Health Education Package Research Articles

Utilization of maternal health care services among indigenous women in Bangladesh: A study on the Mru tribe

ABSTRACTDespite startling developments in maternal health care services, use of these services has been disproportionately distributed among different minority groups in Bangladesh. This study aimed to explore the factors associated with the use of these services among the Mru indigenous women in Bangladesh. A total of 374 currently married Mru women were interviewed using convenience sampling from three administrative sub-districts of the Bandarban district from June to August of 2009. Associations were assessed using Chi-square tests, and a binary logistic regression model was employed to explore factors associated with the use of maternal health care services. Among the women surveyed, 30% had ever visited maternal health care services in the Mru community, a very low proportion compared with mainstream society. Multivariable logistic regression analyses revealed that place of residence, religion, school attendance, place of service provided, distance to the service center, and exposure to mass media were factors significantly associated with the use of maternal health care services among Mru women. Considering indigenous socio-cultural beliefs and practices, comprehensive community-based outreach health programs are recommended in the community with a special emphasis on awareness through maternal health education and training packages for the Mru adolescents.

Development of a Literacy-Appropriate Health Education Package to Create Awareness of Periodontal Disease and Diabetes

Low oral health literacy has been associated with poor awareness and understanding of oral health care needs among diabetes patients. Specifically, the association between diabetes and periodontal disease is not known to them. Objective: To develop a literacy-appropriate health education package to create public awareness on periodontal disease and diabetes. In spite of the rising prevalence of both diseases, many people remain unaware of their early signs and relationship with each other. Method: We divided the study into three phases: needs assessment, development of the package and evaluation of the package. Phase 1 was conducted via a Focus Group Discussion (FGD) involving periodontitis patients with diabetes recruited from the UKM Dental Faculty patient list. For phase 2, we developed three video clips of 5-minutes duration each, based on the themes that emerged from the FGD. Phase 3 was conducted using a set of self-administered questionnaires distributed to the public and patients. Result: Sixty respondents viewed the videos and at least 95% found them interesting, easily understood, useful and satisfactory. There were however some suggestions for improvement. Conclusion: The health education package developed in this study was literacy-appropriate for the general public and should be made accessible to them. DOI: 10.14693/jdi.v22i3.408

Risk factors for human brucellosis in agro-pastoralist communities of south western Uganda: a case-control study.

BackgroundBrucellosis is a zoonosis of veterinary, public health and economic significance in most developing countries. The disease can result in permanent and disabling sequelae and considerable medical expenses in addition to loss of income due to loss of working hours. A case–control study was conducted in Nyabushozi, Kiruhura district, Uganda, so as to determine the risk factors for transmission of brucellosis to humans in these communities.MethodsWe conducted a matched case–control study among participants in a previous study who were positive by the standard Serum Agglutination Test with titres ≥1:160. Controls were two neighbors for each case, matched by sex and age. A structured interviewer administered questionnaire was used to collect data on potential risk factors for brucellosis. Categorical variables were presented as proportions and their associations determined by Chi-square test. Bivariate analysis was performed to explore associations between the disease and the risk factors of brucellosis. Conditional logistic regression models were fitted to estimate independent associations between the disease and the risk factors using Odds Ratios and 95 % confidence intervals.ResultsA total of 45 cases and 90 controls were interviewed. Of the 45 cases, 21 (46.7 %) were male while 44/90 (48.9 %) of the controls were female. The most significant risk factors for infection being an agro-pastoralist (P = 0.05), consumption of raw cow ghee (P = 0.03) and consumption of unpasteurized milk (P = 0.02).ConclusionThe greatest risk factors for acquiring brucellosis in the study area were being an agro-pastoralist, consumption of raw cow ghee and consumption of unboiled milk. We recommend dissemination of health education packages regarding risks and prevention measures for brucellosis in these communities.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1361-z) contains supplementary material, which is available to authorized users.

