Sharing Histories is a new learning strategy being implemented in Peru to improve the performance of female CHWs based on autobiographical memories using narrative communication.
One of the keys to improving health globally is getting mothers to adopt healthy home practices for improved nutrition and illness prevention in the first 1000 days of life: conception to two years of age. Customarily, mothers are taught health lessons which, even if simplified, are paradigmatic and hard to remember. The challenge is how to more effectively promote learning and behavior change of mothers in low-resource settings where access to health information is poor, educational levels are low, and traditional beliefs are strong.
A method of improving health globally to meet the Sustainable Development Goals is adoption by mothers of healthy home practices for better nutrition and illness prevention. The challenge is acute in settings where access to health information is poor, educational levels are low, and traditional beliefs are strong. Customarily, mothers are taught health lessons which, even if simplified, are paradigmatic and hard to remember. Especially in culturally traditional low-resource settings, a transformative method is needed to achieve sustainable change of health knowledge and behavior that will improve the health of women, newborns and children.
The training and deployment of Community Health Workers (CHW) is globally recognized as a key strategy to close the gap between formal health services and communities. However, much work is still required to scale-up CHW programs.
Sharing Histories is a narrative communication strategy is being developed for training CHWs based on autobiographical memories as the potential “secret sauce” that could stimulate women´s empowerment and behavior change for improved health through government primary health care services linked to communities, with the goal to advance the field of behavior change in global MNCH.
The Sharing Histories method is an integrated approach to CHW training and mothers´ behavior change based on local knowledge and experience. Female CHWs share in a learning group their childbirth and child-rearing experiences and then learn best practices from picture cards, guided by a facilitator from the health center. This new form of learning helps CHWs take ownership of their cultural beliefs, and increases their confidence and self-esteem. CHWs then feel better prepared to teach best practices to other mothers, frequently using with them the same method of sharing histories which serves to develop trust between them and more sustainable behavior change by the mother.
This learning method builds self-confidence and empowerment of CHW in learning sessions that build on:
- Guided sharing of their memories of childbearing and care of their children
- Group analysis of cultural practices
- Reflection and new learning based on best practices
CHWs share histories with the mother, thereby building her trust and empowerment to change. For government primary health care staff who are not educators, Sharing Histories is simple to learn and use so that the method can be easily incorporated into government health systems and added onto ongoing CHW training programs.
Previously published research on memory, narrative communication, and neuroscience helps explain the effect of the Sharing Histories method, with conceptual and empirical findings that new integrative learning and behavior can effectively build on the basis of memories. Sharing Histories is a replicable and low-cost strategy grounded in local culture that could improve CHW performance and efficacy to transfer knowledge and change behavior in mothers for improved maternal, neonatal, and child health and contribute to reaching the Sustainable Development Goals.
Sharing Histories—a transformative learning/teaching method to empower community health workers to support health behavior change of mothers explains the CHW training method in detail and why it works to engage and empower CHWs. It enables them to be more effective in teaching mothers so that they in turn can improve their home and household behaviors for better maternal and child health.
Community Health Workers share their own histories of childbearing and child-raising, as well as identify cultural beliefs and practices from those shared histories.
Teaching mothers in the home.
Strengthening knowledge and practicing what was learned.