PRODUCING MANUALS FOR HEALTH WORKERS: How to do it
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- Title
-
PRODUCING MANUALS FOR HEALTH WORKERS:
How to do it
- extracted text
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PRODUCING MANUALS FOR HEALTH WORKERS:
How to do it
by
Peter Godwin
(Educational Officer)
I
CONTENTS
Page
Introduce ion
1.
Why are Manuals needed?
3
2.
What makes a good Manual? An Overview . .
7
3.
What are the problems, with Manuals?
10
4.
Planning a Manual
19
Getting the content right: Relevance
25
6.
Achieving Usability: How should we present
the text?
7.
Publishing a Manual
30
37
Append ic es
A. Testing readability: Tests
B. Using manuals for teaching & learning:
some suggestions
C. Notes oh Needs Assessment for books .
D. A short annotated Bibliography . . . .
References
AM REE
1983
8.082:
376.81
GOD
1
44
48
51
54
Introduce ion
Ih i s
o
booklet
has
been
wr ic t en
tor
tour
ma i n
reas on s :
to
brin
t o t h e a t t en t ion o r m a n u a 1 w r i t e r s
some
areas
cons i d e r a t i o n t h a t h a v e otte n been ignored;
t o s h a r e some e x p e r i e n c e s i n u r i t i n g
ma n u a 1 s ;
t o o f t e r s o tn e g u i d e 1 i n e s t o man u a 1 writers,
b a s e d o n these
ex pe r i en c es ;
t o st i m u1 a t e t u r t h e r disc uss ion,
research and w o r k o n
prod u c i n« better manuals .
of
1 n th is booklet the term "manuals" has been
used rather t ii a n
" n e a 1 t h learning materials" as simpler a n ci
more f ami liar. 1 t has
o e e n used t a i r 1 y interchangeably w i th m ore
general ter m s s u c h a s
" b o o k s " , "textbooks", "handouts" etc. 1 b e 1 i e v e
t h a t we al 1 k n o v;
v/ n a t w e rn e a n when we talk a b o u t " m a n u a 1 s H and
that further debate
o n ter mi n o 1 o g y is u n n e c e s s a r v .
b q u a 1 1 y , t h e ter m "heal th wo r ke r s “ has not
defined: t h e r e are too in a n y d i t t r e n t k i n d s
countries and p r o g r a in m e s .
been p r e c i s e 1 y
i n too m a n v d i f f e r e n t
however, the s a ci d 1 e o f c o :n m o n - s e n s e upon
the horse or i m a gin a t ion
- should, 1 be 1 i e v e, carry the reader to an
appl icat ion o t ” m a n u a 1 s
tor health workers ii that i s ■appropriate t o
h i s s i t ii a t ion.
£
I
i
I
2
CHAPTER
WHY
ARE
ONE
MANUALS
NEEDED?
;•
1
The shortage of learn ing
resources,
for health wo r k e r s around
the wo rid
books so important?
and i n particular
i s notor ious . Yet
books,
why are
F
0
a
c
They are a n in format ion
resource for student s and
teachers o n what is
i s to b e learned .
They help t o s t andardi z e
both training and on-the-j ob
per formance, wh ere these
are often very varied i n
prac t ice depend ing o n quality
an d quantity o f facilities,
teachers , curricula and wor k i ng
conditions.
Appropr lately written and used
they can help to
t o improve
both con ten t and me t h o d s
and quality o f training.
A wo r 1 d
bank
repor t
on
school
textbooks
and
teachers noted :
"From the evidence s o
far, the availabil i t y of
book s a p p e a r s
to be the most consistent
school fact o r i n predict!
ng a c a d em i c
achievement. Lt i s pos i t i ve
i n 1.5 out o f the 18 s
t a t i s tics
(832) . This i s , for
example, more favourab le than
the 13 out
o f 24 (542) r e p o r t e d
recently fo r teacher t r a i n i
ng . " (1 )
Th is evidence trom
from less
less industrial i s ed
societies, while refer ring
t o schools rather than post-school
training, is significant.
i s reflected i n growing demand by Agencies, t i s
It
o
Ag e n c i e s ,
a c h e r s and students
for books, and
all forms of
o f teaching- 1 earning
materials :
"Ther e is need for
more learning materials for
students
and resource mater i a 1 for
teachers . The learn ing mater i a 1
should b e des igned t o p r omot e
a c t i v e s t ud en t participation
in the educat ional
process . ii (2)
A worxshop convened
i n 1976 by the Commonweal th
R e g i o n a 1 Health
becretar iat and the Afrlean
Med i c a 1 an d Research F o u n d a t i
on to
examine the availability
of books and learning resources
for
health workers i n
East, Central and Sou t h e r n
A f r i c a conf irmed :
"that the
th
s h o r t a g e s o f •appropriate
s erious ly decreased the
effic iency
many existing training.programmes
3
teach in g materials
and ef fee t iveness o f
"
(3)
i
!•
i
L ii e w o r k s n o p
I d C il t i i i e cl
mil c e r i a 1 s a s :
t
tin?
”scr iou
a ps
i n
c ii
a v j i 1 . i d i I it y
ot
Job- o r i o n t e ci [ u n c t i o n a I nook s r e 1 a t e d
c o n o n - ii o s p i t a 1
s i t u a t ion s o f a 1 1 types , a t bo t ii
s e n i o r and jju
u n iio
o r lev e 1 .
M o r e I ii e o r e t i c a 1 b o o k s b u t a d a p t e d
t o A r r i c a u ci
d i s eas e
,p a t f e r a s . "
r: a ppi 1 y ,
i n
in i j r t-
ino re
r c countries,
a n d mo
e ci u c a t i o n a 1
techn i ■i 11 s
for
mater i a 1 , d is t anc
a n c e c e a c n i n'g ni a t i' r i a 1 ,
superv i s ors '
gu ides, procedural c ii e c k 1 i s t s ,
• re t e r-e n c e hi a duals
an u on - t a e - j o o wo r k
m annals a r e b e i n g a p p4 'i e-d*. T'n i s
per,! a p s
o n e oi the
tii e m o s t cost-oe.nefic i a 1
aspects of
o r tne wii o 1 e pri mar y
n e a 1 t ii c a r e concept .
L’ r o due i n g
1 e arm n /
add res s i ng
Con fe ren c e i n
A OO G ,
k e ■; i o n a ■
t n e Th i r d C onimo n we a 1 t ii
'J a i r o b
i n 19 75 s a i d :
?i mister
o f
a e a 1 t ii
'A 1 t il
a 1 i t ii e s ii o r t a g e
we nave
a u in 0 e r s o I t r a i n e d P e o p 1 e ,
s c n oo 1
peri e n c e d t e a chers , etc. — that
are go i ag ro t ake
a 1 o a g t 1 :;i e t o bu i Id ii p ,
t ii e lack o i a p p r o p r i a t e a n d
aval 1 a b1e
o o o k s ’ s a v e r v s e r i o u s hand i c a
k 3 )
P •
a 0Od
v.- e n t o n t O describe
s t ’i dent s m u s t o w n tiie hi .
an
i hi p o r t a n t
aspect
of
5ook s :
t aa r
?1 u c ii c o u Id
0u t
t il i s
is
o e said o n the prob 1 e in o I
av a i 1 a b i 1 i t y o t □ook s
n o t the time a n d p lace t o d v.> ell
o n a ri y t ii i n g o t ii e r
t ii a n o n
oas i c
o n c e p t . 1 f a ii e a 1 t n v; orker i s g o i n g
to
ma in t a i n a a d d e v e 1
op h i s k n o w 1 e d g e after n e f i n i s h e s a i s
o a s i c train i n g h e must c o n t i n u e
t o have a c c e s s t o b o o k s
and
j o u r n a 1 s . T n e common p r a c t i c e
o r i s s u e i n g book s d u r i n g
t r a i n i n 5 a n d recalli ug tthem
ii e m on q u a 1 i f i c a t i o n
i s c o m p a r a i) 1 e
t o train in g a carpenter
and taking
his
i s h amm e r away b e f o r e h e
8 Ii
starts t o build. Every health wo rke r s h o u 1 d
wo r k e
f inis h h i s
t r a i n i n S w 1 t ii one, two o r five
v e books that h e takes w i th
11
ii i m .
17 bat
has
a 1 r e a ci y
been
done?
Until th
in i d 1 960 ' s t h e major i t y o f
books for h e a 1 t ii worker s
were o
o ft t w o sorts :
local 1y pr oduced mater i a 1 , and
t ii e w e 1 1 establisiied books from E u r o p e a n d
Ame r i c a . Local 1 y produced
mater i a 1 w a s n o r m a 1 1 y t li e
result o f *energetic i n d i v i d a 1 s
or
tea in s w o r k i n g i n part i c u 1 a r
c ou n t ri e s and p r o g r a m in e s . I t w a s
o f t e n li i g Ii 1 y spec i f i c t o t h e
part i c u 1 a r worker s i n v o 1 v e d i ii
t ii e
p r og r a mm e ;
i t was s e 1 d o m p r o f e s S 1 o n a 1 1 y
published;
i
t
t
c
a
d
e
d
to
arise fro m the p e r s o n a 1
e x p e r i e n c e o f t Ii e w r i ter i n ii i s
o
r
her
teaching or s u perv isory w o r k ;
an d
i t seldom ac h i eved widespread
d i s t r i b u t i o n beyond t ii e p a r t i c u la
r programme -it was’ writ t e n
for .
4
Handbook for Med i c a 1 Ass is tants for use in
E x a m p 1 e s a r e the
Rural Heal th Units" from Malawi (4 ) "Handbook for Dispesary
attedants and medical field unit ass i s t a n t s " ( 5 ) c originally
w r i t t e n for Nigeria in 1 942; and the Midwi fery and M C H Manuals
i n 1958.
produced in Papua and N evz G u i n e a (6 ) originally written in
4
f
T h e w e 11-established textbooks from Europe and Arne r i c a were often
even older; "Aids t o T r o p i c a 1 H y g i e n e and Nurs ing" (7) w a s
I!
ii
Anatomy and Phys iology for Nurses
or i g i n a 1 1 y w r i t t e n i n 1 944;
( 8) was first p u b 1 i s h e d i n 1 9 3 9; "The Control o f Disease i n the
T r o p i c s " ( 9 ) first i n 1 95 6. Some of these books have indeed stood
the test o f t ime we 1 1 ; mo s t however were oriented t o wes tern
needs and s i tuations, with little relevance e i t h e r i n content o r
working
presentati o n to the needs of health workers training an d
countr
ies .
newly-in
dependent
i
n
condit
ions
different
under quite
I n 1962 Jelliffe's "Child Health i n the Irop ies" ( 10 ) was
□ u b 1 i s h e d ; and i n 1966 Maur ice King s "Medical Care in Developing
These two books we r e p e r h a p s the greates t
Countr ies
(11 )
revolution
i n learning mater ials that was t o
in
stimulus t o the
for a wide range o f
specifically
come . Both were written
para-medical
personnel
working i n
ind igenous med i c a 1 and
publishing
Both
were
published
by
major
developing countr ies .
the years
rapid
world-wide
reknown.
In
reknown,
houses; both achieved
immediately following, many of the well-known, highly exper ienced
figures in the new health care approach produced books; Uni ted
Nations Agencies,
Ag en c i e s , Non-Governmental Organizations, Country
Med i c i n e and the big publishing h o u s e s
Programmes, Schools of Medicine
turned to
t o textbooks, manuals, hand-books and t h e product ion o f
series of
o f manuals. For instance: "Mother and Child Health:
Del iver ing the Services " (12): " Community Nursing in Develop ing
Countr ies" ( 13 ) , "Nutr i t ion for Developing Countr ies" ( 14 ) , the
McGraw-Hill Intern at ional Health Services Series with Professor
o f the Liverpool School o f Tropical Med i c i n e a s
N . R . E . Fendell of
consu It ing editor, had by 1974 covered four topics : Midwi fery
( 15 ), Community Nursing (16), Med i c a 1 Care (17) and Laboratory
Services (18); the A f r i c an Med i c a 1 and Research Foundat ion
pub 1 ished t h e first i n its Rural Health Series i n 1975 (19), and
1972 the World Health by 1980 had eleven t i t 1 e s i n the series; i n 19/2
Mater ial for
(
Reference
project
started
REMAH
A
the
Organizat ion
class ifying
screen
ing
Teachers)
screening
and
and
their
Health Auxi 1 iar ies
ii
an
recommended
library".
In
1975
208 i terns to produce a
i n Health
Training
of
Auxiliaries
o
f
on
the
•annotated bibliography
titles
.
Care (20) 1 i s t e d some 300
i n many third
however, Ministries o f Health in
Dur ing the mid-197O‘s
centrally-produced
from
these
world countr ies were turning awa y
t o p r o d u c e t h e i r own , offic ial
books and series, and trying to
workers
. The four volume "Heal th Centre
manuals
for their- health
first produced in 1 9 76; the
Indones
ia
was
Reference Manual" for
and
Female " were p r od u c e d by
"Mult i-purpose Worker Manuals, Male
imilar
series h a s been
ia
i
in
n
1978;
s
a
the Governmen t of. Ind
produced
its "Family Health
Lanka
has
Sr
i
produced in Pakis tan .
cadres .
its
para-medical
for
al 1
Manual": a reference manual
. 5
i
t
!
I
!!
.-x n v a i s pr odue i ng rhe
K u r a 1 Health Practice M a n u a 1 " , a s the
b a s i c o i i t s i< u r a 1 n e a 1 t h bev e1opmen r P r o j e c t train i n g; t h e
Air i c a u i i e d i c a 1 a n d K e s e a r c h E o u n d a t ion’ s i< u r a 1 H e a 1 t h Ser i e s has
Ion
b e e n p 1 a n n e d a s the has is for
tor t he M e d i c a 1 A s s i s t a n t
c u r r i c u 1 um i n 1an zan i a .
f here has
h a s been a s i :n i 1 a r d e v e 1 o p in c n t o t
in a a u a 1 s i n Suu th a n d Latin /\rne
America,
r i c a , China, W e s t A trie a a n u t h e
‘ 1 i d d 1 e E a s t . 1 h c r c have bee 11 many
n a n v different a p p r o a c h e s t o h o w,
^’h y , • a n d w her e t i i e s e in a nuals a r e p r o d u c e d d n d e x p e c t e? d t o a e
us ?d .
6
*
n
CHAPTER TWO
WHAT MAKES
A GOOD MANU AL?
AN
OVERV IEW
The wr i ter o f a manual o r techn ical book faces two demands : his
mater i a 1 must b e r e 1 e v an t , and i t must be usable . A r e 1 e v an t
boo k i s one that matches the user’ s needs; i t contains wh a t h e
needs t o read
I c may o r may not b e usable . A usable book matches
the user* s a b i 1 i t i e s ; i t i s presented in such a way that h e c an
use i t , even though it may or may not be relevant. Relevance thus
t o the presentat ion. The t w o are
refers to the c o n t e n t , u s ability to
closely related, and both are important.
Usable, irrelevant
unusable books .
books
are
n o more
appropriate
than
relevant,
Relevance
T h e search
area :
c
o
c
for
relevance
in
Q
o
o
must
concentrate
on
three
The relevance o f health technology t o the health problems
and needs of the c ommunities in w h i c h i t i s to be used.
The relevance o f the technology t o t h e 1 e v e 1 o f
u n ders tand ing, competence, and res pons i bill t y o f the health
worker us ing i t .
t o the si t u a t ion i n wh i c h i t
The relevance o f the material to
f ac i 1 i t i e s etc.).
available,
will b e used (eg. resources
The w r i ter of a manual must
s e r i e s o f discrete steps :
o
manuals
therefore
find
his
place
within
a
Identify health needs and appropr late intervent ions .
Specify appropriate j o b descriptions .
Identify the competencies needed to fill those j o b
descriptions.
Des i g n training t o p r ov ide the requ ired competenc res .
for the training itself,
Produce supporting mater ial"
for cont inu ing educat ion, and for reference and gu idance
after training.
Note that this throws doubt o n the relevance o f 1 global ’
manuals for any pa rt icu lar programme, and upon the use o f
manuals des igned for particular programmes' in other situations.
7
u i 1 L e r e ii t
o f
I <? v a n c e
1 in- LO i i o w i ng quot al ions £ r om s o tn e o 1
tiie ma n ii a 1
i n t he
p r nd u c ed n y l h e ?\ f r i c a a i’l e d i c a 1 and
K e s e a r c h ron nd at i O I)
(. A.:; a E b ) i 1 1 u s L r a t e d i t f e r e n t a s pec t s o L
re 1ev an c e :
s eires
" i h 1 s m a n u a 1 w a s w r i t t e n a t 11] e
r e q u est a n d w i t n tiie in' 1
P o
tae
... 1 r a i a i n g C e n t r
i n
The g o a 1 w a s c o c o v e i
a 1 1 a s p e c t s o I chi 1 d ii e a 1 t n i n t h e
• . s y 1 1 a bus.
I r\ e I e v i
c ii e w o r k e r s and t o 1 o c a 1 n e e d s j .
o
" 1 he
sect ions o 1 t h e I) o o k o n
w r i t t e n w i t ii the 1 a c i 1 i t
i ii
.‘.lino . . . .
[relevant L o
cone i t ions j .
are
G
m a n <a g e .n e n t
an d
t r e a t m? n t
av a i lab 1e i n ii e a 1 c h c e n c r i* s
tiie
situation a n d t c. 1 o c a 1
es
io
t ii e student
f'n i s 0 o o k i s p r o b a b I y d i f fe rent
t r om o t n e r s
y o u ii a v e used . 1 Ii e r.i e t hod t h a f i t
uses
sei £ 1e a r n in
" 1 o t ne Instruct o r : L'n is book i s n o t
i n L e a u e ci
c o s u d s t i t u t e f o r r e g u 1 a r teach in «»
ac t i v i t i es
1 X
i t 1 S u s e d c o r r e c t 1 y , ii o v? ever, we
be 1 i e v e t n a t 1 t V.' i L I h e 1
y o u t o m a k e m ore err i c i e n t u s e O I v o u r
t e a c ii i a
t i liio
i Ke levant L O I h t? i .i s e o f t ii e □ o o k ] .
