Federal Democratic Republic of Ethiopia Ministry of Health Health Education, Advocacy and Community Mobilisation, Part 2 Blended Learning Module for the Health Extension Programme HEAT HealthEducationandTraining HEATinAfrica i Acknowledgements Health Education, Advocacy and Community Mobilisation is one of the 13 Blended Learning Modules for the Ethiopian Health Extension Programme. Together with the practical skills training sessions that accompany each of the supported self-study texts, this programme will upgrade the Health Extension Workers who complete the curriculum to Health Extension Practitioners at Level-IV of the Ethiopian Occupational Standards. The upgrading programme is sponsored by the Ethiopian Federal Ministry of Health (FMOH) and the Regional Health Bureaus (RHBs). The FMOH gratefully acknowledges the receipt of funding for this programme from the Ethiopian Office of UNICEF (the United Nations Children’s Emergency Fund), The Open University UK, the Alan and Nesta Ferguson Foundation Trust UK, and AMREF (the African Medical and Research Foundation). We are also thankful for the support of the Ethiopian Offices of Jhpiego and the World Health Organization (WHO) for freely enabling their experts to participate in the development of this Module. Health Education, Advocacy and Community Mobilisation is in two separate Parts and was produced by a team of Ethiopian experts, who were trained and supported by experts in blended learning pedagogy from the HEAT (Health Education and Training) Team for Africa at The Open University UK. The contributors of original material are: Mr Abdulnaser Abagero, FMOH Dr Binyam Ayele (Module Academic Coordinator) EPHA Mr Zewdie Birhanu, Jimma University Dr Tom Heller, HEAT Team, The Open University UK Sr Atsede Kebede, FMOH Mr Dejene Tilahun, Jimma University The Academic Editor of Health Education, Advocacy and Community Mobilisation is Dr Tom Heller, with contributions from Dr Anita Rogers and Professor Pam Shakespeare, all from the Faculty of Health and Social Care at The Open University UK. The other members of the HEAT Team are: Lesley-Anne Long, HEAT Programme Director Dr Basiro Davey, HEAT Deputy Director (Ethiopia) Alison Robinson, HEAT Programme Coordinator Dawn Partner, HEAT Senior Production Assistant Jessica Aumann, HEAT Programme Assistant Ali Wyllie, HEAT Lead eLearning Adviser We acknowledge the vital contributions of the Programme Coordinators within Ethiopia: Ato Mohammed Hussein Abeseko, UNICEF Ethiopia and the Federal Ministry of Health Ato Tedla Mulatu, AMREF Ethiopia The cover design for Health Education, Advocacy and Community Mobilisation is by Chris Hough, Learning and Teaching Solutions, The Open University UK. The cover photographs are reproduced with the permission of I-TECH/Julia Sherburne (large photo) and Henk van Stokkom (small photo). The opinions expressed in this Module are those of the authors and do not necessarily reflect the views of any of the donor organisations whose generous support made the production of Health Education, Advocacy and Community Mobilisation possible. ii iii Contents Study Session Part 2 12 Planning Health Education Programmes: 1 13 Planning Health Education Programmes: 2 14 Implementing Health Education Programmes: 1 15 Implementing Health Education Programmes: 2 16 Evaluation of Health Education Programmes 17 Advocacy 18 Advocacy Tools and the Role of Health Extension Practitioners 19 Community Mobilisation 20 Community Conversation Notes on the Self-Assessment Questions (SAQs) for Health Education, Advocacy and Community Mobilisation, Part 2 iv Blackplate(5,1) Study Session 12 Planning Health Education Programmes: 1 Study Session 12 Planning Health Education Programmes: 1 Introduction Careful planning is essential to the success of all health education activities. This study session is the first of two sessions that will help you to learn about ways in which you can plan your health education activities. In this study session, you will learn about the purpose of planning health education interventions, the basic concepts of planning, and what steps to take when you are planning. The study session will focus in particular on needs assessment, which is the first step in planning health education and promotion. You will learn about categories of needs and techniques that you can use when carrying out needs assessment. You may have covered some aspects of planning in other modules such as the Health Management, Ethics and Research Module. However, planning in this study session refers specifically to the health education planning process (Figure 12.1). Figure 12.1 All health education messages require a lot of planning before they are delivered. (Photo: I-TECH/Julia Sherburne) Learning Outcomes for Study Session 12 When you have studied this session, you should be able to: 12.1 Define and use correctly all of the key words printed in bold. (SAQs 12.1 and 12.2) 12.2 Explaiin the purpose of planning health education activities. (SAQ 12.2) 12.3 List the principles of planning in health education practice. (SAQ 12.2) 12.4 Describe the six steps of planning health education interventions. (SAQ 12.3) 12.5 Describe the main categories of needs assessment. (SAQs 12.4 and 12.5) 12.5 Discuss some of the techniques of needs assessment. (SAQs 12.4 and 12.6) 1 Blackplate(6,1) 12.1 Planning health education activities Before you can begin planning your health education activities, you need to have a clear understanding of what planning means. Planning is the process of making thoughtful and systematic decisions about what needs to be done, how it has to be done, by whom, and with what resources. Planning is central to health education and health promotion activities (Box 12.1). If you do not have a plan, it will not be clear to you how and when you are going to carry out necessary tasks. Everyone makes plans — for looking after their family, for cooking, and so on. You can build on experience you already have in planning, and apply it to health education. Box 12.1 Key questions to ask when planning . What will be done? . When will it be done? . Where will it be done? . Who will do it? . What resources are required? 