|Oral Rehydration Therapy and the Control of Diarrheal Diseases (Peace Corps, 1985, 566 pages)|
|Module Six: Community health education|
|Session 16 - Selecting and using non-formal education techniques to promote the control of diarrheal diseases|
"Love him and mek him learn"
Children in school are a captive audience. In the parish of St. Thomas, Jamaica, they are being taught how to help bring up their own younger brothers and sisters. Parents, teachers, and children are responding well.
S. Thomas has long been regarded as one of the parishes in Jamaica most susceptible to poor health and the outbreak of disease. Many families live in extreme poverty with poor standards of housing, and face other environmental problems which affect the physical and mental development of their children.
Since February 1982 a joint programme involving UNICEF, the Ministries of Health and Education, and the Tropical Metabolism Research Unit (TMRU) of the University of the West Indies, has been making inroads into those conditions. Primary school children are at the heart of the programme, taking pan as change agents in a teaching approach which departs from the usual primary school tradition.
Jennifer Knight, the Project Director, describes the results after one year as "very encouraging: we are getting there slowly but surely." e story of the St. Thomas project is, in very large part. the result of her hard work and dedication. Indeed, her indetatigable enthusiasm seems finally to be attracting the attention of the Ministry of Education, with which the programme's long-term prospects rest. According to Jennifer Knight: "Our long term goals are to integrate child health and development, and improve parenting skills throughout the country."
The project is based on the assumption that all aspects of children's development social, emotional, intellectual, health and growth are strongly influenced by their environment, including the quality of child in St. Thomas, parents of very poor children do not have the right knowledge about hygiene and child feeding. They also fail to appreciate the importance of play. So children often fail to develop to their physical and mental best. In addition. health and social services are often inadequate at present, particularly in remote rural areas.
According to Jennifer Knight, the St. Thomas project took a new approach to solving these problems by using primary school children initially, the programme involved seven primary schools in the western part of the parish and later extended to the eastern side, gradually encompassing all the primary schools in the parish. The children were taught basic child rearing practices, focussing on hygiene, child-feeding and child development.
Another objective is to help the school children become good parents in their turn, and to improve the care received at present by younger siblings. Even the parents' knowledge and skills can be improved by their children. And the programme also seeks to improve teachers' knowledge.
The idea is to use the educational services to promote the health of the community.
Children themselves are agents of change
In most Caribbean countries, primary school education is free. Schools have in the main only been used for traditional educational purposes. However, primary schools are a natural channel for services aimed at improving the health and development of young children. They present a captive audience of older children who can be used as agents of change. Large families usually have children whose ages are spread over a wide range, and older children are expected to share in the care of the younger ones in addition, Jamaica recently introduced compulsory education, which has helped to improve school attendance. Teachers are very respected members of the community.
Initially, working with children in Grade IV (9-11 years old), the programme concentrated on teaching three main topics: young child nutrition; promoting a healthy and safe environment, and child development.
Two weekly workshops were conducted with 14 teachers from grade levels four and five, for one school year. Teachers were given detailed lesson plans with ideas and activities. They were encouraged to develop these and to discuss the children's response to the lessons. Modifications were made to ensure that lessons were easily understood and enjoyable. Much discussion took place on health problems, and measures they could use to solve them.
The approach stressed participatory activities for the children rather than didactic teaching, stimulating the children's interest, and motivating them to take home child health messages to their parents and to look after their younger brothers and sisters more competently.
A series of songs and jingles was compiled, using folklore music and the Jamaican dialect, emphasizing all the important child health and development themes. Pictures were designed, which the children coloured and took home. Mindful that the reading level of both the parents and the children was poor, the messages were largely pictoral although a few simple words were added.
Jennifer Knight reports that the project implementors found a higher level of illiteracy in the schools than anticipated but encountered a wide range of abilities among the children. Accordingly, only very basic child health and development messages were used in the curriculum, focussing on preventive activities.
Food for growth
In the first semester, children were taught about the importance of food for the young child's growth, especially in the early years when children grow rapidly. The following lines from one of the songs sharpen the point
"When de baby reach four months old
There are things you should be told
Give the thick porridge from a spoon and dish
And den you will get all that you wish..."
The values of breast-feeding the child at the right time was also emphasized. The chorus of the same song brings out the message:
"She get di breastmilk
(day and night)
She get it for a year
She never get sick
They were taught when to introduce porridge, how to serve food to the young and when to introduce the baby to the family pot:
"She can eat foods from de pot
(at six months)
All de vegetables fruit and meat
All de mashed foods, fish and peas
Mek sure dem all nice and clean
In the second semester, the children were taught how to make their environment a safe and healthy place to live in. These lessons emphasized that germs caused diseases; that certain insects and animals carry them; and showed how mosquitoes can be controlled.
Jingles also focussed on personal hygiene and proper food preparation:
"Germs like dirt
And garbage too
Germs will make you sick
Keep germs out
Germs like food
Dirty hands too."
(From: UNICEF News Issue 119, 1984, pp. 12-14)