Jordan Ash and Dr. Randy Page, Health Sciences

Introduction

The well-intended efforts to promote health education in destitute countries often focus on rallying support for programs. With large goals to reach more people, two vital topics receive inadequate attention: the quality of the education provided and methods to evaluate the success of the program.

I investigated the structure, methods, and materials used by successful non-government organizations in Mozambique and India. I focused on groups that encourage health education and a higher standard of living in destitute communities.

My goal was to create a program in India to help individuals unite to overcome communal and individual challenges in health, economic development, and literacy.

Methods

My investigation was conducted in four steps. First, I did extensive research into existing programs. A wealth of information was found in books recommended by Dr. Page and other experienced professionals (see references). Second, I contacted successful organizations to acquire materials, lesson outlines, and advice. Third, I consolidated my findings, creating a plan of action to apply to community health programs in India. While in India, I began the on-going fourth step of my research: adapting the program with the help of local health administrators to the needs of eleven villages and six slums in southeastern India.

Results

My early efforts gathered effective materials and teaching techniques from organizations around the world. These finding are compiled in a 209 page manual published, translated, and distributed by The HEAL Foundation to health educators throughout southern India. The manual includes teaching instructions and materials for seventy-two, local Indian illnesses. The value of the manual is its use of simple techniques, teaching with illustrations, games, songs, and interaction.

However, even more than the use of appropriate materials, my research quickly showed that using effective methods to reach destitute communities is essential to success. True progress cannot be made merely entering a community and sharing knowledge. Instead, social workers must frequently visit a community over an extended period of time, showing sincere interest and concern. The workers thus develop a strong relationship with the people in the community. Meanwhile they encourage discussion among the people. They help people talk about solutions to their problems. The workers can also build credibility by securing aid or services for their community from outside resources.

The following four-step strategy explains how an organization can enter a community based on the guidelines above:

Assessment
Assess the needs and wants of a community through grassroots evaluation: surveys, regional statistics, and meetings with local leaders and partner organizations.

Training
Hire and train community workers and provide them with relevant materials.

Action
Once trained, these professionals make daily visits to target areas, build rapport with the locals, and work with them to organize social support groups for those with specific needs. They teach health; they lobby for the needs of their communities in nearby hospitals and local governmental agencies; they organize community projects; they also refer individuals to partner organizations where they can receive training in life skills.

Evaluation
Maintain close contact with staff, providing support and receiving feedback. Conduct follow up assessment.

When evaluating the success of an organization, every effort should be made to collect relevant data using proper statistical procedure. A complete evaluation should focus on five key points: first, a strong association between the efforts of the organization and the data being collected, second, a consistent effect over time and space, third, the dose-response relationship, fourth, the cause preceding the effect in time, and fifth, the physical explanation of the effect. While such a complete evaluation takes a great deal of time and effort, it is absolutely essential to the success of the organization.
For more information on the results of this project, visit www.thehealfoundation.org. Results were also presented at the 8th Annual Micro-Enterprise Conference in February 2005.

References

• Bensley, Robert J., and Jodi Brookins-Fisher, eds. Community Health Education Methods . Boston: Jones and Bartlett, 2003.
• Mayfield, James B. One Can Make a Difference. New York: University Press of America, 1997.
• Werner, David, and Bill Bower. Helping Health Workers Learn. U.S.A: Reuben Granich and Jonathan Mermin, 1995.
• Werner, David. Where there is no Doctor. U.S.A: Reuben Granich and Jonathan Mermin, 2003.
• Klein, Susan, Suellen Miller, and Fiona Thomson. A Book for Midwives. U.S.A.: Reuben Granich and Jonathan Mermin, 2004.