| Education for health - A manual on health education in primary health care |
|Chapter 7: Communicating the health message: methods and media|
The most natural way of communicating with people is to talk with them. In health education, we have many opportunities to talk with people. We may do this with one person or with a family, with a small group or with many people together. Health talks have been, and remain, the most common way to share health knowledge and facts. Too often, however, this method is used by itself. Talk alone is too much like giving advice. As mentioned in Chapters I and 4, advice is not the same as health education.
To make a talk more educational, it must be combined with other methods, especially visual aids, such as posters, slides, and flannelgraphs. A talk should be tied into the local setting by the use of proverbs, for example. Interaction and interest should be aroused by using discussion, songs and possibly role-plays and demonstrations.
Talks are usually given to small gatherings, although they are sometimes given to much larger groups. For example, a talk broadcast over the radio may reach everyone in the country.
One problem is that the larger the group, the less participation and discussion are possible. Discussion is necessary so that people can ask questions, share ideas, and be clear about the real message of the talk. This is easy in small groups of 5 to 10 people. In larger groups there is less chance for each person to ask his or her own questions. After hearing a talk to a larger group, some people may go away confused. One way to solve this problem, is for you to stay after the talk so that people can come to you individually to ask their questions.
With talks on the radio, it is not possible to ask questions of the speaker. This problem can be solved by holding a radio meeting (see pages 242-243). Participation and discussion help you learn too. You learn how well you are able to communicate. If many people understand your points, then you are a good speaker. If not, you should try to find out why, and then try to do better.
Do not accept silence as agreement or understanding. Ask the group questions to be sure that they understand your points.
Preparing a talk
The following points must be considered carefully.
Know the group
Find out their needs and interests.
Select an appropriate topic
This should be a single, simple topic. Nutrition is too big as a topic. It would take weeks to talk about all the aspects of nutrition. Nutrition can be broken down into many simple topics, such as breast-feeding, weaning diet, body-building foods, food needs of older people, cooking methods that preserve food value, etc.
Have correct and up-to-date information
Check in your books and consult resource people (your supervisor perhaps) to check that all your facts are accurate.
List the points you will make
There should only be a few main points. People may forget if you tell them too many things.
Write down what you will say
If you do not like writing, you must think carefully about what to include in your talk. Think of examples, proverbs and stories to help emphasize your points.
Think of visual aids
Well chosen posters, photos, etc., will help people learn.
Practise your whole talk
This should include the telling of stories and the showing of posters and pictures.
How many minutes does your talk take?
The whole talk, including showing visual aids, should take about 15 to 20 minutes. You should allow another 15 minutes or more for questions and discussion. If the talk is too long people may become bored and restless.
Good organization demands that you pay attention to many details.
Where will you give the talk?
Is the place free from noise? If it is the rainy season, is the place protected from the weather? Is there room for the whole group to gather comfortably? Are there enough seats for those who need them? Is the place small enough for people at the back of the group to hear and see? Can everyone get to the place easily?
At what time will you give the talk
Pick a time when the people in the group have no other duties. Do not pick a time that conflicts with another community event.
A talk may be given at a regular meeting of a social, religious or other organization in the community. Find out the schedule or agenda for those meetings. Do not take more time than the group offers you. They may have other important business to conduct.
Proverbs are short common-sense sayings that are handed down from generation to generation. They grow out of the experiences of people in each culture. They are like advice on how best to behave.
Some proverbs are straight forward their meaning is obvious. Others are more complicated. The listener has to think carefully in order to understand them. Here are some proverbs from a country in Africa. See if you can understand their meaning.
(a) One does not go in search of a cure for ringworm while leaving leprosy unattended.
(b) A young man may have as many new clothes, but not as many worn-out clothes, as an old man.
(c) A hen drinks water, swallows pebbles, but still complains she has no teeth. Does a goat with many teeth eat iron?
Proverbs can support or illustrate a point about health you want to get across.
Discovering local proverbs
You may already know many proverbs from the village or community where you work. If you do not, the best way to learn proverbs is to talk with the older people. They may even help you with your educational programmes, because they often enjoy telling proverbs.
Proverbs can be combined with talks, demonstrations, stories, dramas, or put on posters and flipcharts. Think of other uses. People are very familiar with their proverbs. When you use a proverb correctly, people will be impressed that you understand their culture. Since the proverb is familiar, they may try to abide by the advice it gives in relation to health.
Here are the meanings of the three proverbs.
(a) Try to solve the most serious problem first.
(b) An old man has more experience than a young one.
(c) Some people have what they need but are still not content.
The first proverb could be useful during a talk to mothers that emphasizes the importance of bringing their children to the clinic when they are sick, instead of going about some other business.
The second proverb could encourage young people to respect and care for their elderly parents.
The last proverb could remind people to be realistic when they plan a project.
If you are with a group of health or community workers, ask each one to tell you a traditional proverb. Discuss each proverb. See how it can be used to help communicate ideas about health.
Fables are make-believe stories that have been told to children for generations. The characters in a fable are often animals.
The actions of the characters in a fable are supposed to teach children proper ways of behaving. Fables also show adults what values are important to the community.
Fables can be used with individuals or small groups. They can also be used in radio programmes that reach a large number of people.
A sample fable
The tortoise is an animal that often appears in fables. Children always listen carefully to this fable to find out if the tortoise will solve the problem.
The tortoise and the goat were good friends. They often took long walks together. One day while they were walking, the goat said: 'I fancy something nice to eat. Let's find some food.' The tortoise agreed and they began searching. Soon they could smell some delicious food cooking. They followed the smell to the lion's house. They looked around and saw that the lion was far away from his house. The tortoise said, 'There is a small door in the back of the house. We can go in quietly, eat quickly, and then escape through that small door. The lion will never catch us.' They squeezed themselves through the small back door and began feasting on the lion's supper. The tortoise ate a little and was satisfied, but the goat continued to eat and eat. Soon they looked up and saw the lion returning. They rushed to the small back door. The tortoise slipped through the door easily, but the goat was so full of food that he could only get halfway through. He got stuck. The tortoise tried to pull him out but it did no good.
When the lion came into his house he was very hungry. He said, 'I need my supper but someone has eaten nearly all of it, and there is that fat someone trying to escape through my back door.' He pulled the fat goat into the house. Since the lion didn't have any other food he decided to make goat-meat stew for his supper. By this time the tortoise had run far away. He realized that he had only escaped because he hadn't eaten too much food, but also that the lion needed his food because he was hungry. He decided he would never take another person's food again.
From this fable children would learn not to steal and not to be greedy.
Fables are useful when you are talking to small groups of children. They are also useful for health education with parents. The parents will then be able to tell the fable to their own children. After telling a fable you should always discuss it with those who listened. Ask questions. Why did the goat eat the lion's food? Was this a good thing to do? Why did the lion eat the goat? Was the decision the tortoise made at the end a good one? By encouraging people to think about and discuss the story, you will help them learn. Ask people to tell their own fables too. See if they can make one up about health.
A fable used for health education would describe how behavior affects health. It would show what sort of behavior promotes health and what is harmful. The fable should also give reasons for choosing healthy behavior. By the end of the fable the sorts of behavior that are best for health should be clear to everyone.
A sample health education fable
Here is a sample fable that was made up to show children the importance of cleaning their teeth regularly. The characters are a horse and a dog. When you make up your own fables, use animals that children in your community will recognize.
The horse and the dog usually ate their food together in the evening after a hard day's work. After the meal the horse would go to sleep straight away because he was tired. The dog was tired too, but he always cleaned his teeth before he slept. One evening the horse asked the dog, 'Why are you always cleaning your teeth? Why don't you sleep early like me so you will be rested for tomorrow's work? The dog answered 'Cleaning my teeth makes them stronger. Dogs must have strong teeth for chewing bones and for protecting the house against dangerous animals.' The horse just laughed and went to sleep as usual.
