A SUPPLEMENT TO THE MANUAL ON HEALTH EDUCATION IN PRIMARY HEALTH CARE
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- Title
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A SUPPLEMENT
TO THE
MANUAL ON HEALTH EDUCATION
IN PRIMARY HEALTH CARE - extracted text
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WORLD
HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANTE
A SUPPLEMENT
TO THE
MANUAL ON HEALTH EDUCATION
IN PRIMARY HEALTH CARE
ASSESSING SKILLS IN DEVELOPING COMPREHENSIVE
ACTIVITIES FOR HEALTH EDUCATION
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121 I GENEVA 27-SWITZERLAND
Telegr.: UNISANTE-GENEVA Telex: 27821 OMS
121 1 GENEVE 27-SUISSE Telegr.: UNISANTE-GENEVF
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ASSESSING SKILLS IN DEVELOPING
COMPREHENSIVE ACTIVITIES IN HEALTH EDUCATION
The reader is asked, here, to bring together all the ideas, planning skills
and health education methods to design
comprehensive health education
activities for a common health problem. This will serve as an opportunity
for the reader to apply what he or she has learned from the manual on Health
Education in Primary Health Care.
You are not asked to start from scratch. Questions are asked and space is
provided for the answers. With most questions you will find the number of a
section in the manual. A look at that section will help you to answer the
question.
The reader is kindly asked to return a copy of his or her answers to;
Division of Public Information and Education for Health
World Health Organization
1211 Geneva
Switzerland
Attn: HED
This will help the planners of the manual to know if it has been useful and
understandable.
The health problem used as an example is burns (and scalds). Burns are a
common cause of injury and death among small children throughout the world.
Although adults may be burned also, the major concern here is children. We
do not assume that burns are a priority problem in every community. The
reader should of course find out what the community sees as its own
priorities before beginning a real programme.
The reader should attempt to answer all the questions. Answers should be
based on the real situation in the community where he or she works or lives.
In the introduction to the manual it was stated that it was to serve as a
guide to front-line health workers both for their work in the community and
for the training of community health workers. After such training, it would
be useful that the trainees themselves answer the questions in this
supplement.
Many of the community health workers may not be able to read and write very
well. If this is the case, the questions could be discussed with them
either individually or in small groups, and the answers recorded. What the
community health workers say should be recorded exactly as they say it. It
would be useful if copies of their answers were also returned to WHO.
The reader's assistance in testing the manual is greatly appreciated.
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THE PROBLEM OF BURNS
Before planning activities it is necessary to understand as much as possible
about the problem being tackled. This section briefly presents some of the
aspects regarding the causes, prevention, first aid measures, treatment, of
burns and rehabilitation. The reader would be expected to gather more
information from books, resource people and organizations such as the Red
Cross or Red Crescent Societies, before proceeding on an actual plan.
a)
Causes and prevention
For the most part burns are a result of human behaviour, often in the home
itself. For example, a kerosene lamp does not light itself. Electric
appliances do not plug themselves into outlets. Pots containing hot water
or oil do not turn themselves over. Of course lightening may strike a
house, starting a fire that burns people inside. But most burns come
directly or indirectly from a fire lit by a human being. Because behaviour
usually causes the problem, health education is an important part of the
solution.
Prevention involves behaving safely with fire and hot objects. It also may
require the community to think of new ways to use fire that are less
dangerous. For example, further on, you will be asked to think of ways in
which you and the people in the community where you work can find safer and
acceptable alternatives to cooking fires that are placed at ground level
where children can reach them.
b)
First aid and treatment
Below are summarized the first aid measures and treatment for burns used by
the Red Cross and Red Crescent Societies. As mentioned, the reader and
community members should make inquiries in the community to find out more
details about the issue of burns before beginning action.
1.
Whether burns or scalds are caused by dry heat, flame or hot liquid, all
basically require the same first aid measures.
2.
If a person suffers a burn or scald that is bigger in size than the palm
of his own hand, he must be referred to qualified aid after first aid has
been given.
3.
The first action is to cool the burn with water; this may be done by.*
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putting the burned part into clean water;
placing the burn under running water; or if neither of these is possible,
putting wet, cold and clean pads on the burn.
