Participatory Learning and Action Produced by the PPAZ/GRZ Community-Based Distribution Project in Eastern Province, Zambia with funding from DFID
Introduction CBD agents work with groups in three ways, in this order: 1. Participatory Learning and Action (PLA) aims to identify, analyse and find ways of solving sexual and reproductive health problems; 2. Group discussions aim to explore priority problems in more depth, using discussion starters; 3. Talks aim to provide more detailed information and skills on a topic requested by the group in the group discussion. This Booklet covers PLA and how to organise and facilitate groups. Group discussions and talks are covered in the Booklet on Using Stories, Drama and Pictures in Group Activities. What is Participatory Learning and Action? PLA helps us to plan improvements in reproductive health with the involvement of community groups, using methods that help people to share and increase their knowledge of their lives, to plan and to act. These methods help people to talk freely, understand things better and come to good decisions. They include drawing pictures, maps and diagrams and using role-plays to analyse situations and plan action. I think a good thing about growing up is that boys propose to us Yes and walking to school holding hands with a boy feels good 2
CBD agents help groups to discuss these questions: What are the good things about sexual and reproductive health and what are the problems? Which are our most important problems that we want to tackle soon? What are the consequences of these problems? What are the causes of the problems? What are we doing now to solve them? What has gone well and what difficulties do we face? What more can we and the CBD agents do to solve the problems? We treat everyone s views as important: young and old; men and women; married or single; rich and poor; people who have been to school and those who have not. We also learn a lot from clients during counselling, in relaxed conversations and watching what goes on and on home visits. Sometimes people will share their thoughts, feelings and actions more easily in a one to one conversation than in a group. Why is it important to learn with the community? The participation of different groups in the community brings many benefits to the CBD project: CBD agents, health staff and community understand their situation better and plan effective action. Both CBD agents and community members take an active part in the development of the community. Learning and planning together helps people to make good decisions in other parts of their lives. PLA helps men and women, young and older people to talk together more easily about sexual matters. Gladys, you are growing up so fast, let s sit down together and talk about women s things 3
When people discuss the changes that they want, they become motivated to take action. We learn with the community at each stage of the project cycle to: Plan our work to help people to use our services and participate in group activities at times and places convenient to them. Help different groups to discuss their dreams and needs, analyse their situations and decide what actions to take. Learn how well the project is meeting the needs of different groups. What do people like and not like about our services and group activities? Are the topics we discuss relevant? Do we leave some people out of our services? This is monitoring. Learn which things have improved and whether anything has got worse as a result of the programme. This is evaluation. Good CBD agents are always interested in people s lives and how well their work is helping people. They ask questions and listen carefully to the answers with respect. They ask for feedback from the community and go on learning more every day. Organising Groups In the CBD project, we work with single sex peer groups of different ages. These are adult men, adult women, young men, young women, adolescent girls and adolescent boys. This is because people feel more free to talk openly about sexual issues with their own peers. They build trust and agree on confidentiality. Men and older people do not do all the talking. It's easier to talk without the teenage boys laughing at our old ideas! And without the women to see our weaknesses! 4
However, it is important that men and women, younger and older people are able to learn about each others' ideas and needs. Sometimes men and women from the same age group can meet together to share ideas. This may be easier if they are married couples. This helps men and women to communicate together more easily outside the group. It's really helpful to talk these love things over together Yes, the traditional secrecy stopped us understanding each other So that is the end of my story of Matilda and Frank and their problems with dry sex. What do you think they should do? Well, we came to meet this way in our initiation ceremonies But to tell you the truth, I have never liked it much, I only did not know how to talk about it with my wife If the peer group members do not want to speak directly to the opposite sex or age group, the CBD agent can share their ideas indirectly, without saying where they came from. For example, a CBD agent could turn an issue raised by the women's group into a picture or role-play to show to the men's group for discussion. CBD agents need help to organise groups because many things can get in the way of a successful group meeting. For example, lack of interest or information, funerals or saboteurs. Ways to encourage participation in group meetings by all the peer groups Take time to sensitise the chiefs, headmen, Neighbourhood Health Committees and Health Centre Committees of all the communities about the 5