One day a friend brought the horse some crisp, hard apples. The horse loved apples and decided to save them until after dinner. That night while the dog was chewing his bones, the horse started to eat his apples. He took one bite of the hard apple, but just as he bit, he heard a loud crack. He felt a terrible pain in his tooth, and started to cry.
The dog ran to see what had happened to him. There on the ground next to the apple was a large piece of one of the horse's teeth. The horse cried 'Can't you put the tooth back? I want my teeth to be strong again.' Unfortunately it was too late. The dog couldn't help his friend replace the tooth.
After telling this fable, a health worker should ask children questions like: Why did the horse's tooth fall out? Why were the dog's teeth strong enough to chew bones? Do you want to be like the horse or the dog? What can you do to make sure your teeth stay strong? Children could be encouraged to draw a picture like the one above to help them remember what they have learned.
What fables do you remember being told as a child? What are some of the common fables told in the community where you work? Are any of these related to health matters?
Talk to elderly people in the community to learn more local fables. Try to make up your own health education fables about the common health problems of children in your community. First tell the fables to a few children to see if they understand the main point. This is pre-testing. After making corrections, you can use the fable in your health education programmes.
Stories often tell about the deeds of famous heroes or of people who lived in the village long ago. An older person, instead of directly criticizing the behavior of a youth, may tell a story to make his point. He may start by saying, 'I remember some years ago there was a young man just about your age. . .' and then continue to describe what this young man did that caused trouble. Stories may also be a way of re-telling interesting events that happened in a village. So stories can entertain, teach history, spread news and information, and also serve as lessons about behavior.
Stories can be used to give information and ideas, to encourage people to look at their attitudes and values, and to help people decide how to solve their problems.
Stories can be told to individuals or to small and large groups. They also can be used on the radio to reach communities, regions or even whole countries.
Characteristics of a good story
The story should be believable. The people in the story should have names. They should do the kind of work that people in your community do. Their actions should be normal, not strange. Be sure that you do not name or describe real people in your story. If they hear the story they may become embarrassed or angry. The story should be short, otherwise people will become bored. They may also forget parts of the story. Five to ten minutes is all you need.
The story should make a clear point in the end. It should be obvious to the listeners which action is good and which is not.
Avoid scornful and unkind words in the story. If you say, 'This foolish mother did not bring her child to the clinic in time' some mothers may get angry. They too may have been unable to bring their child to the clinic on time. They may not listen to you again. Simply describe the actions of the people in the story. Let the listeners make up their own minds. If you tell the story well, the listeners will be able to judge correctly.
Always follow a story with discussion and questions. Do not tell the listeners which person in the story did the best thing. Ask the listeners for their own opinions. By encouraging people to think about the story and to discuss the points that impressed them, you will help them to learn more.
A sample story
Mrs Alto is a busy woman, but she always tries to do the best for her children. She is a seamstress. She uses the money she makes to buy good food and other things for her children. Last year she bought mosquitos nets for her children. Now they sleep peacefully at night. Since fewer mosquito bite them, the children do not get fever as often as they did before. As a result the children, and parents, are much happier.
Mrs. AIto's son David is a bright boy. He always does well in school and this makes his parents proud. David has many friends. Thomas is his best friend.
One day Mr and Mrs Alto received a letter from their home town. Mr Alto's mother was very sick and the family wanted Mr Alto and his wife to come home right away. David asked if he could stay with Thomas while his parents were gone. Thomas' parents, Mr and Mrs Bella, agreed.
After staying for some days with Thomas, David could see that Mrs Bella was not like his own mother. Mrs Bella had a shop in the market. She stayed there very late in the evenings. Many times she gave the boys only a small amount of money to go out and buy rice and beans for their supper.
Thomas did not have a mosquito net. At night he and David would toss and turn because of the mosquito bites. They were always tired in the morning. One day David felt hot. Then he felt cold and had pains. He could not go to school for several days. The Altos returned to find David still sick. Mrs Alto took him to the health centre. When David recovered, he thanked his mother and asked her to talk to Mrs Bella about taking better care of Thomas.
Here are some questions for discussion. Why did David get fever? Why does David do well in school? How can a mother spend the money she earns to ensure that her children shy healthy? What advice should Mrs Alto give lo Mrs Bella7 How can Mrs Allo give the advice so that Mrs Bella will not feel hurt and angry?
If malaria is a common problem in your area, tell this story lo mothers in your community. Change the names or occupations to make the story more relevant to the people. Now make up your own stories about health problems that are common In your area.
In a way case studies are like stories except that case studies are real-life experiences. They are based on facts and present events as they really happened. Details of how to write and use a case study, and a sample case study are given in Chapter 5.
Demonstrations are a pleasant way to share knowledge and skills. They involve a mix of theoretical teaching and practical work that makes them lively. For details of how to plan and hold a demonstration, or series of demonstrations, see Chapter 5.
A poster is a large sheet of paper, often about 60 cm wide by 90 cm high with words and pictures or symbols that put across a message. Posters are widely used by commercial firms for advertising products, and to reinforce the message being delivered by other mass media.
Posters can be used effectively for three purposes.
- To give information and advice.
- To give directions and instructions.
- To announce important events and programmes.
The target group can be small or large. It can be the whole community. Sometimes you may also want to use posters with individuals. You may be counselling someone in the clinic, in the school, or at your office. If there are posters on the walls that relate to your client's problem, you may take the client to see those posters.
A number of rules should be followed in making posters.
- All words should be in the local language.
- Words should be few and simple.
- Symbols that illiterate people will also understand should be used.
- Colour should be used to attract attention.
- Only put one idea on a poster. Too many ideas will make the poster look clumsy and confuse people. If you have several ideas to pass on, use a flipchart (see pages 222-225).
Posters announcing events should contain the following information.
- The name of the event.
- The date and time.
- The place.
- The organization sponsoring the event.
The poster should be big enough for people to see clearly. If you are using a poster with a group, make sure people at the back of the group can see it well.
Place posters where people will see them.
- Put them in places where many people are likely to pass (market areas, meeting halls).
- Ask permission before you put a poster on a house or building.
- Some places, buildings, rocks and even trees are sacred or special. Never put posters in these places. It may make people angry, and then they will not learn from your poster.
- Do not leave a poster up for more than one month. People will become bored and begin to ignore it. Change posters often to keep people interested. When you remove old posters, save them if they are in good condition. If a poster is worn and torn, dispose of it properly in a dustbin to set a good example.
Where to find posters
The ministries of health, education or information, voluntary agencies and some private companies may have ready-made posters to give or lend. Before you use such posters, pre-test them to make sure that they will be useful in your community.
You, and the people in the community, can design your own posters. A ministry or a private printer in town may be able to print them for you. Find out the cost of printing before you try this. The size of the poster and the number of colours affect the price. Ask the printer's advice about the cheapest way to design the poster. You may have to seek gifts of money to cover the cost. If the poster idea is very good, the ministry or a voluntary agency may decide to print it for nothing, but don't count on this. The community can make its own posters from local materials. The rest of this section describes how you can make your own simple posters, pre-test them and use them effectively.
Materials that can be used include: large sheets of paper, pens, pencils, crayons, markers, paints and paint brushes, photos, old magazine pictures and glue.
Decide on how to use the poster. This will tell you how many to make. If you want to use the poster as an aid in your health talks, you will need only one. If you plan to use it in the community, you will need many. First count the number of places in which you will put the posters. Do not make more posters than you need, because they will waste money.
Make a test drawing of the poster first, before putting it on a large sheet of paper. Involve your group or health committee in designing it. Make several copies so that you can pre-test the design before you make the final posters.