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4.
A burn or scald should not be put under water but dressed with a thick
pad of the cleanest cloth available if the burned area is;
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larger than the person's palm; or
the skin is burned away; or
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blisters are broken.
The same measures should be taken if the burn is on a part of the body that
cannot be put under water.
Putting anything else besides clean cold water and a clean cloth pad on a
burn will probably lead to infection.
5.
Burns bring about pain and fear that could result in shock. To prevent
shock the sufferer should lie down on his back, with something like a
pillow or rolled up blanket under his feet to raise them. The reader
should find out more about preventing shock by looking up the subject in
a manual on first aid.
6.
A burned person may become thirsty and dehydrated. Prepare an oral
rehydration drink for the person but only if he is conscious.
7.
To prevent infection and further injury;
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never open blisters;
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never pull away clothes that are burned onto the skin; and
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never put an open blistered burn into water, just dress it with a clean
pad.
c)
Rehabilitation
Burn injuries, if serious, may require a long convalescence or may result in
disability such as blindness or crippling. Since many different types of
problems may arise after burns, rehabilitation will not be discussed in
detail. The health worker should be prepared to counsel families who have a
disabled child and link them with appropriate rehabilitation resources.
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responsibilities of health team members and other community workers
For example, during a home visit, a public health inspector can discover
dangerous situations that may lead to burns.
If he notices such problems,
he can counsel the family, demonstrate safety measures and link them with
resources to improve the situation.
a)
Team members
List your own occupation or profession below. Then list the other health
and community workers who can be found in the community where you work.
b)
Roles
As in the example of the health inspector above, describe what each person
you have listed (including yourself) can do for the prevention and treatment
of burns. See section 5.9 of the Manual.
RELATIONSHIPS AND COMMUNICATION
In chapters 1 and 2 the importance of good relationships and communication
between the health worker and the community was discussed, especially in
sections 2.1 and 2.2.
In the space below, describe your relationship with
the community in which you work. Mention what you do to make yourself
visible and accessible to the community you serve. Also note improvements
you would like to make in your relationship with the community.
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COMMUNITY PARTICIPATION
For example, some communities have health or development committees that can
plan action and mobilize people for self-help. Such a committee would be a
base from which to plan activities on burns. See sections 2.3, 6.5 and 6.6.
a)
Existing groups
In the community where you work, are there any health or development
committees, village councils or other groups representing the community?
yes, list them and describe their normal activities.
Say how they might
participate in the planning of activities about burns.
b)
If
No groups
If there are no community groups, describe what you would do to make sure
that there was community participation in planning the activities on burns.
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COLLECTING INFORMATION
In a good plan there must be information that describes the situation at the
beginning of the activity; it will then be possible to judge whether any
change for the better has occurred by the end of the activity. Review
section 3.1, then outline;
a)
what information would be needed about burns:
b)
how it could be found in the community where you work:
c)
who would be responsible for gathering the information:
d)
how clinic records would be useful;
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UNDERSTANDING BEHAVIOUR THAT CAUSES BURNS
Review sections 1.2 and 3.2 for assistance with this part.
a)
Things that are normally hot
Some things are supposed to be hot, for example a cooking fire, or an iron
for clothes. These can cause burns if children touch, knock over or fall
into them. The actions of adults can make these hot things more or less
dangerous for children. One example is given below. Think of more and
write down all the places where one normally finds fire and heat in the
community where you work. Then write those down and as many other examples
as you can think of.
If an adult does this;
then a child may
builds a fire or puts a stove at a
low level and leaves it unattended
touch or fall into a cooking fire or
stove
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b)
Accidental fires
Fire may get out of hand and burn a house, field or forest. Children can
get caught in such fires. Here are two examples of how people's behaviour
may be responsible for starting such a fire. List as many other examples as
you can think of.
Hatches were left around the house and children played with them.
Someone burned refuse in the open on a dry, windy day.
c)
Reasons for the behaviour
For each kind of behaviour you have listed above, describe how this
behaviour may have been affected by beliefs, knowledge, values, attitudes,
availability of resources and skills, and the influence of important
people. Here are examples; A cooking fire may be built close to the ground
because the family has neither the knowledge or skills to build it any other
way. The fire may be left unattended because an important friend or
relative wanted to visit the mother.
