| Education for health - A manual on health education in primary health care |
|Chapter 5: Health education with groups|
A common activity of most of the groups described in this chapter is the holding of meetings to discuss and solve problems. This section considers what is needed to conduct good meetings.
There are different kinds of meeting. Some involve general participation in the discussion and in taking decisions (committee meetings, board meetings, public meetings on an issue of concern to the community). Others, like the annual assembly of an association, use a few speakers who address a largely passive audience. In health education we are concerned with the first type of meeting.
Meetings are held to gather information, share ideas, take decisions, and make plans to solve problems. Meetings are different from group discussions. A group discussion is free and informal. Meetings tend to be held for a special reason and are more organized. They have, for example, appointed or elected leaders. Meetings are an important part of successful self-help protects.
Size of group
In meetings held by organizations and associations, 20 to 50 people may come together. Community leaders may have small meetings where 5 to 10 people take decisions about community needs. On the other hand, the whole community can come together in a meeting to learn about problems and express their views.
Planning a meeting
It is important that the members of the organization or the community see the need for a meeting. Does the problem require a meeting, or can it be handled easily by one or two members?
The decision to hold a meeting should be made by the group members or community leaders themselves.
Time and place
Many organized groups have regular times and places for their meetings. The village heads may meet once a week at the Chief's house. The neighborhood council may meet monthly in the community hall. The tailor's guild may meet every two months at a school or mosque.
Make use of regular meetings to solve problems and set out plans for action. If a special meeting is necessary, the leaders of the group should decide on a time and place that will be convenient for all.
Announcing the meeting
Each group or organization has a way of informing members about meetings. This may be by posters, town criers, or word of mouth. The group should make the announcement itself.
Word of mouth is often the best way to announce meetings in a village or small neighborhood. The need for the meeting can be announced by the leader to the people he or she works closely with. These people then spread the word to others, who in turn tell others, and so on.
Announcements will spread more quickly and reliably if a system to facilitate communication is set up. In such a system, each member of the group has the responsibility of contacting certain other people. Here is how it might work:
The leader will contact four people to announce the meeting. Each of these people knows the names of four other people whom he or she will contact. These people in turn will contact others.
One way to do this is to look at the different sections of the village or neighborhood. There should be someone in each section for the leader to contact first. If Mr A is away when the leader tries to contact him, Mr F could then fill in for Mr A.
Meetings should be announced several days in advance to give people time to prepare. But do not announce the meeting too far in advance or people may forget when it is.
Preparing an agenda
An agenda is a list of the topics or issues that will be discussed at a meeting. This should be planned carefully. People will lose interest if they come to a meeting where no one knows what is supposed to happen.
If the group already has leaders, see them some days before the meeting. Discuss the agenda. There may be issues remaining from the last meeting that must be discussed first. There may also be new topics to add. An agenda should not be too long. Ideally, it should include only one or two important topics. A long agenda means a long meeting. After one hour, people start to get tired. After two hours, they start to leave. If people leave before the work is finished, the group may not be able to solve its problems.
Also, a long agenda may force people to make quick decisions which they may regret later. When the agenda has been agreed upon, look at the topics listed. What information will the group need to be able to discuss the topics carefully? If the members of a farmers' cooperative want to meet to discuss ways of improving their crops, they will need information on types of fertilizer including their cost and effects. Some of the group leaders should volunteer to find out this information. You can guide them on where to look. Do not do it all by yourself. It is useful for people to learn how to find information and resources.
When the meeting is announced, also tell people briefly what will be on the agenda. This will help them prepare. Members can look for information themselves. They can begin to think of ideas to be put before the meeting.
Conducting the meeting
Most organizations, associations, and councils have their own leaders. These are the people who should be in charge of the meeting. You will have already given them encouragement and suggestions during the planning of the agenda.
You should speak when the leaders request it and should occasionally give other comments. Be sure that the other members of the group have the opportunity to speak their minds fully.
Participation in the meeting depends on the culture of the community. In some places leaders do most of the talking. In others, every member speaks. Encourage the kind of participation that is acceptable to the people. You can add comments like the following to encourage more people to talk:
- It would be useful if we could hear more about this flooding problem from the people who live near the stream.'
- 'This problem of dog-bites worries us all. I am sure those members with small children must have some experience in this area that they can share with us.'
Make issues clear
Before the meeting can reach intelligent decisions, everyone must understand the problems and the suggested solutions. Comments like these can help:
- 'Is everyone clear about how much money this project will require?'
- 'Does anyone want us to explain again how these immunizations work?'
- 'Does everyone understand what will be the responsibility of the community and of the sponsoring agency in implementing this project?'
Here are four ways in which decisions can be made in meetings:
- The group as a whole discusses an issue. After some time the leader or another member may say 'I think that we all agree to take this action. Does everyone feel this way?' At this point anyone can object. If there are objections, then discussion continues until there is a final sense of agreement. This is called consensus decision-making.
- The leader listens carefully. When he or she senses that everyone is in agreement he or she announces a decision.
- An issue can be placed before the group and members can be asked to vote on it. Action is taken according to the majority vote, that is, action is taken on the idea that the largest number of people prefer.
- The leader alone may decide on what he or she thinks is best and announce that the decision stands for the whole group.
The first two methods are very similar. In both cases a decision is not taken until there is general agreement in the group. This may take longer than voting or than the leader deciding for the group, but it encourages participation. When everyone is in agreement, action is very likely to follow. It is a good idea to make a note of what is agreed at a meeting so that people do not forget.
The purpose of a meeting is to decide on plans that will help solve a group or community problem. Look at Chapter 3 for ideas on planning. Simply put, the group must:
- Set objectives (desired results).
- Decide on strategies (ways to solve the problem).
- Find resources.
- Set a timetable for action.
- Arrange for tasks to be carried out by individual members or small groups of members (committees).
- Meet regularly to review progress and make improvements or changes in the plan as necessary.
Think about meetings you have attended. They might have been staff meetings in your agency, community meetings, or meetings of various organizations. Why did some meetings turn out successfully? Why did others have problems? What did the leaders do to make the meeting run smoothly? Did the leaders create any trouble' Why was that? In what different ways did the groups make decisions? What happened when people were not happy with decisions?
An educational game about decision-making
Here is a simple game you can use to help people learn about making decisions. No materials are needed. Twenty or more people are usually required. If there are fewer than fifteen people you will have to divide the group into two instead of three, keeping 'Group 1' and choosing either 'Group 2' or 'Group 3' (see below) as the other group.
Divide the group into three equal-sized smaller groups
Ask each group to select a leader. Explain to the groups that they must try to decide what is the most important problem in the community.
Meet separately with the leaders first
Tell the leader of Group I that he or she must encourage decision-making by consensus in that group. Explain carefully what consensus is. Tell the leader of Group 2 that he must force his group to agree with whatever decision he himself makes. Tell the leader of Group 3 to ask the people to vote on the different suggestions put forward.
Allow each group to meet
Make sure there is space for each group to meet separately so that they will not disturb each other.
Give plenty of time for the game
It may take some hours to reach a decision. You may have to ask the groups to report back the next day with their decisions.
Bring everyone back together
When the groups have reached their decisions, get a member from each group to explain how they reached their decision. Have various people say what they thought and felt. In Groups 2 and 3, you will probably find some people who are unhappy or angry because the group decision went against their views.
Ask the groups to report on what they have learned
Ask if they feel that what they have learned will improve the way they work together to make decisions in the future and if so, what sort of improvements they expect.