■: ■; a t
1‘ n e s e a s p e c t s
Cbap t er
o I
relevance
are
c o v e r e ci
i ii
•.I o r e
ci e t a i 1
in
Usa□ i j i t y
L n recent y e a r s , c o n c e r n Lor the u s e
o t a 1 1 books a a d 1 e a r n i n
g
mat e rials h a s gone beyond t h e b a s i c
conc ep t s of ” 1 i t e r ac
and
11 u n u e r sLand in g •
M a n y n e w terms are used i n our
assess m ent O £
learning resources : r e a d a l) i 1 i t y ,
compre hens ibility,
c omm u n i c a b i 1 i t y
u s a b i 1 i ty . All thesee terms suggest the v; i d e
range oofr problem s e n c o u n t e r e d . l’
n e s e prob
problems
1 e ni s tend t o Lail into
t ri r e e ma
main
i n areas:
o
the c o g n i t ive demand s o f 1 e a r n i
from reading, roll o w i n g
ng
ins t r u c t ions, making d e c i s i o n s ,
applying in fo rmat ion, and
solving problems;
o
t h e o p e r a t i o n a 1 d eina n d s o f r e t e
r r i n g t o material, . .. u s 1 n 8
a n index,
interpret ing pic Lures and niagrams,
d i a g r a m s , us i ifg
a p p r o p r i a t e read in
strategics (mainly adjusting t ii e
s peed a
att wii i c h t o read);
o
a s Lar a s health workers are
concerned, a further
turtner area
o £ c ’o n c e r n i s i n the pro fes s i
o n a 1 d e in a n d s o
o ’"ff applying
g eneral i ze d knowledge
e of
o f heal t h t o the part i c u 1 a r
c as es
pat lent o r c o mm unity n e e d s .
d
of
I
Behav ioral , educat ion al, and linguistic research have s u g g e s ted
that there i s no one answer to these problems. Rather, t h e
i n selecting the a p p r o p r iate P resen tat ion
solut ion seems to lie in
readers and
o f material t o suit the needs of part i c u 1 a r
i s necessary i n f o u r a s p e c t s o f
situations. Selection is
presen tat ion :
o
1
des i g n i n g o r structuring
for wh i c h i t i s needed reference, for teach i n g,
controll ing
i C to
match it
the
the
the
as
for
mater i a 1 t o suit the situation
learn i n g material, for general
on -the-’job guidance;
language i n wh i c h the material
reading level o f the readers;
is
written
to
o
t o suit the
A d ju st ing the ph y s i c a 1 layout o f the material to
use
non
prose formats
eg.
of
or
the
readers,
needs and skills of
diagrams
,
illustrations,
flowcharts),
( such as notes o r
tad 1es ;
o
or the
Considering the need for training in the use of
situat
ions,
non-tra
in
ing
material; introducing it i n
exercises,
and
so forth .
teachers' g u ides, suppiemen tary
Unfortunately,
few
i f any manuals contain sentences
like
this :
carefully
"The language and layout i n this ma n u al have been
it ."
from
learn
and
con trolled, t o help you read, look up
[Usable by t h e workers J .
Usability, and ways of
d e t a i 1 i n Chapter 6 .
achieving
it
are
descri bed
in
more
Conelus ion
learn i ng material i s open t o c r i t ic ism a s
M u c h existing health learning
books has
regards both r e levanee and usability. Shortages of
led to the use of inappropriate ma terial for a wide range of
1 e v an c e
health workers . Failure t o demand spec i f i c a t i o n o f r e
that
assumption
tionable
q
u
e
s
led
to the
and u s a b i 1 i ty has
the
s , a priori, relevan t and usable. Some of
material i n use iis,
descr
ibed
problems th is has produced, a n d ev idence of this, are
in th e next chapter .
a
9
■
IS
il A P 1'1^
uA 1
1n
the
t i rs t
i a c t <> r s
of
the
in
1 HE
P K0b dE Mb
1 1H
MAn'd AES ?
ha I t
th
P r o i) 1 e hl s
■■■ n o
A KE
o f th is
chapter
writ!i n g o r
‘ ‘1 a a u j 1
that ar > s e .
1hes e
wr i t t? 8
’
1
sha1 ] d
e s c r i o e fo u r
Ior h e 1 t h
ma i o r
w o r i< e r s
- o u r f nc t o
an d s ome
r <
are :
manual s
t ii e ;a
•v ha t
t ii e
o1e ot a
C3
manuai i s
a e w
C e v e 1 o P m ent
8
i n
u' r i t i u y
i;! a n u a 1 3 e
in
t n e •’ ec on d
a a 1 f O L
t h e c H a p ter
prob 1 e s
t h a t oc c u r
sh a 1 I des c r
i n
i - £ icn 1 £ j
the u8 e
i b e s ome
es tn a t
o L
!} - r t i c u 1
mau
a I s, a n d
i ii
a r
r es ea r c I
r e a d i n <- a a d
8 u m mar i
h as s h o wn
p
u d i (j
8 o in e
the i r
e
s
‘•i a n u a 1 s .
reader ’ have
iv’ h o
G
••• ri o
read 8
a 11 u a i
9
i ne ca r 1 i
es t
local 1y
Prac t i s i n
Pr oa u c ed
g doc tors
ma t e r i a j wa s
involved
the P r o g r a m m e
os u
i [ y
i n the t r
u’r i l ten
s th ey
a in i n
by
a n n r u u n in
n ad
a n <j
been
8
(J
1.
a
r
perv
is ion
£e 1 V
i n s t
g
.
1
’
h
e
wo
r
Idot
i n t ei r e s t
wide
r u id e n t a 1
i n m3 t e r > a 1
i n o r e 3 n i .z f n
m a n u a 1 s: that
s Parked
aoc t ors d i
tor such
o f f tii e
s s 3 t i s f i eu
P r o g r a m in g s
great
the y t o u n d
w i t h t he
were prod
i
n
d
u c ed I a r g e 1 y
1 n tthese
he s
and 9 u a 1 i t
c on c <e p t s
bv
P r og r amines
y
o f heal tn
and t e c h n o 1
as
an at t
Jeve 1 o
care
e
m
p
t
ogles
into
t o mtr od
ping count
the ih e a 1 t h
uc e n ew
r i es t h ey
ioca 1 1v c are
were
■'
iPro[j'uced
8
y
s
t
e
in
s
work ji n
.nateriai
o
f th e
i
n
.
ma t
P e r s o n n e 1j
The
Ii a s
fo 1 1 owed
i n Par t i cu 1
r
e
v
e
r
s
i
--ion
to
the
8 o i t a b 1
a r c oun tr i
same pat
e for the
e
s
t
r
tern;
’
y
i
ng
health
Parti C (J 1 a r
t o prod
c o u n t r y > and
Prob1e ms
orapplin
a a d c o n d i i u c e mater ji a 1
P r o v id 1i n g
with the imrnen
ons of the
heal t h
s e tech n i ca 1
i r
care to 1 a r
u n ed u c a t e d
ge
ly
prob 1 e ms o f
c 1 i en ts ” .
rural,
i a rge 1 y 1
seen a s P r i m a r i
The writ!
i8o1a ted , 1 a
iy a
of a
r i gh t .
Prob 1 em of
manual h a s
rge ly
thereto r e
g e t t i n g the
been
med ii c i n e ,
the content,
Mos t p
’ pe r i one ed
cx
manual wr i t
manu a 1 is to
e r s feel
th a t
answer th e
do? "
the ma i n
Th e in-trod
2 u e s t i o n : "Wn
P u r p o s e of
u
c
t
i
a
t
book
o
n
i
s
a
to
t h e work e r
d esc r i b
P r i in a r y Child
e s how
su PPos ed
Ca re”
child
we should
t o
(1) s t a t
sh o u Id be
care
for c h i Id
es: "tnii s
ex am i r
p re fac e
n ed , d i
r
en
.
It
t o th e
agnosed5
s hows U 8 h
C o m in u n•• ii t y Nurs
man
ow a
ed an d
i
,nPoss i b 1 e
treated
to
M
a
n
put i n
n8
u a 1 "
k-uow.
fb
•
The
(2) states
o"e book a 1 1
ey
"I t 18
that
k 11 o w 1 e d ge . cannot know e ii P u g h .
c
o
in
in
un i ty
is the
n
u
r
a
g
v
e
n
es
m o r G i2 m
S h o u Id
need t
mpo r t an t
° use th
than
h n o w 1 cd^e
n
ew
e
a
d
y
a 1 r
p os a es s ed
1 i)
■
'' T o the Reader" , i n "Child
Health " (3) states :
Jus L as this book
will n e e ci to be per i o d i c a lly
revised and brought up c o date s o
your know1ed g e must b e
cont inually refreshed.. rt The
Preface and
Object ives o f
Community' Diagnosis
L) i
and Health Ac t i on: a Manual
I o r Tropical, and Rural Areas”
(4) s t a t es : "Th i s book has been
set
s 6 that Sect ion 1 gives
out sO
a n o v e r v lew of c o m m u n i t y d i
a g n o s is :
w ii a t iitt is and how i t i s done .
Section 2 deals w i t h methods and
a p p r o a c h e s to o b t a i n i n g i n f o r m a t ion. . it
Two p r o b1e m s are likely t o arise from
fr
this sort o f a u t h o r s hip .
i s the nature o f what
One is
the w r i t e r w r i t e s , the other
is the
competence o f the writer. To look
a t the first prob 1e m:
the
concern of the writers, being
h e a Ith practitioners, i s t o
establish the health technolog ies
they advocate. Thus manuals for
h e a 1 t h workers, and indeed mos t
other
learning material
have been
largely seen as information
--- - ion stores, o r data-banks;
a resource
for the student; a s tatemen t
o f the content of wh a t
the s t u d e n t
i s t o learn . L i t tie
attent ion has been given t o
the ac t i v i ty o f
the student learn ing from
om th i s manual. As
e r & Teld
Penter
ielder (5)
s ay
. textbooks have often
oft
been written more to
t o satisfy
an a u t h o r s need f o r
logical organ izat ion o f content
than a
student's needs for
psychological organ izat ion o f s ome t hi
learned . ”
nS t o be
Second 1 y, even wh e r e writers
d o wish t o adopt a more
educat ional
a p p r o a c h t o manuals and pay
more attent ion t o the needs
and
act ivit ies of the r e a d e r s ,
they are seldom qualified,
let
alone
exper ienced, i n the wr i t i n
des ign ing and produc t ion skills
p r e p a r ing learn in g mater i a gIs>
of
a s o p p o s e d t o the verbal ski Ils
o
f
teachig.
S • Though, indeed, many wr i t e r s o f
manuals
many
have
years
experience in
i n teaching students,
their skills i n teach ing have
usually been
e e n learned a s a
response to the i r working s i tuat ion,
with little, if any, real
t r a i n ing .
Who
reads Man u a 1 ?
1 h e earliest local
m a n u a 1 s were usu ally produced
for a very
d e f i n i t e a u d i e n c e : the
s tudents or workers involved i n
the
particular programme . As i n t e r e s
t i n m a n u a 1 s and i n the training
of health workers
expanded, however, it became
clear that many
of the prob 1 ems
faced by t h e s e workers and much
o f what they had
t o learn, were
common t o many different countr ies
and situ at ions .
At a S y m p os i urn for
World
Health
i
in
1*970
organ
ized
b
b . baker, P r o f e s
y C I B A,
s o r o f Internat ional
a t Johns H o p k i n s
Health at
U n i v e r s i ty said :
.I
Since many o f the t r a i n iing
needs of a u x i 1 i ary heal th
workers are the same i n
different countr
(
ies, economies
could b e a c hieved by having
'universal 1' textbooks. it (6)
1 1
!
.1
1 he t euden
t Ii e r e f o r c d e v e 1 o p e d
t o writ e m a n u a 1
w i d e - ranging a u d i e n c e s .
t o r very
I Ii i s t e n d e a c y was
f a c t t h a t wr i t p r s a 11 d
e x a c e r b a t e d b y the
trainers f o u n d t h a t
t au h t fa i r 1 y J u n i or
much of w h a t t h e y
wo r k e r s wa s eq u a 1 1 y
a p p 1 i c a b 1 e t o mor e
seni o r w o r k e r s a s
well; e v c i) t o t ii e
doc t o r s
wes tern m e d i c a 1
wh o s e t r a i n i n g i n
s c ii o o 1 s ,
o r local mode 1 s o f
quite ou t -o
t
i
i e s e , w a s often
tone h w i t h local
c o n d ■ i t i o n- a n d n e e d s .
f h e 1 n t r o d uc c i o n
to
Uh i I d Heal th i n t h e
"It i s n o p e a that
Tropics
(71) states :
th is brief a c c o u n t
has b e e a preji a r e d
s u i t a b 1 e tor m i o r
in a
u s e select i v e1y oy
m e d i c a 1 a n d para m e d i c a 1
p e r s o n n e 1 and
e s p e c i a 1 1 y by i ns t r u c t o r
s a ri d trainer s
var ions t y p e s of s
o 1 th es e
t a f f . " Th e P r e f a c e
t
o '' U a r e o i ti h e
Ii a nu z a a i a ” (d)
111
H' e w b o r n b a o y
rates : "Th is ma nual
v,’ a s wr i t t e n 1 o r
>i e d i c a I A s i s t a n t s ,
T a 11 z a n i a
b u t n u r s e s , rural
in e <i i c a 1 aids, m e d i c a 1
s t uden c s and doc t or i
s h o u Id find i t
u s e £ u 1 11
w i d e - r a (i g i n g a u u i e n
P e r h a p s t h e mos t
c e was t ii a t e n v i s a g e d
ii
o
r
d 1ann in
"Obs
t
a n ci P a e d i a t r i c s ;
r i cs .
Fam i 1 y
a ma n u a 1 o 1
P r a c t i c a 1 m a n ag eme n t
doctors a n d n u r e s 11
fo r
( 9 ) .
The i n t r o d uc t ion t o
" 1 h i s chapter is
o n e c h aot e r state s
intended a s -3
g u ide for t h e m i u w i
norma I deliver y
ma u aging a
t h e m i d w i f e wh o
hi a s t o cope w i t h
c o m p 1 i c a t e d s i L u a t ion,
t n e mo r e
a n d t h e doc t o r w h o
h a s t o ci e a 1 w i t h
r r a a k 1 y pathological
a
situation.
ih
prob 1 e ;n
here
been
s u ra m e d
up
by
Pent a
1' e 1 ci e r (5)3
W hen a b o o k
review ends with the c o ram ent
t h a t the volume
’•>’ i 1 1 b e useful to m e d i c a 1
to
student,
intern , resident
fi r a c t i t loner al ike,
and
i t i s general 1 y
safe t o conclude
the book will not
that
rea
be us e f u 1 t o a n y
i s the case with
o f them . Such
many instruct i o n a 1
•a i d s w h i c h have
been produced to
often
serve t h e needs o r a n
f o r others like
a u t h o r , des igned
h i in, a n d then s h o w n
t o groups o t v a r y i n g
level s o f s o p h i s
t i c a t ion and i n t e r e s
t 111 the hop e
some port ion o f
that
the presen tat i o n will
serve their needs . ”
This prob 1 e m i s
greater when the
range of readersh i
v a r ies from the junior
P
work e r with 11i m i ted
t o d o c t o r s o r sen i o r
basic ed
education,
workers with the best
their country can
educat ion
give..
1 Lv
With exper ience,
a n <1 the res □ its o f
a s varying read in
research into such
lac tors
a b i 1 i t<. ii e s a m o n g di f f c
work e r s , manual
rent cadres o t
w r 1 t e r s h a v e recently
□ i m p o r t a n c e of c a r e f u
been s t r e s s in g the
1 y s e 1 e c t i n g th e
intended a u d ience
piece o f m a t e r i a 1 .
o f any
1 2
What
is
the role of a Manual?
Tlie third major factor to be found in the development of manuals
over the last 25 years reflects confusion as to the role of a
manual: its place in a continuum of.resources from curriculum to
reference book. Early manuals were often written as a supplement
to, or extension of the teaching and notes given to the students.
Their use as a resourse was established in close contact between
trainer and trainee. With the wide-spread production of manuals,
however, this close contact, and common understanding of the
role and nature of the manual has sometimes been lost.
In the McGraw Hill International Health Services Series, one
volume, "Medical Assistant’s Manual" (10) is "desiged to help the
medical assistant in his front line task of diagnosis and
treatment .... If he cannot make a diagnosis at once, he can look
up the patient's main symptom in the Symptom Index at the back of
the book..." (Preface). This is clearly a manual to be used on
the job. Another volume, however, "Community Nursing Manual 11
(2), is "intended for use during training. In addition, it
should prove a useful source of reference for practicing nurses"
(Preface). "Primary Child Care" (II)
(11) suggests:
sugges ts: "Try
"
to get a copy
of this manual for yourself. Learn from it while you are in school,
look things up in it afterwards. Don’t read it from the beginning
to the end. Don’t learn it by heart. Instead, learn now to use it."
Pharmacology & Therapeutics" (11), number 5 in the AMREF Rural
Health Series, has been developed from lecture notes prepared to
cover the syllabus for Medical Assistants (Preface). Similarly
"Child Health" (3) number 1 of the same series, aimed
"to cover all aspects of child health in the medical assistant’s
syllabus" (Acknowledgements). These two are clearly textbooks, to
be used in training. Yet the general editors of this series
indicate that students are expected to keep the books with them
after their training for reference, and on the job guidance.
In the case of this series, this multi-purpose role
is deliberate.
Many manuals, however, either do not indicate where on the
continuum from initial learning resource to reference book or
operational guideline they are primarily intended to fall, or are
deliberately intended to cover the whole continuum, as in the
case of the Rural Health Series and Dr King’s manual mentioned
above. Yet as Srivastava says in his investigation of India's
Community Health Workers manual:
"One would wonder how all three functional measures (learning
resource, reference book, operational guide) could be lumped
together as 1 three-in-one’ in the same manual.
13
h
I
As each ol tnese three tunctional ns es' o I the manual demand
distinct perspective and or i en t a c ion o i it s torm and content,
is advisable that there be t h r ee var i an ts ol one and the same
inan ti al". (12)
Few manual writers at present ac cope
hypot hesis.
1 L
S r i vas c av a 1 s
i\ew Developments
tour CIj and final tactor to be considered concerns the tact
lhe tourth
all responses to changes and new approaches in training and
training methods for health workers: those nave virtually all
□een medical. Lt is only to be expected tnat the primary
response siiould be a medical one; what
wli a t is s i gn i f ican t, however,
is how little other disciplines, seen as education, sociology,
psychology or linguistics nave been invited to respond to this
major iield oi development, bo tar, remarkaoly little expertise
trom otner, deeply concerned disciplines has been brought to Dear
on the problem of writing manuals. 4o
.\orw
ing ad
advances
t w i t iis tCano
ana in
van c es that
have been made in educati ona 1 theory, socio-1inguistics and
readaoility measurement to mention a few crucial areas, v e r y
little o tais new knowledge is utilised in tiie writing O £
manuals.
Lt is only very recently tnat any attempts have been made in this
rield. riaurice king early on attempted a frequency word count for
nis nutrition oanual (13) and in 1977 engaged the present writer
to systematically simplify (at syntactic level) the text of his
Child Care book (1). A major break-tiirough in this field was
fne project conducted in India in 197b, where the Department or
Linguistics or Delhi University was engaged to evaluate aspects
of tiie Indian Community Health Workers Manual (12). Some of triese
ideas have been used in attempts to evaluate fne Rural Health
Series Manuals from an educational and linguistic stand point.
