This article reports on the use of children as message carriers in a rural water and sanitation project in western Honduras. The Honduran Water and Sanitation Project represents the 1st such effort to have a specific health education component. It was decided to direct the education component toward children because of their important role in providing and handling drinking water and caring for younger members of the family. Rural primary schools surfaced as a potential channel of communication. The comic book format was selected because it is simple enough to be used in the schools without much training, economical to produce (US$0.30/copy), effective and attractive to children, and consistent with the Project's philosophy that dialogue and participation are essential components of health education. Each comic book contains a single-concept message, e.g., 1 cause of water contamination or a method of water purification. The 1st module was pretested in 3 rural schools. Following classroom study of the comic book, correct answers on 5 questions related to the comic book story increased from 59% to 80%. 95% of the children indicated that they liked the characters, and teachers expressed satisfaction with the materials. 1200 copies of the 1st module have been distributed to 30 rural schools, and production plans include 11 additional modules on topics such as prevention of water-related sickness and personal hygiene.
This article reports on a project in Kenya in which environmental lessons are taught through a children's magazine. The Mazingira Institute, a research institute in Nairobi, collaborates with the editor of Rainbow, an English-language weekly newspaper for children, in producing 1 issue each year devoted to a topic of developmental and environmental concern. Rainbow has a regular circulation of 17,000/week (75% in the smaller towns and rural areas) and an estimated readership of 150,000. The press run of the special environmental issue is increased to provide 3-5 free copies to each of the 10,000 primary schools in Kenya. Special topics have included water, renewable energy, trees for food, and nursery development of tree seeds. The topic is explored through an editorial, theme article, comic strip, and letters. In addition, each special issue contains a contest centered around 12 questions which provide valuable information about children's perceptions and understanding of the theme. Contest winners and their headmasters are brought to Nairobi, where headmasters meet with Institute staff to provide feedback on the use they make of the newspaper as a teaching tool. The budget for the project is under US$30,000. The last 2 issues were funded by the Canadian High Commissioner. The Mazingira Institute has proposed enlarging this project to include 8 English-speaking countries in Eastern and Southern Africa.
Jamaica's experience shows how lack of understanding can result in grievous misinterpretation of the communication message. The Ministry of Health initiated a program aimed at reducing the prevalence of childhood malnutrition. 1 aspect of the program was a scheme for changing attitudes and practices related to breastfeeding and infant feeding. Materials and media to be used were slides, booklets, a flannel board and cutouts, and practical demonstrations given by community health workers. The target group was low income mothers attending antenatal and child welfare clinics in 2 parishes of the island. The 1st problem to arise concerned the scripts, which had been written to be read rather than spoken. When they were read aloud to some groups, certain words were not heard correctly. For example, a word like "rarely," sounded like "really." Thus, the statement could have been heard "A breastfed baby really (rarely) gets diarrhea." Other words were unintelligible to the audience because the script had been prepared without an understanding of local idiom. A thorough background knowledge of the audience being addressed is essential. It is only then that the communicator will be able to respond to the specific behavioral needs of the audience and formulate the most appropriate strategies and approaches for delivering messages. This information needs to be collected early in the program planning process, as was done in a baseline survey undertaken before Jamaica's Nutrition Education Program in 1977. This helped in the selection of themes and in the exact content and wording of the messages and in the choice of media. Messages went beyond recognizing and stating the problems to acknowledging existing behavioral constraints. Health and nutrition programs will continue to fail unless communication is made an integral part of the process of change. Successful communication helps ease the transition between old and new ideas by motivating people to accept change and then giving them the tools and skills to deal with new practices. The best way to learn if people will respond to messages and media at the behavioral level is to listen to them.
Some of the strongest challenges to established communication structures emerge from the development arena. 1 element of the challenges comes from those working to place communication between deprived communities and those providing them expertise at the center of development planning. Communication specialists maintain that human communication is the pivot on which balances the success or failure of the whole process of development as well as individual programs. Yet, the vast majority of development programs are conceived and executed without a serious communication component. Communication personnel are irritated by the approach of planning first, and communicating only after a failure. As more and more after the fact appeals are heard, it is becoming clearer to planners that communication is more than another hardware component consisting of posters, radio messages, and so on, but a central and decisive factor of any program. The attempt to raise communications to a more appropriate place in the development context has been aided greatly by recent evidence of its impact. Among those who must be classified as successful in fully investigating their target group and understanding how to communicate with them are the commercial manufacturers. Their advertising campaigns have revolutionized consumption habits and lifestyles across the world. An increasing number of voices, recognizing the impact of commercial advertising, are advocating that their techniques be adopted in the promotion of social development. Richard Manoff is one experienced advertising man who has used his commercial skills to promote developmental messages. He maintains that there is no idea that cannot be promoted as are commercial products. Changes in communication strategies will not by themselves eliminate the most fundamental problem facing humanity, i.e., the eradication of poverty, but they can contribute to that goal. A comprehensive communication strategy can help awaken people to release their energies in the service of development.
This article describes a method of conveying health care to poor villages by training residents for part-time voluntary service, combined with localized health insurance covering both local medicines and the fees for a nearby health center. The project began under the auspices of the Foundation for Christian Hospitals in Hurakarta, in Central Java. The village of Klampok has a population of 5,614, mostly farm workers. Health services are supplied by the Emmanuel Health Center. Although the program was granted funds for jeeps, buildings, instruments, and personnel, the center lacked community participation. Health workers developed a strategy of communication and understanding of the village to encourage participation. Implementation of the strategy included 2 elements: the village health cadre, voluntary workers from the community selected by the community; and the village health insurance scheme, in which each household partially pays for the overall health service, and credit is extended. Rather than being distributors of health care, the project staff sees itself as a stimulant and enabler of the community being able to accept the responsibility of handling its own health problems. This Indonesian experience has proven itself replicable in that health cadre systems have spread to several surrounding villages. To make community health care participation a viable plan both the health personnel and community leaders need to be oriented and motivated to the idea.
