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  1. 1

    Africa: using radio soap operas to promote family planning.

    Lettenmaier C; Krenn S; Morgan W; Kols A; Piotrow PT

    HYGIE. 1993 Mar; 12(1):5-9.

    This article describes four radio soap operas, which were produced as part of larger family planning campaigns in The Gambia, Ghana, Nigeria, and Zimbabwe. A summary is provided of the program evaluations of impacts on listenership, interpersonal communication, knowledge and attitudes, and behavior. All dramas are 15 minutes in length and were broadcast one or twice a week. The main characters are average men and women who must face the difficulties of raising large families or couples benefiting from small families. Modern and traditional values are contrasted. Evaluation includes a baseline survey, a follow-up survey, a survey of new acceptors, services statistics, interviews with listeners, and marketing surveys. All four dramas were popular. Audience feedback indicated people enjoyed the programs. Listenership was lowest in Nigeria, however low listenership could have been related to poor reception from rural battery operated radios or a power outage in urban areas. The program led to considerable discussion about family planning between friends and spouses. Discussion was widespread in Nigeria and Zimbabwe. Survey knowledge and attitude increases were evident in The Gambia. Knowledge and attitude changes affected both men and women and were greater among uneducated survey respondents. Results from other countries confirmed the changes in knowledge and attitude about family planning. The programs had a dominant impact on women. The findings are viewed as supportive of radio dramas as effective tools in attitude and behavior change about family planning. In The Gambia prevalence of contraceptives increased between the two surveys from 19.3% to 30.4%. Persons who listened to the radio dramas were most likely to use contraception than those who did not hear the shows. The program increased the number of new acceptors. The radio drama format was more effective in reaching men than pamphlets and motivational talks.
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  2. 2

    Is health education effective?

    McKenzie A; Ngobeni O; Bonongo F

    NURSING RSA. 1992 Jul; 7(7):26-7.

    Primary health care (PHC) workers from 20 hospitals, PHC nurses, community health care nurses, and other PHC workers attended a session on health education and effectiveness in South Africa in September 1991. Discussion is directed to an overview of health education as presented in the day's session, the effectiveness of health education, and recommendations for improving health education. The first session on health education aimed to explore the breadth of possibilities for health education, and to emphasize some important problems, such as inconsistency in messages. Role plays were enacted within different groups: the 1991 Tintswalo PHC nurses class, the Tintswalo People's Awareness of Disability Issues group, and the Nkhensani PHC nurses group. The second session involved a panel discussion with 4 speakers. The first speaker directed attention to the need for an adequate education as insurance for effective health education. Modern trends have been responsible for the destruction of black culture. There is a problem of victim blaming, when in fact the problem of rural mortality is the system. Socioeconomic conditions and politics must be changed before health education can be effective. Health personnel as representatives of the middle class may be viewed as part of the problem. The second speaker spoke of the ineffectiveness of teaching someone what ought to be eaten but not providing the means to acquire the food. Oppression has led to blaming the oppressed. The third speaker noted that health workers were indeed part of the problem, e.g., health workers do not practice the advice given out and many times are junior personnel who are not evaluated. There are requirements for tracking what nurses do, but little on evaluation of appropriate messages. Appearance replaces substance. The fourth speaker felt health education is about training people and satisfying the educator and the system. Politics and health were related and too much time was misdirected to fighting with the community. Situation analysis was recommended before action was taken. Recommendations involved, for instance, building rapport with the community, and the need for a greater grasp of health knowledge by health educators.
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  3. 3

    Smoking and health in China [letter]

    Tomson D

    Lancet. 1987 Aug 15; 2(8555):394.