Knowledge and practices regarding menstruation among school going adolescents of rural Nepal

Background: Adolescence is a transition period from childhood to adult life during which pubertal development and sexual maturation take place, thus making physiological development a challenge adolescents have to face. There is a substantial lacuna in the knowledge towards menstruation among adolescent girls. Menstrual hygiene and management is an issue that is insufficiently acknowledged and has not received adequate attention. Objective: This study was done to assess the knowledge and practices regarding menstruation among school going adolescents. Methods: A descriptive study was done among sixty-one female adolescents of Shree Himali Secondary School, Panchkanya, Sunsari, where data were collected from the adolescents meeting the inclusion criteria. Results: It was found that 36.1% correctly reported about menstruation where most common informant was mother (39.3%). Dysmenorrhoea was the commonest problem faced during menstruation (78.7%) followed by back pain and excessive blood loss. More than half of respondents (54.1%) used sanitary pads and frequency of changing pads twice a day was highest (50.8%). Initial reaction was of fear/apprehension at menarche by 36.1% of girls whereas 44.3% perceived it as an expectant process. Girls still faced different types of restrictions like not being allowed to visit holy places, not being allowed to cook and touch male family member etc. Conclusion: Traditional beliefs regarding menstruation still persist and menstrual hygiene among the adolescents was found to be unsatisfactory. It highlights the need of targeted interventions to raise awareness and provision of family health education package to all girls. Menstrual hygiene is an issue that needs to be addressed at all levels.Journal of Kathmandu Medical College Vol. 2, No. 3, Issue 5, Jul.-Sep., 2013 Page: 117-121DOI: http://dx.doi.org/10.3126/jkmc.v2i3.9962Uploaded date : 3/4/2014

Health education and the control of intestinal worm infections in China: a new vision.

BackgroundThe transmission of soil-transmitted helminths (STHs) is associated with poverty, poor hygiene behaviour, lack of clean water and inadequate waste disposal and sanitation. Periodic administration of benzimidazole drugs is the mainstay for global STH control but it does not prevent re-infection, and is unlikely to interrupt transmission as a stand-alone intervention.FindingsWe reported recently on the development and successful testing in Hunan province, PR China, of a health education package to prevent STH infections in Han Chinese primary school students. We have recently commenced a new trial of the package in the ethnically diverse Xishuangbanna autonomous prefecture in Yunnan province and the approach is also being tested in West Africa, with further expansion into the Philippines in 2015.ConclusionsThe work in China illustrates well the direct impact that health education can have in improving knowledge and awareness, and in changing hygiene behaviour. Further, it can provide insight into the public health outcomes of a multi-component integrated control program, where health education prevents re-infection and periodic drug treatment reduces prevalence and morbidity.

Development of an educational cartoon to prevent worm infections in Chinese schoolchildren

BackgroundWith more than two billion people infected worldwide, soil-transmitted helminths (STH) are the most widespread infections. To date, STH control efforts rely predominantly on recurrent mass drug administration (MDA), which does not prevent reinfection. Additional public health measures including novel health educational tools are required for more sustained integrated control of STH. We describe the development of an educational cartoon video (The Magic Glasses) targeting STH infections in Chinese schoolchildren and its pilot testing in China.We applied an extensive community-based mixed methods approach involving input from the target group of 9–10 year old schoolchildren and key informants, such as teachers, doctors and parents, in order to identify potential STH infection risks in the study area and to formulate key messages for the cartoon. The development of the educational cartoon included three major steps: formative research, production, and pilot testing and revision.ResultsWe found that most adults and approximately 50% of the schoolchildren were aware of roundworm (Ascaris) infection, but knowledge of transmission, prevention and treatment of STH was poor. Observations in the study area showed that unhygienic food practices, such as eating raw and unwashed fruit or playing in vegetable gardens previously fertilised with human faeces, posed major STH infection risks.ConclusionsIt was crucial to assess the intellectual, emotional, social and cultural background of the target population prior to video production in order to integrate the key messages of the cartoon into everyday situations. Overall, our strategy for the development of the cartoon and its incorporation into a health education package proved successful, and we provide a summary of recommendations for the development of future educational videos based on our experiences in China.