12.2 The purpose of planning in health education There are several benefits to planning your activities. Firstly, planning enables you to match your resources to the problem you intend to solve (Figure 12.2). Secondly, planning helps you to use resources more efficiently so you can ensure the best use of scarce resources. Thirdly, it can help avoid duplication of activities. For example, you wouldn’t offer health education to households on the same topic at every visit. Fourthly, planning helps you prioritise needs and activities. This is useful because your community may have a lot of problems, but not the resources or the capacity to solve all these problems at the same time. Finally, planning enables you to think about how to develop the best methods with which to solve a problem. Figure 12.2 Every village in Ethiopia is different. Planning is required so the health messages are tailored to the specific conditions. (Photo: UNICEF Ethiopia/Indrias Getachew) 2 Blackplate(7,1) Study Session 12 Planning Health Education Programmes: 1 ■ Haimonot is a Health Extension Practitioner. She is working at a health post near your village. Haimonot is doing health education activities — but not planning them. How would you convince her that planning health education activities would be helpful? What points would you want to talk about? Use the paragraph above to help you plan what you want to say. □ To convince Haimonot to plan her own health education activities, you could explain the purpose of planning to her. You could explain that: . Planning will make it easier for her to identify what she needs to do, and be more efficient in her work. . Planning would help her to prioritise the health problems in her community that need intervention. . Planning would help her choose the problems that are most important, and to match resources with the problems she intends to address. This would enable her to use her scarce resources more efficiently, and avoid unnecessary activities. 12.3 Principles of planning in health education In this section you will learn about the principles you should apply when planning any activity in the community. Planning is not haphazard — that means there is a principle, or a rule, which you should take into account when developing your health education plans. You should always consider the principles shown in Box 12.2 when you plan a piece of work. Box 12.2 Six principles of planning in health education 1 It is important that plans are made with the needs and context of the community in mind. You should try to understand what is currently happening in the community you work in. 2 Consider the basic needs and interests of the community. If you do not consider the local needs and interests, your plans will not be effective. 3 Plan with the people involved in the implementation of an activity. If you include people they will be more likely to participate, and the plan will be more likely to succeed. 4 Identify and use all relevant community resources. 5 Planning should be flexible, not rigid. You can modify your plans when necessary. For example, you would have to change your priorities if a new problem, needing an urgent response, arose. 6 The planned activity should be achievable, and take into consideration the financial, personnel, and time constraints on the resources you have available. You should not plan unachievable activities. 3 Blackplate(8,1) ■ Meserete is a Health Extension Practitioner. Some time ago she developed a health education programme for her community. At the beginning, she identified some important health problems that were occurring in her community. Local people were recruited to identify their own health problems, and to look for a solution appropriate to their setting. Meserete also identified local resources that would be helpful for her health education activities. Finally, she developed a plan to meet the needs of the community and started to implement it. However, she faced a shortage of resources to carry out all of the items in her plan, so she prioritised the items and modified her plan according to the resources that were available. Look at Box 12.2 above, and work out which principles of planning you think Meserete used. □ Meserete has worked well, and used all the principles of planning. She understood local problems [principle 1], and considered the interests of the community [2]. Local people participated in the programme at all stages [3]. She also identified local resources for her health education programme [4], and made sure that her plan was flexible [5]. Meserete also modified her plan, and she thought very carefully about what was achievable [6]. 12.4 Steps involved in planning health education activities Planning is a continuous process. It doesn’t just happen at the start of a project. If you are involved in improving and promoting individual, family and community health, you should make sure that you plan your activities. Planning can be thought of as a cycle that has six steps (Figure 12.3). In this section, you will learn the basic steps to take when planning your health education activities. Figure 12.3 Steps in planning health education activities. (Source: Henk van Stokkom) 12.5 Needs assessment Conducting a needs assessment is the first, and probably the most important, step in any successful planning process. Sufficient time should be given for each needs assessment. The amount of time required for a needs assessment will depend on the time you have available to address the problem, and the nature and urgency of the problem being assessed. 4