    I have questioned 1000 people in 4 sample populations in China about their attitude to and knowledge of health information on smoking and about smoking habits. I then interviewed 50 people from this sample in greater detail. I also studied past smoking control efforts in China. Greater attention must be given to health education in schools and to young people. Smoking is common among schoolchildren and, and at least in Guangzhou, Canton, health education about smoking appeared limited. Of 250 schoolchildren only 40% reported exposure to health education. Smoking is banned in schools and the attitude seemed to be that there was therefore no need for education about the dangers. On the other hand, 70-80% of the whole sample seemed aware that smoking is harmful to health. Thus there is a need to increase not only the level of health education but also its sophistication, so that the gap between health knowledge and behavior can be closed. Attention must be given to women's attitudes to smoking. Generally I found a small proportion of female smokers (a study in Tianjin excepted), and the impression at interview is that smoking among women is considered impolite or "not done." Add this to the fact that women were more aware of the dangers of smoking (77% of 286 females vs 63% of 701 males, with 62% of women saying smoking was "very" harmful compared with 37% of men) and the potential for using women as health educators becomes apparent. The increasing understanding of passive smoking and the fact that women are usually the casualties might also be useful ammunition in this context. However, there may be competition for the attention of women--'Slim Kings' aimed specifically at the female market, have already been introduced into Hong Kong. 1 of the most important elements in any approach to smoking control must be an attempt to influence public policy. The history of government China is 1 of sporadic initiatives originally formulated by a joint committee involving several departments (public health, finance, agriculture, and light industry), but more recently only involving the Department of Public Health. Some action has been taken but a question mark remains over the strength of political will. Many factors operate against a reduction in cigarette production, which earned the state $6 million in 1984. Remarks by a representative of the State Tobacco Company suggest enthusiasm for increased production and more joint ventures with the multinational tobacco companies. Both British American Tobacco and Reynolds are now working in China, and the Canton Biannual Trade Fair and Grand Prix Tennis Tournament were sponsored by tobacco companies. I recently revisited China after 2 years and was struck by the volume and increasing sophistication of advertising and by the continuing cheapness of cigarettes which are now sold by increasing numbers of private entrepreneurs. Deregulation of the market and farmland may encourage increased tobacco production. These are all worrying developments for the "antismokers", who will need all the determination Sir John Crofton talks of to help them push forward a multipronged attack on the smoking pandemic and the vested interests that support it. (full text)
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  4. 4

    Immunization in Nigeria: public awareness is inadequate [letter]

    Chiwuzie JC

    WORLD HEALTH FORUM. 1986; 7(2):165.

    The Expanded Program on Immunization has proved to be the most cost-effective public health scheme yet undertaken in Nigeria, as it costs very much less to prevent diphteria, pertussis, tetanus, measles, poliomyelitis and tuberculosis than it does to cure them. About US$5 are sufficient to fully immunize a child against all these diseases, allowing for a nurse's salary, vaccines, syringes, cold chain equipment, and all other items. This is about 5% of the cost of treating a child with any one of the diseases (and the child could still die). It is quite possible to achieve a high level of immunization initially, but maintaining a satisfactory level is more difficult. Consistent government support, and public awareness of the importance of immunization, are vital for the success of any immunization scheme. Because the attitudes and understanding of mothers to immunization are crucial, we interviewed 575 women of childbearing age in Bendel State, 320 of whom had failed to complete or had not even started the immunization of their children. The replies of the latter group (in table) show that for maximum gains to be made from the Expanded Program on Immunization, which receives strong financial support from the Nigerian authorities, as well as from the WHO and the UN Children's Fund, community education and the mobilization of mothers have to be stepped up. This becomes even more obvious when it is realized that the women in this study had received some form of health education in antenatal clinics, infant welfare clinics, general practice clinics, and immunization centers. This group represents less than 25% of women of childbearing age in Nigeria: over 75% in most rural areas and in improverished urban areas have no access to modern health facilities. Consequently, there is a need to create and sustain public and official support, and to induce a widespread demand for immunization. (full text)
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  5. 5

    Public policy and public opinion toward sex education and birth control for teenagers.

    Reichelt PA


    Government policy toward provision of sex education and contraception for adolescents is influenced by public opinion. This is reflected in the fact that recent program formulation appears to follow the conventional wisdom of a general conservative shift among the American public; i.e., recent policy toward adolescent pregnancy is conservative in the sense of being reactive rather than preventive. The validity of this conventional wisdom was checked by examining available data on public opinion toward sex education and birth control services for teenagers. However, these data reveal an upward, not a downward, trend in public approval of such services for adolescents, which runs counter to the conventional wisdom. The available data on American opinions and values demonstrate that the overall movement in attitudes decisively contradicts the idea of a simple conservative swing. Provision of more and better contraceptive services and sex education to teenagers is an important policy goal that would lower the incidence of adolescent pregnancy and would be supported by the American people. (author's modified.)
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  6. 6

    The pregnant adolescent: problems of premature parenthood.