There are many ways to make pictures for your posters. You or someone else in the group or community may be able to draw or paint well. If there is no one who can draw, you can trace a picture from a book or magazine. Another way is to cut out pictures from old magazines and glue them on the poster. Photographs can be glued on too.
Involve people in making posters. Make one poster as an example and ask members of your committee to help you make more. Schoolchildren can help too. You might even hold a postermaking competition. This will interest people and help them learn more about health.
Remember to pre-test your poster to be sure people understand and accept it. Posters cannot speak. If people do not understand a poster, they cannot ask it questions. All posters that you place around the village or town should have a very clear message.
Using posters in a group
If you are using posters with a group, attach the poster temporarily to a wall or tree in front of the group so they can all see. You may also ask for a volunteer from the group to help you hold up the poster. This may be better because the volunteer can walk around the group with the poster so everyone can see it closely.
Do not stand in front of the poster while you are talking about it. Do not try to hold it up yourself. This would make it much more difficult for you to communicate effectively with the group. Posters can be used as a basis for discussion. Do not hold up a poster and start explaining it right away. Instead:
- Ask everyone to look at the poster carefully. Give them a chance to see it well.
- Ask people what they see. What do they think is happening in the pictures? Let them think for themselves.
- If there are words on the poster, find out if someone can read. Ask him or her to read it for the group.
- Add your own ideas as the discussion continues.
- Turn to the poster again at the end of your discussion. Ask once more what people think is the message of the poster. Repeating and reviewing the message of a poster helps people remember.
Protecting and storing posters
It is a good idea to glue a piece of cardboard to the back of a poster, at least at the top. This will stop it tearing when it is held up for a group to see. Posters should be stored in one of these two ways.
- They may be kept flat inside a cupboard with a blank sheet of paper on top to stop them getting dusty.
- They may be rolled up with a string or rubber band around them. If you attach a small tag to the poster with the title and topic, then you can identify the poster without having to unroll it.
Be sure to keep posters dry and free from dust.
A display is an arrangement of real objects, models, pictures, posters, and other items which people can look at and learn from. Displays can be very simple or very sophisticated. They are most successful if they use a variety of materials to attract people. The illustration shows two displays using posters
A display provides ideas and information, but whereas a poster contains only one idea, a display has many. The ideas usually relate to one theme such as 'Better farming methods' or 'How to build a poultry farm' or 'How your child develops and grows'.
Displays are usually set up where large numbers of people will pass by and see them. For example you may set up a display at a market or in the community hall. Everyone will be able to walk past one by one, or in small groups, to look at the display.
A display is made up of things that people can look at and learn from. You can use posters, photographs, real objects and models. You may have seen expensive displays, put up by companies or agencies, that use slide projectors and tape recordings. We are concerned here with simple displays you can make yourself.
Since posters and photographs are discussed in other sections of this chapter, we will only look in this section at how to prepare real objects and models.
Real objects are just that real. If your display is on 'Family Planning Methods', you would display real IUDs, pills, diaphragms, condoms, and foams. If your display is about 'Weaning Diet', you would show real foods and the tools used to prepare them, making sure that the food items do not spoil.
You may have seen paper, cloth or plastic flowers that look like real flowers. They are models. Models might be used for three reasons.
- If the real object is not available, for example, certain fruits may be out of season or certain food items may spoil if left out on display. You can make models of such items.
- If the real object is too big to put on display. In this case you can make a small model. A lorry or a well, for example, would be too large to put on display.
- If the real object is too small to be seen easily you can make a larger model. For example, many insects are too small to be seen easily.
Models can be made of different materials. Clay, mud, wood, stone, straw, paper, cloth, and paper pulp (see below) are just some of the materials you can use for a model.
You must write on the display that the object is a model so that people will understand the display. Be sure to say if the model is larger or smaller than the real object. This will help people know what the real object is like. Here is an example of what you might write under a model of a mosquito in a display about malaria: 'Model of a malaria mosquito about 20 times larger than life-size.
How to make paper pulp models
1. Tear old newspapers into small pieces about the size of your little finger-nail.
2. Soak the pieces in water in a pot (bucket or gourd) for one whole day.
3. Remove the pieces from the pot and squeeze out as much water as possible.
4. Mash the pieces of newspaper in a mortar with a pestle until they are completely mixed.
5. Dry the mashed material (pulp) in the sun until it is completely dry. Leave it on one side for the moment.
6. Make the basic shape (papaya, chicken, banana, etc) with wire, small sticks, wood strips, string or whatever is available. This will look like a skeleton of the thing you are making.
7. Wrap the shape in pieces of dry newspaper to make it look like the object you are making.
8. Prepare a smooth paste using water plus starch or wheat flour.
9. Put the dried paper pulp into a pot, then add some of the starch.
10. Mix the paper pulp and starch with a stick. Keep adding more starch bit by bit and stir until everything sticks together well. If the mixture is too dry or too watery it will not stick to the model.
11. Take some of the pulp mixture in your hand and mould it around the basic shape of the model that you made earlier until it looks like the object.
12. Tie string, straw or raffia to any part of the model. Hold the model by the string, and hang it up by the string to dry.
13. Paint the model with any available paints. Colours should be as much like the real thing as possible don't make a blue banana!
Help in making models can come from many people in the community. The carpenter and mason can help make small model houses, wells and latrines. Schoolchildren can help make model fruit and vegetables with clay and paper pulp. The tailor can help make small model clothes.
Setting up a display
Find out how much space you will have for your display items. Select your display items according to the space you have. Do not crowd too many things into a small space.
Find out what can be used to support your display. Will there be tables, benches, chairs, poles or walls? Choose your display materials according to this. If you only have wall space for a display, you may not be able to use large models or real objects. Instead, you could use photographs, posters and small objects.
Arrange all display materials in a logical order. Individual items might be numbered so people know what to look at first, second and so on. For example, if your display shows the steps needed to build a well, place each photo or model in order from left to right, or top to bottom. Place them in an order that is easy for people in your community to understand and follow.
Make sure all materials are securely fastened to the wall or table. You do not want your photos, posters, models or objects to fall down, blow away or be picked up by other people.
Make sure that there is a clear explanation for every item in the display. This may be in words, symbols or pictures. Displays, unlike demonstrations, are usually left alone. If there is not a clear explanation for the items, people will have no-one to ask for help in understanding the display.
Storing display items
You will probably want to use display items several times. Be sure to keep them in a dry place. Cover models to keep off dust. Insects may try to destroy models made from wood, cloth or paper pulp. If you do not have dry and insect-free storage for these items, it is better to make your models from clay and other strong materials.
A flipchart is made up of a number of posters that are meant to be shown one after the other. In this way several steps or aspects of a central topic can be presented such as 'prevention of burns' or 'how to dress a small wound'. Flipcharts, with blank pieces of paper are also useful for recording ideas that come out of group meetings or discussions.
To give information and instructions, or record information.
Flipcharts are best used with small groups. They are not put up around the community like posters.
Where to find flipcharts
You may get flipcharts from your ministry or voluntary agency, but it is usually best to make your own. Making your own has the advantage that the topics you include will exactly match the educational needs of the group and community.
The individual posters or charts are joined together at the top. You can probably think of many ways to do thisglue, string, or nailing or tacking posters to a long, thin piece of wood. Since the individual charts will be turned over many times, join them with something that will stop them tearing or coming apart. If you have the resources, you can cut a thin piece of wood the exact size of the posters, and glue or tack all the posters together at the top of this board. You can then stand the board on a chair. This will make it easier for you to show the flipchart and turn each poster, one after the other.
A flipchart tells a story. On each chart or poster one idea is presented. The illustrations are arranged in order to match your talk or story. Five is a good number of posters to put in a flipchart, although you may have more or less. If you have too many ideas, people may not remember everything.