Yet very few other attempts
s of this
tn is nature have been made, loo
many manuals are based on trie
the assumption stated in the
introduction to "Where there is no Doctor
(14): "Any one who can
read can use this book".
A few notable
exceptions
should
be
pointed
out,
however,
to
number of tiie points made above. One is tiie Government ol
Pakistan Health Division's "Mid-level Health Worker Training
□
Programme Modules".
These modules
combine as
a manual,
structured round a conipetancy-based curriculum, including
learning objectives and activities as part of the technical
content.
This must
potential
model
for
be seen
as
an
important
future manuals.
14
step
forward,
and
a
Another is
i s the Sri Lanka Family dealt h Manual for v,’ h i c h , before
print ing, work was done t o simplify and control t h e language i n
wh i c h the. manual was w r i t t e n , and to
t o pre-test trans 1 a t ions into
the other two local languages: S i n h a 1 a and T a in i 1 . A third
except ion i s the " 0 p e r a t i o n a 1 level Training Manual" for the
Kenya E :< p a n d e d Programme o n I mm u n i z a tion .
No t w i ths t an d in g w h a t ii a s been said above, there are many manuals
that do not f i t neatly into t h e framework that has been used. 11
is intended, however, that this o v e r v lew will ind icate some
general trends i n manual wr i t i n g over the last 30 years, and help
t o identify some o f the prob 1e ms that are 6 f press ing concern t o
those engaged in the product ion o f manuals . This is not t o
condemn all p r e v ions manuals, and all attempts to support and
improve the training o f heal th workers. It is rather to
t o provide a
f r a m e w o r k for cons id e r a t ion o f the kinds o r manuals currently in
use for training h e a 1 th w o r k e r s , wh i c h will lead t o discuss ion o f
some o f the kinds of problems found i n wr it ing manuals . Th i s
discuss ion will, i t i s in tended , enable some solut ions and some
gu idel ines for manual w r i t e r s t o b e sugges ted i n later chapters .
Prob 1e m s
wi th
The
Use
of M annals
To highlight problems w i t h the use of manuals by readers, a
summary is now given o f an inves t igat ion into how rar readers
were able to use one o f the Rural Health Ser i e s o f Manuals
published by the A f r i c a n Med ical and Research Foundat ion i n
Kenya .
The investigation cone erned the first i n th e AM RE F series, 11 Child
Health"
This manual, pu o 1 i s h e d i n 1 9 75, aimed "to cover all the
a s p e c t s of child health i n t h e Med ical Assistants' (of Tanzania)
Syllabus. ii The p r i m a r y a u d i e n c e i s therefore the Tanzan i a n
Med i c a 1 Assistant, and his Kenyan counterpart, the Reg ist e r e d
Clin i c a 1 Officer . It was hoped, however, that a much wider range
o f health worker wo u Id find i t .useful : for examp 1e, C o m m u n i t y and
Enrolled Nurses, an d Ru r a 1 Med ical Aids .
■ The inves t igat ion chose four areas o f use o f the manual t o
'el
c o n c e n t r a t e on :
read ing the text fluently
look ing th i n g s accurately
interpret ing the nature a n d purpose o f the texts w i th i n the
manual
trans forming t h e generalised, forma 1 informat ion given
into pract ical, part icu lar appi icat ions .
Fu 1 1 ci e t a i Is of this
Med ic a 1 and Res e a r c h
investigation- are available from the
Foundat ion, P 0
Box 30125, - Nairobi.
15
A fr i c an
ser i us o f
w e r e c o n s t r u c t e d o n the in a n u a 1 C o 3 v e
quant it at i v e, object i v e i n d i c a t o r s or perto r m a n c e i n these
a r e a s . lues e tests were t h e n give n t o n e a r 1 v 3 OU student
h u a 1 t h i; o r k c r s ,
£ r o m a v a r i e t y o 1 cadres ,
i n Kenya a n d T a n z a n
K es u 1 t s f r om t h e s e t e s t s s h owe d that the man u a 1 , w ii i 1 e s u i t a b
s o m n o I 1 t s in tended p r i ni a r y a u d i e n c e , w a s b y a n d large t•
i f t i c u 1 t 1 o r o t i i e r cadres oi
o I w o rke r t o use.
!i e a d i n
the
text
1 111 e n t 1 v
A s t a r a s read in g t h e t e x t f 1 u e n t 1 y w a s concerned, 0 1 i n i c a
0 f r i c e r s 1 l! K e n y a cou 1 d □ a n a g e i t we 1 1 . N.o o t h e r group cou
a s a v.’ i i o 1 e . L e s s t ii a :i h a 1 f tiie i'l e d i c a 1 A s s i s t a n t s • could r e <
t e x t f 1 u e n t 1 y , w i t h o tj t h e 1 p . Table 1 g i v e s a u e x a m p 1 e o r
r e a d a u i 1 i t y s c o r e s f o r dirterent cadres o n on e text f r o m tl
manual . 11 s hou Id d e n o t e d. that t h is wa s o u e o r s i x texts t
rrom t ;i e manual t o r testing. Some were slightly e a s i e r , son
tar :.no i* e d i f f i c u 1 t . in one
o n e text, t n e average o f every c a d r t
per t o r m a n c e i e 1 1 a c "£ r u s t r a t ion level 11
verv
w o r any
cou Id r e a d i t .
o
Look! n
tn ings
up
r eg a ru
t O 1 o o k i n g u p i n t h e rn a n u a 1 , a s i in i 1 a r s i t u a t i o
Uni y stu de n t s i u their f i n a 1 y ear of era i n i n g , w h o h
o e e n us in g t n e book lor s o ni e time, scored mor e t h a n 6U A
accuracy i n look i rag u p t ii e a n s w e r s to
t o questions i n t h e book
1' ii e o v e r a 1 1 average tor a 1 1 the workers t e s ted was 5 0/^. Th i
can be interpreted
i vi
loosely. that when ri e a 1 t ii workers try t o
r e 1 e r t o t a e in a n u a 1 ,
they can only fin d the 1u format io n the
w antj even i t it is i n t h e manual, h a 1 f the time.
.7 1
[OUI1U .
G
Interpret i n g
t ii e
nature
an d
purpose
oL
the
text
Results r r o m tests t o see h o w health w o r k e r s interprete the
nature and purpose o f the d i f f e r e n t texts i n the b
o o k were
book
less r e v e a 1 i n g . L) e f i c i e n c i e s i ri the test d e s i gn m a d e this
P
o t the investigation d i f f i c u 1 t t o interpret.
A general trend s e e hi s t o be, however,
t li a t health workers d i
not clearly distinguish be tween parts o f the manual
that a r «
genera 1 ised i n f o r rn a t ion t o be, learned o r parts that are
op erat ion al procedures t o b e fol lowed practical iy • There
se(
t o b e i n d i c a t ions that s t u d e n t s general 1 y feel that a
manu a
i s pure 1 y a store of i n f o r in a t ion t o b e learned, r a t ii e r
than
I) o o k contain in g info r m a t i o n t ii a t can b e a ppi i e d i n
p r a c t ice,
we 1 1 a s learned tor pass i n g e x a in s .
1 6
A p p1 i c a tion
i.
1.
.d
You
ie
o
n
a<
s
y
□rt
? rn
a
formal
knowledge
o f results, however,
t r iking set of
The m o s t significant, and s
lication of
knowledg
o f formal knowledge.
app
comes from the tests o f the questions
that required
r e q u i r e d information
M o s t cadres scored well o n
be
reproduced
in
a formal
i
n
re
learned from the manual t o
complicat
ions and
features
,
framework: eg.
eg • the clinical
groups scored bad 1 y
treatment of whooping c o u g h . The same
format
ion to answer
in
however, when asked to use this
question s like:
id
e
a
of
see
W hat
What
What
a child w i th whooping c ough :
would you ask h i s mother and
would you d o for him?
w o u 1 d you look out for until
look
for?
he
gets
better?
difference o f
Among Clinical Officers a
difference
of
30%, be tween
o
f
Ass istants a
found
.
wa
s
sets o
off questions
20%,
and among Med ical
scores on the two
two
we can see that the manual ’ s
Looking a t these r e s u Its o v e r a 1 1 ,
a fairly restricted audience:
u sefulness i s limited t o
have
better Medical Ass i s t an t s , wh o
Clinical Officers and the
half
least
At
training
.
manu a 1 extensively i n the i r
used the manual
Even
i t very difficult t o read.
the Medical Assistants find
time
first
the
the manual for
Clinical Officers, approach ing
o
t
he
r
For
informat ion in it.
find it difficult to locate
d
i
fficu
It ies in reading and re f e r r i n g
cadres o f health worker,
ome, notably Rural
eater. For ssome,
to the manual are much g r
overwhelming. Al 1 the health
Med ical Aids an d Enrol led Nurses,
very difficult t o see how the
workers without exception find i t
i e d i n practice.
in format ion i n the manual i s app 1
useful the manual i s ?
how
show
How far do t h e s e results
i t is
cannot read his manual,
Obv iously, i f a Health Worker
cannot refer t o 11
useless t o him. Similarly, i f h e
Yet these r e s u Its
limited.
fulness is
accurately, i t s usetulness
ted could
Many o f the workers t e s
s h o u Id not b e overemphas ized.
that i s , with some help
the "instructional level":
read at the
from teachers or colleagues.
i n c r e a s ed
f am iliarity with the manual
The tests showed that
in i t .
readers could look th ing s up
the accuracy with wh i c h
to
ability
their
i n training:
All the workers were students
in
limited
was therefore still
cope with pract ical s i t u a t i o n s
m a n y ways .
manu a 1 cannot
however, clear evidence that the
T here i s still, however,
should hope and ex p e c t . 11
b c used as easily and as well as we
that this .manual, an d
wou Id obviously greatly be des i r e d
make them mo r e easily
future manuals, could be improved t o
necessary
d o this it i s
read, u nderstood and referred t o . To of things tested here are
t o examine more closely how the sort
can b
be
e controlled.
r e a 1 i s. e d in manuals, and how far they
17
I
■
rn i s me a n s t o e :< a in i n e wh a t
manuals are, and how they
i £ will then b e necessary
C o look at
a t the concept or
"us ab i 1 i ty
and how it c an
be
ana lysed
and
are
achieved.
Table 1 :
CLOZE TEST
CH/6
Numbei:r..?I-Su^.ects or different reodobnity Ieve|s
Cl inicol Officers
j
Community Nurses.'
1 st yeor
3rd year
o o
o
o O O o o
o O o o O
Fluency
ieve;
Medical Assistants
3rd year
O o
o o
ti
o o Q o O
Rural Medical Aids
2nd year
o o
O
3 0 0 0 Q
o
O rj O o
O
0O
O
Q0 Q n
O
instructional
' '3 ° 0
level
O
O O O Q C?
o
ooo^o
O
G O
GOO
o O O O o
I
W O O G
u O Q O o
I
Frustration
'
I_
o 0
o
& o o o 0
level
o
I
Each dot represen/s
o o o O o
o 0 O O Q
O O G
o o a o o
o o o o ©
o g o o o
one subject
The distribution of subjects in four
•
J
groups ot different reodobility levels is shown in the loble.
Note that while the maj_.k.ulll,
iority of community nurses foil in the fluency level, o lorge minority
(3/%) fall in the instructional level,
Among Med,col Assistonts the situotion is even more
marked
with 7 members of the class
foiling ot frustration level. These two groups ore
?Ir!'Cular,y inter«tin3/ as the overcge SCores
as
overage scores on the test for both ore 6CP/0 (nurses) ond
5(T/o (Medical Assistants),
ould oe o m,stoke to ossume thot the text is odcquotely reodoble
for either class as a whole.
* furth- Poly - note is that the Medical Assistant
group IS In it's 3rd and final year. There
to help those at the instructional level to
1
I
I
of
wdft^^om0^ ra^’:::n ,h:hRMAs
o,il
instruction could help most subjects to'reach flu'en^level'0"0
18
oniy very few
P' W'"le W"h
°,her 9r°UpS'
used.
CHAPTER
PLANN ING
FOUR
A MANUAL
used?
How are manuals
In 1 9 74, a documen t produced by Dr. R. J . M c M a h o n , WHO
Coord i n a t o r for M e d i c a 1 Auxiliary Training i n Tanzania,
ci fined a ma n u al thus:
It
Dr .
is a book wh i c h :
contains basic, essential and m i n i m a 1 informat ion on a
sub j ec t
i s pres en ted clearly a t the level o f educat ion o f the
s t ud en t
contains operational instructions (how t o do things)
t o the job description (work) and
i s entirely adapted to
syllabus of
the
s
student
t
u
d
e
n t and there fore directly related
of
medical
conditions, and problems
(national)
the local
imposed
by local facilities."
w i th in t h e restr ictio n's
M c Manon
then
"( i)
For
( i i)
For
outlined
the
adv an tages
o f manuals :
t h e student
All students know exac t 1 y-.-. t h e min i m u m they must
k n o v; .
11 refers him t o other sources i f h e wan t s t o
k n o w more detail.
11 can be kept as
a s a reference after qualifying.
o f taking notes i n
It saves the necessity of
lectures.
h
the teacher
All teachers know exactly what the students
must know.
Teachers don’t need t o make s o many notes .
Teachers don't need t o give s o many lectures .
Helps expatr iate teachers wh o are unfamiliar
w i t h rural med i c in e'3 and ( local) conditions,
M a k e s trans fers and taking over from other
teachers a lot easier."
From th i s description
c o n n e c t lnS , users o f the
the
the
and
some ,o f
to
i s clear that three possible,
manual are envisaged:
and
student i n training,
teacher doing ’ the t r a i n i g ,
the w o r k e r after training.
19
ii
Di t 1eren t
uses
o1
a
manual
!•' r o m t 11 1 3 we c a n i n r e r that
manuals can be used for lea r n i n g ,
toteachi ng,
for r e fere nee, fo
a c o m b i n a t ion o f these. Bu t
t
h
e
s
e
a r e d i s t i n.c t I y d i f f£ e r e n t u s e s
o f <3 book
book:;
indeed ,
they are
d i c i n c t 1 y u i tier e nt uses
use s o £ in f or mat io n, even t ii o u g h
the y m a y i r
p r a c t ice a p p e a r i n s e p a r a b 1 e .
C o g n i t i v e strategies for learn i ng
differ from tii os e ffor
o r r e f e r e n c 1 n g , part icu 1 a r 1 y
with r e g a r d C 0
learni HE- fro m o r r e f e r r i
ug t o books . They are learned skills,1 e s s o b v i o u s , and m o r e c o m p 1 e x
than we often real is e .
Tii i s b e c o m e s c 1 e a r e r v/ h e n
we loo k a t t h e wa v a
p a r t i c u 1 a r user
uses a b o o k . •r h e n e v e r a
r e a d e r refers t o a manual (as
( a s opposed t o
s imply r e a d i n
i t for w a n t o f a n y t h i n g
betterr to
t o do) he has
formed certain questi o n s i n
h i s m i n d ; the purpose of
o f refer ring t o
t ii e ma nu a 1 is
1 s to find t h e a n s w e r s . Th i s
a p p 1 i e s equal 1 y whet ii e r
n e is a student silt
1 n g i n his study a t the t r a i n i n g cent
re
read i n
up " 1 mmu n i s at ion"; o r
checking u p o n a p a t lent h e
s aw i n
tiie m o r ii i n g 1 s Or D clinic;
o r a t e a c h e r read in
t
ii
e
m
an
ua
1
g
in
o r d e r t o e x p 1 a i n s ome t hi ng t o
his students . Depend ing o n
w h a t h i s reason i s f o r
1 o ok ing i n t h e manual , he is
I ik e iy t o
have di tie rent ■sori: s o i
questions.
W hat
sort
of
q u e s t ions
It i s useful t o c r y
q u e s t ions ma v o e . I
3 s or t s :
( i 1
(ii )
( iii)
<3
do
readers
h ave ?
t o wot k ou t what t h e
have o u n d i t helpful
d i f feren t
t o divide
sor ts ot
the rn into
General
1 e a r n i n g 11 questions, wh ere
the reader
d o e s n 1 t yet know wh a t sort
o f in format iion is
1 s 1 i k e iy
t o p r o d u c e his answer .
11
Simple
reference" questions,
where the reader
(health worker ) needs a s i ng 1
e item of straightforward informal io
ion. In
In this
this sort of
ques t ion the
reader has i d e n t i f i e d precisely what
data h e needs,
and formu lated his question precisely,
Complicated "prob 1 e m-solving"
-solving" questions,
where
the reader needs a lot o f
information to help h i m
solve a prob lem a r i s i n g from
a si t u at ion h e i s faced
with, In this case the
r e a d e r 1 s q u e s t i o n i s much
less p r e c i s e ; h e may also
need help i n i n ter p r e t i n g
informal i o n to produce
his answer .
For example:
Q u e s t ions i n ( i ) may
be t h i ng s
What sorts of skin d i s e a s e s
What i s i m m u n i z a t ion?
What causes s c a b i e s ?
1 ike :
are there?
20
informat ion
r o r these ques t ions the reader i s usaully looking fo
experience,
of
knowledge,
or
experience.
He
o
r
t o add t o his cogni t ive store
is
Locating
the
information
does not intend t o apply it directly.
and
questions
are
vague
his
n o t u s u ally such a prob 1 em because
he
u n f o rm e d . He often only consciously forms his ques t ions as
t r i e s t o structure the in.format ion h e reads .
■i
and
I t is important here t o distinguish between ’'informat ion
an
w
h
i
c
h
"knowledge". In format ion i s data.' Knowledge is data
d i v i d ua
u a 1 has stored i n a meaningful way.
ind
Q1 uss t ions i n ( ii) may b e th i ng s like:
Do I apply Benzyl Benzoate t o the child's whole body for
sc ab ies ?
H o w long should Benzyl Benzoate b e left on for?
What drug and in what dose s h o u Id I give for gonorrhoea?
r o r these quest ions the reader already k nows how to apply
in format ion h e finds in the answer . He may, however, need
i n iocat ing the part icular piece o f informat ion h e needs .
Ques t ions i n ( i ii) may b e things like:
H o w can I get mothers to carry o n the
a t home ?
W h a t should I and my colleagues d o a s
scab i e s i n this district?
W hat can I do about unma r r i e d mothers
the
help
treatment
for
scab i e s
to
cut
down
a
in
t e am
this
area?
r or t h e s e ques t ions the reader i s usually looking not o n 1 y for
in format ion, but also for how t o apply it. He i s often very
unsure o f how to locate the in f orma t i on that i s relevant t o his
need.
Ihe
two
d imens ions
of
use
? :
o f a manual
These three sorts o f ques tions i n t e r - r e late with, but do not
necessarily match, the distinction be tween reader a s referencer,
t o the
a s learner an d as teacher . There are thus two dimensions to
Both
have.
use or read ing purpose, that users o f m a n u a 1 s
dimens ions r e q u ire purposive cogni t ive strategies on the part of
the reader and may well r e q u ire practical operat ional strategies
a s w e 1 1 : for example, how to use an index .
