|Education for Health (WHO, 1988, 274 p.)|
|Chapter 3: Planning for health education in primary health care|
In the first chapter we discussed the important effect that the presence or absence of resources can have on behavior. This section looks at ways of finding the resources necessary to promote health, and conduct health education programmes.
Resources inside the community
Be aware of the resources within your own community that can be used in solving the problems of individuals, of groups, or of the whole village.
Here are some examples of the many kinds of resources you will need:
- Places to hold meetings, discussions, and training sessions, such as schools, and town halls.
- Some people may be able to donate money to buy materials.
- Some people may have skills that would be useful for community projects. Among these are carpenters, teachers, masons, artists, traditional healers, weavers, and potters.
- Many able-bodied people can give their labour.
- Some people may own bicycles, motor cycles, or other vehicles. Transport is valuable for carrying materials for projects or taking sick people to the clinic.
- Materials such as wood, cloth, and food can be given by people for large community projects, or to help families in times of crisis; for treating sick people you may find that some local herbs work very well; you can encourage people to make tools and equipment for their projects.
Make sure you know who has any of these resources, and how they can be obtained. As can be seen from the list above, the members of the community themselves are the most important resources for solving problems.
Resources outside the community
It is best to solve problems with resources from within your own community. Sometimes, though, the project may be too big for the resources available. Also the problem may be difficult to solve. Then it is necessary to look outside. Here are some resources you may find outside your community:
- Some agencies and ministries give funds and technical assistance for community projects or for individuals and families in need.
- People with skills, such as finding underground water for wells, may come from outside.
- Materials such as cement may have to come from outside as well; for educational material such as films and posters, you may look to different agencies; vaccines, drugs, and medical equipment are sent from outside; many kinds of machines and equipment are sold, loaned, or given by outside agencies.
We have said that it is best to find resources inside your community. For one thing, it saves money. But, more important yet, people are proud to be able to help themselves. This pride will encourage people to try to solve more problems by their own efforts.
Use local resources to solve problems. Carpenters in this community have helped by making crutches for handicapped children.
It may not be necessary to buy cement outside to make incinerators, for example. Mud, clay, bricks, and stone are appropriate local building materials.
A tractor may look like a wonderful answer to farmers' problems. After some time though, they may be disappointed when they see the cost of petrol and the difficulty of getting repairs when the tractor breaks down. An improved design for local ploughs or the use of horses, mules, oxen, or buffalos might be more appropriate and have better long-term results.
Linking people with resources
Once resources have been found that will help solve the problem of the person, the group, or the community in need, you must still bring the people and the resources together. Good relationships with people and communication skills are very important here. Only through good relations can you bring together the people in need with the people who have the resources.
This woman is collecting special leaves and grasses that can be used to make medicine these are often a valuable local resource.
When we talked about participation, we said that it was a mistake to do work for people that they can do for themselves. This is true with resources, too. Do not get resources for people if they can get them for themselves. If you do it for them, they may not be able to find help the next time they are in need. This is what happened to one community worker, Mr Neb.
Mr Neb was talking one day to a farmers' cooperative in his district. The farmers said that they needed money to buy seeds and fertilizers. Mr Neb promised he would help. He went to the Ministry of Agriculture and found the section that gives loans to farmers. He got the forms and brought them back. After asking the farmers a few questions, he filled in the forms for them. He took the forms back to the ministry and got the money for the farmers.
Later that year Mr Neb was transferred to another district. When the time came to repay the loan, the farmers did not know what to do. Only Mr Neb knew all about the resources at the ministry. Finally, an angry official from the ministry came to collect the money. The farmers gave it to him, but were afraid to ask him more about loans because they could see his anger. When the next planting season came, the farmers did not know how to get a loan.
Sometimes problems become more confused when a health worker tries to get people a resource that they could have obtained themselves. This is what happened to Mrs Sandos.
Mrs Sandos, a community midwife, heard that people in her community needed a reliable well. She volunteered to go to the provincial capital to seek help at the Ministry of Public Works. An official at the ministry gave Mrs Sandos plans for a well. The officer also promised to help with costs and supplies if the villagers dug the well exactly to plan.