How to use a flipchart
Each chart or poster must be discussed completely before you turn to the next one. Make sure that everyone understands properly each idea. At the end, go back through the charts to review and help people remember the ideas.
You can get ideas for the charts by looking through books and magazines about health.
Sample flipchart on child growth and development
Suppose you need to talk to mothers of preschool children about child growth and development. You could make a flipchart consisting of five posters, as shown in the illustration. Notice that each picture shows a single, separate idea and that they follow a logical order. Also notice words chosen for the posters are short and simple. Important words are written so that they stand out more than less important ones.
Ideas for a flipchart on preventing blindness in children
Can you make up pictures and simple words for the five charts
Chart 1: Eyes are important to our children. We must protect them.
Chart 2: Keeping flies away from children's eyes helps prevent blindness.
Chart 3: Washing face well, especially around the eyes, helps prevent blindness.
Chart 4: Eating fruits and vegetables that are red (tomatoes, oranges, oil from red palm fruit,
papaya, carrots) and dark green spinach and other leafy greens prevents blindness.
Chart 5: Measles can cause blindness. Prevent measles with immunization. If a child gets measles, keep him in a darkened room to protect his eyes.
Now think of some of the common health problems in your village. Pick one example. Use small pieces of paper as practice sheets and make a flipchart.
A flannelgraph is a board covered with flannel cloth. Pictures and words can be placed on the board to reinforce or illustrate your message. When you prepare a talk that you want to illustrate you should think of the different pictures, words and shapes you will need for the topic.
Flannelgraphs help people see more clearly what you are saying during a talk.
Flannelgraphs are used mostly with small groups. Like posters, flannelgraphs must be seen clearly by everyone. In a large group this would be difficult. If you have an office, you can keep the flannelgraph there, to use with individuals who come for help.
Making a flannelgraph
If you want a flannelgraph, you will probably need to make your own. There are two basic parts to a flannelgraph. One is the cloth-covered board. The other is a set of pictures which you can stick to the board.
1. First make a board. Cut a square or rectangular piece of wood that is less than one metre long. The width can be shorter than the length.
2. Buy three metres of thick, coarse cloth. Thin, slippery cloth will not work.
3. Put one metre of cloth over one side of the board. If the cloth has a rough side and a smooth side, the rough side should be on the outside. Save the rest of the cloth.
4. Fold the edges of the cloth around the board. Fix the edges securely to the back of the board with nails, tacks or glue.
5. At this point you should have a board with its front covered with cloth.
6. Now you need pictures to stick on the board.
7. You can cut pictures from magazines or draw your own. Look for pictures of single subjects such as a person, a baby, a type of food, a vehicle, a tree, and so on.
8. The picture should be about as big as your hand. If the picture is too small, no one will see it.
9. You can also cut out words that are in large print. Words such as family, health, food, danger, help, and prevent can be put on the chart along with the pictures.
10. Cut out the pictures and words. Leave a border around them about as wide as your smallest finger-nail.
11. Now paste the pictures and words onto the rest of the cloth. If the cloth has a smooth side, stick the pictures on that side. If you do not have paste or glue you can make some with starch, or wheat flour, and water. Smooth out the pictures on the cloth with a slow sweeping motion of your hand.
12. Cut out the picture carefully, with its cloth backing. This time trim off the small border.
13. Allow the paste to dry before using the pictures. Otherwise they may get detached from the cloth.
14. Try to place your pictures on the board. You wail see that the rough cloth on the back of your pictures and words sticks to the rough cloth on the board. Now your pictures will stay on the board while you talk.
15. If you can find, or buy, small pieces of different coloured rough cloth, you can cut out different shapes. The shapes of perhaps fruit, plants, animals or buildings, can be stuck on the flannelgraph just like pictures.
16. You can also paste pictures on the smooth side of sandpaper. The rough side of the sandpaper will stick to your flannelgraph.
How to use a flannelgraph
Put the flannelgraph on a table, chair or easel.
Place all the pictures, words, and shapes you will need on a table near the flannelgraph so that you can see them and reach them easily. Carefully place the pieces in the order in which you will use them.
While you talk, place pieces on the board, or remove them from the board, as you make your points. Be careful not to turn your back to the audience. Practise working sideways.
You may want to arrange several pieces to make a whole picture. This may actually look like a poster. Be careful where you put the pieces. If you put a chicken on top of a man's head, or something funny like that, people will laugh and not concentrate on the message.
When you make a point, ask someone from the group to come up and select the right piece and place it on the board. During the review at the end of your talk ask members of the group to use the flannelgraph to make their own points.
Storing the flannelgraph
The flannel-covered board itself should be kept dry and covered. If it gets wet or dusty, it will not hold the pieces very well. Keep your pictures, words and shapes in envelopes or paper bags. Write on the outside of the envelope or bag what pieces it contains. An envelope may be marked, for example, 'vegetables' or 'animals'. Another way is to put all the pieces for a particular programme in one bag. The next time you want to give the same talk, you will be able to find all the pieces easily. Write the title of the programme on the envelope.
Photographs are a useful educational tool. They can show situations and objects exactly as they are in reality. But people have to be used to looking at photographs to be able to understand what they represent.
Photographs can show people new ideas. They can also show new skills being practiced. Show and discuss them as you would show a poster or a flipchart. They can also be used to support and encourage new behavior.
Photos are best used with individuals and small groups. This is because of their size. It is expensive to make large photographs. Still, they have to be big enough to be seen. A photograph about the same size as a page in this book, or a little larger, is about right. Photographs can sometimes be pasted together to form posters for the whole village to see.
Where to find photographs
The cheapest way to get photographs is to cut them out of magazines. Sometimes ministries and voluntary agencies have files of photographs. They may give you copies of these to be used in health programmes.
You may hire a commercial photographer to take photos for your programme. Black and white photos are the cheapest and are quite suitable for most purposes. In fact, in most small towns, photographers only make black and white photos.
Content of photographs
Several points need to be kept in mind when you choose photographs.
- The people and surroundings in a photograph should look similar to the people who will look at the photograph. People may not understand the idea in the photo if it looks strange to them.
- The photo should focus on one clear idea. Close-up photos are usually better than ones showing wide areas. If the photo shows too many things happening, people may not be able to see the main point.
- A series of photographs can be used to show different scenes in a story. They could also show the steps needed to complete a project or to practice a skill.
- Community events such as plays and clean-up campaigns are good subjects for photographs. You may request a photographer from the ministry or get gifts of money to pay for a local photographer to attend the events. People will feel proud when they see themselves in the photos, and they will be encouraged to continue their good work. Such photos should be posted on the wall of the school, at the health centre or in the community hall. Praise and interest will support people's changes and improvements.
After long use, photographs may become worn at the edges or torn. Your photographs will last longer if you can tape or paste them on to strong cardboard.
Make sure your photos do not get wet. Keep them in a file or box in a dry place. Organize your photo files according to the topic or subject of the photos.
Projected materials are simply educational materials that are shown to people using a projector. Projectors are machines that can only be used where there is electricity, and an experienced person to operate them. They need to be well cared for by someone who knows how to repair them if something goes wrong. Although these drawbacks mean that projectors are not usually practical for the community health worker to use in his or her village, a brief introduction to their use is given.
Projected materials are useful to underline the most important points in a talk or lecture. Therefore you should prepare your talk first. Then make or find transparencies or pictures that show the point well and help to clarify or illustrate it. Projected materials can also help people to learn a new skill, but a picture without practice sessions is not enough. Therefore, always include discussion or practice if you are using projected materials for teaching.
Projected materials are useful for groups of 30 people or less. If the group is too large, not everyone will be able to see. There are some small viewers for slides that can be used with one person.
Types of projectors
These machines show transparencies, which are clear, plastic sheets. You can write on them with special ink or wax markers and the writing can be rubbed out later.