To h e Ip determine the p r e c i s e use
d i m e s ions apply to an y particular
i s sugges ted .
ddf a manu
al,, and how
manual
manual,check-list o f
t h e s e two
ques t ions
i
■
21
■I
P 1ann i ng
a
Manu a 1
here 1 s a c h ec k- 1 1st
o f q u e s t ions .
hen you start
planning a
m a n u a I go t h r o u;; h this
check- list. Tick
t h e an s we r
ques t i on tha t
for each
i s rn o s t p r e c i s e for
your m a n u a
1 .
a' h y
i s
as
as
-
a
a
a
the m a n u a 1 needed?
source o f i n f o r in a t ion
source of info r ma t ion
as
s o u r c e o f in t o r m a t ion
to s t and ard i s e
per f o r m a 11 c e
le v e 1 s o f
c omp e t e n c e ;
2
1 e a r n i ng;
teachi n g ;
for refer e n c e ;
i n the field a n d
establish
use
will
Who
for
for
t h e manual?
i n t r a i n i ng ;
trainers d o i n g train!
ng;
workers
i n the field;
superv isors ,
support p e r s o n n e 1 ;
trainees
“
~
3 .
Wh a t
-
■
■
4 .
ri ow
~
read
“
witn
trie
rn a n ual?
they
and
do
1earn
wh i c h
is
thes e
in
things?
t r a i n i ng ;
and 1 e arn on their
o wn ,
w i t hou t training;
teach with i t i n
t r a i n i ng ;
look th i n g s
UP in
i n it a t home o r
i n the centre;
check their per forma
nee with i t as they
d o things;
take i t t o v i 1 1 ag
e s and teach f r
om i t;
Where
in
at
in
in
6 .
wi 1 1
read
"
do
refer c o i t
f o r info
r m a t ion they ' ve f or g o t ten
uncommon;
use i t as an a i d
i n problera-solvi
1 n g;
c h e c k procedur e s
and act ions;
teach w i th i t;
use 1 t a s background
read i n g;
“
“
“
5 .
wi 1 1
t bi e s e people
lea r n fro m i t ;
and when will they
do
the t r a i n i
ng centre;
home;
these
things?
their off ice/cen tre
etc;
the v i 1 1 ag
es ,
at t ii e
ages,
bus -s top,
i n peoples ’
f i elds,
,
at the village meet i n g
p 1 a c e etc;
Q
What snou Id go
into the manual ?
explanations (background)d escriptions
of situat ions
processes etc;
des c r i p t i o n s
o f procedures;
instruct ions
for procedures;
lists, d
data,
at
e x a c t information;
info
teach i ng m a t e r i a 1
fo
tiie reader t o pass on ;
22
homes, i n
the
I
How s h o u Id we organ i s e al 1
we present i t ?
a s learn ing ma ter i a 1 ;
a s teach ing mater i a 1 ;
a s reference data;
a s e x a c t ins true t ions;
a s regu lat ions, s t a n d i n g
this
in format ion
orders
and
how
should
etc;
W i 1 1 it need any support?
teach ing aids;
notes for the teachers u s i ng 11;
teacher ’ s book,
a teacher's
lesson plans etc;
supplementary exercises;
supplementary data;
supervisory check-lists;
a.dministrat ive instruct ions or back-up;
instructions o n how to use i t;
You m a y find yourself t i c k i n g al 1 the answers. Then you will have
very great d i f f i c u 11 y with your manual . You are not being prec i s e
enough about i t . Or you are aiming a t too wide an aud ience.
However,
i f you are really trying t o write such a wide-spread
manual , try to break it down into sections. and answer the
ques t ions for each section.
The importance of
o f this check-list lies in the relat ionship
between the questions, The c r u c i a 1 question 1 s question 2 . Yet t o
justify quest ion 22, the an s we r t o ques t ion 1 i s necessary. This
then leads t o ques t ions 6 & 7. These
T h e s e are vital for the
t h e content and
□ e s i g n o f the manual . Yet 6 & 7 can only b e prec isely answered i n
the light o f answers t o questions 3,
Ques t ion 8 shows h o w
3, 4 &
important the s u p p o r t t o a manual can be. It i s also a way o f
coping w i th too many answers to
t o questions 1 , 2 and 3 .
Conelus ion
I
To
of
su mma riz e,
i t would appear that there are
questions t o be asked i n order t o prepare
7 h o are the readers ?
Wh a t d o they know?
W hat can they do?
W hat prob 1 e m s d o they
'■.?hy
■
■
do
What
What
have?
four c r u c i a 1 groups
a good manual.
I
they need the manual ?
do they need i n the text?
will they do with the text?
23
II
i
■
*1
W hat
•s h on 1 cl r,o i n i t ?
is h a t s h O U I d they know?
V.'h a t are tiie y t o do?
How a r e the y t o do it?
Wii a c a r e t h e y t o teach?
H ow, sii o u 1 u
W ii a t
ii o w
w e p r e s e n t t ii e
factors ddo
o we need
w e control these
<1 o we
text’?-'
to take i n t o
i actor s?
1 o t r y t o s 11;; g e s t g u i d e 1 i n e s
sb a I 1 look a t each of t’nes e
a c c (.) ti n t ?
ior t ne prepara t i on ot
group s o f questi o ns i n
J
24
a man u a 1 ,
turn .
we
GETTING
THE
CHAPTER
FIVE
CONTENT
RIGHT
RELEVANCE
In this chapter we cons ider the three groups of questions 'Who
are the readers o f the manual?', 'Why do they need the manual?'
an d 'What s h o u 1 d go i n t h e man u a 1 ' . The answers
an s we r s to these
questions are impcr tant for ensur ing the relevance o f the content
of the manu a 1 .
V’ h o
are
the
readers ?
To answer the ques C ions 1 what d o they know'
know ' and ' wh a t can they
do' it is necessary t o spec i f y very carefully e x a c t 1 y wh o the
intended readers of the manual are to be . It i s usually best t o
direct a manu a 1 at one particular level , o r cadre o f worker.
Manuals aimed a t several different groups o f worker often end up
suitable for none o f them. This is b e c a u s e o f the differences i n
different groups ' basic educat ion, training, job descriptions and
expectations . Manu a 1s can, i n spec i a 1 circumstances, be
b e written
for different groups or cadres.
But i n these the role of each
group has to b e carefully specified.
W hen cons ider ing wh a t the readers already know, and can do,
d o , it
may be necessary t o look be yon d the syl labus of their training.
If the readers have t o use weight charts,
charts, for example, i t 1 s
important t o find out whether they understand graphs . It may b e
necessary t o find OU t their level ooff school educat ion, and see i f
graphs were covered i n the school mathemat ics syl labus .
The* answers t o t h e s e two ques t ions have great bear ing o n what
you
put in your manual, and how you arrange i t . The answer to the
third ques t ion, " w h a t problems do they have?", i s also important,
both for content and for presentat ion . To show this, a number o f
common prob lems that health wo rkers have will b e ou t 1 i n e d .
o
Read ing
Prob lems
Many health wo r k e r s, depend ing on t h ili r level o f background
educat ion, may be
b e inexperienced readers . Many have to use
manu a 1s written i n a language
age other than their mother-tongue«
Many, therefore, exper fence s ignificant read ing difficulties
with complicated language in manuals. Simplification of the
language of
o f a manual can produce d r am a tic r e s u.l t s .
F
i
J
25
Locat in g
1n forma c i on
M a n y o t t h e a call i) w o r k e r s w i i o
v.’ i 1 1 u se ma
nuals f i nd i t
manuals
difficult t o use a u i n ci c x t o
look u p s omething in a book .
In
add it ion,
there m a v b e ma u y pro b 1 e in s a r i s i
from the
n
S
1 a y out o t p a g e s O I' texts,
f r om h e a d i n g s and u u m her i ng
s y s t e in s .
1 f someth i n
i s d i ft i c u 1 t t o 1 o o k u p ,
readers u s u a i ly e i t h e r
don't both e r t o look i t I]
P , o r t ii e y f i u d a n inaccurate
a n s v; e r , o r i t t a k e s tiie m s o 1 o n g
a s t o b e a waste o 1t t i in e .
!»
Unde rs t and i n g
tne
Nature
and
Pu rpos e
of
I n f o r in a t io n
f n e informalio n i n s r r u c t ions,
Is tne
s u g g e s t io n s or
o r background
i n i o r m a t i o n ? is
i s it f o r learn in
or for i e 1 e r e n c e ? K n o w i n g
tiie a 11 s w e r s to
t o t ii e s e s o r t s o
q u e s t i o n s he 1 ps readers t o
u n d e r s t a n d a n d u s e i n £ o r in a t i o n i n
m a n u a 1 s better.- but t h e y
are the ver y quest ions t a a t
i n e x p e r i e n c e d r e a ci e r s o f t e n
have
diti i c u 1 t y w i t ii .
in a n v h e a 1 t ii w o r k e r s see in
ni t o feel
t ii a t i n r o r m a L ion i n
manu a 1 s
i s u s u a 1 I y to help
del p readers un d er s t a nd t h e
pr i nc i p 1 es o 1 a t op i c ,
rather t h an practical
instruct ions o n h o w t o d o s ome t ii in
g •
C o n s e q u e n t 1 \ t ii e s e w o r k e r s feel
that i t i s more i m p o rt ant
to
1 e a r n t ii e in fo r in a t ion
t ri a n t o r e f e r to i r o r c’neck up on
up
i t .
I he V ten d t o t h i n k of m a ii u a 1 s
a s textbook s t o b e learned
by
hear t i n t h e i r training
rather t i i a n a s p r a c t i c a 1
manuals t o
h e 1 p t ii e ni o n tiie job.
joo. iS’h i 1 e i n some cases the y
m a y b e right
( to p a s s e x a m s £ o r e x am pie)
t ii e i r p r e d i s po s i t ion i s
t o assume
t ii a t al I m a n u a 1 s are t o
b e used 1 i k e t ii i s .
o
App lying
the
In f o r in a t i o n
in
ri a n u a 1 s
in
Prac t i ce
Peoplee tend to learn i n f o rm a t ion
in the way i t i s presen ted
c o t ii e m . T hey t h e n often find i t
difficult t o apply t ii i s
information in
i n a different s i t u a t ion.
M any ni a n u al s present
i n I o r m a t ion in e forma 1
ac a d ein i c way. T h i s
e d i f fi c u 1 t
can b
be
for ii e a 1 t ii workers t o
ap p1y in the w o r k i n g situations
O£
d i s t r i c t hospi tals,
h e a 1 t h centres and dis
pensar ies ,
o
Prob 1 e m
Solving
i
Very few -Ai a n u a 1 s use a prob
1 e ni sol vmg approach .
Ibis mean s
that health workers have t o
search t h r o u gh a m ass of
informal ion t o f i n d t h e
an s w e r to a particular
prob 1 e m . Th ere
are, however, a few manuals
wliich try to
t o hel
help with this
prob 1 e m . • A manual of d i a g n o s
t i c flow-charts has- be e n
produced ( 1 ) . An o t h e r recent
m a n u a 1 has a section of the
end o t
each chapter headed "Car i
ng for a child w i th
A n o t h e r has an
Index o f symptoms" a t t Ii e
back .
26
■a
Learning
an d
Teach ing
Health workers, and manual writers, often get confused a s t o
whether .the in format ion i n manuals is to
t o be learned by th e
reader, or t a u g h t directly to his clients by h i in . Th i s
confusion, bet vz. e e n the m a n u al •a s a. learning resource .for’ the
reader (•Health Wo r k er) and teaching resource f o r
h e reader ' s
trainer, and the manu al a s- a teaching resource for t h e reader
(Health Worker) , can li a v e disastrous
<
effec t s .
A great part of the Health Worker's job is to p a s s on
in format ion a b o u t good health practices t o his clients . But
few Health Workers are really
rea
trained i n this . They often end
up giving lectures called ’’health educat ion” that are a mere
regurgication o f intormation’from their textbooks o r manuals o
i s often too difficult for villagers t o unders tand . The
This is
difficulties that arise from the problem o f c ommun i c a t ing
w i t h illiterate rural people j the prescriptive and peremp tory
tone of much o f the advice, the complicated nature of much o f
the adv ice, often stem directly from the fact that the Health
W o r k e r i s trying t o pass on information directly f r ora his
manual, without filtering i t through his unders tand ing o f the
needs and background o f his listeners . While this i s not only
a prob 1 em oi tthe
h e manual, i t may be one we can help with in
the manual.
If the manuals talks about three food groups and balanced
diets, can o r s h o u Id the Health Worker try t o teach this t o
mothers i n v i 1 1 a g e s ? If the manuals talks about s o c 10economic f a c tors i n malnutrition, does i t give the Health
W o r k e r the r igh t t o patronise and adv i s- e v i 1 1 a g e r s even i f
they are his elders and s o c i a 1 betters i n the eyes o f
v i 1 1 a g e c ommuni t i es ?
One set o f manuals ( o r rather handbooks ) prepared i n Ind i a
at terns to solve s ome o f these problems, The booklet s are based
o n a list o f very s i m p 1 e "ru les for bet t e r care” (4) . They
pres ent i n forat ion i n the way it can b e passed o n directly t o
villagers, a s s i mp1e ques t ions an d atiswer s .
by do
they need
the
manuals ?
s was shown i n Chapter 4, health workers either a s
students i n
draining, o r after training when working, need manuals t o help
them answer ques tions . These may b e ques t ions they ask t h e m s
elves
when they are learn ing about their j o b ; ques t ions
they
ask
11) in s e 1 v e s wh e n they are
working and want to check up or refer t o
something t o make sure t h'e y do it correctly; ques t ions they may
nave wh e n they come a c r o s s a problem in
i n their w o r k and think
"How can I deal vzi th this”?; o r
questions they. are asked by their
clients”.
27
vJ h a t e v e r the quest ions are, different workers will
ask di f f e r e n t
questions i n different situations for different
reasons . This
mean s t fi e y will use t ii e i r manuals d i f f e r e n
tly . Th e c r u c i a 1 job
i o r the m a n u a 1 writer,
iiss to try t o dec ide e x a c t ly wh a t sort
of
quest ions real readers will wa n t t o ask i u real
si t u a t ions a b o u t
a u y task,
topic, disease or c o n ci i t ion that i s t o b
e covered i n
t h e m a ii u a 1 . fie ,
the' writer, mu s’f t ii e n p r ov ide t h e a p.p r o p r- i a t e
answer, and present 1 t s o that the reader
can find it ‘and use i t
as e a s i 1 y , accurately and quickly a s
pos s i b 1e .
T h e t wo f u n d a m e n t a 1 questiions t li a t
t ii e wr i ter h a s t o ask h i ins e 1 f ,
and answer there fore are:
W h a t ques t ions will these w o r k e r s
have?
W h a t a n s w e r s do they need .
P u b 1 i c Heal t fi Technic i a n s lea r n i n g
about schistosomias is i n
t r a i n i n o > for example, w i 1 1 probably h
a v e ver y different
ques t i o n s t o cl i n i c a 1 off icers in
i n the fi e a 1 t Ii centre, c h e c k i
u p about schist o s o m i a s is .
Io start w i th, t Ii e m a n u a 1 writer
m u s t select the areas h i s manual
i s t o cover, and break d o v/ n
t h e s e areas into a series o f
ques t ions that h e a 1 t h w o r k e r s are
1 i k e 1 y t o a s k . Th e n h e m u s t
cons i d e r how ti e will an s we r these
ques t ions . The greater t h e
d e t a i 1 i n w h i c h the t o p i c i s
b r o k e n d o v,’ n into realistic
q ue st ions, a n d the more pr e c i s e • a n d
p r a c t i c a 1 t h e a n s w e r s are,
the more r e 1 e v a n t t ii e content will
be. Th i s i s not an easy task,
and r e q u ires c 1 o s e and s e n s i t i v e
c o n t a c t with real workers o r
s tudents o n the part o f the writer .
kf hat
should
» e can
into a
go
in
the
manual?
usual 1y break d o w n t h e informat ion
we
manual under four different rieadi
ngs :
W h a t the reader needs t o know
What h e i s t o d o
How t o d o i t
What he i s t o teach, o r pass
on
to
the
wish
to
pu t
public.
Some manuals, a n ci not o n 1 y h e a 1 t h
manuals, use t h e s e a s
actual head in gs in t li e text .
This may
m a y not always be f e a s a b 1 e .
11 i s important t li o u g h , t o
assemble the content o f a
manual i n t h i s ')a y > a s i t helps
to ' ensure the r e lev anc e o t
wh a t goes i n .
2b
i
I
Q
Wha t
reader
the
needs
to
know
Writers o n health worker training an d man power development
o f not overloading h e a 1 t h
. constantly stress the importance of
w o r k e r s wit h unnecessary and irrelevant knowledge. The use
wayof
of ensuring that this does not
task analysis is one way
off teachers and practicing h e a 1 t h
happen . The experience o
w o r k e r s i s also invaluable i n m a k ing sure you only pu t i n
what the readers need to know .
a
hat
he
is
to
of
do
this, the job descript ion o f the in tended reader i s vital .
the official job descr ipt ion i s often not enough . Exper ience
ac t u a 1 work done in the field i s usually necessary to make
the
of
that
tu 1 1 details of what i s t o b e done are included .
sure
For
but
Selecting content under this h e a d i n g i s also useful i n making
sure that operat ional and admin istrative procedures are conta ined
a s technical procedures. Lack o f c 1 a r i t y
in the manual a s well as
i s one of
o t the common failures both
about operat ional procedures is
o f manuals and of the training of health workers.
o
How
to
do
11
T h i s head i ng covers the details of the procedures descr i b e d
t o split
under ' What he is t o do ' . 11 i s often useful to
proc edures under t h e s e two headings, particularly when there
are detailed techn ical procedures t o b e described .
These two ques t ions, What i s t o b e done? and How i s i t t o b e
done? may often r e q u ire s ome r e -thinking o f answers t o the
first: What needs t o b e known ? You may find that you have
inc luded knowledge t o b e learned that i s not justified by the
procedures to be c a r r i e d ou t; or left OU t important knowledge.
o
What
the
reader
is
to
teach
As was pointed out earlier, many manuals fail t o distinguish
between wh a t the reader needs t o know 1 ji ms e 1 f and what he is
to pass o n t o his patients, o r others i n his community. The
health worker i s i n many wa ys a filter for health
in format ion. He needs t o unders tan ci clearly wh a t , and how, h e
s h o u Id pass o n t o others .
Thinking about and select ing content under these four
head i n g s will help t o ensure the relevance o f the mater ial
both to the - level and needs of the worker and t o t h e
situation i n wh i c h h e works .
29
I
CHAPTER
AC KIEV ING
in chapter
usab i 1 i t :
importance
USABILITY
HOW
S IX
S H 0 U L'i)
WE
PRE SEN T
1 HE
TEXT
2 we ment i on ed t h e three ma in f act o r s that
a f fec t
structure, 1 a n g u ag e .-an d layout, We
meat i o n ed t n e
o
ol1 controlling t h e s e
tor s- t o suit t h e readers .