Health-Education Package to Prevent Worm Infections in Chinese Schoolchildren

BackgroundSoil-transmitted helminths are among the most prevalent sources of human infections globally. We determined the effect of an educational package at rural schools in Linxiang City District, Hunan province, China, where these worms are prevalent. The intervention aimed to increase knowledge about soil-transmitted helminths, induce behavioral change, and reduce the rate of infection.MethodsWe conducted a single-blind, unmatched, cluster-randomized intervention trial involving 1718 children, 9 to 10 years of age, in 38 schools over the course of 1 school year. Schools were randomly assigned to the health-education package, which included a cartoon video, or to a control package, which involved only the display of a health-education poster. Infection rates, knowledge about soil-transmitted helminths (as assessed with the use of a questionnaire), and hand-washing behavior were assessed before and after the intervention. Albendazole was administered in all the participants at baseline and in all the children who were found to be positive for infection with soil-transmitted helminths at the follow-up assessment at the end of the school year.ResultsAt the follow-up assessment, the mean score for the knowledge of helminths, calculated as a percentage of a total of 43 points on a questionnaire, was 90% higher in the intervention group than in the control group (63.3 vs. 33.4, P<0.001), the percentage of children who washed their hands after using the toilet was nearly twice as high in the intervention group (98.9%, vs. 54.2% in the control group; P<0.001), and the incidence of infection with soil-transmitted helminths was 50% lower in the intervention group than in the control group (4.1% vs. 8.4%, P<0.001). No adverse events were observed immediately (within 15 minutes) after albendazole treatment.ConclusionsThe health-education package increased students' knowledge about soil-transmitted helminths and led to a change in behavior and a reduced incidence of infection within 1 school year. (Funded by UBS Optimus Foundation, Zurich, Switzerland; Australian New Zealand Clinical Trials Registry number, ACTRN12610000048088.)

Review of Community Pharmacy Staff Educational Needs for Supporting Mental Health Consumers and Carers

Development of a mental health education package for community pharmacy staff should be informed by mental health consumers/carers' needs, expectations and experiences, and staff knowledge, skills and attitudes. This review (1) explored research on community pharmacy practice and service provision for mental health consumers/carers, and (2) identified validated methods for assessing staff knowledge, skills and attitudes about mental illness to inform the development of a training questionnaire. A literature scan using key words knowledge, skills, attitudes, and beliefs combined with community pharmacy, pharmacist, and pharmacy support staff, and mental illness, depression, anxiety was conducted. A small number of studies were found that used reliable methods to assess pharmacists' training needs regarding mental illness and treatment options. There was little published specifically in relation to depression and anxiety in community pharmacy practice. No studies assessed the training needs of pharmacy support staff. A systematic analysis of pharmacy staff learning needs is warranted.

Drug adherence behavior among hypertensive out-patients at a tertiary health institution in Manicaland province, Zimbabwe, 2011

ObjectivesThis study investigated the level of drug adherence among hypertensive outpatients at a tertiary hospital in Zimbabwe. Specific objectives included measurement of blood pressure (BP) control achievement, estimating prevalence of drug adherence behavior, and establishing the association between drug adherence behavior and achievement of BP control.Methods and materialsAn analytic cross sectional design was applied on a convenience sample of 102 participants using an interviewer administered questionnaire. Self-reported adherence was assessed using the Morisky Medication Adherence Scale.FindingsThe median age of participants was 68.5 years (Q1 61;Q3 76). The majority were female (n = 71;69.6%). BP control (< 140/90 mmHg) was achieved in 52% (n = 53). Self-reported drug adherence was 40.2% (n = 42). After multivariate logistic regression analysis, participants with normal BP measurements were more than three times as likely to report maximal adherence to prescribed drug schedules (odds ratio 3.37; 95% confidence interval: 1.38–.24).ConclusionPoor drug adherence behavior prevails among hypertensive outpatients. This contributes to poor achievement of BP control. The hospital is recommended to set up a specialized hypertension clinic in the Out-patients’ Department where an intensified health education package can be introduced as well as community awareness programs on the importance of medication adherence.

Assessing the outcome of peer-led education about contraceptive methods among college girls

Received: 17-1-2011| Accepted: 22-7-2011 | Published Online: 31-08-2011 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (creativecommons.org/licenses/by/3.0) Conflict of interest: None declared Source of funding: Nil content and methodology of the adolescent reproductive health education packages, such as whether to include detailed reproductive health issues or not; whether sex education should be dealt or not; who should provide the educationteachers/ health care professionals/parents or peer group; etc. [8].

