Report and recommendations
THE ASIAN REGIONAL WORKSHOP ON EFFECTIVE COMMUNICATION FOR NUTRITION IN
PRIMARY HEALTH CARE
Education and information for behaviour change are being increasingly
recognized as key interventions in the improvement of health and nutrition.
However, functional illiteracy, the lack of infrastructure, and expensive
technology often mean that efforts in health and nutrition communication at the
community level are minimal, difficult, and disappointing.
Many Asian countries have adopted primary health care (PHC) as the
fundamental philosophy in their health-care systems, making effective
communication crucial. It was for the purpose of evaluating, expediting, and
expanding the progress made by various countries that the Asian Regional
Workshop on Effective Communications for Nutrition in Primary Health Care was
held from 3 to 7 October 1983.
The five-day workshop featured eight papers on various aspects of
communication, ranging from a broader view of planning to more specific details
regarding media production, methodology, and application. Three case studies
from Thailand, Indonesia, and the Philippines gave insights into ongoing
projects in nutrition communications. Six country reports and three individual
reports described the efforts of various countries and institutions in Asia that
are working with communications for nutrition education.
Special interest groups discussed planning, development evaluation, and
growth charts. Pertinent points were raised in regard to each activity,
providing a chance for the exchange of ideas between resource persons and
The small group discussions covered the following four topics:
- Integration of communication in PHC.
- Human resources and
training needs recommendations.
- Information network needs and
- Research needs and recommendations.
Problems, constraints, and possible or potential solutions were discussed,
and the recommendations for each of these topics were as follows:
Integration of Communications in PHC
- Increase communication among policy-makers/planners concerned with
PHC in the various agencies and ministries.
- Define common goals for all
agencies and revise them until acceptable to all.
- Establish monitoring
and feedback loops between village workers and all levels in agencies and
ministries (including reinforcement of "good work").
easier channels for communities to request resources and assistance.
- Use existing community leadership and information networks, with different
change agents for different goals.
- (a) Involve communications experts
in early stages of planning and development; (b) provide training programme in
communication techniques for all involved in PHC.
Human Resources and Training Needs
- Recognize the enormous number requiring training in PHC in Asia:
- 300-400 million parents;
- 30-40 million village workers; and
- 20-30 million subdistrict- to
- Train, using strategies to maximize cost-benefit: (a) standardize using same
basic training package from top to bottom; (b) "piggy back" content on
other successful training programmes (e.g. nutrition may be piggy-backed on
family planning); (c) use participative, job/task-oriented training methods -
train for behaviour change; and (d) evaluate and monitor the training process
(pre- and post-test the training materials).
- Develop trainers and
supervisors of training before starting to train the change agents and
caretakers (effective and efficient training requires significant level of
- Tap other sector resources: (a) advertising agencies,
consultants, etc.; (b) other government agencies - family planning, community
- A second workshop should be planned with
geographic- and problem-specific focus.
Nutrition Information Network Needs
- Establish a national-policy-level committee to co-ordinate nutrition
information activities (include non-governmental agencies).
this national committee by: (a) appointing national head of nutrition as member
secretary; (b) using mass media to publicize needs; and (c) providing research
findings to committees to convey nature and urgency of problems.
- Establish monitoring and feedback loops between the community and policy
- Set up intra- and inter-country clearing-houses to make
nutrition messages consistent.
- Set up Asian facility for inter-country
exchange of information concerning communication projects for nutrition in PHC -
perhaps a newsletter sponsored by an international agency like UNICEF.
- Explore models for scaling up pilot projects.
appropriate task-load for village volunteer workers.
"positive deviants" with regard to: difference from
"average"; - what maintains their behaviour.
- Research which
format/medium is most effective for which type of objective.
methods of systematic monitoring for decision-making and planning and provision
of timely feedback to village workers.
- Investigate use of growth charts
vis-á-vis: (a) mother's understanding of use and purpose; (b) impact on mother's
knowledge of normal growth; (c) impact on child's nutritional status; and (d)
effect of mother's ownership of chart on child's nutritional status.