1 n tii is c li a p t e r w e provide
some p r a c t i c a 1 g u i d e 1 i n e s
for a c h i e v in g u s a b i 1 i t y : h o w
t o present t h e text so a s
m a r c h t h e needs, skills and
p u r p o s e s o f t h e readers .
to
Struct u r e
1 .
W hen y o u start t o cons i d e r
tiie
put i t t o y o u r s e 1 f like t ii i s :
top ic
“A ri e a 1 t h Worker o r stuaent
will
o f t h e manual i 11 order t o
learn,
o r rev i s e, o r teach
you
wi 1 1
writ e
on ,
read, o r look up t h i s
o r find out, o r check
bit
up ,
1 h e sort o
oft a n s w e r s you use t o
complete this sentence
s h o u Id become your head logs ,
They should c o n t a i n the
reader 1 s possible q u e s t ions.
T hey s ho u Id b e t h i n g s like:
"now t o
"Why
"Wha t to
"When t o
Use
t Ii e s e
11
11
do
for
11
M
as
section
like ’’Pathog e n e s is",
’’Method",
2.
Then
as k
0r ,
0r >
0r ,
etc.
you r s e 1 f
headings, rather tn an formal ones,
H
Contraind icat ions , "A e t iology",
very
carefully,
W h o will ask tills onest ion?
W h y will they ask i t ?
When will they ask i t ?
What d o the y already know?
W hat’ will t ne y d o with the
answer ?
The answers
a n s we r s to t h e s e q u e s t ions
will help
he 1
you dec ide
t o write: how mu c h d e t a i 1
what to
t o inc 1u d e; how much
background you need t o pu t i n ;
whet h e r to write as
instruct ions, o r as d e s c r i p tions .
Th i s really helps
decide on the structure of
the manual .
you
to
30
L
• lead i n g s
3
U s e the head ings you find under 1 , above . You may want
c o them t o specify what you want the reader to .do with
section. You may . add th ings I.i ke : .
"You shou Id learn this” o r ,
"Check up on
o n this from time t o t ime " o r ,
"Fol low these instructions carefully” o r ,
"Teach this t o mothers”.
will help the reader
the i n f o r m a t ion .
This
with
know what
he
is
supposed
to
to add
the
do
Use ques tion head ings . People often learn better i f they
have a ques t ion first, that directs them as they read, But
if you do put
pu t a ques t ion heading, make sure the answer i s
clear . It i s usually best to give a s imp1e answer firs t,
then explain it.
5 . Where appropr late,
use func t ional
head ings and sub-head ings. Rather
these ques t ions " (see 1,
1 , above).
6.
rather than forma 1
than ■ I History ii use
zXs k
If your m a n u a 1 is tor
for severa 1 different sorts of worker,
or wi11 be u s ed
e - z by different cadres o f worker, spec i f y
the role o f »li Li ll worker . For example:
Con t r o1
Measures
What
W hat
What
Pub lie Heal th Technician
Health Educator can do
Nurs e can d o
the
the
the
Th i s helps
readers t o
for
Bi lharzia
can
do
to par ticularise general informat ion.
apply theoret ical informat ion .
11
helps
-arn i ng
7
If you wan t readers t o learn from the m a n u a , try t o help
1
them, Try to incorporate some learn ing strategies
or
activities in the text, You may need to get help from
educational expert for this .
Try t o show your readers h o w wh a t they’ re learning relates
their lives and their •jobs . You may try to put some commen ts
like this after each section:
31
'TM Ho
H(
1 h i n k how o t t e n you have
s e e n this i n your own
cl i n i c "
or
19 o y o u th ink you can d o
this n o w ? Try i t .
Practice"
or
C a n y o u n o v/ t h i n k o f s o in e
examples f r om your own
e x-p e r i e n c e 1 i k e t h i .$ ?
'i' e a c h i n
I f you want readers t o teach
s o m e t King i n ‘the manual ,
g ive
t h c m help, o r instruct ions
o n h o w to do i t . Tel 1
them wh i c h
p arts t o t e a c ii . Don 1 t
a s s u in e that they can w o r k
ou t for
themselves wh i c h part t h
e y should teach and wh i c h
part they
s ii o u 1 d ’ t .
Very £ew Hea 1 th Wor kers
are trained t o
he 1 p w i t h 1 t . Tel 1 tnem
w h e n and wh ere
1 e 1 1 them w h o t o teach
i t ,
a n d wh o not
teach i t . 0 o this f o r e a c h
section.
t e a c h , s o give the m
t e a c Ii s o rn e t h i n g .
t o . T e 1 1 the in h o w to
to
y o u w a n t the r e a d e r s '
t r a i n e r s t o use t h e m a n u a 1
as part
o r t h e i r teaching,
specify this. Th i s may take
the
form
of
"aot es £or th
t eah er
a t strategic points i n
the
manual,
o r even a h a n d o o o k t o
accompany t ii e manual .
9.
Dec is ion
making
Al u c h of
o r the wo r k a Health
Worker does
dO
involves making
dec is ions . i-i any junior
health workers f in d 1 t di f f i c u1t
m a k e dec is ions that
to
involve more t h a n one
or two v a r i a b 1 e s
at a time. In your m a n u al ,
try t o break things
down into
s i m p 1 e YES/NO d ec is ions
. One way of do i
this
18
ng
t o use
f 1 o w-ch ar t s .
10 .
Mak e i t
You may
very
like
clear w here
to put i n a
t h e reader has t o
make a decision.
1 i s t o f ins true t- i o n s thin
like:
11
i\ o w dec ide
i t clear what the
c r i t e r i a are for making t h e
decision.
R a t h e r than wr
ing :
"If S U c h - an d -such,
o r sirch- and- such, o r
wh e n sueh-andsuch happens
11
i t
m a y b e more helpful
to the reader to pu t 1 t
like t h i s :
"Ask t h i s q u s t ion :
such-and-such?
I f the answer i s
YES - Do . .
I f t lie answer i f NO
ii
Do.
Hand 1 e th i s with great
care, h o w e v e r , -as it can often
more c o m p 1 i c a t e d ,
ge t
rathe r than 1-es s 8 O .
M ake
32
1 •
Rererencin g
1 1 .
to
If you want people t o look things up i n the ma.n u a 1 ,
refer to it, ma k e sure it has either an index, or a detai led
clear table o f contents . Make sure i t has a clear,
s traight forward referenc ing system. Many Health Workers
prefer a s i m p 1 e page n urn be ring s y s tern i n the index,
rather than h a v i n g each sec t ion numbered . If you do
number t h e sections, don ' t use c om p1i c a t e d hierarchial •
number i ng s y s terns like:
2 . 1
2 . 1 . 1
2 . 1 . 2
2 . 1.2(a)
These confuse readers. Use a s i m p 1 e
through the chapter : 2.1, 2.2, 2,3,
Don 1 t
fill
the
2 . 6
pages
with
numbered
sequent ial
2.4.
s y s t em
sub-sections :
( i)
( i i )
( ii i )
or
4.2.3
(a)
(b)
Readers rarely count the numbers, or remember them. A
s i m p 1 e indentat ion or dash is probably al 1 you need.
Somet imes, however, students say they like t o have th i n g s
numbered i f ■i t helps them t o remember. For example:
There
1 2 .
Making
a good
o
o
©
are
1 .
2 .
3 .
4. .
four
main
of
caus es
a good index requires
index like this:
time
and
skill
Bu t
you
can
make
Collect 200 blank index cards; o r you can tear up
sheets of paper t o make cards .
Go through the text f r om start t o finish, Every time
you find a reference that you think will need to be in
the index, write i t on a fresh card or paper with the
page number. The s ame reference will often c ome o n
many diffrent cards .
Now put all your cards, o r pieces o f paper, into
alphabet ical order .
i
33
e
Th e n
o
Y ou
trans f e r a 1 1
n o vz h a v e your
ou t .
1 3 .
the same r e f e
r en c es onto one
index.
1 t simply needs
to be
card .
typed
you
1 f
w a n t people t o
refer t o your
manu a 1
prob lems,
make sure t h a t t h e y
c an
find the
t h e i n d e x o r s om e
sort o f p r o b 1 e m s '
list.
For
to
solve
prob lems
i a
example,
a group of Health
W o r k e r s were a s k e ci
t o ref e r
manual
for wh a t the
y s h o u Id d o f o r a
new-born
thrush . They
baby
were u n a b 1 e t o d o this
d i d not a p p e a r
since " thrush.” •
i n the index,
and
was not men t i o n e d
unde
i\ e u - b o r n m a n a gement”.
o
c
c
u red
i n the section
h e a d e d "P os t Part
u in Care”.
Th is was
n
i
the
index,
none o £
but
t h e readers,
unders tand a b 1 y ,
had
thou
g‘h t ’ to look
under
i t .
to a
Wi th
Ih inx
very
m i gh t
wan t
car e f u 1 1 y about wh a t
sort o f th i ngs
t o look up. M a k e
sure t h e y can.
people
L a n g u ag e
14 .
?i a k e
sure the r e a d a 0 i 1 i t y
level o f your
text matches
read i ng 1 e v e 1 o f
the
your reader s . Don ' t
assume that bee a u s e
your readers can
speak whatever lang u
ag e your ' r e u s i n
can read easily in it as
they
O J
i t
well. Testi
Testing
readability and
s i m plifying language
is
lang age
a specialized job. You
w i t h this. Some
may need help
Some suggest
ions are given
i n Append ix A.
Here
wr i t e
are,
h o wev e r ,
s imply.
&
'fry
not
c
Try
to
a
©
a
to
use
pos s i b 1 e .
Try t o use
some
s i rap 1 e
notes
that
have more than 20
wo r d s
in a
s i m p 1 e sentences with
as
few
can
help
you
to
sentence.
clauses as
c ommo n ,
familiar words .
Do not use synonyms.
same word each t i m e .
not to use idiomatic
words and ph r a s es
Try not
to use passives and
negat ives . Use
pos it i ve sentences.
active,
Try not to use generalisati?
ions . Use personal isat ions
situat ions;
eg . Rather than : "Dirt in wounds prevents i n
heal i ng " use
wounds
you get dirt
into a cut,
not heal”,
the cut will
Try t o avoid
participle p h r a s
es , T h e s e are ph
"By was h i
rases
like:
a wound ...
"Hol
dii n g the
•
•
or
- ;your r igh t hand
fore e p s with
Use
Try
the
'11 f
o
Try to pu t t h i n g s
in the c o r r e c t time
wound after s h a v i n
g the area” i s more
"Shave the
area,
then wash t h e
wound
34
sequence: "Was h t h e
complicated t h a n
15 .
11 m a y b e necessary t o
have your text translated.
Get help in
ass ing- the readability
o f the trans lat ion.
Trans
lat
ions very
rarely i f ever, s imp 1i f
f y. simp 1e tr ans lat ions
r e s u It f r om a
s i m p 1 e original.
Be very careful that
your 'translation i s n 1 t
in a " h i g h - b r o w “,
c. 1 as s i c-a 1 • f orm • of ithe language.
•In
c oun t r i e s where there is
is a classical’ and a
o f lang u ag e , mos t
c o 1 bo q u i a 1 form
trans 1 a t o r s tend t o use
the classical, w h i c h
may b e much too difficult
for the sort o f people
you are
writ! ng for .
16 .
Iry to make your 1 angu age
d i r e c t and personal. If you
the reader to do someth!
me ah
ng say: "You s h ou Id d o this
11
"Do this
or
" not,
This i s done
.The latte r ,
impersonal, pass ive use,
often conceals confus ion
i s actually to d o
about wh o
some thing . If you ' re not
sure wh o s h o u Id
d o somethin g } your
readers certainly won 1 t be .
Layout
17 .
Following o n 7 above, try. as
f a r a s poss ible t o break
text up into a note-for
the
m . I n e x per i e n c e d readers f i n d
long
paragraphs and pages o f text very
difficult. They plough
slowly through them, out
but gain very 1 i t t 1 e .
Make imag mat ive
use of s p a c ing, type-faces
and layout . You may need
specialist help with this .
A Caution: Use of different
type-faces and s tyles (eg .
italic, bold, capitals,
i s conven t i o n a 1 . It
etc.) is
does
have intrinsic mean!
ng • Your readers may not b e V e r y
familiar with these conventions;
you may have t o point
out, o r t o teach them.
not
them
Cons iderab ly mo r e research
needs to b e done i n this
area:
just what
wh a t are appropriate 1 a y o u t s
for health worker s ,
b eear
a r i n gp iinn mind their o v e r a 1 1
b o o k - u s ing skills.
18 .
Use pictures and diagrams
t o help explaii n compl i;p a t ed
procedures o r techniques . Bu t make
sure that the pictures
are c 1 o s e to the text they refe
r t o . A 1 s o make sure
your
p i c t u r e s are clear, and mean
t o your read e r s the s ame
thing
they mean t o you. Pre-tes
Pre-testt them.
19.
Try using tables t o present
informatiion. People often find
it easier to locate in format i
ion in a tab le fat he r than i n
a
paragraph of text . The-y also
oft e n f i n d i t e a s i e r t o m a k e
dec is ions f r om a table than
from text.
35
i’ i n a 1 1 y
z\ t a 1 1 t i in e s ,
try C O think how real readers will
a c t u a 1 .1 y u s e the
manual i n p f a c t i.c e . Will it
become a door-stop
in the ou t door -s
pat i e n t s ' .c 1 i n i c , a paper-weight
on a bookshelf, ’ a certificate o f
c r e d i b i 1 i t y in the ’health centre
1 i b r a r y locked a w a y a nd; hoarded, .
o r will i t be a useful tool, a real
resource, a pr a c fi c a 1 aid to
t h e health worker, student o r
graduate, i n his daily ’work?
i
s
I
j
i
36
CHAPTER SEVEN
PUBLISHING A MANUAL
Publishing a manual is taken here t o
mean the complete series o f
operat ional s teps from p 1 a n n i n g
the ma n u a 1 (Chapter 4) up t o
distributiing copies t o the
intended readers . This can b e
done i n
very m any different ways,
depend ing on tiie
the
size
o
f
the
manual
and
the number o f copies needed, and the
print ing res oures available.
In general, three main
operat lonaI areas need t o be considered
i n pr odu cing manuals :
G
o
G>
Writ ing and editorial work
Produ t i on and manu fac t u r e
P r omo t ion and distribution
Manuals start a s ideas and needs,
identified overall in
i n reviews
and des i g n o f t r a ini
ng , o r ar is ing from part icu lar
shortages
and
demand s . These ideas and needs
must then be trans lated into
c o h e r e n t plans for spec i f i c
materials and books .
The rirst
first s tage, therefore,
r e, is the writing and ed i
t or i a 1 stage;
this is
i s oft e n the most draw-ou t
and c r u c i a 1 stage in produc ing
effective manuals . One important
con siderat ion regard ing this
stage i s i t s cost, part icu lar ly
if workshops
wor ks h o
are held or a u t h o r s
are scattered around the wor1d
and have to be consulted a t
z ario u s s t ag es in the ed i t i n
process. It is es t imated that some
>0% o f the cost o f produc ing g
manuals i s may be used at this
s t age . It seldom takes
less than a y e a r , and may often b e up
to
o u r or five years o r even
longer.
fh e next major step i n v oIves
turning the final typed manuscript
’ n t o a p r i n t e d book
There are two ma i n types of
o f activity in this
tep: production, o r preparat ion,
of the material, and the actual
r r i n t ing.
he d i v i d i n g line be twe
en the two
t V7O stages,
produc t ion (copy
d i t i n g , spec ificat ion, typesett ing,
proof-read ing, layout) and
printing (dec id ing on and bu
buying paper, impos it ion,
filming,
late making, printing, fold ing,
collating
ng and bin aui ng) is
□ met i m e s difficult t o d e f i n e b e c a u s e
several o f these steps rn a y
c ake place at tthe
h e same time. The aim, h o w e v e r , i s t o
ensure the
accuracy and cons is tency o f every
sentence in t h e book and t o
1 k e the whole thing easy t o use
and read, practical, attractive,
-.id long lasting. Produc t ion
and printing are estimated ttoo make
up about 33Z of
o f the cost ot
o f a book . T h e s e stages also r e q u ire
a
’eat deal of time,
t i m e , usually taki ng between a
year and two years
‘pend ing on the length ad
a d complexi t y of the book .
37
final s t a g e , t h e pr omo tion and
distribut ion o f t h e book o r
mater i a 1 , i s o f t e n ignored by
non-profess ional producers o f
books . Y es i t is oorf cruci a 1 importance,
as the p r i m e reason for
p r od u c ing the material i s t o
i t into the hands o f the
get it
health
workers wh o need i t . Th i s
stage also involves considerable
e x p e n s e i n establishing a
storage an
andd distribution system. Books
are b u 1 k v a n d. the i r
a
n
d
s t or ag e
distribution
ion is relatively
e x p e n s i v e . In add it ion,
iinn storage represent a consider a bl
□
o
o
k ss
e
a m o u n t o f money.
Whate ve r system i s used t o
produce a book, the basic process
o u t 1 i n e d above i s the same . The
a i m i n this booklet is not,
h o w e v er, ttoo provide a complete
g u ide t o al 1 the complex! t i e s
of
this process . Some n o t e s o n t h e
s i m p 1 e , s m a 1 l-scale • produce
or
material can b e found i n Ab b a t t
Tea chi ng for Better Learning"
( 1 ) . An e x t r e m e 1 y d e t a i 1 e d guide
to the organizat ional and
a s p e t s of
management aspets
o f preparation, product ion and
distribution
u t i o n of
textbooks has been prepared by UN ESCO: 11
E
due
a
t
ional
Development
A^practical issue: Guidelines
f o r the prepar at ion, production
and
distribution of
textbooks
of
” (2). A s i m i 1 a r de t a i led a na 1y s is
o
f
large
scale
ge
p r o d u c t i o n o r books is i n the W o r 1 d
Bank paper:
“Pub 1 i s h i ng f o r Sciioo Is :
T e x t b o o k s and the less Oeve loped
Conneries
(3) .
W hat will b e done i n the rest o r
the c h a p t e r is t o ou t 1 in e the
e x p e r i e n c e o f the Air i c a n M e d i c a 1 and
Res earch Foundstion in the
med i urn scale production o f
textbooks . AMREF has i t s own print ing
department and distribution unit, and
produces about 40,000
copies of its books a year, Its
exp e r i e n c e i s therefore a useful
guideline for those t h i n k i n
S of enter ing the book production
bus in ess o n a med i u m scale .
There follows a checklist o f
activities fo
producing books, deriving fr o in our
experience.
Wr i t ing
1 .
and
general
Subject
proposal
editing:
A number o f thin gs need t o b e
es t ab 1 i s h ed a t
o
Au d i e n c e :
Who ? How many?
a
Content:
r e1ev an c e , level, des i g n,
o
Use/Nature o f book
o
•L a n g u a g e
o
Author
o
Fud in g
this
stage.
etc.
