Adapting Health Education Context

Adapting Health Education Context
Over the years WATCH has determined the following problems as causes of the poor
levels of maternal and child health in the Jayawijaya District:
the three major medical problems of malaria, pneumonia, and diarrhea
poor antenatal/maternal care
poor environmental sanitation
malnutrition
gender imbalances
While it is not very difficult to target these as causes of poor health in Jayawijaya, it is far
more difficult to determine what interventions are appropriate and effective in the
physical and socio-cultural environment of Melanesia.
Over the span of the project WATCH staff have collected various examples of
educational material addressing these topics (including some material produced by the
project itself). And yet the staff expressed considerable frustration and a sense of futility
in attempting to use such material, either because the material was inappropriate, the
people were unable to comprehend the material, or if they did understand it, they were
simply unwilling to change their behavior. The basic approach to health education
implied by much of this material could be described as the “injection method” in which it
is assumed that by merely “injecting” health messages into people, there will be an
automatic change in their behavior. Obviously, this method was not working and not
producing the desired outcomes. In sum, many of the attempts at health education and
promotion by the project and by DepKes had resulted in numerous frustrations for the
staff and not resulted in much behavioral change on the part of the target communities.
As the project staff were coming to realise, success in health education does not
necessarily result from the production of flashy materials. It depends rather on how health
messages are understood, accepted, and implemented by the learners. This means that
the health messages themselves must be carefully analysed and formulated from the
perspective of the learner, the target audience. By presenting health messages in
understandable and relevant ways, they will hopefully ‘resonate’ with the learners and
have maximum potential to impact their behavior.
But successful health education is particularly difficult and elusive in a place like
Jayawijaya because of the cross-cultural context in which health workers and target
communities interact. The ‘language and culture gap’ makes it difficult for health
workers to communicate understandable and relevant messages to the target audience.
While they may have considerable medical knowledge, health workers are rarely trained
in cross-cultural communication skills and principles. When their attempts at health
education fail, it is easy for victim blaming to occur. The people are accused of stupidity
and unwillingness to participate in ‘development,’ when in fact, those initiating the health
education have failed to communicate successfully.