| Nutrition learning packages |
|Nutrition Learning Package 8: COMMUNICATING NUTRITION MESSAGES|
Many training programmes still teach health workers to give talks, or lectures, on nutrition to mothers, children and other community people. The lesson plans and teaching materials to go with these talks have often been designed by outsiders to the community in which they are given. The health worker may be encouraged to use questions and answers, flip charts or posters, but the information and advice still travel mostly one way - that is from the unseen expert who prepared the materials, through the health worker, to the listeners.
The results from such prepackaged nutrition talks are often disappointing because for many reasons (shown in Fig. 62) people may not accept the information.
If people are to learn about how and what to eat for good health, the educational approach should deal with real problems in a real way. It should be an 'active' process in which community health workers and people from the community learn and explore new possibilities together.
Some ways to teach and learn about nutrition
The methods can be used by health workers, parents, schoolchildren and other people. Choose the methods that are most like the methods people already use to teach each other in the community; for example, choose a method that is similar to the way mothers teach their children.
Stories can help people to think about their problems and look for solutions. They are used best in small groups, with the group taking part in story-telling, or discussing the stories afterwards. Drawings can help to illustrate the stories, and can encourage discussions.
You can make up games with nutritional messages. These are best if they involve problem-solving and are based on decisions, rather than on luck.
You can demonstrate how to prepare nutritious meals. Demonstrations can be carried out in the nutrition centre or in people's homes. Let mothers prepare the food themselves and help teach others to prepare the food. Use foods that are available locally, for example ones that can be bought in the market or grown in family gardens.
Regular weighing of children
Children under five years should be weighed monthly to help spot problems early. Their weights should be recorded on growth charts (see Nutrition Learning Package 2). The time that the mothers spend at the health centre while their children are being weighed can be very useful for passing on nutritional information.
Role-playing and drama
Theatre is excellent for getting people to think about ideas that require changes in the usual way of doing things. Everyone can take part, or a group of villagers or health workers can perform. Follow up the performance with a discussion.
These can be useful in some communities. It is best if people from the community make puppets, and conduct the show themselves.
Work in small groups
Many subjects can be covered with small groups of mothers, fathers, young people, etc. For example, a talk about different foods can be brought alive if everyone in the group brings real foods to the group meeting. That way you will be sure to teach about foods that are available locally. It may, however, be difficult for poor families to bring foods. Can the group find a way to get over this problem?
Gardening and agricultural projects
The best way to learn about these is to do them. For example, family or school gardens could be planted, or storage bins could be made for grain.
Slides and films
Films and slides should be used only if health workers will have access to projectors and electricity in their communities.
Community practice and experience
As much as possible, community health workers should have a chance during their training to practise all these different activities and teaching methods with people in a real village or community.
Notes on using drama
• Home-made, open-ended drama can be very useful in communities where it is part of the tradition. People who present a play or skit will learn twice as much if they also take part in creating or writing it. The story can be developed from the actual ideas and experiences of the participants. The group must invent the story and work out how to present local problems in a convincing way. This helps them to develop skills in planning, thinking, problem-solving, organizing, and communicating. All these extra benefits are lost when trainees simply memorize a script written by someone else.
• Encourage people to use their own words. Speaking in public is not easy for many community health workers or villagers. Often poor people are used to remaining silent in village meetings, while a few people do the talking and make the decisions. At first, trainee health workers may be embarrassed to speak or role-play in front of a group. They may be too shy to say things in their own words, and will often prefer to memorize the words of someone else. This takes more work, but seems safer. They feel less exposed.
However, the ability to stand up and state your own thoughts with confidence is an extremely important skill. Encourage trainee health workers to use their own words in role-plays, rather than simply repeat lines they have memorized.
But go slowly. Help people gain confidence little by little. Start with role-plays in the classroom, or with a small group in which everyone takes part. This way there is no audience. Everyone is an actor and a member of the audience at the same time. As the trainees become more confident, they can begin to do presentations for larger groups.
Taking part in role-playing and community theatre helps people gain confidence. It gives them the courage and skills to speak their thoughts.
• Involve mothers and children. Be sure the drama is relevant to them. Health workers may be able to interest children and their mothers in putting on skits or puppet shows for the community. People are more likely to take part if the subject of the drama is important to them.
• Entertainment is more powerful than preaching. If theatre is to reach many people, especially those who are the most difficult to reach, it needs to be entertaining. Theatre can be used for health education. It can help get people thinking about specific problems and possibilities for action. It can contain a strong health message. But if it is to hold the interest of an audience, and convince people to come back for more, care must be taken not to preach. Few people enjoy being told what they should or should not do, especially when they have come to have a good time.
To be effective, build the message into the story. The positive or negative results of the actors' actions can be made obvious, but the people in the audience must be free to draw their own conclusions. Respect their judgement and their intelligence.
• Leave time for discussion afterwards. Whether it is a role-play in the classroom or a theatre presentation in the village, a discussion afterwards will help people relate personally to what they have seen. A follow-up discussion can help turn acting on the stage into action in the community. Follow-up discussions get people personally involved.