Of main importance i n this
stage i s t o e s t a b 1 i s h the
re lev an c e and u s a b i 1 i t y o f
the mater i a 1 t Q be produced;
how i t will b e produced,
b y wh o m and i n what sort o f
numbers a n d des i gn; and what
resources are needed for
this .
38
2.
First
draft
This r f-e r s t o the original
may b e . a s ingle author, o r
o r collection o f writers .
Act i v i ties
o
o
o
3 .
invo1ved
man u s r ipt t o be
a co 1 labor a tive
produced,
effort o f
It
a t e am
are:
Writing
Typing and duplicating as a first draft
Pic tures (to bbee considered /produced a t this
stage)
Workshop
It is essential that a book be acceptable t o those wh o
will have to
t o use it; not only the actual r a d e r s , bu t also
their trainers and superv isors and policy makers, It has
been found very useful t o hold a short workshop with
representat ives o f thee groups t o in troduce the first
draft and to al low c o r r e c t ions, changes of emphasis, and
e s tablishing of policy dec i s i o n s .
Prelimin ay testing 0 f >
be done at this stage.
therefore are:
o
o
o
G
4.
Au t h o r
for
Technical content
Technical c o n t e n t
Acceptable?
Readab le?
s
example, readability, may
points t o establish
correc t ?
appropr i a t e
and
relevant?
rev is ion/editing
At this point the author may h i m s e 1 f revise and
book, o r i t may go to an e d i t o r wh o takes over.
wa y certain things have to be cons idered :
©
o
o
Much o f
g e t t ing
also
The main
ed i t the
Either
r e v i s ions f r om workshop incorporated
appropr iate presentat ion established: language level
(readability); teaching/leaning struture;
des i g n/struc t u r e of content
referencing s ys tern established : page/sect ion number ing
d e s i g n for pre-teat ing ( i f necessary)
this editing relates t o
the pres en tat ion of the
39
ensur ing usability:
book right.
5 .
Select in g
Th is
can
o
o
o
i 1 1 u s t r a t ions
be
a
prob 1 e rn .
The
main
points
f i n d appropriate i 1 1 u s t
rat ions,
a u t h o r draws t h e m ,
or
c qmmi s s ion a n •artist.
A t this point
car e f u 1 1 y
to
cons i d e r
or
the s tyle•of the ill
ustrat ions
established: phot os/I ine drawings/
6 .
are:
need s to
cartoons,
be
etc.
Pre-testi n g
.1 f the book i s t o
b e pre-tested, c n i s is
this'
u s u a lly the best
stage • 8 e p a r a t e
parts can be pre-tested
before
d r a f t i s prepared
the final
Pre-tests can cover :
e
Q
o
Final
readability
pic Cures
learn i ng •
draft/exp er i rn e ii t a 1
ed i t i o n
A t this point i t
1 S
p o s s i b 1 e t o put
t o g e t h e r a final
draft. This may
go direct ly t o product ion
i t may be
dupl icated a s a n
or it
exper imen t a 1 edition.
An experimental
edit ion i s oft e n
useful as i t can reach
r e a c h a wider a u d i e n
than the earl i e r
ce
workshop. 11 •nay, h
o we v
however
hold up the
production of the book
while you wait
wa i t for commen ts
react ions . I f yo u
and
produce a n exper imen tai
will have t o
ed
i
t
i
on
you
cons ider the next
activity.
8.
Ke-ed it
0
G
experimental
incorporate
re-type.
edition
commen ts
Production
9 .
Copy-ed i t ing
This is the painstaking job
f o r typesetting, it involves o f getting a typescript
It
these
e main activi t ies :
<5
O
a
o
ready
Edit in
for cor. s ;
consistency and accuracy of
o
use/spel 1ing/word
language
--- 1 emphasis /punc tuatlon/headi
Producing and
---- 1 ng , etc.
an d checking the
front and end pages:
foreword/introduction/
a c knowledgemen ts/
etc.
append ices,
index
Dec i.-ing
d i
on posit ions
and style o f
i 1 1 u s t r a t ions/tables
etc.
Technical content
edit ing (if
necessary) .
40
10 .
Spec i f i c a tion
Th i s involves spec i f y i ng
types e t.. It covers these
o
□
©
to
be
etc
is now typeset. 1 original and 2
the galleys shou Id be produced.
Proof-read ing
o
author's pr oof-read ing
copy editor’s proof-read ing
corrections made and typeset .
Q
O
13 .
is
Typesett ing
The specified text
cop i e s (proofs) o f
12 .
manuscript
page s i.z e / 1 i n e lengvh/texttyp e face an d
size /layout / il lustrat ions/justifica’t iion,
des i g n o f head i n g s, etc.
prepar ing pas te-up grid sheets
c ovr des ign .
O
11 .
ho w the
things :
D u mmy
A copy
of
11
is
used
to
prepared
dummy
layout .
Extras
The index cannot usually be made until
actual page numbers from the dummy are
i s then typeset and proof-read .
5 .
Final
this point as the
needed . The index
Pas te-up
The o r i g i n a 1 fr om 11 i s now pas t ed-up to make
camerar e ad y copy. It needs t o b e carefully checked,
espec ially
for pagination . The or ig i n a 1 illustrations are pas ted i n
pos it ion a t this point .
Print i ng
6’.
Preliminaries
o
o
Q
Selec t ion o f printing
etc.
Impos i t ion s ys tern
Cos t ing
1
process/number
41
o f copies/bind ing,
—__
1 7 .
M a k i ng
Th e
the
first
final
<?
o
Id .
Negatives
stage o f
pas te-up
ac t u a 1
print i n g i s making
above ) . Th i s can also
(15
negat ives
involve:
'Str i p p i n g - i n ' o f illustrations
and h a 1 f- t on es .
Retouch i n g, to -remove
u n w a n ted 1 i n e s , blemishes
from the negative.
Plat e
from
etc
mak i ng
k! hen finally read y,
the n e g a t i v e s are e x p o s e d
directly onto
t h e P r i n t i n g plate.
The resulting meta 1 p 1 a t e s
are then
P a s s e d t o the m a c h in e for
print i n g .
19.
M a k i ng
ready
the
mac h i ne
and
printing
The m a c h i n e i s ' m a d e r e a d y ' o r prepared with
c o r r e c t paper,,
ink, and t ii e plate
from 1 o above. The fi
r
s
t
proofs
are
checked for p o s i t i o n and
o v e r a 1 I printed quality.
Te n u m o e r
o f copies needed i s
then run.
20 .
Fold i n g
21 .
Pages o f a manual are usu
ally printed eight o r
more at a
t ime (d e pend i n g o n
the press being used) on
a
larg
e sheet o f
paper . Th i s la r ge sheet
is then folded so that the
pages
a p p e a r i n the right
order. A manual may c o n s i s t
of many s u c h
' s ec t i o n s ' . All t h e s
e sections are then 'collated'
(put in
c o r r e c t order) and pu t
together t o form the
c omp 1 e t e book.
Bind i n g
Th
22 .
cover
and
is
collar i n g
pti t
on ,
and
s t i tc h ed
or
!
!
I
glued .
I
Fin i s h i n g
■
The whole book i s t r i in m e d
to the c o r r e c t size
see that al 1 the
pages are there, and all
11) e
i n the r igh t order,
etc.
and checked t o
right way
UP,
D i s t r i b u t ii o n
I
$
A s was mentioned
earl i e r , d i s t r i button
o £ books i s an important
part i n the pub 1 ish i n
g process. In essence, dis tr ibut ion
m a k i n g the r igh t book
me a n s
s avai lable t o the
right people a t the
time and place,
right
and at a price they
can afford . There are
main areas o f
three
concern : the target au d i e n c
e;
the channels o f
d i s t r i bu t ion and
the prac t i c a 1 prob lems
o
f order 1 n g , p ayment
s h i-p p i ng .
and
42
i
a
Target
Aud i enc e
who are you trying t o provide
with books ?
(students, teachers, health
workers )
w here are
(training
they?
schools,
health
h o w many are they?
(now and i n the fu t u r e ,
institutions).
by cadre)
which books d o they need?
(curriculum, book choice,
price)
how many books do they need?
( library referenc e, student
loan,
o
Distribution
s tud en t
issue)
Channe Is
which book s are already
av a i 1 a b 1 e
( c h o i c e o f titles for each
topic)
fro in
publishers?
ph ys i c a 1 distr ibution routes from
publish er to
t o reader?
(publisher, wh o 1 e s a 1 e
bookseller, retail bookseller,
training school store, ‘direct supply)
who chooses w h i c h books t o s u
PPly to readers ?
(reader, teacher, M i n i s t r
y o f Health)
who pays
(reader,
o
Practical
for the books ?
school , M i n i s t r y of Health,
donor )
Prob 1e m s
what are the forma 1
t o make an
procedures to
(reques t authorisation,
budget, important
how much time will i t take
(immediate, one month, six
how should books
(1 kg, 1 ton, 10
to deliver
months ).
order?
permi ts )
the
books ?
the
books ?
b e packaged?
tons, 100 tons)
how much money will it cost to
del i v e r
(freight, s t o r a g e , c ommun ications)
Dec i d i n g on ansewrs t o t h e s e
questions will depend very much on
the situations and you are in,
the regula t ions that
apply, and
the resources available.
43
I
Append i x
A:
T e s Ling
« s •i m p 1 e method
t o a part i c u 1 a r
This is
is a
re1 i ab 1e .
Readability
:
Cloze
to' test the r. e’a’d a o i 1 i f y
group of-health worker s
u s e f u 1 method, as it is
i s so
It i s also very versatile.
Tes t s
of
in
a manual- with; r e f e f e n
c.?
the cloze ‘procedur e .
s i in p 1 e ,
easy
to
use
an d
The c 1 o z e procedure
measures readability, that is, the readin
the
1s }
d i f f i c u 1 t i e s in h e r e n t in
g
i n a text, for a n y given reader or
group
of readers
1 t does not directly
measure c o m p r e h e n s ion, though
c o r r e 1 a t e s highly with other
tests o f compre hens ion, and
has
been used ss a measure o f
compreh e n sion
it
2).
Readability i s only one o f the
fact o r s that influence
in f1
read i n g
a b i 1 i t y o r read in
g skills. Yet i t is a fundamental
one.
It
relates t o t h e reader 1 s language
a b i 1 i t y and f a m i 1 i a r i t y .
F a c tors
such a s I a m i 1 i a r i t y with
content a n d / o r technical
terms, flu e n c y
i n the spoken lan
o r aptitude i n study
g u a g e, or
u d y skills, are o f
second ary i in p o r t a n c e
compared w i th the ability t o
decode writ t e n
lan g u a g e . I f the reader
cannot 'decode t h e lang u age, he h a s
1 i tt1e
hope o f d o i n g a n y t h i n g
with a text, a p a r t from
"barking at
a t pr i n t
the recognition and
reproduction o f me a ningless
sound-symbo1
relat ionships .
Th i s procedure, known
as a 1 cloze test' oy w h i c h a
pas s ag e i s
mutilatedby h a v i n g every
n th " word w i t h d r a wn ,
was
introduced by
T a y 1 o r with n a t i v e
speakers i n 1953 (3) • It ha s
since
been widely
used and validated for both
n a t i v e and second o r f o r e i g n
language
speakers, w i t h many 1 a n g u
ages and many kinds o f
s u b j ec t s . Olle
has used i t extensively with second
lang u age learners (1 ,
K 1 a r e has used it for training
materials and translat ions (5),
and recently it has been used
very effectively
f ' "
to survey read in
skills and texts i n
g
Governmen t Schools in
Botswana.
Once a passage has been
mutilated, s u b j e c t s
are asked t: o replace
the miss i n g words . The
nu mb er o f c o r r e c t wo r d s
replaced gives the
readability score . The "correct"
words replaced may be
e i ther
those w h i c h were o r i g i n a 1 1 y
removed, o r any acceptable
w1 thin the constraints
alternat
ive
of •■^n e a n i n g , g r a m m a r
and context . "n" (how
often words are left out)
h a s beerf found t o b e
opt i m a 1 for test
purposes between 5 and 10 i n
English . Figure 1 gives an
of a cloze test . Note
example
that i n this tt e
e tt n
6^, and there are 33
blank s . It i s u s u a 11y best
t o try to
t o make the test o n a
o f conneted prose
passage
about 250
300 word s long .
Leave two o r t h r e e sen t e n c e s
a n introduct i o n th e n si m ply
a t the beginning of the
s tart c o u n t i n g the
words
^4
passage a s
u p to n . A t
n , leave a blank, then
count another n words, leave another
blank, and so
s o
on. Count figures and numbers as single
words .
Leave a sentence or two at the end as a fade-out. You
can present
t h e text i n v a r ions different ways.
ways . One way is as in the figure .
Another way i s s imply to leave the blanks where they
occur in tlie
text and let the subjects write their answers-there.
I t does not
seem to make much difference wh
whichever
i c h e v e r way.you present i t .
-H£U ££>1
4.2
IMMUNITY AND ANTIBODIES
A child only gets whooping cough once.
He does
not got whooping cough again because he is immune
He becomes immune by making antibodies.
to it.
Antibodies are special protein in
I
Antibodies 'fight' the organisms
2
disease, or the toxins (
Antibodies fix
make.
kill it.
5
6
2
3
) that organisms
3
4
an organism and
4
can also fix onto toxins
antitoxin is a
ll
antibodies
8
.
kind of antibody.
9
10
5
The
which fight toxins are called
organism
I
cause
stop them causing harm.
different
blood.
7
6
So an
7
A
8
of antibody fights each
toxin.
12
fight measles virus.
ll
tetanus
12
15
13
important for
14
describe antibodies
15
fight malaria.
14
not helpful in diphtheria .
immunity, but we
Antitoxins against
16
17
10
They
13
cells in the blood are
9
Tor example, measles
The
here.
16
While a
19
18
is ill with measlesIds
begins to make the special
17
20
18
against the measles virus. He
21
on
19
making measles antibody for
22
22
rest of life.
20
H2
immune, and never has measles
23
24
When a child makes his
.
25
21
22
antibodies, he has an active
26
.
He
23
can become actively immune
27
27
two ways,
24
He can become
cr
29
30
28
with the disease itself,
rxa can give him a vaccine.
we give a child a
antibodies against the
organisms of the
32
31
t he makes
or harmless
'33
He has no symptoms, or
25
26
27
28
29
34
mild
30
symptoms, such as a mild fever. The antibodies
which he makes can fight the harmful organisms
32
of that disease, and so prevent him becoming ill.
33
31
34
rr/cr'r' /~i
I
I
A s s e s s i n y,
O L
cloze
tests
is
usual 1 y
done
on
a
3
level
scale:
U n d e r 4 5 A : 1 r u s t r a t ion level
T h e r e a d e r can decode par t s o £ f li e text but c a n n o t gras p
1 t s comp I e t e m e a n i n g .
to 60Z
i n s t r u c t i o n a I level
1 h u r e a d e r can c o p c. w i t h th e t e x t 1 1 s o tn e instruct i on a I n e 1 P
i s give.
A o o v e 6 J : ‘o : £ 1 i) e a c y level . Tn e r e a d e r can r e a d t (i e text .
iv ii e n assessing cloze
c 1 o z e test scores i t i s unportantto remember. t h a t
m
e
a
s
u
r
tney
r e a u a b i 1 i t y , not n e c e s s a r i 1 y c om p r e li e n s ion, t h o u g h
t n e t w o a r e c 1 o s e y 1 1 inked . Tn u s a s u o j e c t whoralis a t t ri e
z r u s t r a t ion 1 e v e 1 ;a a v w e 1 1. b e a b I e t o guess a C t h e genera 1 sense
o r t h e p a s s a g e . 1 t t n e r e are pictures o r o Cher clues, o r ii e i s
ver y £ a m i I i a r w i t n t ii e content, he
h e may well b e able t o guess
quit e a c c u ra tely what is in t n e passage. but h e cannot read i t .
h e c a n n o c decode s u f f i c i e u c words in the p a s s a g e and 1 i i i k t n e in t o
e a c n o t ii e r s y u t a c t i c a 1 1 y and s e m a n t i c a 1 1 y t o b e sure o £ wh a t
;ne a n t 0 y t n e passage . a t the instruct' i o n a 1 1 e v 1 a reader has
m ore idea o i wh a t cue p a s s a g e i s actual L y s a y i u g , out r n e r e art
s t i 1 1 hi a j r g a p s in his d e c o d 1 ;'1 g a n d interpret i n g. 1 n e s e a r e
s u r £ i c i e n t 1 y £ e w h o wever, t n a t v; i t h some sort o t i i e 1 p ,
like a
1 a o e 1 led d i a r a m o r a picture, o r i n s t r -u c t ion r r oin a teacher o n
t h e passage
i t s contents, h e can read i t well e n o u g 11 t o grasp
c h e me a n i n g intended. S i n c e the point o £ in a n u a 1 s i s t o p r o v ide
important in format io n w h i c h t h e user m u s t have access to on n 1 s
own , b v read i 11 S his :n a n u a 1 , i t i s very important that radability
scores tall i n the r 1 u e n c y level . A t the instruct i o n a 1 level,
m a n u a 1 s are useless t o reader 8 w i t h o u t the help o f a t e a c ii e r .
I
■
I
P e r n a p s the inos t u s e f u 1 aspect o f cloze tests in
i n their use as
c o m p a r a t i v e ins t r ui.ie n t s , t o s h o w the difference
e in
i n read a bilit y o £
one text tor d i t £ e r e n t groups . Thus a manual produced tor several
di f fe r e n t cadres o f worker m u s t take into cons iderat ion varying
read in
levels of different groups,
It i s important t o note that readability scores i n d i c a t e t h e
interat ion o £ a reader and a particular text . They do not, per
s e,
i n d i c a t e anyth i n g about that readers ’ grasp o f lang u age , o r
read i n g s Kills in
i n general. Thus ,
the fact that a group o f workers
may fall mainly at
a t frustration 1 e v e 1 i n a cloze test does not
m e a n t h a t they cannot read English, 11 does, however, m e a n that
that text i s too difficult for them t o read . T h e y m i g h t cope
e a s i 1 y w i t h a s i in p 1 i tied vers Jo n o r the text, where language, n o t
content i s simplified.
Indeed, t e s t s c a r r i e d ou t with health workers i n several
c o U ll tries ‘ i n d i c a t e c 1 e a r 1 y that linguistic simpli’ficat ion o f a
text can be
b e carried out w i t h o u t t a in p c r in g with the content, and
that sign! r icant increases is
i s r e a d a b i 1 i t y r e s u It .
46
I
Appendi x
B
:
Using books
sugestions
for
teaching
and
learning
some
Books d o very little good if t.iie y-just sit on a
shelf. Ln order
: o serve as - a learning t o o 1 , books must be- used.