Effectiveness of a Reproductive Sexual Health Education Package among School Going Adolescents

To assess the effectiveness of a school based "Adolescent Reproductive Sexual Health Education (ARSHE) Package" in improving students' knowledge on reproductive sexual health matters. An ARSHE package originally developed at Child Development Centre, Kerala, modified and approved by ICMR taskforce group was administered in three urban schools (One boys only, one girls only and one co-education) and one co-education rural school at Thiruvananthapuram district, Kerala. The study sample consisted of 1,586 adolescents including 996 boys and 560 girls of class IX and XI. Pre and post intervention knowledge regarding reproductive sexual health matters was assessed using a self-administered questionnaire. In the pre-intervention period, it was observed that majority of adolescents were poorly informed about reproductive sexual health matters, particularly about contraceptives. As compared to boys, girls had much poorer knowledge about prevention of pregnancy and after intervention; there was a statistically significant increase in the knowledge in both boys and girls. Among girls percentage of poor knowledge had reduced significantly from 64.1% to 8.3% and among boys from 37.7% to 3.5%. Similarly, increase in knowledge level was also observed in various other aspects of reproductive and sexual health including, STI, HIV/AIDS and perceptions about premarital sex. The study results revealed the feasibility and effectiveness of school based reproductive and sexual health education intervention programs for adolescents.

Health education training needs of educators at Makapanstad schools in the North West province

The purpose of this study was to explore and describe the health education needs of educators at health promoting schools in Makapanstad in North West Province. Qualitative, exploratory and descriptive paradigm was conducted. The population consisted of educators, at Makapanstad schools, who were directly involved with learners. The participants were purposively selected. Focus group interviews were conducted to collect relevant data from the participants. Tesch data analysis process was used to reach the findings of the research. The following categories were identified and theoretically confirmed: The need for the support by the University for the training of educators; The need for the University's acknowledgement of educators' responsibilities; The need for basic knowledge of health promotion; Common health needs of learners; and indirect health problems. It was recommended that a health education package be developed to assist in empowering learners in Makapanstad schools.

Knowledge, attitudes and practices about malaria among communities: comparing epidemic and non-epidemic prone communities of Muleba district, North-western Tanzania.

BackgroundMuleba district in North-western Tanzania has experienced malaria epidemics in recent years. Community knowledge, attitudes and practices are important in enhancing disease control interventions. This study investigated determinants of malaria epidemics in the study area in relation to household knowledge, attitudes and practice on malaria.MethodsA community based cross-sectional survey involving 504 study participants was conducted between April and June 2007 using a structured questionnaire focusing on knowledge, attitudes and practices of community members in epidemic and non-epidemic villages about malaria transmission, signs and symptoms, treatment, prevention and control. Multivariate logistic regression analysis was used to assess determinants of malaria epidemics.ResultsA total of 504 respondents (males = 36.9%) were interviewed. Overall, 453 (90.1%) mentioned malaria as the most important disease in the area. Four hundred and sixty four respondents (92.1%) knew that malaria is transmitted through mosquito bite. A total of 436 (86.7%), 306 (60.8%) and 162 (32.1%) mentioned fever, vomiting and loss of appetite as major symptoms/signs of malaria, respectively. Of those interviewed 328 (65.1%) remembered the recent outbreak of 2006. Of the 504 respondents interviewed, 296 (58.7%) reported that their households owned at least one mosquito net. Three hundred and ninety seven respondents (78.8%) knew insecticides used to impregnate bed nets. About two thirds (63.3%) of the respondents had at least a household member who suffered from malaria during the recent epidemic. During the 2006 outbreak, 278 people (87.2%) sought treatment from health facilities while 27 (8.5%) obtained drugs from drug shops and 10 (3.1%) used local herbs. Logistic regression analysis showed that household location and level of knowledge of cause of malaria were significant predictors of a household being affected by epidemic.ConclusionsResidents of Muleba district have high level of knowledge on malaria. However, this knowledge has not been fully translated into appropriate use of available malaria interventions. Our findings suggest that household location, ineffective usage of insecticide treated nets and knowledge gaps on malaria transmission, signs and symptoms, prevention and control predisposed communities in the district to malaria epidemics. It is important that health education packages are developed to address the identified knowledge gaps.