You can make the transparencies in advance, or write on them during your talk, while they are on the projector. People usually prepare a series of sheets and use them like a flipchart. The use of projected drawings and words makes a lecture more interesting.
Slides for this kind of projection are taken by camera. Instead of being printed, like photographs, the pictures are produced on small pieces of clear plastic, and usually mounted in cardboard frames to protect them. Although slides are small, the projector makes the picture appear large against a wall or screen.
Slides can also be shown in a series. Often special boxes can be attached to the projector to hold the slides and make it easy to show one quickly followed by another. A tape recorder with music and words can be played along with the slides. This seems very much like a film or movie. In fact sometimes slides are joined together and called a film strip. Then you will need a film projector.
Check with different ministries and voluntary agencies to find out what slide programmes and film strips they have. Some topics may be relevant to your work. Always look at the programme before you show it to others. Make sure it is right for your community.
With an opaque projector you do not have to prepare special materials like slides or transparencies. This projector will show pictures, photographs, diagrams and words direct from a book, magazine or newspaper. It is not even necessary to cut these materials out.
If you are giving a talk you can find pictures that are related to your topic and show them. This will help the audience get a better idea of what you are talking about. The problem with this projector is that it is large and heavy. Modern slide and overhead projectors are lighter and easier to carry.
Where to find projectors
Even if you work with a ministry or agency that owns some of these machines, you may have difficulty getting one yourself. Projectors are usually available at your state, regional or national ministries. The ministries may loan you a machine for short periods and send someone to run it.
Using projected materials
- Five to ten good transparencies or pictures are enough for a talk. People may become confused and miss your points if you show too many.
- Each individual transparency or picture should be simple. If there is a lot of information the writing, drawing or pictures have to be small and it becomes difficult for the audience to see what the transparency is showing.
- Materials projected through the machine can be shown on a light-coloured wall, a white sheet or a special screen.
This is only a brief description of projectors and projected materials. If you would like to use them, you will need more skills. Find out if your ministry or agency gives demonstration classes on the use of these machines and on the preparation of materials for projection.
The type of tape we are concerned about here is the cassette tape. These can be played on small, portable machines that use batteries.
Because of the expense of buying the machine, the tapes and the batteries, it is unlikely that this tool can be used by community health workers. Middle-level, for example district, and front-line, for example community, health staff, however, may find it useful as an aid in various circumstances.
To provide health information and strengthen the health message.
The most common use of tapes is with groups. Sometimes in the clinic, hospital or school setting, individual patients or pupils can be requested to listen to a tape on a health topic related to their interest or problem.
Types of tape programmes
Once a lecture has been recorded, it can be played whenever there is a group or an individual who wants to hear about the topic. To make the recording more lively and interesting, it is a good idea to play some music briefly at the beginning of the tape. The whole recording should be short, no more than 10 to 15 minutes. Since the audience has nothing to look at, they will become bored if the talk goes on for too long.
These can be taped and played again for anyone who missed hearing them.
Role-playing and group discussions
When you play back the tape of a discussion or role-playing exercise, people can hear themselves. This will teach them about their behavior, attitudes and values. Before recording a discussion or play, ask everyone if they agree to be recorded. It may surprise or embarrass some people if you record them without their knowledge. It is usually better to erase the tapes after the session. People may have said things that they do not want others outside the group to hear.
Statements from important people
Short recorded statements from important people can be used to liven up and reinforce your own lecture or health message. It also adds prestige and weight to the statement.
Tape with slides
Slides and tapes together make an interesting programme, but it needs to be planned carefully. The talk that you want to record on to the tape should be written out first. This is called the script. The script should be clearly marked to show exactly when to change the slides. The person operating the machine will read the script while the tape is playing, and change the slides at the right time.
Many cassette tapes come in small plastic boxes when you buy them. It is necessary to keep the tapes in these boxes so that dust and dirt do not spoil them. If you do not have these small boxes, find a larger box or case for storing your tapes.
If you have a combined tape recorder and radio, do not leave the tape inside the machine while you are playing the radio (unless you are actually recording a radio programme). Tapes may pick up crackling sounds if left inside the machine. Also do not store tapes near other electrical machines, for the same reason. When you get your tape recorder, ask how to clean it so that it will not damage or put extra noises on the tapes.
Put a label on all educational tapes. The label should show the title of the topic, the name of the person or group speaking, and the date on which the tape was recorded. This will make it easier to find the tapes when you need to play them again.
Films or movies
People like films, because they provide action, colour and sound. They are a useful communication medium.
Many different kinds of films are made. Some provide mainly information. They look like lectures that use sound and visual aids. Some demonstrate skills. Others are like plays, and show real-life situations. People can learn about new behavior, attitudes and values in these films. Many are for entertainment.
Films can be shown to the whole community, but the larger the group, the less participation there will be. If possible, show films to groups of 30 people or less.
Where to find films
Ministries, libraries, voluntary agencies and some companies have films that can be borrowed. You will also have to borrow a film projector and possibly a small movie screen. Obviously you need electricity or a generator to show films. You may also need a skilled person to run the projector.
Do not base selection of a film only on the title. You should see the film first or talk to someone you trust who has seen it. Before you agree to show the film ask yourself these questions.
- Is the film in a language that the people understand?
- Does the film have correct and up-to-date information?
- Will the culture of the people in the film and the setting of the film look familiar to the people who watch the film?
- Does the film contain ideas that are practical for the community?
If the answer to any of these questions is 'no', do not choose that film.
You may think it is difficult to find a film for which the answer is 'yes' to all those questions. This is often true. Films are expensive to make. It is not possible to make a film to match the needs and culture of every community. It is often better to use plays, stories, puppets and demonstrations, because these can match your local culture.
To have a good film show, you need to do the following things.
- Find a time and place that will be convenient for everyone who wants to watch.
- Pass the word around the community, neighborhood or group so that many people will come.
- Show the film at night or in a place that can be darkened.
- Tell people, before showing the film, what it is about. This will help them know what they should look for and expect to learn.
- Make sure that everyone has a clear view of the screen. If too many people come and crowd the place, the view may be blocked. You may have to show the film twice so everyone has a chance to see it.
After showing the film hold a discussion session. Ask the audience questions about the film. Get them to ask you questions. Make sure they understand the film's message. If the group is large, break it up into smaller groups. Ask other health and community workers to help with the discussions in each of these sections.
The main purpose of newspapers is to spread information. They print 'news', which usually consists of reports of events. They also include 'features', which are articles on a particular topic, and 'editorials', which express opinions about various subjects.
Health topics can fit into any of these categories. Health news might be a report of the launching of an immunization campaign, or a speech about health made by a well-known official. A health feature might be an article by a doctor about a certain disease or health practice. A health editorial might urge people to take part in a clean water programme.
Newspapers reach many people, very quickly. The press can play a very important part in increasing people's knowledge about health.
Size of group
Newspapers come in all sizes, from very large to very small. A major newspaper in a national capital or other big city may reach hundreds of thousands of people throughout an entire country. Many are printed daily on large modern presses and are mainly concerned with national and international news.
However, smaller cities and towns frequently have newspapers of their own, which may be printed once a week. These papers have a special interest in local news, and a health event in your community might receive attention in such a newspaper.
Finally, the idea of a newspaper can be reduced down to the community level. Some villages and urban have 'wall newspapers'. These are like posters. They can be hand-made, in just a few copies, and posted on walls where people gather.
Using newspapers for health education
Newspapers can be used for health education in several different ways.
One way is to help your own professional growth. It is important for you to be aware of what is happening in health and community development. Newspaper articles are a good source of new ideas. For example, there may be a story on a successful community programme in another part of your country. You may wish to discuss it with your community leaders to see how it might be adapted to your own community.