Many, people have
asked u s for sugg.es t ions on how to use books mor e
effectively. I n
this section, then, some sugges t ions are offered
in two areas:
o
o
por
o
ways that teachers
ways that teachers
effect i v e 1 y .
can
can
use books m their teaching;
train their students to
t o use books
mor e
Teachers
Use books
in
the
classroom.
Reading is a very good way of
o f learni ng information, 11 i s mu c h
better t o read a lot of tech ical content than
t o have a
1 e c t u r e o n i t . Students can wo r k a t the i r own
pace wh e n
reading, Give people enough . t ime for r e a d i n
g • If you have a
mixed group of students, you may find
it better
be t t
t o read round
the class than for everyone t o read by t h e m s el
v e s . A 1 ways
allow clasroom time for reading. Very few
people will wa n t t o
read o n the i r own i n the evenings . The
ones who do are u s u a lly
the ones who d o not need to, as they are
more keen t o learn than
the others . You can ask s t u d e n t s to buy
their own books, s o
that everyone has one, o r take OU t a
classroom set o f books
from the 1 i b r ary.
Make
referenc e s
to
books .
Instead o f giving a 1 e c t u r e o n a topic, tell you r
students
to read about the topic i n books i n the library.
Give them the
referenc e s t o the books an d also t o the pages o r sec t ions
they
s h o u Id read. You can then discuss m class
wh a t they have
read.
At first you may find that students are
unaccustomed t o this
sort of learning . They may c omp lain o r
ask for a lecture')
ins t e a d of the read i n g ass i g n m e t . But if you ins i s t
o n their
read ing, they will benefit, It helps t o
train them in skills o f
learning and s earch ing for informat ion . Th e s e skills are
some
o f the most impor tan t that they can develop
an d will help them
t o cont inue learning on the i r own after
they have left the
classroom.
48
I
Use
o
boo ks
for
1
prob 1e m-s o1v i n g .
i
Give t h e s t u d e n t s a problem, Tel 1 them to find
t lie s o1ut ion t o
the pro b1em i n t h e i r books . Then let them discuss
i n class the
s o1u t ions they have found . The prob 1 e m you give
the s t u d e n t s
c o u Id b e like this:
A p r i m a g r a y i d ci come s t o your health centre in tthe
h e end of
t h e first s t a g e o f labour w i t h . <3 breech
presen tat ion. W hat
thin
m a y go wrong i n t he delivery? What shou Id y o u
do?
o
Teac h
The
r or
next
how
sect ion
to
gives
use
books
more
some
hint s
i m p o rtan t
skills
on
are threc
books :
how
how
how
to
to
to
use
ary
use
very
this .
for
Teach
your
students
an i ndex
the i r read in g speed for diffrent
a book t o solve prob lems
Like a n y o t h e r skills, skills in
i n using
C 1 a s s room t i in e devoted t o learning and
time we 1 1 spent; for after t h e student
books and other r e a d i n g materials will
source o f cont inu in g educat ion .
o
effec t i v e1y.
stud e n t s
There
u s i ng
o
o
o
s t uden ts
i
students
how
to
use
an
to
pu r p o s
acquire
of
in
read i n g
a book r e qu ire p r a c t i c e .
practicing t h e s e skills i s
leaves the class room,
b e h i s o r her princ ipal
index.
Many
students will not be f a in i 1 i a r wi th a n index .
T a k e five
minutes a
att the beginning o f each s e s s ion for a week .
Write a
word on the board (like virus, diarrhoe a ,
breech
presentat ion), and ask the students t o look i t
up i n the
index . Then they shou Id turn t o
the page o n wh i c h that word
discussed and see wh a t i t s a y s on
that page . D i s c u s s
difficulties that come up . For
example, you may ask them t o
look up heart. If they can ' t find ’heart'
i n the index,
suggest they look for o t h e r words related t o
'heart, ' like
'cardiovascular. '
C o n t i n u e daily practice with the index
u n t i 1 the students
confident us i ng an index . Th e n
check the in per i o d i c a 1 1 y
tri rough out the course.
49
feel
o
Teach
your
students
how
to
vary
their
read i n g
speed
We all read a t different speeds, depend ing on what vze are
reading an d w h y . If s ome thing is very complicated
o r very
impor t a n-1 , we usually read it s lowly, to make sure we d o not
miss anything.
anyth i n g . If we are trying to find something for
.instance a reference we wa b f t o c h-e c k i n a book. — we s k i m •
quickly t h r o u g, not taking much notice'of everything else It h a t
1 s there . The most impor tan t th ing about
reading 'for learn i n g
i s to be able t o choose the best speed a t
which to
t o read
s omething and t o b e able t o deliberately
control our reading
speed .
There are two main ways o f reading: receptive/reflec tive
reading and skim/scan r e ad i ng . Each
requires a different
r eading speed, Train your students
t o choose the right type
reading for the purpose.
Keceptive/reflective
of
read i n g
This means reading slowly through s omething, a n
d gathering
a s much informat ion from it a s we can. We
often need t o
stop t o th ink about wh a t we are reading,
We may wan t t o go
back a 1 i t t 1 e from t ime t o time, to check
something we read
earlier, o r just pause for a few momen t s to think about
what we ’ v e read.
S k i in / s c a n
read i n g
Th is means ski p p 1 n g through s ome thing v e r y fast, t o
get a
rough idea of what it is
i s about an d w h e t h e r we want t o read
i t carefully or
o r not. We
W e also use this type o f read ing t o
go
through something we have seen before an d see if a
particular item iiss there or find a piece o f information that
we know is there
there.. Skim/
Skim/scan r eading is a fas t style o f
r e a d ing.
Every tune we read an y t h i n g , we need t o
choos e the best style o f
r e a ding. Otherwise we was t e a lot o f time and
often do not learn
2 s i 1 y . Try to train your student s to vary their reading s p e d s .
~ ive them small exerc ises to do. For example, ask them to read
something a n d then a n s w e r questions. Or as
k them to skim quickly
ask
i r o u g h a passage i n a book to find a p & i c u 1 a r item of
i format ion.
Teach
your
students
to' use
books t o
solve
prob lems .
Students s h ou Id learn that books are rsources
like teachers
or c o 1 1 e agues . You can a-s k qustions o f books just a s you ask
ques t ions o f teachers or classmates.
50
-A. A
!■
i
t i c e this i n t h e c 1 a s s r o o tn . When
q u e s t i on , s u g g e s t that the c 1 a s s al 1
then and there,
i n the i r book s .
Help
ways
the
s tuden t s
to
see
that
books
a student asks a
try to
C o find t h e answer,
are
very
useful
in
I
Ii
t hs e
■
for
getting
i n f o r m a t ion
fo
h' e 1 p 'th e in
solve- problems;
ror re fe ren c e ,
t o c h e c k th i n g s like doses and
procedures;
t h e n they ci o not need t o m e in o r i z e these
tli i n g s but can
s i m p 1 y look them up i n t h e i r book s a s
needed .
fo
1 e a r n i n g from,
s o m e t h i n g they d i d
a t their own pace, w h e n
not fu 1 1 y unders t and i n
there i s
c 1as s .
M a n y o f t h e s e ideas a b o u t books will
b e u n f a m i lar t o your
students . A t first t h e y m a y reject them .
But try t o encourage
t h e m t o u s e books i n t h e wa y we have
sugges ted . 1 t w i 11 help
t h e m t o learn a ci d will a 1 s o make your
work as
a s a teacher e a s i e r
i n the Ion g run .
Learning t o use boo k s effectively, then,
i s one o f the
most imports n t skills a student can acquire.
The student who
cannot use a book will learn only while he
h e is i n the course, a a d
in a v not e v e n learn very we 1 1- then. But
he may
Bu t the student wh o h a s
developed skills i n us i n g books can c o n t i n u e
t o learn f o r the
rest of
o f his life,
Ion g after his b a s i c training i s over.
!
I
i
I
Appendi x
C :
Notes
on
Needs
Ass e s in ent
for
books
Details o f m a k i n g a needs assessment
about books for health
w o r k e r s are best left t o be worked ou t
for particular situations.
The WHO report of
o f a group meeting on the Health
Learn ing
Materials Programme held i n Alexandria
i n Febru ary 19 76 sugges ts
some gu idelines .
I n this appendi x we will
for needs assessment . As
0
o
o
s imply suggest some broad cons iderat i
ions
sessment will cover s i x main areas :
Numbers and levels o f health workers for
whom books are
needed .Q T his will inc 1 u d e students i n
training,
ng > in-servi c e
health workers,
trainers, a n d ; future enrollment s
and
ex pans ions .
Bubjects/topics/jobs
ICS
for which books are needed . Th i s w i
1 1
r e q u ire d e t a i led ana 1y sis of
c u r r i c u 1 a , job-desc r i pt ions and
working conditions.
K e 1 e v a n c e and Usability studies,
t o ascertain what the needs
of the
t h e health workers are an d what r
e ad i n g s k ills they
possess.
II 0
51
OSZol
A
p
p(
/
Q
r.
I d e n t i f i c a ion of existing books, and priority
gaps . This
mu s t b e done o n the basis of the first
three assessments .
Cost ing o f v ario u s approaches : eg . bu y mg
books, produc ing
the m locally, w h e r e and h o w written, etc.
Priority sett ing on the has is of all the
above .
For example, t o see how s ome d f t h e s e
cons i derat ions
important, let u s examine a f i c t i o n a 1 c o u n try.
are
EXAMPLE
It has five main cadres o f wo r k r s wh o need b o o k s .
There are 30
training schools for these wo r k e r s each with an
approximate
enrolment of 30 s t u d e n t s per year. Ana lysis o f
their curricula
show that each cadre needs an average
of 8 textbooks for their
course. (Note, these are not unreasonab le figures for
a me d i um
sized country).
The
rough
es t imate
of
books
30 x 30 x 8
7200 books
needed
for
(schools
x
students
08$
If the av e r ag e price
boo k s i s $5 7, 000 .
of
a
book
is
This
take
into
account
<5
a
f i gu r e
does
not
these workers
health workers already in the
changes i n student enrolment.
8.00,
X
is :
books)
Che
investmen t
in
field
.’his figure does not tell u s how the
books are t o b e used. If
every student i s e x p e cted t o own the 8 books,
t o keep after
raining for referenc e and on the job help, the figure is
$57,000
er ye ar . This money will either have to be found by
the training
institutions, o r by th e s t ud en t s themselves .
his fig u r e a 1 s o does not take into account
exis t ing
school lib rar i e s and students’ possess ion.
These are
far fewer than i s generally expected.
books i n
likely t o
be
DECIS IONS
n the basis o f these figures,
a number o f dec is ions :
o
o
the
country planners
can
now make
Wh eCher t h e y can afford t o buy the needed books, cons
ider ing
fore i g n exchange situations, t h e rising cost o f book s
etc.
Whether they can i n v e s t i n 1 o a 1 production, and hope t o
r ed u c’e the cost per book t o lower the overall
figure .
52
■W
I
I
I
o
o
o
o
Q
W h a t existin g books can be used, and w h a t prioit i es can b e
set, us i ng their available resources, either for buying o r
prod u c i ng .
W h a t p o 1 icy on student use they will adopt: free
distribution t o every student t o keep; distribution t o
c 1 a s s s o f students t o b c returned a t the erid of the year o r
course; expand i n g 1 i b r a r y f a c i 1 i t i e s C o make fewer c o p i e s o f
the books go r o u n d better; . e x p e c t 1 ng students to buy the i r
own books; etc.
W h a t other alternat ives there are: re-printing other books,
looking f o r grants, using other forms o f teach iug ma t’e r i a 1 ;
e
T r a i n i n g book producrs, writers, printers etc.
Expendi t □ re involved i n the mars storage and d i s tribution
of
books .
I
T h e s e are some of the considerations
a c c o u n £ i n m a k i n g a needs
health learning mater ials
assessment,
programme.
that
and
need t o b e taken into
i n using i t t o plan a
!
I
3
53
Append i x
D
B a 1 c o in b ,
1975
John .
short
annotated
bibl iography
■
'C o m m u ni c a t ion for' development:
••from propaganda . t o dialogue’,
Educat ional Broadc as ting
In tern at ional, March.
A short art i c 1 e broad 1 y outlining some of
o f the problems in the use
o f c omin u n ication media in deve lop ing countr ies. The author is
primarily interested iin
n Che use of rad io, TV a n d Drama a s a means
o I e s t a b 1 i s h i n g a dialogue between consumers and s e n d e r s o f
messages, meaningful in t h e consumers' frame o f reference.
b e e b y,
1966
C.E .
’ The quality of Education i n
Developing Countr ies ' , Harvard
Univers ity Press .
Mainly of i n t e r e s t for the author ' s an a 1 y s i s o f ’ educat ional
stages’: ho w the level o f the teacher, i n terms o f his training
i n teach i ng and h i s knowledge about the subject, determine the
kinds o f teach i n g h e can do.
d o . Important for anyone wr i ting
teaching o r 1 e a r i n g mater ials .
Coombs,
1 9 6b
Ph i 1 i p
The W o r 1 d
A Systems
Educ a ion Cr is 1s j
Approach, 0 . U . P .
Excel lent basic description of the crisis
of the systems a p p r o a c h t o educat ion .
Coppen ,
1970
Helen.
in
eciucat ion
’Visual Percept ion ’ ,
Secretar iat .
today,
and
Commonwealth
This is a short rev lew of the literature on cu Itural prob lems
with pictures, d i a r ams, charts, po s ter .
It s u mma r i z es general find ings and' p r o vides guidelines for the
use ootf visual material particularly in teach i n g . The 1 iterature
i s mainly concerned with studies c a r r i e d out i n A f r i c a .
reviewed is
Important for anyone
o r x i n g w i c h visuals . -i
Court ,
19 74
D &
Gha i
D.
E d u c a tion,
0.U. P.
Soc i e ty
and
Development,
A collect ion of research papers on the Kenya educat ion system.
Excellent for identifying some of the b a s i c prob fems and factors
i n e d u c a t io n systems iinn developing c o u n tries .
54
■*■11
U r i p er, C .
v,1 i d d o ws o n ,
19 75
&
H.G .
WIJMIBIII im IM
' Soc iolingu is ics a n d L a n g u a g e
Teaching’,
in Papers i n A p p 1 i e d
Linguistics, Vo 1 . 2 o f The Edinburgh
Course i n A p p 1 i e d Liguistics, ed .
J . P . B . Allen & S . P i t Corder,
Oxford University ’Press
A thorough ’ i n t r o d u c t i o n • t o soc iol inguit ics for a n y oire in teres ted
i n look in g in more detail at the variable an d f u n c t i’o n al n a to r e
o•
language. P a r t i c u 1 a r 1 y u s e f u 1 f o r anyone in teres ted i n k i n d s. o f
language used i n m a n u a 1 s a n d Ii o w t o in a t c h this * t o t h e 1 a n g u a g e
u s ed b y wo r k e r s .
Cr i pwe 1 1 ,
19 7 1
K. R.
' Govern m e n t a 1 wr i t e r s a n d A f r i c a n
Readers iinn Rhodes i a ' , Language
Society, 4, Gt. Britain.
A description of some o
t h e factors that cause complex! t y i n
off the
1 a n g u a g e, aand
n d how man
ma ni p u 1 a t ion
i o n of
o £ these f a c tor s c a n produce texts
ver y different levels o
at very
off c o m pIex i t y. Very u s e f u 1 l o r a n v o n e
w i t h simplification of
concerned witii
o f language.
Cr i pwe 1 1 ,
19 76
K. R.
•' What i s a Cloze
use i t ' , M o d e r n
Vol. No . 7 .
a n d how d o 1
Engl i s hi T e a c h e r ,
Tes t ,
A s i m p 1 e introduct ion t o the Cloze procedure: h
o w to make a cloze
how
test, h o w to use 1 > what i t does, why it is useful. Important
for anyone starting t o use cloze tests for r e a d a b i 1 i t y .
Dow,
19 79
G yn e t h
Earn in g t o Teach : Teach ing t o
Learn; Rou tledge & K eg a n Paul,
London .
A n excellent book d e s c r i b i n g an innovat ive teacher train ing
programme a t Melbourne University. Has some fundamental th i n g s
say about teacher training .
Fuglesang,
1973
A.
1 A p p 1 id Communicat ion i n
Countries ' , H a in in a r s k j o 1 d
F o u n d a t ion .
to
Developing
A c 1 a s s i c on the prob lems that in a y arise wh
e n using w r i t t e n
when
material o r pic tures wi th v i 1 lagers i n developing countries.
Particularly interesting ‘for the author ' s sugges t ions about
alternative ways of presenting pictures . Bas i c read ing for
anyone
concerned with producing c o m m u n i c a t ion mater i a’ 1 for use w i th
v i 1 1ag rs .
55
I
Gagne , Robert M.
19 77 (Third Edit ion)
The Conditions of learning,
Rinehart and Wins ton .
A b a i c text on the Psychology of learn ing .
detai led, but a fund amen tai text.
Paolo .
Pier
G ig1 i o 1 i ,
19 72
Compl icated
Holt,
I
and
Language an d S o c ial Context' e d . ,
P engu in Modern Sociology Readings,
P en gu in Educat ion .
sociolinguistics,
A collection of read ings by the great names i n
Fairly
technical
etc.
L
ab
o
v
Gump
er
z
,
Byrnes, Searle, Berns tein,
interested
m
s
ome
one
for
and fairly detailed, Only useful
of
mean
ings
uses
and
looking in s ome detail a t the soc ial
language .
Gilliland,
1972
John .
1 Readability' , a United Kingdom
Read ing Assoc iat ion Teaching of
Reading Monograph, Unibooks, Hodder
and Stoughton.
o f the
A discussion o f wh a t r e a dability is; a clear s umma r y
legibility
like
of print,
res earch that h a s been done on things
off assessing
f a c tors affecting readability, and methods o
however,
more recent or
not
cover,
author
does
readability. Th e
detailed discussions o f wh a t 1 reading' 1 S V Useful for anyone
looking in some d e t a i 1 at readability.
'Fifty Guidelines for Improving
Instructional Tet*, Pr og r ammed
Learning and Educational
Technology, Vol. 4, No. 1 ,
February.
Hartley, j. &
B u r n h i 1 1 , p.
1977
Largely
the way o f a check-list of potential problems,
some
w
i
th
physical
design
of
texts,
though
concerned with the
ideas
for
check
t
o
hints about re adability. Most useful, perhaps,
wh i 1 e writing a manual .
More
i ii
Holmes,
1963
Alan
C.
' A s tudy of understanding o f visual
symbo Is in kfen y a', OVAC publ. no .
10, Overseas Visual Aids Centre, 31
Tavistock Square, London W.C.l.
villagers have
A small,, early study of some of the difficulties
clear . Conf ined
in understanding pictures which to us are quite
pictures with
to Kenya, but useful ttoo anyone interes ted 1 n using
villagers, as a starting point.