Impact of health education package on knowledge and practice of women regarding food adulteration

Impact of health education package on knowledge and practice of women regarding food adulteration

Impact of health education package on knowledge and practices of women regarding food adulteration

Impact of health education package on knowledge and practices of women regarding food adulteration

Echinococcoses and Tibetan Communities

Echinococcoses and Tibetan Communities

Place of menstruation in the reproductive lives of women of rural North India

Objective : To ascertain the perceptions and experiences of women regarding menstruation. Methods : An integrated qualitative and quantitative study on reproductive health of Indian women was conducted in two primary health centre areas of rural north India. Present article reports on the perceptions of 1205 women regarding various aspects of menstruation. Results : Major source of information about menarche/menstruation was friends/relatives (72%). Mean age at menarche was ~ 15 years. Very few women (0.4%) used sanitary napkins. Majority of women had strong beliefs about effect of diet on menstruation. Most of them considered menstruation a dirty act and indulged in various taboo behaviours. Initial reaction was of fear/apprehension at menarche in majority of girls. Conclusion: Women in rural north India still hold tranditional beliefs regarding menstruation. Provision of a balanced and healthy family health education package to all girls is recommended.

Reducing selection bias in a cluster randomized trial in West African villages

Selection bias in cluster randomized trials may threaten the validity of the results. This bias may occur either at the level of the cluster or of the individual. We describe measures for maintaining comparability of intervention groups in a cluster randomized trial of a health education package to reduce dietary salt. The setting was 12 villages of the Ashanti region of Ghana. In total, 1896 villagers between 40 and 75 years of age were selected to take part in the trial using stratified random sampling, based on age and sex. Following individuals' consent and baseline measurements in a pair of villages, villages were randomized to intervention or control arms, stratified for locality (semi-urban or rural). Primary outcomes of the trial were reduction in 24-hour urinary sodium and blood pressure. Of the villagers, 1013 individuals agreed to take part, with a response rate of 53%. The groups were comparable with respect to mean (SD) systolic and diastolic blood pressure (125/74 (27/14) mmHg versus 126/75 (25/14) mmHg) and other outcomes. In conclusion, in this study blind recruitment, aided by randomization in small blocks, and stratified random sampling of the subjects within the clusters helped to ensure comparability of intervention groups, which is vital for the validity of the trial results.

Reproductive health education intervention trial

To measure the effectiveness of a reproductive health education package in improving the knowledge of adolescent girls aged 15-19 years in Chandigarh (India). A reproductive health education package, developed in consultation with parents, teachers and adolescents, was delivered to randomly sampled classes of two senior secondary schools and one school was selected as control. In one school, a nurse conducted 15 sessions for 94 students in three batches using conventional education approach. In another school she conducted sessions for a selected group of 20 adolescents who later disseminated the messages informally to their 84 classmates (peer education). Using a 70-item structured questionnaire the knowledge of 95 adolescents from conventional, 84 from peer, and 94 from control school were assessed before and one month after the last session. Change in the score in intervention and control groups was tested by ANOVA taking age and socio-economic status as covariates. Teachers, parents and students overwhelmingly (88%, 95.5% and 93% respectively) favoured reproductive health education program. Five percent of the respondents reported that someone in their class is having sexual relations, and 13% of the girls approved of pre-marital sexual relations. Reproductive health knowledge scores improved significantly after intervention in conventional education (27.28) and peer education group (20.77) in comparison to the controls (3.64). Post-test scores were not significantly different between peer education group and conventional education group (43.65 and 40.52 respectively) though the time consumed in delivering the peer education intervention was almost one third of the time taken to implement conventional education. Peer education and conventional education strategies were effective in improving the reproductive health knowledge of adolescent girls but peer strategy was less time consuming.

Mothers' skills in preparing oral rehydration salt solution.

This was a community based thirty cluster survey, carried out in rural Chittagong district, Bangladesh during 1996 with the objective to assess the skill of mothers in preparing packet ORS solution. A total of 420 mothers whose children had been suffering from acute diarrhoea were investigated. There were 377 (89.8%) mothers who demonstrated the preparation of ORS and 43 (10.2%) mothers never ever prepared the solution and were unable to demonstrate the preparation. One hundred and forty (33.3%) mothers were able to demonstrate the preparation correctly and the rest 237 (56.4%) demonstrated the preparation incorrectly. The incorrect preparation was found to be associated significantly with the refusal of ORS solution by the children (p < 0.01). None of the maternal factors were found to be associated with the correctness of preparation of ORS solution except previous exposure of the mother to the demonstration of ORS solution preparation (p < 0.000). Therefore, demonstration of preparation of ORS solution to the mothers should be in built in the health education package of oral rehydration therapy for diarrhoeal diseases.