**6.2 Model for promoting of sexual and reproductive rights in rural women**

Women living in rural areas socialize their lives in an environment where there is no stimulus. This kind of socialization has perpetuated a condition of procrastination, subordination, inequality, and exclusion that make the practice of the exercise of sexual and reproductive rights unfeasible, as set out in the Cairo Plan of Action and the Beijing World Women's Conference. On the other hand, the institutional social resources responsible for the promotion of these rights, for various reasons, have not been effective in managing to position women as subjects of right in the definition of their sexual and reproductive life. The proposed Active Communication Strategy Model for Rural Women (MECAR) is a complementary instruction/information alternative that seeks to promote the empowerment of rural women around the exercise of sexual and reproductive rights.

The challenge of opening a space for the effective exercise of sexual and reproductive rights and, as a consequence, to modify relations of inequality in the work of reproduction and sexuality opens up a possibility, for health and social sciences professionals and students, to contribute to the recognition of the links between women's health status and the socially structured environments in which women live.

MECAR model objectives:


Expected result of MECAR: To obtain an approach to the degree of change and contribution that MECAR produces to the process of strengthening women's self-management and self-determination to begin the path that will allow them to assume their condition as subjects of rights responsible for their life project.

Methodology: the intervention, MECAR, uses the sequenced combination of a communication strategy and interactive sessions as complementary alternatives to education on sexual and reproductive rights. The idea is to apply the model generated from the customs and traditions of the rural women's population, respecting the idiosyncrasies of their socio-cultural context, also incorporating official and traditional health resources.

MECAR has two essential components: instruction/information actions aimed at promoting reproductive rights and sexual rights for rural women, and instruction/information actions for the health team and formal and informal health leaders. A transdisciplinary team will implement instruction/information activities through a communication strategy and group workshops and analysis meetings with women, health care providers and other local leaders (active strategy).

The model operates through the following thematic axes: Gender Concept and Relations; Communication and Identity; Safe Shared Sexuality and Motherhood; Constitutional, Legal and Human Rights; Reproductive Rights and Reproductive Health; Family Planning; Prevalent and Emerging Diseases of Women; Sexually Transmitted Diseases; Adolescence and Sexuality; Women's Program Health Services; Prevention and Consequences of Physical Abuse; Family and Parenting, Role of Mother and Father, Community Participation and Leadership, and Creation; Legal protection against actions of violation of rights.

The contents will be developed in 16 radio modules and reinforced with group workshops, using active, participatory, experiential, and reflective methodology, which has as its central axis the commitment of the person, their experiences and learning of life. This methodology provides the only opportunity for participants to discover their own knowledge and the ability to learn new and diverse content related to the situation they face. The activities will be implemented with teaching-learning modules that allow women to replicate them in their family and community context. Each module will have predefined objectives, themes and methodology in which practical and theoretical activities will be combined. An important component of each module is the evaluation process because it allows for feedback to the program. The symbology and codes used in the module design are adapted to the population receiving the intervention.

In parallel, training activities are carried out for professionals and students in gender relations, reproductive health and sexuality; human rights, sexual and reproductive rights; quality of provider-user interaction for health service providers, doctors, midwives, dentists, nurses, paramedical assistants, administrative and service personnel, with monitoring and evaluation of baseline behaviors before and after the application of the training, in order to contrast the responses they are able to give to behavior change in the population of participating women.

In the field, a simultaneous examination of family and community factors and resources that may facilitate or interfere with women's health-related behaviors is conducted. This will prepare the health team and students for the potential increase in demand for health services. In harmony with this model, the people who carry out the activities will establish a dialogical communication with the women to create a link in the community.

#### **6.3 High complexity case study: problem-based learning construction**

It offers a space for reflection and practice of a contextualized, integrated, and flexible learning model based on problematic situations where the student defines strategies for the autonomous and collective construction of knowledge.

In this proposal, the sequential combination of three axes is used:


For the first axis: An educational strategy is proposed that combines educational methodological resources related to cognitive, operational, and social relationship and interaction. Activities are proposed to strengthen skills in the use of conventional system records, interviews with program supervisors, professionals, and officials. Activities are planned with groups of women, affected by similar health problems, to learn the opinions and meanings they give to their problems and ways of solving them. Participant observation, field work, individual interviews with women. Joint presentation of the analysis of critical situations in a round table with the participation of experts Training and monitoring activities for the use of resource networks such as: data banks and networks, documentary networks, project banks, scientific cooperation networks, governmental and non-governmental community resources. The integrated participation of students from schools of the Faculty of Medicine, Law, Informatics and Anthropology, community agents, specialists and officials are considered.

For the second axis, transdisciplinary systems of field work, consultancy and monitoring are implemented, both individually and collectively, according to the profile of the problems to be addressed. A cadastre of access systems is configured, as well as a map of methodological, information and social resources that will be located on a university server site.

The third axis consists of a training program expressed in seven workshops: Incorporation of the gender perspective at work, Social Vulnerability Approach, Application of qualitative methodologies for the contextualization of the social reality, Problem-based learning, Evidence-based health care, Communication-Expression, and Leadership. For the execution of these workshops there are specialists convened by invitation. Also considered is the idea of convening teams from other centers, from the intersector, to enhance the multiplier effect of the workshops. For the execution of the workshops, we count on the facilities of the primary health centers of the public network.