aims of the project. Make it clear that it aims to respond to the different needs of adolescents and older people, it is not just about contraception. But the adolescents and old people do not need these contraceptives We can help people with more than contraception. We can talk with the adolescents about growing up as responsible people, and the older people on how to help their teenagers stay safe Request that the headmen explain to the whole community the aims and activities that take place in the group meetings, in a way that encourages them to attend. Use drama, song and dance to encourage people to attend and ask them to inform their friends and relatives. Arrive on time for meetings and be organised and prepared. Focus on group meetings in the dry season when people have more time. Find times and venues where people feel comfortable. For example, the school for adolescents. How to encourage participation Introduce yourself and explain the purpose of the meeting. Sit among the group at the same level. Try to have about 15 people in a group. Go into pairs or smaller groups for sensitive issues. My husband isn t interested in sex with me anymore... Mine is the opposite - wants to go on all night 6
Help people to co-operate together. Agree on some groundrules. Everyone should speak But not too much Let's agree on how we want to work together Let s speak one at a time and listen to each other Let s respect each other s views and not judge But we should challenge ourselves too Let s not gossip outside the group Let's have some jokes too Agree on topics for discussion with the group. Start with less sensitive topics. Ask for permission to talk about sensitive issues. Agree on why you need to talk about them. Point out the talking about sex does not mean that someone is very free in their sexual behaviour. How can we talk about such things? It's taboo in our culture If we refuse, how can we protect ourselves? Would it help if we discuss why we don't like condoms? I don't like condoms because I like to feel him coming inside me (Whispers) Listen to her talking! What a prostitute! That's nonsense, talking about sex doesn't make you a prostitute! 7
Don t talk too much or set yourself up as the person who knows everything. You have some facts about health from your training but there is a lot you still don t know. The people in the group also have a lot of knowledge. Share your knowledge. Encourage group members to answer each others questions. Only give additional information if you need to. (Whispers) Look at Mr Know All!, a) Blah, blah, blah (Whispers) Just because he went on a course! Use all the communication skills described in the Booklet on Communication skills. Use open, probing and follow-up questions to find out as much as you can about people s ideas. Listen actively with empathy. Say I see, that s interesting, tell me more. We will learn from each other how to improve our lives But you know about contraceptives and diseases we don't know anything Of course we do! Haven't we been spacing our births since the time of our ancestors? Don t take one person s opinion as the opinion of the whole group. Ask "What do other people think?" Try not to interrupt, put your point of view or argue. It is NOT your job to educate, persuade or convince people of your point of view. It is your job to understand how they see things. Don t show disapproval or astonishment at what people say. If you are using a method with writing like flow charts, invite participants to draw pictures if they prefer or use symbols to mark something. Divide people into pairs at first to increase confidence. 8
If people ask you what you think, say that you will discuss it at the end. If people ask questions, throw them back to the group or say that you will answer them at the end (Make sure that you do so). Encourage participants to discuss the topic among themselves. Encourage shy people to speak and control talkative people. Allow silences. Follow the PLA guide and decide how much time to give to each question. Keep people on track if they start talking about something different. Answer any questions. Summarise and agree with people what will happen next and when you will meet them again. Checklist for observers If you do not have an observer, ask the note-taker to observe. If you are alone, be aware of the following questions as you facilitate. How does the facilitator establish a friendly relationship? What skills does the facilitator use to help people to talk? What questions does he or she ask? Who talks most and who talks least? How many people participated actively? (Draw a sociogram) What is the mood of the group? What feelings are shown? (Look at body language) What is the level of agreement in the group? Is there any conflict? How did the situation of the meeting affect its success? Were there any saboteurs and how were they coped with? 9
Guide for note-takers Ask permission to take notes and explain that you are making them to remind yourself of what is said and to share it with your supervisor. This will help you to serve the community better. Invite a member of the group to take notes if anyone is able to read and write. If you are facilitating alone and there is no-one to take notes, just jot down the main ideas as you go along. You can write fuller notes when you go home. Do not spend time writing as this will slow the discussion and stop you paying attention to the group. If someone is taking notes, ask them to record as much as they can of the discussion in their own language. The discussion about the diagram is more important that the diagram itself. Write in direct quotation marks (" ") any particularly interesting, funny or nice way someone has said something. Record any diagrams into your notebook. Label with community, peer group (sex, age, number of people), names of facilitator, note-taker and observer. Record any personal thoughts and observations on the interview. Write up your notes as soon as possible after the PLA while you remember them. If you have a note-taker and observer, meet to write it in your notebook together. 10
PLA questions, steps and methods 11
