One of the basic principles of health education is to understand the attitudes, beliefs, perceptions and feelings of population in question. At least in Pakistan (and perhaps other developing countries), based on personal experiences, I have found this be the oft forgotten component in health education. Many health education messages are designed primarily as translations of their successful and proven English versions. Some of these efforts even consider the cultural sensitivities of our local population, but few actually attend to the problem of methodically researching in depth, the views, beliefs and attitudes of the population towards the health issue being addressed. Without this knowledge, our health education messages may at best be slightly better than shots in the dark.
The issue was raised by Dr. Saeed Farooq (Professor of Psychiatry, Lady Reading Hospital, Peshawar) during one of our faculty CME sessions, while discussing our teaching methodology for medical students. It reminds me of Stephen Covey's famous book "The 7 Habits of Highly Effective People" where he suggests that we "Seek first to understand, then be understood". Indeed this principle applies to health education as much as it applies to personal communication.
Interestingly, a few days after this discussion, I met a far off relative who happened to visit Peshawar. She had brought her son for medical care because he was bitten by a dog 11 days ago. While inquiring about the details, I found out that she had told the doctor that the dog bite was only one day old. Surprised and annoyed, I asked her why she had done so, and she replied that she did so because she thought that the doctor would not give him any treatment if the dog bite was too old. If this is a common belief in a village, then perhaps doctors are receiving wrong history from these patients at times.
Now one might arrogantly conclude that she is an illiterate woman who needs to be educated on the seriousness of dog bites. However, if one wants to really design an effective health education message, it would be useful to consider her belief that an older wound will not receive treatment by a doctor. Perhaps a more penetrating message would explain to her that even an old dog bite should receive treatment because it can still increase the chances of survival (in case it was a rabid dog). The point here is not to ignore the bigger problem of her waiting too long for treatment, but only to explain how the knowledge of current beliefs of people could be useful in determining the appropriate messages for them, in order to induce healthy behaviors.
Following a discussion amongst faculty members at CHS, we have now decided to reduce our reliance on transplanted health education messages from developed countries, and inculcate a stronger "We don't know what they think" attitude in our health education efforts.
The issue was raised by Dr. Saeed Farooq (Professor of Psychiatry, Lady Reading Hospital, Peshawar) during one of our faculty CME sessions, while discussing our teaching methodology for medical students. It reminds me of Stephen Covey's famous book "The 7 Habits of Highly Effective People" where he suggests that we "Seek first to understand, then be understood". Indeed this principle applies to health education as much as it applies to personal communication.
Interestingly, a few days after this discussion, I met a far off relative who happened to visit Peshawar. She had brought her son for medical care because he was bitten by a dog 11 days ago. While inquiring about the details, I found out that she had told the doctor that the dog bite was only one day old. Surprised and annoyed, I asked her why she had done so, and she replied that she did so because she thought that the doctor would not give him any treatment if the dog bite was too old. If this is a common belief in a village, then perhaps doctors are receiving wrong history from these patients at times.
Now one might arrogantly conclude that she is an illiterate woman who needs to be educated on the seriousness of dog bites. However, if one wants to really design an effective health education message, it would be useful to consider her belief that an older wound will not receive treatment by a doctor. Perhaps a more penetrating message would explain to her that even an old dog bite should receive treatment because it can still increase the chances of survival (in case it was a rabid dog). The point here is not to ignore the bigger problem of her waiting too long for treatment, but only to explain how the knowledge of current beliefs of people could be useful in determining the appropriate messages for them, in order to induce healthy behaviors.
Following a discussion amongst faculty members at CHS, we have now decided to reduce our reliance on transplanted health education messages from developed countries, and inculcate a stronger "We don't know what they think" attitude in our health education efforts.