Other valuable information might be a new or improved treatment of a certain disease, or a statement by a high official on the importance of health, which you can use to encourage participation. It is a responsibility of every health worker to be as well informed as possible. Newspapers can help you in this. Cut out and save interesting articles. You may be able to use them later on in your talks, discussions, or community meetings.
The second way in which newspapers are useful is as a way of sharing information with others. Even though many of the people you serve may not be able to read, there will be some who can. Often these are among the community leaders. They will appreciate your sharing information with them.
Newspaper articles are also useful for children in school. Health articles give excellent practice in reading. They may also stimulate young people's interest in a health topic. Remember that many school-age children play an important part in caring for their younger brothers and sisters, and that an enthusiastic youngster is often a very good educator of parents.
Writing your own news story
If an interesting health event is going to happen in your neighborhood or village, you should consider writing a news article, and taking or sending it to the newspaper that serves your area. Of course it may not be printed. But if the event is unusual, and the story is well written, it will stand a good chance. Newspapers, especially local ones, often need new material.
Even if the story is not printed, the task of writing it is a very good exercise. It forces you to think about how to express your message in a few clear, understandable words. This in turn makes it necessary to decide what are the most important facts and ideas you wish to communicate. This discipline will help you to communicate your message more effectively through other means as well.
Study a few examples of local news stories. You will probably find that most of them have several common characteristics. They are generally quite brief, with between 100 and 300 words. They use simple words, short sentences, and short paragraphs. They tell the reader the most interesting or important things first. They answer the questions who? what? when? and where? and then tell why and how if there is enough space. Some news stories tell about an event before it happens. Others report on it afterwards. Both kinds of report can be useful.
Now let's apply these general rules to a particular situation. A certain village is holding an immunization clinic and has invited a popular local orchestra to attract people to the clinic and entertain them when they are there. Your first idea might be to start by describing the target diseases and why it is important for children to be protected against them. But this would not be a news story. Get the unusual feature 'up front'.
'Mothers can get their children protected against four serious diseases, and listen to good music at the same time'.
This-answers the question who, and catches people's attention. Now let's answer the other key questions in the next paragraph.
'The popular Colima Mariachi Band will perform at a Special Health Festival (what) to be held on Saturday, 20 July, from 1.00 pm to 6.00 pm (when) at the town square in Santa Barbara Village (where).
Now it is time to explain why. Name the diseases against which the immunizations will be offered. Tell why they are important. If possible use some simple statisticsnewspaper editors like facts and numbers. Also, if possible, use a quotation. If the President or Minister of Health has made a statement on the importance of immunization, use part of it. If not, use a quotation from your local or district health officer.
This example was written to be used before the event. If you are reporting after the event, start with the most important thing that happened.
'More than 200 children were protected against four serious diseases at the Santa Barbara Special Health Festival on Saturday, 20 July'.
Now try this technique on a real or planned event in your community.
Making your own health 'newspaper'
Stories like the one just discussed can be used in your own neighborhood or village, even if they are not printed in a formal newspaper. The 'wall newspaper' mentioned earlier is one way. Perhaps a teacher in your community school would like to have his or her students make a wall newspaper as a class project. Or a local artist can write out and illustrate the story. Of course, if you have access to a typewriter and an inexpensive way of reproducing copies you may wish to prepare a one-or two-page paper for special occasions, or even on a regular once-a-month basis.
Magazines are another branch of the mass media with some uses in health education. They tend to be less accessible for the health worker than newspapers. They are generally intended for audiences in a very wide geographical area and are therefore less likely to be interested in local stories.
Many magazines do, however, carry useful information about health. Magazines written for women, for example, often have very important articles on child care, problems of pregnancy and maternal health, food and nutrition, etc. Even magazines intended principally for the entertainment of the general public sometimes carry health information.
Like newspapers, magazines can be an important source of continuing education for you as a health worker. In fact, magazine articles tend to be longer and more detailed than newspaper stories. Also, as with newspapers, such articles can obviously be shared with readers in your community and used as a basis for discussion.
From the health education angle, however, probably the outstanding feature of magazines is that they are a source of pictures. Magazine pictures are usually more numerous and often of better quality than those in newspapers. Many are in colour. Frequently you will find attractive and useful pictures even in magazines that have no articles on health, for example, pictures of healthy families, various foods, and many other things. These pictures can be used on posters and flannelgraphs, and in many other ways. Some magazines are devoted entirely to health. These are sometimes published by professional organizations, such as nurses' associations, or by ministries of health. They are especially valuable to you for your professional growth and for training programmes.
Of all the communication media, radio may now be the most effective for reaching very wide audiences with important messages. Certainly this is true in large parts of the developing world. Even in remote areas many farmers carry radios with them to the fields.
Radio programmes serve many purposes. Some are purely for entertainment. They provide popular music and dramatized stories. Others are informational. There are several news broadcasts each day on most radio stations, at regularly scheduled times, and entertainment programmes may be interrupted for a news bulletin if something important happens. In addition, some radio programmes are designed for instruction or education. In many countries there are daily or weekly programmes on food and nutrition, on farming methods' and on health.
Finally, radio stations in many countries use very short messages, usually of one minute or less, for commercial advertising or to make public service announcements.
The size of the area covered by a given radio programme or station varies widely. Some are national or even international. In some countries, all the radio programming is done at the national level, and the local stations in smaller cities outside the capital, if they exist at all, are used mainly as transmitters. In a number of other countries, however, there are local radio stations in smaller cities and towns. These may transmit national news and some other national programmes and also broadcast local news, local advertisements, and local educational programmes. So, even on the same radio station, some programmes may be designed for an audience of millions and others for the much smaller target of a district or region.
Use in health education
Health messages can be delivered by radio in many different forms. News items about health events can form a part of regular news broadcasts.
Special educational programmes on health topics can be broadcast, ranging in length from a few minutes to an hour or more. These can be in the form of talks, interviews, or discussion programmes at the radio station.
Because radio is a very important entertainment medium, some of the most effective messages can be delivered through songs, stories or plays. In many places there are very popular dramatic programmes usually dealing with the problems faced by a family or group of individuals. When these problems are health-related, the message is contained in the way in which the characters deal with them. The audience does not realize that it is being educated as well as entertained, but it does receive the message, which is all the more likely to be remembered because of the form in which it is conveyed. Care needs to be taken with this method to avoid being over-emotional or trying to force people to change their views.
The information given in radio advertisements poses a special problem. Some of it is true, but some is only partially true, and some deliberately misleading. Many radio stations receive a large part of their financial support from the products they help to sell. When these products are harmful to health, as in the case of cigarettes, for example, the message that people hear is false. Part of your job is to help people to be aware of these things and to be careful listeners.
It is usually possible to obtain a schedule of broadcasts in advance from the radio station that serves your area. This is important information for you. You can learn when programmes about health will be broadcast and what the subjects will be.
If you find out that a programme on a subject of importance to your community will be broadcast in a few days, spread the word. Put up notices in key places. Inform your health committee members and other community leaders. Urge everyone to listen. Better still, invite people to meet in a convenient place and listen together. Ask them to come a few minutes before the programme is scheduled to begin, so that you can introduce the topic. Then encourage discussion and questions as soon as the programme ends.
One of the so-called disadvantages of radio in health education is that it is a one-way medium. People cannot ask questions or talk back. By holding radio meetings, you can turn this disadvantage into an advantage.
One small word of caution: do not be afraid to say that yow don't know. You will have prepared yourself as well as possible in advance of the programme. But something may be said that you do not fully understand, or some question may arise for which you do not have an answer. 'I don't know, but I will find out' is alwais an acceptable response, and is better than giving an answer that may not be accurate.
Getting your community programme on the radio
If you live within reach of a local radio station that does some of its own programming, you may be able to use radio more directly. Many local radio stations, like local newspapers, need interesting news items, interviews, or public service messages.