The villagers were happy to receive Mrs Sandos' report and began digging the well right away. Before they were half-way down to the depth required by the plan, they struck water. Though they tried, they could not go deeper. When Mrs Sandos reported back to the ministry, the official said that he would not give any help now, because the well was not dug according to the plans. Mrs Sandos tried to explain the problem, but the officer would not listen. Mrs Sandos was embarrassed to return home with the bad news and, when she did, the villagers accused her of Iying. They gave up interest in the project and today they still have no reliable well.
Think about these two stories What could the two health workers have done to make a better link between village and resource?
Actually there are several things that you can do to assist individuals, groups, and whole communities in learning to link up with resources. First you must supply background information that will help people to make an effective link. Such information should include:
- Names of agencies, organizations, and individuals that have resources.
- Description of type of resources provided.
- Location of the resource agency.
- Special requirements the agency may have before giving resources.
Selecting the best resources
Discuss the benefits and difficulties that might come with each resource and what is best considering the culture and needs of the community itself. The people involved should make the decision. Do not force an idea on the people.
The community will learn more about the resource if a visit is made to the agency that has the resource. While you may provide some background information, it is better if the people learn at first hand what the resource agency offers.
You should not go to the resource agency alone. If the villagers are not confident enough to go by themselves, you can go with them the first time. But they must soon learn to go by themselves. If you are working with a group, the group may send a few representatives to see the resource agency. You can introduce the people but should encourage them to speak for themselves. The person or the group who made the visit will report back and encourage further discussion.
Many different resources can be used to solve a problem. For example this health worker has many drugs to choose from when supplying a community medicine kit. The pharmacist can help her choose the most appropriate ones for her community.
Obtaining the resource
The people should make their own decision whether to accept the resource or not. They themselves should also make all arrangements directly with the agency. You can be with the people to make sure that they understand what is happening and that no-one is taking unfair advantage of them. People must know in advance what, if anything, the agency expects them to do in return.
At each step of the linking process, explain carefully to the people what is happening. Be sure that more than one person in a group or community knows how to link up with resources. Then, in case of sickness or travel, there will always be someone around who knows what to do.
Communities will benefit from the resources of many different agencies education, agriculture, social development, information, public works, and a variety of voluntary and special purpose organizations. Help the community establish ongoing links with these different agencies.
Health education resources
In this section we have talked about resources needed to achieve actual programme goalscement for a well, or volunteer labour to build a community meeting-hall, for example. We must also remember that special resources are needed to communicate the health message that will encourage people to undertake the programme in the first place. All the points we have raised about general programme resources (type, availability, and appropriateness) also apply to education and communication resources.
When collecting information about the community, you should look for local and traditional means of communication. These may include proverbs, stories, and fables which elders use to pass traditional values on to the young. Local leaders may use town criers or bell-ringers to announce coming events. Traditional songs or plays may communicate important ideas and values. Some people may own a print shop and be able to make posters to inform the public. There may also be a photographer in the neighborhood.
Consider which of these and other communication media are available in your community. Use the ones that will best support your health education efforts. By using locally available means of communication you will be involving the community in the programme. Get their ideas on which traditional proverbs, songs, or stories will be most appropriate for conveying the health message. Involve local leaders so that they would be willing to use their town criers to announce important health events and rally the community to take part. Local artists, printers, and photographers can be involved in designing, and producing educational material.
Also identify communication resources outside the community. These may include mass media such as newspapers and radio. The ministries of health and of information may have films, posters, and vans with loudspeakers that can be borrowed for local health education programmes. Find out who in the community has access to newspapers, radios, and other information sources. These people can be encouraged to share the health information they obtain. A local school-teacher who subscribes to a newspaper can save articles that relate to health and use them to teach pupils and inform parents. A community member who owns a radio could invite neighbors to listen when health programmes are broadcast.
You, as a local health worker, should be aware of such newspaper articles and radio programmes so that you can encourage community members to read and listen, and benefit from the information provided. This involves resource-linking. Contact the radio or television station and obtain their programme schedule. When health programmes are broadcast, encourage community members to listen. You may even encourage them to gather as a group to listen, so that after the programme a discussion can be held to make sure that everyone has understood the ideas presented.
Get in touch with the ministries of health and of information. Find out what resources they have and on what conditions they loan materials such as films. Read Chapter 7 to learn more about different educational media and communication resources.