Mapping A catchment area is a geographical area where people live who are to be reached and served by the CBD agent. A community is a group of people with common interests and networks of personal interaction. They may live in the same place or have the same interests or both. Ways of using maps Maps are essential for planning CBD work and reaching everyone. Use maps to plan your home visits. Mark homes or parts of the community so that you know who to visit frequently, for what purpose. Use the map to evaluate how many homes you reach every month. Different groups and sections in the community may have different problems. Mark these on your map and plan your work accordingly. Mark places in the community where people are more likely to practise risky behaviours. For example, a lorry park or bar. Plan to distribute condoms and educate people in these places. Mark on the map health resources such as clinics, TBAs, Community Health Workers, retired nurses or shops which sell condoms. Add agriculture, social welfare, NGOs and anyone else who could help with your progamme. Mark people who are trusted to help with sexual matters by different groups or individuals. Plan to collaborate with useful people. Mark opportunities for meetings and activities. For example, a women's group which meets at the church or a youth club. Use your map to remind yourself what is important in planning and evaluate your progress. 12
Make your maps with community groups Mapping is an excellent first activity when doing PLA with peer groups because it gets everyone drawing and active. Making maps can raise awareness in the community of different aspects of sexual and reproductive health and get people working together. If you make maps with different groups, you will see what is important to each group, where they meet and who they turn to for help. What to put on your map All homes with their characteristics Clinics, drug stores and traditional healers People with knowledge and skills in reproductive health People who are trusted as helpers in sexual matters Different sections of the community with different problems Meeting places for different groups Areas where risky sexual activity might take place Areas where people might talk about sex Channels of communication 13
Listening, chatting and watching We can learn a lot by listening, chatting and watching what goes on in the community. People are relaxed and talking about what they really think and feel in their own way. Spend time with people on buses, in the market, in bars, in the clinic and listen to their conversation. Join in and introduce topics of interest to you. Record important points in your notebook when you get home. Seasonal calendars A seasonal calendar is a picture showing the main activities, problems, and opportunities throughout the year. It can help to identify: months when different people are most at risk of family/reproductive illhealth; factors which are important in people's lives; months when CBD and community activities can take place. 14
The seasonality calendar is very important for planning your work. Group work is best done from May to September. Daily and weekly routine diagrams A daily routine diagram shows all the activities that a man or a woman does from the time they get up in the morning until they go to bed at night. People then discuss how these activities affect their lives and compare them with other groups. A weekly or monthly activity diagram shows major activities on each day of the week or month. 15
Ask these questions to learn more about how activities might affect sexual and reproductive health: do daily activities put people at risk of unsafe sex? do men and women have time to enjoy their relationships? do any activities cause health problems? does physical exhaustion and stress affect people's relationships? when are men, women and young people free to participate in the Project, go to the clinic or attend meetings? Daily routine diagrams are very important for planning our work. In November, is it best to do group activities between 11 and 16 hours when people are free from their farms In many countries women work longer hours and have less rest and time for themselves than men. This may result in women being too tired to enjoy their relationships or care for their children. 16
What are the joys and problems in our sexual and reproductive lives? Sexuality is interesting to everyone. We are born a boy or a girl; our bodies change as we grow up and we learn how men and women are different. We may have loved someone, married and had children. None of us would have been born without sex. Sex can give us joy and bring us close to each other. Many of us also have questions or problems about sex. It may be hard to find help because we feel shy to talk about sex and it is not allowed in our culture. We may talk about it with trusted friends, relatives or helpers. In this activity, we are going to share our ideas about the good and bad things about sexual life. We can use drawing, role play or stories to help us share freely or we can just talk to each other. Drawing Divide the group into small groups or pairs. Ask people to draw using a stick in sandy places or chalk on hard ground something to do with sex in some way. This can be good or bad, happy or sad, funny or frightening. People can explain their drawings to each other. When people have finished drawing, come together and look at all the pictures. Which ones are good things and which are problems? Look at all the pictures of joys. This is people s vision of good sexual health. The CBD Project aims to help them reach this vision, so record the ideas to use in action planning. Discuss the problems and record these also. 17
