encouraging parents and families to seek medical services instead of those of spiritual healers when they have symptoms of sickness.
Gender biases and misconceptions can contribute to or exacerbate existing health issues in communities. There is currently an imbalance of health service utilization and health information dissemination among women and men, creating a knowledge gap that is a major setback to progress in community health. In addition, it is often assumed that women should take responsibility for her family's healthcare. In practice, women use birth spacing services, look after children and patients, and attend health education sessions more frequently than their male counterparts. Meanwhile, income generation and family decisions often fall into the male sphere of influence in a family. The gap between gender and health accessibility/utilization is a health behavior change.
To overcome these obstacles, RACHA collaborates with Provincial Department of Women's Affairs to raise awareness of gender issues in communities. A gender perspective is instilled across all health activities from breastfeeding promotion to infectious disease prevention. Gender training is provided to Village Health Support Group (VHSG) through forums for trainees to discuss solutions to specific health problems related to gender in the community. Following the training, the VHSG become key actors who disseminate and generate discussion among villagers on relevant gender issues during routine health promotion. Through RACHA's crosscutting activities about gender, communities are better educated and informed to create equal family partnerships.
Client and Provider Rights
A vital aspect of strengthening Cambodia's health system is improving accountability at all levels of the health system and RACHA believes that local communities can hold their respective authorities accountable to ensure health services are sustainable, available, and of a high quality,. With the support of Ministry of Health, health center staff, local authorities, VHSGs, and other partners, RACHA aims to increase the knowledge and practice of client and provider rights in the community. Training is not limited to those employed in the health system. Community members, who often may feel intimidated or unable to voice their concerns, are educated in their rights as clients to empower them to ask for what they need. With education to both clients and providers, communication and accountability is increased, and healthcare improves.
Behavior Change Communication Material Development
A key component of the Community Health Mobilization department is creating health communication to influence healthy behavior change. Materials are developed in collaboration with technical units, government health agencies, and other health NGOs. RACHA is one of the major contributors to the national behavior change communication efforts.
Health Promotion Contests
Community participation is a key factor in the sustainability of successful programming. Health promotion contests are held to educate and asses the current level of knowledge of community members. In collaboration with health facility staff and VHSGs, RACHA host numerous health contests throughout the year. Participants receive rewards for accurate knowledge and health record keeping. The contests span all types of health knowledge, including water and sanitation/hygiene, antenatal care, birth spacing, infectious diseases, and diarrheal diseases. VHSGs from different villages compete with one another in the contests to test their knowledge on all topics from trainings, motivating them to stay up to date on health information and policies.