Radio news items, like those for newspapers, need to be brief; in fact, perhaps, even briefer than for newspapers. In the case of the story about the Santa Barbara Special Health Festival a radio news programme might use only the first two paragraphs, plus a list of the immunizations offered. But, unlike newspapers, radio stations may use the same item several times over a chosen period.
In many places radio interviews offer a special opportunity. If your community is having an important campaign or event, and especially if your health officer is well known and a good speaker, you could suggest to the radio station that they carry out a radio interview.
If this should happen, you would probably be expected to draft a list of suggested questions that will bring out the information you wish to convey. You will also need to be sure that your health officer or spokesperson gets to the radio station in good time, so that he or she and the announcer can get to know each other a little. You also need to be sure that the people of your community are gathered to listen.
Public service announcements
If you have access to a local radio station, it may be willing to broadcast very short public service announcements on health. These can serve many purposes. They may announce an event like a health fair or immunization programme. Or they may give very brief health messages to serve as reminders to those who are listening.
Some announcements are as brief as 10 seconds. Even these can be useful, however, especially if they are broadcast many times. In a 10-second announcement you could say.
'It's Health Week in Santa Barbara. Remember, mothers: for your baby, breast milk is the best milk.'
Other public service announcements last 20, 30, or 60 seconds. Obviously you cannot include a very complicated message. But it is surprising how much you can say in a minute if you write the script carefully.
Try writing a few health messages of the various lengths just mentioned. This will be a good exercise in choosing the most important words and ideas, and seeing how many words you can fit into the given time.
No other medium creates such lively interest as television. It can have a great impact on people. It can extend knowledge, influence public opinion, introduce new ways of life. In the health field, in urban areas and even in rural communities, it has already served as a powerful advocate of healthy behavior in many instances. This is especially so when the health workers are able to integrate television programmes into their local activities, and to extend the impact of the medium through group discussions on the lines we have already discussed for radio programmes.
There is a new aspect of television that has much potential for health education. This is the use of video films. In some areas, video films are shown to small audiences by local groups. These groups may, or may not, have commercial interests. There are even places where series of films are projected throughout the day and people go to the show just as they would go to a cinema.
Do you know whether this approach is being used for health purposes in your community or in other communities? Do you think it has value for health education? What problems do you foresee?
It has often been said of health educators that 'all they do is give talks and hand out booklets'. We know that this criticism is exaggerated. But it must be admitted that, in many educational programmes, too much dependence is placed on distributing written materials in the form of booklets, pamphlets, or flyers without the necessary back-up in the hope that they will do the job alone.
Even with a highly literate audience, written material alone will rarely, if ever, lead to healthier behavior. This is especially true if the literature is filed with technical terms and jargon understood only by professional health workers, or if the booklets are poorly illustrated, written in long, complicated sentences, and printed in small type. Unfortunately this describes a great many booklets that health educators distribute to the general public.
It is, of course, self-evident that such material is even less useful for audiences with limited reading ability. To depend upon booklets or pamphlets to do all, or even a major part, of a health education task is to invite failure.
Nevertheless, written materials can serve a useful purpose in an educational programme. Written materials can achieve the following.
- They can remind individuals or families of a health message they have already learned in other ways. For example the importance of protecting children against a specific disease.
- They can provide additional information about a health problem or health practice for those who have a special interest in it.
- They can show the steps that must be followed in order to achieve a certain health goal, such as the way to mix the salt and sugar for the oral rehydration drink.
- They can share information with those who may not have received it in other ways.
Using written materials in the community
You, as a community health worker, probably do not have the facilities to produce your own written material, beyond simple posters, wall newspapers, or single-sheet flyers. Therefore your task is to select, from what is available, the material that is most appropriate to your community's needs, and to decide how to use it most effectively.
Selection requires, first, that you know what is available. Your regional or national health education office should be able to tell you about written material on a particular topic and perhaps send you samples. Other potential sources of useful booklets include voluntary associations, professional associations and commercial sources. International organizations like WHO and UNICEF have prepared pamphlets for communities on a number of subjects (see the Reading List).
Once you know what written material exists and how it may be obtained, there are several questions you need to ask yourself before deciding to use a certain booklet.
- Is it written in a language and style that people in my community can understand?
- Is it well illustrated? Will the pictures seem familiar and relevant to my audience? This is a special problem in the case of pamphlets produced on an international scale. They may show houses, clothing, etc., that will seem alien and strange to your community, and this strangeness may interfere with the usefulness of the publication.
- Does the booklet contain the message I wish to convey? This is an especially important question in the case of commercially produced pamphlets. They may be very attractive and give useful information, but may also contain a hidden advertisement that is contrary to your purpose.
- Assuming that relatively few copies will be available, how can I make most effective use of them?
In general, booklets or pamphlets are best when they are brief written in plain language, full of good pictures and, above all when they are used to back-up, rather than form the basis of an educational programme.
Local or traditional media
In many countries health messages may be communicated through traditional media such as art, town criers, songs, plays, puppet shows and dance. These are discussed below.
Shapes such as hearts, crosses or those of certain leaves have meanings for people. The meanings are different in different cultures. The use of animals in art also has meaning. An owl in one culture may mean wisdom, in another it may mean evil. Other animals are used as symbols to represent such characteristics as honesty, cleverness, laziness and courage.
Colours have meaning. A painter or weaver will choose colours for a purpose. Some colours are considered lucky. Some colours are thought to be best for children, some for adults. Meanings may range from bravery to cowardice, purity to evil. Some colours are used for special circumstances.
Talk with the weavers, painters, carvers, potters and other artists in your community. Find out the meaning of certain shapes, signs, animals, plants and colours. Use these symbols when you design a poster or other visual aids such as flipcharts, and flannelgraphs.
If you are designing a poster about the dangers of drinking untreated stream water, find out what signs, colours or animals mean danger. Use them on the poster. If you want a poster that shows the benefit of immunization, use colours and symbols that mean good luck and happiness. Your educational message will be clearer if you use traditional art forms and symbols.
Involve the traditional artists in your village in designing and making educational tools. The artists could go with you to a school to help teach the children about health and art at the same time. With the guidance of the traditional artists, children could do art projects with a health theme.
Can you name the artists in your community? What different kinds of art are there? We mentioned some that you can look at. How about art that you can hear? Poetry and music are two examples. Can you name others?
Do you have any examples of traditional art in your house? Do you know the meaning of the signs, shapes and objects on the piece of art? How could you use these in your educational programmes?
Before radios and newspapers were invented, people had ways Of spreading information and news. In many rural areas there are no newspapers, and radios only carry regional or national news. In most villages, then, there are still other ways of spreading the word about an important event or idea. Announcement by the town crier is one of these ways.
If the leaders of a town or village want to get information to their community quickly, there are usually special people who can help them. These people have the job of spreading information. When they have something to say they may use a bell or drum to attract attention. Drum beats and other sounds can be a special code or signal that people understand.
If the village is small, the town crier may go to a central place and begin announcing the message from the leaders. If the village is large, the town crier will walk around every section. In the larger towns, there may be several town criers to ensure that the news spreads quickly to all parts of the community. The announcements often sound like songs.
Town criers may use their own voices or various musical instruments, or both.
The message carried by town criers could be to ask everyone to assemble at the chief's house, or at the town hall, for an important meeting. The message could be news from a neighboring village. It could also be a warning about some danger like the outbreak of a disease. Town criers may announce the birth of a baby or the death of an elder.
Many of the messages normally delivered by town criers relate to health. This is good, but you cannot go out singing messages yourself. People in the village know who is the real town crier and may only respect information coming from him or her. Nor can you ask the town crier to make the announcement for you. He or she works under the orders of the town leaders.