    Bolton FG Jr

    Beverly Hills, California, Sage Publications, 1980. 246 p. (Sage Library of Social Research Vol. 100)

    This book's objective is to describe the circumstances surrounding adolescent pregnancy, demonstrate the need for social support, and describe how these supports might be offered. It contains 2 basic thrusts. The early chapters describe the adolescent pregnancy problem and the parallels between the development of the adolescent pregnancy and the potential child maltreater. What follows from this description is the author's sense of methods which will help to reduce the risks generated by participation in either, or both, of these environments. The information presented in this volume suggests that the time for joint study of child maltreatment and adolescent pregnancy has arrived. The demand for correlational study of these 2 social situations is viable for 4 interrelated reasons: both child maltreatment and adolescent pregnancy are social phenomena which demonstrate a dramatic increase in reported incidence in the past 25 years; both child maltreaters and adolescents who have experienced pregnancy appear to share multiple demographic or situational variables, i.e., minority overrepresentation, low income, low education, and high unemployment; the development of the maltreating event and the adolescent pregnancy reveal an unusual similarity, and the intergenerational aspects of both problems could well be strongly related to the snowball effect that these problems have on each other; and if the problems of child maltreatment and adolescent pregnancy are found to be symbiotic in their support of each other, rather than independent responses to a uniform social context, the direction of prevention efforts in these 2 areas could produce beneficial reductions in the rates of both problems. The best hope for the provision of prevention services in adolescent pregnancy rests within an alteration in public fears and misconceptions related to welfare dependency, contraceptive use, sexual education and information, and possibly even a general view of the adolescent in society. There is no question that contraceptive programming for the adolescent can serve as a vital preventive measure. The cornerstone of this service returns the perspective to education. Preventive services must include education for contraception, education for appropriate decision making, and education for survival of a parent and child. The community-based multidisciplinary system for the adolescent pregnancy or parent has been demonstrated to be the most effective model for programming today. It is also the most difficult program to find or or develop. Services to adolescents must begin as soon as community standards will permit them to be initiated to prevent the occurrence of the problem. Only when a collage of services in the prevention, treatment, and rehabilitation realms is available for the individual adolescent can it be said that a meaningful program exists.
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  7. 7

    Overcoming cultural and psychological barriers to vasectomy.

    Bertrand JT

    [Unpublished] 1982. Presented at the Conference on Vasectomy, Colombo, Sri Lanka, October 4-7, 1982. 13 p.

    There are 2 general types of barriers to vasectomy acceptance, cultural and individual. Cultural barriers include: 1) the idea that contraception should be the woman's responsibility, 2) that vasectomy represents a tampering with the natural processes of reproduction and this conflicts with many religions, 3) there is confusion over the legal status of vasectomy even though very few countries actually prohibit it, 4) the idea that men, due to their higher status in many societies, should not be exposed to unnecessary risks, 5) the idea that men who are not capable of reproducing have no worth in society, and 6) that men may need to be able to reproduce at a future date since in many societies only men are permitted to remarry. Research on psychological barriers to vasectomy is based on followup studies of vasectomized men and shows that negative male attitudes toward vasectomy stem from negative perceptions about the nature of consequences of the operation. Some men feel that vasectomy is like castration, that it is painful, has demasculinizing effects, causes a loss of vitality, and is irreversible. The population must be educated in order to overcome these barriers. Any communication program must include: 1) identifying existing sources of motivation for vasectomy, 2) increasing awareness of vasectomy through mass media and interpersonal channels, 3) increasing awareness through wider availability of the operation, and 4) improving the public attitude by publicizing client satisfaction with the operation. Men should be encouraged to seek vasectomy for the intrinsic benefits of the operation.
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