Role plays Go into pairs. Ask each pair to prepare one role play of something good about sexual and reproductive health and one role play of a problem. The role plays do not have to show good and bad sides of the same situation, they could be on different topics. The pairs then present their role plays to the whole group and discuss them. Ask people if they have any good or bad things to add. Keep a record of all the ideas for the next session. Come on, let's go shopping, I'll buy you some nice shoes But I'm on my way to school What are our most important problems? We have identified the good things and problems about sexual and reproductive health. Now we will decide which ones we want to solve now because they are most important. We can do this in three ways. Now, Soon, Later Make four lines on the ground with a stick or chalk and mark them NOW, SOON, LATER Recap on the problems identified. Which pictures show main problems? For example, unwanted pregnancy, STD and HIV, sexual abuse. Are some of the effects of problems very serious? For example, STD can cause infertility. Do some of the causes result in several problems? For example, a lack of services for young people may result in unwanted pregnancy, STD and HIV. 18
Discuss the problems and agree on: Problems we want to solve NOW Problems we want to solve SOON Problems we want to solve LATER Ask: What reasons are we using to decide? These may be the serious effects of a problem, how common it is, whether solving one problem will also deal with several others, whether the problem is more easily solvable. If we cannot agree on where to put a picture, we can put its number in two or more lines to show the disagreement. It may help to score the problems using stones. Give everyone five stones and ask them to vote for their three most important problems. Stress that the discussion during prioritising is very important because it raises awareness in the group and helps the CBD agent to learn more about how the group sees things. Scoring Take ten stones each. Divide them among the problems in any way you like, giving the most stones to their first choice, fewer to the second and so on. Explain why you have put them in this way. Continue until everyone has finished. Try not to let other people influence your score. If this is a problem, people could score secretly on a piece of paper. 19
Explain that we shall begin by exploring the priority problem in more depth and finding ways to solve it. But the other problems are also important so we shall talk more about them in group discussions. Why do we behave as we do? Many people in Zambia have heard of some modern methods of contraception and want to postpone pregnancy but do not use a method. Many people can tell you how to protect yourself from HIV infection but few practise safer sex. Most schoolgirls see teenage pregnancy as a major disaster and yet many still fall pregnant. There are five types of forces that influence our behaviour in sexual and reproductive health. These are knowledge, feelings, skills, support and resources and power. Understanding these forces makes it easier for us to solve problems and change our behaviour. If we give individuals information and responsibility for changing their behaviour, without taking into account the other forces, we are unlikely to succeed. What do we know? People need to know about how their bodies work; contraceptive methods; STD and HIV and how they can protect themselves from infection. However, many people need more than information to make healthy choices. What do we feel? People rarely make decisions on the basis of facts alone. Their values and feelings are also very important. Health is only one concern among many when people have sex. We might care more about pleasure, togetherness, approval, power or money than health needs. 20
Feelings that help us to make good decisions in sexual health might be that we are worth protecting; we want healthy children and mothers and good marital relations.; or a feeling of power because we are able to plan pregnancies. What can we do? We need the skills and confidence to practise a new behaviour. For example, talking with a partner about safer sex; using a method successfully; or refusing unwanted sex. However, skills and confidence can only develop if partners and others support the new behaviour. What support do we get? If we want to change our behaviour or environment, we often need support from other people. These may be family, peer groups, community or worker's associations, groups with special interests or health workers or teachers. Materials and media can support our new behaviours if others see and agree with them. A woman may know that condoms can protect her from pregnancy and STD/HIV and know that her husband's behaviour puts her at risk of STD, but still choose the injectible because her husband does not agree with the use of contraception. She cannot put her knowledge into action. You know, we men should stop competing for more children Yes, it only makes us poor and worried 21
The normal behaviour of groups needs to change to maintain changes in behaviour. We need an environment where it is easy, acceptable and routine to practise safer sex. Do we have the resources and power to do it? We need enough power to make informed choices about our sexual behaviour, and low cost services close to our homes to put our choice into action. A man may wish to remain with his wife only but his job takes him far away for many months of the year and he cannot manage without girlfriends along the way. What are the causes of the problems? A better understanding of why we behave as we do and the underlying causes of the problems can help us to solve problems and change our behaviour. Flow charts This picture shows how the different causes of problems link up. Put the problem in the middle and then ask, what are the causes of this problem. Put each cause around the problem and link it with a line or stick. If one cause links to another cause, link that too. When people have put the immediate causes, ask again "But why does this happen?" use your skills and helper questions get to the root causes of the problem. 22