56
■
Internat ion al
Extent ion Col leg e
1 9 7 8.
'Writ ing
draft .
to r
Distance
Educat ion'
This i s the first draft o f a m a n u a 1 for w r i t e r s of- distance
t e a c ii i n g texts . 11 contains a lot o f very useful ‘material,
e x e r c i s e s and examples, b-as ed o n w i d e exper lence, mainly in
A f r i c a , of p r o d u c ing mater i a 1 for. e xt e n s ion e d u c at io n col leges .
E s p e c i a 1 ly u s e f u 1 for e d u c a t i o n a 1 f a ctors for anyone w r it ing
learning in a t e r i a 1 .
Jenkins ,
1976
Janet .
‘Editing Dis tance Teaching
Teach ing Texts',
Intern at ion a 1 E x t e n t i o n■ College
broadsheet s o n Dis tance L e a r n i n g ,
No . 9 .
Th i s 1 handbook for those involved i n prepar ing printed course
m a t e r i a 1 ' , i s concerned mainly w I t h the d e t a i Is and
technical i t i e s o t e d i t i n g and set ting out p r i n t e d in a t e i a 1 . Useful
if you have c o d o t h i s sort o t ed iting a n d p h y s i c a 1 des i g n
you r s e 1 f .
Jones,
1968
S h e i la.
1 Des i g n o f Instruction
I' r a i n i ng
In format ion Paper No . 1 , Dept.
o f Employmen t and P r o d u c t i v i t y ,
HNSO .
T h i s booklet r e p o r t s some of the b a s i c res e a r c h i n
the e f e c t s o f
negat ives, s e q u e n c mg , complexi ty i n instructions.
Very useful
for a n y o n e looking closely at the wr iting of
o f instructions.
Lesotho Dis tance
Teach ing Centre
‘Understanding Print : A survey i n
rural Lesotho of people1 s a b i 1 i t y
t o unders tand text and
illustrations', Lesotho Dis tance
Teaching Centre, P 0
Box MS 781 ,
Maseru, Lesotho.
Th is detai led study looked at
a t rural people ’ s abilities to
t o handle
such th i n g s a s photos, diagrams, maps , enlargements,
texts,
photo-s tr ips r a c^i
d.^i o listening, arithmetic. It
11 gives a clear picture
of the sort of problems
ems that can arise with the use o f t h e s e
materials. Important and
___ stimulating material
mater ial for anyone produc ing
mater ial, o r testing it.
57
Lt
G.
T
E
f
E
P
E
mzer , £ r i c &
ir dner , Keith
Read ing,
The Effec t i v e Use of
Heinemann Educ . Books
read ing i n
p r o j ec t exam ing
1
C
o
u
n
c
i
res e a r c h
School ‘ s
1 1 e n t analys is an d
1 c report of a
c o rhe
Contains some e x c e
Rather spec
ngl ish Schools•
reading t O learn .
f r om .
ind ings- concern ing
be extra p o 1 a ted.
bu t can
Sys
tern,
n g 1 i s h S ch o o 1 f .
the
Learning, UNESCO &
Teach mg &
of
In tern at ion al A s o c iat ion
ackenzie, Norman,
Univers ities .
rant, M i h a e 1 &
H yw e 1 C .
,o n e s
.'970
edu at ion,
about higher
an d
\lthough talking
methods, mater i a 1 s
teach
i
g
on
Iternat ives .
ideas
J- he rese arch on a
.nuch of
contains some
technolog i e s .
very useful
Summariz es
an d Difficulty
' Scor mg M e t h o d s
of
Levels for Coze Tests
Oller, J . w.
as Second
in
English
y
1972
Pro f ic i enc
'} Modern Language Journal,
Langu ag e
March .
Vol. 56 ,
s ome ot the
measure some
iment s t o
and on
f
e
xp
e
r
o
different languages
d e t a i led account
i
n
looking
tests
A fairly
for anyone-^
i n cloze
v ariables ope rat ing
formers . St i m u1 a t ing be used. Fairly
per
-na t ive
native and non
and how they can
a
t Cloze tests
mor e c 1 o s e 1 y
technical.
Second Language
s of
’Cloze Ts tProficiency
and Wnat they
Learn ing
Oller, J . W .
23 , 1 •
Learning,
Language
Measure'
1973
use
look ing a t t h e i r
tests, also
description of
ot Cloze
anyone working
St imu lat ing or
A technical
translat
ions
.
and
with p i t u r es
cloze tests .
c 1 o s e 1 y with
Handbook',
i c a t ion
'Visual C omm un
i
Id ford and
Lutterworth press, Gu
Saunders, D. J •
Lon don.
■ 1974
J b 1 e m s of v i s u a 1
oach to
01 the Pr
ssome
ome of
t
o
c onnn u n i c a t ion.
rd appr
iques ot s u c h
techniques
use the
A straight forwa and the basic techn
and how t o
projectors,
c o m m u n i c a t ion,
how to make materia
of
f i Im-strips,
po s
charts, posters,
S imp 1 e d e s c r i p t i on s
or use of s imp le
flip
most common med i a• engaged in the production
Useful for anyone
Is.
i c a t ion materia
visual c o m m u n
58
i
I.
Scrpe 1 1 ,
1975
’Culture's Influence o n Behaviour' ,
Essent ial Psychology s e r i e s ed .
Peter Herr i o t , Methuen .
Robert .
An up-to-date
to-date a c o un t of cross-cu 1 t u r a 1 psychology. The author
r e p o r.t s on
o n extensive. e x p e r i e n c e s r- and e x p e r i m e n t s w i th crossj? s y c h o 1 o g y a u d percept ion i n developing
c u 1t u r a 1 p r ob1ems o
countries, m a i n1y in A f r i c a . Useful for anyone c o n- c e r n e d w i th
in di f f e r e n t cultures .
us
p r o u u c i n g m a t e r i a 1 t o be used
S ina i ko ,
19 75
H .
TV s
ir b
leg i
ir *■ e
t<
' Verbal fa ctor s i n human
eng i n e e r ing : some cultural and
psychological data', Chapter 10 ,
E t h n i c Var iab les i n Human Factors,
ed . A. Chapani s > Johns H o p k i n s
Press .
.
A s t i m u 1 a t i n g a c c o u n t or a s e r i e s o f tests and experiments,
largely focused on tanslat ion, v i s u a 1 perception and learning,
c a r r i e d out in Viet Na m. User u 1 r e ad ing for anyone producing
material f o r t r a a s1 a t ion, a n d i n teres ted i n cross-cu 1 t u r a 1
percept ion.
Srivastava,
1978
R.N .
ec
a1
E v a 1 u a t i n g Communicability in
Village Set i n g s , Parts 1 & 2 .
A v a i I a b 1 e f r om U N IC E F, New D e 1 h i o r
Dept . o f Linguistics, Univers i ty o f
De1h i .
A report on
o n the evaluat ion o f t h e communicability and
comprehensibility of the Indian C o mm unity Health Workers Manual.
H
Contains some f u n d a m e n t a 1 descriptions ooff "verbal repertoire1 in
implications.
villages an d i t s teaching/learning
S t e nh o u s e ,
1975
Lawren c e
Turnl
Ba r c
19 5
U
:c
1
si
b ac I
rr s
c 1
A
1
7
Th i
av.
2'
r
9
An Introduc t ion t o Curr icu lum
Research and Dev lopment, He inemann,
London .
h
K>n
An excellent discuss ion of new trends
inc 1 u d e s a critique o f the objectives
t hfQ process model.
alternat ive
in curricu 1 u m deve1o pm e n t;
model and sugges ts an
th
r
lc
d
LT
Taylor,
195 3
W. L.
’Cloze Procedure: A New Tool f o r
M e a s u r ing Readability', Journal ism
Quarterly, Autumn.
One of
o f the first descript ions o f cloze t e s t s ,
cons true t ing them, and what they may ' me a s u r e.
a n y o n e using cloze tests . Not too technical.
59
different
A classic
ways
for
of
i
D
u 1 1 , A.T.
R. N .
&
C ommun i c a t i o n
' The Graph i c s of
Winston.
and
Holt, Reinhart
,
1c s as us e d
visuals and .graph
of
range
wh
ole
gu
idelins for
book covers the
s u mmary of
i n e s . A us e f u 1
and
mag
a
2
anyone
Doks , pap-er s.
St imulat ing for
of print .
Useful
ib
visibility
i
1
i
ty
and
bi1ity
effect of mater i a 1 s .
an
d
imp
ac
t
visual
methods .
res ted i n the
descriptions of printing
its
for
pictures in
1 Communicatin g with
study by NDS
EF & N D S , Nepal
Nepal’ , Repor t of a
Ka
thmadu
.
and UNICEF,
(photos, photos with
sorts of p i c t u r es
wh
a
t
etc ) were
u d y inves t i g a ting
drawings, stick f igures
use of
ound eliminated, line
on
the
-gr
It also touches
recognisable by villagers .
pictures
.
with
for anyone working
Dur . S t imu 1 a t i n g
1er,
Kobert
Text',
' Number ing Systems m Research
Textual C ommun i c a tionEducat ional
tu t e of
Group, Ins t i The
Open Univrsity,
Technology,
, England.
Milton Keynes
implications o f number i ng
at s ome of the
that can
mimeograph
looks
s
s ome of the problems
discusses
data s e ems t o
terns in text, and
ly little hard res earch
Unfortunate
in texts which
interested
.se .
for anyone
Imp
o
r
t
an
t
a i1b le on this.
number ing.
pire referencing
igh t ,
77
Pa t r i c i a
j Technical Informat ion :
’presenting
Finding’,
A Survey off Research
Instructional Science, 6 .
I
1
research done recently
of
exam ines; mu ch of the
article
the implitations
is
l and looks at
informat
ion
ion of i “pplication in prepar ing
Pr e s en t a t
different ways o f
for p r a c t i c a 1 a
research
things like
is
at
looks
It
flow chats,
format ional material.
prose, tables of
between
king tables, choos ing
also discusses th e.
f mater i a 1 in
.fferent styles of pr°s e . It
actual t e s t i n gJ o
an
d
e
a
r
c
h
the author, i t
lterrelationship of res
other articles by
e
v
e
r
a
1
s
f fec t ive
op ether with
ie field.
tieiu. T
Together
concerned with the e
5 V
ery
useful
for
anyone
ful
very
-esentat.ion ooff m forma t ion .
I
I
■
60
1
;\ E r E R E i\ C E S
1
Chap ter
1 .
1
W li y
are
Need ed ?
Man u a 1 s
1
WORLD BANK STaFF W 0 1< E 1 a G P APER,
' I ex t books and Achi e v eme nt : What
we
know',
0c cober
WHO Tech n i cal R e p o r t Ser ies 6 3 3 , ’Training
a u x i I i a r y personnel 1 o r rural h e a 1 t n teams
countr ies ' , 1 9 7 9 .
2
1
19 7b.
and U t i 1 i z a t i o n
i n d e v e 1 o p i n y.
AFK ICAR MED IC A L AND KES EARCH FOUNDAT LON & COMMONWEAL 1 ti
REGIONAL H E A L T ii SEC KETAR IA I, 'Books tor Heal th Workers i n
English-Speaking Countr ies o r East, Central and Sou t ii e r n
A f r i c a , 1 9 76 .
1
fa
ROBE K IS Ou, K .
' H a n ci b o o I; 1 o r Med i c a 1 Ass is t a n t s tor u s e i n
Kura 1 Heal tn Un its’, M i n i s t r v o r Heal th M a 1 a w i , Govt . P r i n t e
Z om J a, 1 9 6 9.
Me LETCH IE, J • L, EYRE, H.V. , a n ci O'NEILL, E . N ,
' h a n u o o o k tor b is pensary A t t e n d a n t s a ii d Med i c a 1
Ass i s t a n t s 1 , 0 . U . P . 1 9 5 6, reprint 1 9 6 4.
r ie1d
6 .
BOWLE K, D . P . 'Child
Nurses ’ , reproduced
nealth
7 .
EKE AM, Willi a m C, 'Aids t o Tropical ri y g i e n e & Nurs ing ' ,
Bai 11 i e r e, Tindall & Cox, London 19 6 4 (5th ed . )
5 .
Heal th Manual
by WHO, 1 9 7 0.
JACKSON , Sheila M . , 'Anatomy &
ELBS/Baillier e T i n d a 1 1 , 19 79
o e
DAVEY 6 W i 1 s o n ,
ELBS/H.K. Lewis
10 .
JELLIFEE, D . B,
E d w a r d Arnold,
11 .
K ING ,
12 .
JELLIFEE, B . D & WILLIAMS,
Del i v e r ing t ire Services',
13 .
BYRNE, Monica N& BENNETT, F . J . ,
Develop ing Countr ies '
0. U . P • ,
Maur ice,
C o nun u n i t y
Physiology
'Control o f Diseases
& Co . , 1971
in
in
the
’Med i c a 1
in
Develop ing
Care
for
the
'Child Health
London, 1962
Nurses’,
Tropics1,
Tropics 1 ,
C . , 'M other and
0.U . P . , 1972
14 . K ING , Maur ice,
Les 1i e, and
Countr ies ' ,
tor
Countr ies 1
Child
Ileal th
' C omin u n i t y Nursing
1973
in
KING, Eel i c i ty, MORLEY, Dav id, BU KG ESS,
BURGESS, Ann P. , ' N u t r i t i o n i n Develop ing
0. U .P ., 1972 .
61
Unit
H.J .
6.
LEE DAM,
E.J. ,
7 .
WYATT,
19 73
G.B &
for
A gu ide
COX, J.H., ' M i d w i f e r y M a n u a 1
midwives, M c G r a w - H i 1 1 , 1971
McGraw-Hill,
'0 ommunity Nurs i n g Manual 1 ,
'Med i c a 1
J .L. ,
Assistant's
au x i 1 i a r y
1972
McGraw-Hill,
Manual’,
for
Assistant* s -Manual : a .guide
ROGOFF, M., 'Laboratory
M c G r a w - H i 1 1 , 1 9 74 .
med i c a 1 laboratory assistants',
Versluys, g.t 'Child
H u e n g e s , R . , Hart, R., and
9 . 8 AL L D IN , B . ,
Research Foundat ion, Nairobi,
Health' A fr i c an Med i c a 1 and
19 75
in Health Care',
'The Training* o d Auxiliaries
EELIOTT,
K.,
.0 .
Group, London, 1 9 75 .
In t ermedi a t e Technology Development
8 .
Chapter
3
Wh a t
are
the
1 .
KING, Maurice, KING ,
Child Care, Book 1 ’ ,
2.
LEE DAM,
3.
BALED IN,
Health',
4 .
BENNETT, F. J , ( ed )
M a c m i 1 a n , 1979
5 .
6.
E.J .
w i th
problems
Manuals ?
McGraw-Hill,
'0 ommunity Nursi n g Manual',
B, HUENGES, R,
AMREF, 1 9 75.
R and VERSLUYS,
HART,
'C ommun i t y D i agno s is
' p r imary
S
Felicity and MARTODIPOERO,
O.U .P. 1 9 78 .
and
'8,
1972
'Child
Heal th
Action'
Aids to
Thomas ■V . , 'Aud iovisual
PENTA, Frank, B, & Telder,
for
t he
Programmes
of Education
learning' in 'Development
1
9
73
.
52,
public Health papers
Health Professions ~ WHO
'Teamwork f o r Wor Id
Ln WOES TEN HOLME , G and O’CONNOR, M .
Health', J & A Churchill, London 19 7 1.
in
'Child Health,
the
Tropics ’,
7 .
JELLIFFE, D.B.
London, 1962
8 .
the
HAMZA, M.H. and SEGALL, M. 'Care of
•Publishing House, Dar
Tanzania, T an z an i a
9 .
PHILPOTT, R.H. ,
Family Planning
axton,
j.h.m and SAP IRE,
Associat ion
of Rhodesia,
Edward
Arnold,
Newborn Baby i n
e s Salaam, 1 9 75 .
i
K ,E . , 'Obstetrics,
undated.
62
J
&
Ass i s t a n t 1 s
1;;.
Y AT f ,
1 9 7 3.
1 1 .
M1 U L I A ,
12 .
' Evaluat ing
SR IV AS LAVA, R . N . ,
S e t C ings” , U a IC E F , N e w Delhi,
G . 5 .
J . L,
1.A. f . ,
' H pd i c a I
1 P h a r ni a c o 1 o g y
&
?1 a nual 1 ,
Th e r a p e ii t i c s ’ ,
13. ‘A ING , M a u r i c e , * A L N G , ■Eel i c tty,' M0K‘LE Y , David •C .
h . J . Les 1 i e, a u d f BU K-GESS , A n n P . 'Nutrition for
C o u n t r i s 1 > 0 . U . P . , 1972
14 .
E R a E A , D a i d , 1Wu ere
r o u u u a t ion, 19 7 7
Gett i n g
U ii a o ter
There
i s
Content
the
Right
1 .
t S S t X , b . J . ' Di agnos t i c P a c h w a y s
Church i 1 1 L i v i n g stone 1 9 7 7.
n
K LAG ,
1 9 7d .
?i a u r ice
3 .
WYATT,
1973 .
G . b .
4 .
Voluntary Health Association
S . D . A . , N ew Delhi,
Ind i a .
Chapter
7
:
6
o t
a 1 .
J . L.
Publishing
Doc L or '
no
’ P r i in a r y
i n
Ch i 1 d
o I
BURGESS, •
Dev elop i n g
Hespertan
Clinical
Care,
Ind i a,
Medicine1 ,
Book
One’ ,
Manual',
C-14 ,
0. U . P . ,
Mc G r aw - H i 1 1
C onnn u n i t y
Cn t r e ,
a M an u a 1
1 .
ABB ATI,
2.
'Educational Development
A practical
UNESCO,
Gu ide l ines for the preparat ion, production and
o f textbooks ' , UNESCO, 1980
3.
WOK.LD BANK, ‘Publishing for Schools
Developed- Countr ies ' , Staff W err k i n g
1 98U .
F. R. ,
Village
Ke 1e v anc e
Assistant' s
'Med i c a 1
19 76
AM R E h ,
in
Communicability
19 78
ixi c G r a w - H i 1 1 ,
'Teaching
for
better
63
learn i g ' ,
W.H.0. ,
198U .
issue :
d is t r i bu t i on
: Textbooks and t h e
Paper N o . 3 9 8 , W o r 1 d
less
B a ri k ,
1
|
Append i x A
Tes tin g Read ability
:
of Second
OLLE R-, J . W . , ’Cloze Tests measure',
and
what
they
Profic iency
23,1, pp. 105-116, 1973.
Cloze
language learn i n g
in Language learning,
” • , R. N.. e t al., ' Evaluat i’ng
SRIV ASTAVA,
UNICEF, New Delhi,
Village Settings',
L-i .
+ •
5.
Tes ts
Commun i c.a b i 1 i t y
1976.
in
Measu r i ng
Procedure ’ A New Tool for
'
Cloze
L.
,
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