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TREATING BURNS
Again look at sections 1.2 and 3.2 but also refer to pages 2-3 in this
chapter.
a)
Immediate action
Immediate action to stop or remove whatever is causing the burning is
necessary. Infection and shock must also be prevented. While certain first
aid actions were recommended earlier, there are always traditional home
remedies that people want to use. For example, people have been known to
put grease, butter, banana leaves, animal hides, papaya (paw paw) leaves,
herbs and faeces on burns.
List the traditional actions that people in the community where you work
take as first aid measures for burns and scalds.
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b)
Health education activities for the whole community
See chapters 6 and 7 for ideas.
Think about the ways of behaving and the reasons for these behaviours that
you have listed on previous pages. From this, what health education
activities do you think would be appropriate for the whole community? List
and describe briefly these activities:
If you have listed a poster among these measures, make a small drawing of a
poster that you think might be useful in your community. Describe how you
would make sure that the poster is acceptable.
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c)
Health education activities for groups
Refer to chapters 5 and 7 for help.
List all the groups in the community where you work with which health
education activities could be planned for the prevention of burns. Say why
and how each group could help.
List and describe health education activities that would be appropriate for
these groups.
Let us assume that a story may be a good method to use with one of the
groups. Write out a story below and say with which group you would use it.
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d)
Health education with individuals
Read chapters two and four for assistance.
One example may be a demonstration during a home visit. Describe what you
could demonstrate in homes in your own community. What materials would you
need? How would you go about collecting the materials and presenting the
demonstration?
Now describe other opportunities and activities for health education with
individuals on the problem of burns.
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HEALTH EDUCATION ACTIVITIES FOR FIRST AID AND TREATMENT
Using the last section as your example, write out plans for health education
activities concerning first aid and treatment of burns. Consider (a)
objectives, (b) activities for the community, (c) activities for groups, and
(d) activities for individuals. Describe your ideas exactly as you have
done in the previous section.
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RESOURCES
See section 3.4 for guidance.
a)
Resources inside the community
As mentioned in this manual, it is best to try to find resources in the
community. For example, can you think of any local source for clean pads
for covering a burn?
List below the resources that would be needed to prevent burns and give
first aid and which could be found in the community.
b)
Outside resources
Now describe what, if any, resources (people, money, materials, etc.) would
need to come from outside the community. Also describe how you would go
about making the link between such resources and the community.
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A TIMETABLE FOR ACTION
Section 3.5 discussed the value of drawing up a timetable so that the people
involved would know what is to happen and when it should happen. Draw up a
sample timetable for the activities you have proposed for burn prevention
and first aid. Be sure to indicate by what date people should be practising
preventive and first aid behaviour.
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EVALUATION
Review section 3.7 for ideas on this subject.
a)
Evaluation of progress
It is necessary to look for problems early so that they can be corrected
before too much damage is done. Describe steps that you and the community
planning group can take to make sure that action on the programme is going
as desired.
By way of example, let us assume that first aid supplies have been ordered,
but have not arrived on the scheduled date. What would you and the planning
group do about this?
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b)
Evaluating results
Look at the objectives you have listed for prevention and first aid.
Describe how you and the planning group would get the information that would
tell you whether the objectives had been achieved.
c)
Considering results
1) Assume the activities were successful. What should the planning group
do at this point about the problem of burns and about other issues?
2) Assume that the activities were not as successful as desired.
would you do in that situation?
What
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INFORMATION ABOUT THE READER
In addition to answering the questions in the previous sections, you are
also invited to write a little bit about yourself.
1.
Occupation/Profess ion
2.
Number of years practising occupation/profession
3.
Current status or position
4.
Sex
6.
Tick the word that best describes your home area
5.
Age
large t
rural village
small town
7.
big city
Tick the word that best describes the place where you work now
rural village
small town
8.
Describe your past education and professional training
9.
Please write out any comments or criticisms that you have about this
manual on health education in primary health care.
Date and place
la
big city
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