For example, some one puts on the flow chart that a cause of teenage pregnancy is poverty. If you leave it there, you do not get much further in understanding. Ask "But why does poverty lead to teenage pregnancy?" and so on for each answer until people do not have any more answers left. Encourage the group to ask each other "But why?" until they run out of new ideas. Take different colour pens or crayons and underline the causes on the flow charts to classify them as knowledge, feelings, skills, support, and resources and power. Ask: are there any differences between the flow charts of men and women? which are the most important influences on the causes of the problem? how could the CBD agents, the community and other agencies help people to address these causes so that it becomes easier for people to enjoy good sexual and reproductive health? Explain that we shall use these flow charts again when we look at ways of solving the problem and addressing the causes of the problem. Role plays Divide into small groups. Think about the behaviour that leads to your priority problems. Now role-play what happens before that risky interaction up to the time when the interaction happens. You could use words, song, dance or body language. Show clearly who the people are, what the situation is and how the people are interacting together. 23
Watch all the role-plays in the circle one by one and ask these questions: What were the good things about this encounter? What were the bad things about this encounter? Who had power and control? Why did the characters behave as they did? List all the reasons why the characters in the role plays behaved as they did. Alcohol, Tradition and Money Alcohol If alcohol is raised as a problem in PLA, use flow charts to show the good and the bad things about drinking alcohol. The good things tell us about people's reasons for drinking alcohol. The bad things tell us about the consequences of this behaviour. Ask participants: Are there any differences between men and women's charts? What influence does alcohol have on sexual and reproductive health? What can we do in the community and with the CBD Project to reduce the problems caused by alcohol? Traditions Ask the groups to draw flow charts to show the good and bad things about traditions that they identified in the joys and problems of sex or the causes of problems. 24
Ask participants: What effect does this tradition have on sexual and reproductive health? What changes can we make to keep the good things and stop or reduce the bad things? Money If money is raised as a cause of sexual health problems, discuss it in more depth in a group discussion. Ask: What are the good and bad effects of money (either a lack of it or plenty of it) on sexual and reproductive health? How could the good things be maximised and the bad things made less harmful? Draw an income and expenditure tree to show how typical people in this group earn a living and what they spend it on. Now draw a pie chart to show what proportion of the work needed to earn money is done by the peers and others. Now draw a pie chart to show what proportion of the money that is earned is spent by the peers and others. 25
What are the consequences of the problems? We now take the priority problems and explore the consequences of each for the peer group, their loved ones and the community. This helps people to become more aware of how problems affect their lives and how one problem can lead to another. This motivates people to take action and change things. We can use a method called flow charts or role-play to explore consequences. Flow charts A flow chart is a picture that shows clearly how one problem can lead to another. First put the problem in the middle of the diagram. Then ask the group "what are some of the consequences of this problem?" Encourage everyone to contribute to the flow chart using drawing, symbols or writing in their own language - whatever they feel happy with. People can make flow charts on the ground with chalk or draw them in sand and use any available object to remind people what is in each of the circles. In this way, people who cannot read and write can join in as equals. Ask more questions to understand the consequences more deeply and encourage everyone to give their ideas so that the flow chart is as full as possible. For example, if someone puts STD as a consequence of the problem of no condoms, ask "and what are the consequences of having an STD?" When the groups have finished, ask them to draw their flow chart onto flipchart paper to keep as a record and share with others in the community. Record the flowchart in your notebook. 26
Role-play Ask people to divide into small groups and prepare a role-play to show the consequences of a priority problem. Show each role-play to the whole group and ask people to identify as many consequences as they can from the role-play. Encourage everyone to participate in the small groups. Record the consequences in your notebook. What have we been doing to solve our problems? We have found ways to solve problems and improve our lives for a long time before the CBD project. Let s value our skills and experience and build on them. Let s look at what we have been doing to solve our problems, what we have achieved and what challenges remain, what has helped and what has hindered us. Let s look at the resources we have in the village and whether we can use them better. Nshima diagram (Pie chart) The nshima diagram helps us to look at which people and institutions we go to for help with our sexual and reproductive health needs. An nshima diagram shows people, agencies and groups who are important to our sexual and reproductive health. We show the importance of each one by the size of its segment on the nshima diagram. Making nshima diagrams helps us to realise how many sources of help we have for sexual health and builds our confidence in our community. We can use it to plan who to work with and who to refer people to for help. After some time we can use it to see what has changed as a result of the project. Refer to the maps that you drew earlier. They can help you to brainstorm and name all the people, groups and agencies that are important for sexual and reproductive health. 27