Therefore the way to involve town criers is through the town or village leaders, with whom you will probably already be working closely if you are planning a community health programme. The leaders can tell the town crier to help you. Here are examples of messages that could be passed on.
- A reminder to mothers to immunize their children.
- A request that people participate in a village clean-up campaign.
- A call for people to work on a community project such as digging a well.
- A warning about dirty water during a cholera outbreak.
People sing to express ideas and feelings. Many songs are about love and sadness. Songs may tell a story of a famous person or event. Some songs are religious, others are patriotic. Songs are sung to help children fall asleep or to celebrate special occasions. They can also help to educate people. Singing comes naturally in certain cultures, but not in others.
Songs can be used to give people ideas about health. If the tune is attractive, people will remember the song and the information it contains.
Depending on the local culture, songs can be used at the beginning of a health talk, a meeting, or any other organized programme to create enthusiasm and interest. They can also make a meeting end on a happy note.
Size of group
The group can be large or small. Songs may also be played on the radio to reach a wider area and audience.
A play portrays life and people and tells a story that usually involves conflicts and emotions. The action and the dialogue are typically designed for theatrical performance with dramatic effects.
Just like stories, plays make us look at our own behavior, attitudes, beliefs and values in the light of what we are told or shown. Plays are especially interesting because you can both see and hear them. They can even be used to raise funds for community self-help and other projects.
Size of group
Plays are usually performed for large groups and are intended to reach whole communities.
A play is based on a story. The story may be true, or it may seem like the truth. The story has a beginning and an end. The people who are putting on the play know the whole story, but the audience does not.
A play has characters. That is people who act the different parts in the story. You can have any number of characters.
A play has scenes. If a story was acted out just as in real life, it could take several days. A play is generally a couple of hours long, but can be less. So, a play is made up of important short scenes or events.
A play can have a message. It may have a definite ending where all the problems are solved for better or worse. In this case, the lesson or message people learn from the play is usually obvious. Some plays have uncertain endings. They stop before the problems are solved. This makes the audience think hard. They wonder what might finally happen. They are curious about the characters. After this kind of play people like to talk and discuss. Since the message is not clear, people ask themselves 'What would I do next if I were that character?' This helps them practise decision-making skills.
Types of play
In many cultures there are traditional plays that are performed during festivals and at special times of the year. They are often based on the lives and actions of ancestors, spirits, and famous people from the past. Traditional plays have a theme or message for the community. There may be ways in which the message relates to health. Such plays are closely tied to community values and beliefs. This makes people feel close to their culture and community when watching them. Social support grows out of this feeling. Traditional plays with health themes can be performed during a community health education programme. You may even write a play of your own resembling the traditional type.
You can write plays about present-day people. Take one of your health education stories and make it into a play. You could write out the words and actions for each character. To create more participation and interest, you could gather a small group of people who are willing to act in the play. Tell them the story. Let them choose what characters they want to be. Then ask the group to make up the speeches and action themselves on the basis of the story.
Clothes or costumes
What will the actors wear? They should wear the kind of clothes that would be natural for the characters they are playing. Farmers, businessmen, teachers, and religious people will all wear different kind of clothes. You might have to make special clothes for the actors to wear, but first see if they already have or can borrow suitable clothes.
Where does the story take place: on a farm, in town, inside a house'? You will want the audience to know. You may borrow furniture and you may paint large pictures on paper or wood. Do not spend a lot of money on scenery. Sometimes you can just tell the audience where the story takes place. Ask them to 'see' the scenery in their imagination.
What kind of work do the different characters do: cooking, sewing, carpentry, farming? Collect or borrow things that these characters will need to use in the play so that they can look real while they act. A farmer may need a hoe or a knife. His wife may need cooking pots.
Find people in the community who are interested, who are not afraid to perform before an audience, and who can speak fluently. Schoolchildren can be successfully involved in plays as part of school health projects.
You can make posters or use town criers to let people know about the time, place, and theme of the play. It is a good idea to give the play an interesting title. That way people will get an idea of what it is about. If it is a good title, people may come out of curiosity.
Planning the performance
The actors must practice until everyone knows his or her part in the play. You might ask some friends to watch practice sessions and give their comments. This is a way of pre-testing.
Make sure all materials needed are gathered together well in advance. Select a location for the play. If the play lasts longer than 30 minutes, people will need to be able to sit down. Plays can be done indoors or outside, depending on the weather. You can use a town hall, school, or other public meeting place. An audience can sit on a hillside, for example, for a play acted outside. In fact, you can do plays anywhere. Short plays can be performed in the market or the town square. People will gather when something interesting is happening.
Make sure that everyone can see and hear. You will probably want to repeat the play on several days if your village or neighborhood is large. That way everyone will get a chance to see it.
Participation and learning
A play provides a good opportunity for people to participate. As we have seen, some can act, some can make or donate costumes and scenery, and others can make posters and announcements. Many different jobs go into making a successful team.
Everyone involved in putting on the play will learn because of their direct participation. They will learn the health messages of the play, and they will learn skills. These include planning and communication skills.
The audience will gain from watching the play, but you should me' e sure that they learn. Therefore, after the play, get the actors to discuss it with the audience. Questions can be asked back and forth to help the audience learn.
Puppet shows are very similar to plays. The main difference is that puppets do the acting. People are still needed, however, to make the puppets move and talk.
Just like stories and plays, puppet shows give examples of how people behave in real-life situations and can make us reflect on what is good and bad for health.
Uses of puppets
Puppets are made to look like small people or animals, but they behave like real people and become involved in a series of events resulting in conflicts and problems. Since you can make puppets look like animals, you can also use puppets to act out fables. You can even use a puppet to help you give a health talk.
Size of group
Since puppets are usually small, it is best to show them to relatively small groupsabout 20 people. In that way, everyone is able to get close, and see what is happening. Of course, you can make puppets as large as children or as small as a mouse. Children usually love puppets. And their parents often enjoy watching with them. There are many types of puppet. Here are three common types.
These puppets are made of cloth. You put your hand inside the puppet to make its arms and head move. You can hold hand puppets on your lap, or you can go behind a table and use the table as a stage for the puppets to stand on or you can make up a stage using a box and some cloth for curtains, as shown in the illustration.
These puppets have strings tied to their arms, legs, head and mouth. You stand above the puppet and pull the strings to make it move. String puppets can be made of wood, cloth, cardboard, and other common materials. Local artists such as wood carvers can help you make puppets.
Shadow puppets are net pieces of paper, wood, or metal, made in the shape of people or animals. These are painted and decorated with faces and clothing. Sticks are attached to arms and legs to make them move.
Shining a light on these puppets makes their shadows appear large on a wall or screen behind them. These puppets would be used at night or in a darkened room.
A similar idea is to place the flat puppets behind a white sheet or a thin screen. A light is shone on them from behind, so that their enlarged shadows appear on the sheet or screen. The audience only sees the shadows so it is not necessary to paint or decorate the puppets.
Planning the puppet show
The steps that must be followed in planning a play also apply to puppets. Selecting the story, words, and action, drawing or painting scenery where necessary (though for smaller scenes), choosing a good place to show the puppets and encouraging audience participation and discussions, all need to be carried out carefully.
People can communicate ideas through movement of their bodies. This happens, for example when you wave your hand or wink your eye. In some cultures, traditional dancing is used to tell stories.
Some dances do not tell specific stories, but they mark certain events. There may be special dances for births or funerals. There may be a special dance for the beginning of the planting season to express hope that the land will be fertile and the crops productive. A dance at harvest time may be to give thanks. Such dances communicate ideas.
To bring people together in fellowship and happiness and to provide feelings of support and communicate ideas.
Size of group
If dance is a common means of expression in the culture where you work, use it, together with plays, during a health talk or at a club meeting to communicate appropriate ideas and feelings of support.