Ask these questions: Where do people go for help with sexual and reproductive health problems? Who have we been working with to solve these problems? What new people, organisations or groups might we work with? Who influences our sexual and reproductive health and decision-making? When you have a list of all the people, groups and agencies, discuss how important each group or agency is. Make a big circle on the ground and cut it up into pieces like an orange, with each piece representing one helper. Agree on how important each one is and therefore how big its segment should be. Make your nshima diagram using chalk on blackboard or cement walls or floor, or draw in the sand or earth with a stick. You can then change the picture as you discuss it. Use pictures, symbols or words to label the circles. What has helped us and what difficulties have we faced in solving our problems? When we take action to improve our lives, some things help us and others slow us down or make things difficult. We can then talk about how to use the helpers and avoid or reduce the obstacles. This will help us when we make our CBD action plan. Nshima diagram Use the nshima diagram to talk about what has gone well and the problems with the actions that have been taken so far to solve the problems. Take each helper in the nshima diagram one by one and discuss what has gone well and badly with it. 28
What options do we have to solve our problems? We have identified our most important problems, understood their causes and consequences and looked at what we have done already to solve them. Remind each other of these, looking at any pictures or diagrams. We are now ready to look at the different ways that we might improve things. We need to hear everyone s ideas, whether they are old, new or crazy before we look at which are the most useful ones. Use the flow chart or other information on causes of problems Look at the flow charts again or your lists of causes of problems from roleplays, stories or discussion. Rank the causes by scoring their importance with beans. Look at the top five causes and make a list of the solutions for these causes. Some causes may have the same solution. Look at the causes that were not prioritised. Do the solutions you have identified help with any of these causes? 29
Brainstorm Everyone thinks of ways to solve the problem without speaking. Then go round the circle and ask each person to give one of his or her solutions without repeating what others have said. No one should comment on the solutions at this point until people have run out of ideas. Now discuss each option and put similar ones together. Leave out any that the group agrees are not useful. There will be more than one option for solving a problem, so keep all those that are useful. Give each option a symbol or colour or picture. Now ask each person to choose their five best options and rank them from one to five. Add up the results and list the top five options. Keep these for more discussion later. So we have Let's do a drama to agreed that show the community too much beer and discuss what is a major everyone can do to reason why stop it boys force girls to have unsafe sex? Let's brainstorm on what we can do to address that cause We could ask the beer sellers not to serve boys Or to stop serving them before they get drunk We could keep away from them when they have been drinking - stay safe at home What are the costs and benefits of each option? We are now going to look at the costs and benefits of each option, including helpers and obstacles to carrying out that option. This will help us to decide on the best options. 30
Impact diagrams An impact diagram is a flow chart used for thinking about the possible good and bad results of an option. Take each option in turn and make an impact diagram. For example, one young women's group wanted to abolish lobola and have a small token dowry instead. What good and bad things might result from this change? 31
Which are the best options? Now that we have fully discussed each option, we are ready to agree on the best options. We can do this by voting. Making an action plan It is now time to make your action plan with the community, either with the whole community or with the peer group. In planning, we answer these questions: Why are we doing this activity? (Look at your priority problems, charts of causes and consequences and reason for choosing this option) Who do we want to benefit? When are we doing it? (Use your seasonality calendar and daily routine diagram) Where are we doing it? (Use your map and transect walk) Who are we collaborating with? (Use your nshima diagram) How are we going to do it? 32
What resources do we need? Where will they come from? (Look at your income and expenditure tree) What results are we expecting? See below: Incorporate the action plans of the peer groups into your own action plans. What changes do we want to see? We want to know whether our efforts will result in lasting good changes in our lives and whether there are any bad changes. Discuss with the peer group: What changes we hope to see as a result of the CBD programme in six months time and one year s time? Draw these changes and record them in your notebook. How we could find out whether each of the changes has taken place or not? Who will collect this information? Explain the indicators that are used to evaluate the CBD project and compare them with the group's indicators. 33
Many people have contributed to the development of this Booklet, including CBD agents, and Rural Health Centre and District supervisors in Eastern Province; the PPAZ CBD project team and IEC Department, and consultants from Options Consultancy Services. The PPAZ/GRZ CBD Project in Eastern Province is supported by the UK Department for International Development. Illustrations by Paul Kalapwe Design by Julian Gray Printed by the Chipata Catholic Press