Health education and community participation in the control of urinary schistosomiasis in Ghana

Abstract

Objective: To study the role of health education and community participation for the provision of facilities necessary for the control of urinary schistosomiasis in southern Ghana.

Hypothesis: Health education facilitates community participation in the provision of facilities for the control of bilharzia.

Study area: Three rural communities drained by the Densu river in southern Ghana.

Participants: Individuals aged 14 years and above formed groups of 10-12 persons by age, sex, ethnic and educational background; 15-16 groups were formed.

Interventions: Based on existing structures, one community received active, another passive health education and the third had no education. All three communities received chemotherapy.

Design: Study was carried out in three phases: pre-intervention phase--during which baseline data on residents' knowledge, attitude, beliefs and perception about bilharzia were collected using focus group discussions (FGD) prior to the second phase, intervention. Another FGD was held after 18 months to evaluate the intervention--third phase.

Results: This study suggests that most community members were aware of schistosomiasis but not as a disease. Before the health education, some residents believed bilharzia was a sign of manhood while others attributed the red colour of the urine to the red colour of a variety of sugar cane eaten in the area. After the health education, residents in the three areas constructed hand-dug wells. In addition, those who received active health education constructed two toilets for the schools and weeded the banks of the rivers. Residents also associated the disease with the water snail.

Conclusion: Health education was useful in changing community perception on bilharzia.

PIP: This paper examines the role of health education and community participation in the control of urinary schistosomiasis in Ghana. The study population included individuals 14 years old and above living in three rural communities drained by the Densu river. Focus group discussions were employed in the pre-intervention and evaluation phases of the study. Meanwhile, interventions include passive and active health education on schistosomiasis and chemotherapeutic treatment with praziquantel. One of the communities served as a control where no health education was employed. The investigation found out that most community members were aware of schistosomiasis, not as a disease but simply as a sign of manhood. Still others associate the condition with eating red sugar cane, sexual intercourse with infected partner and so on. The health education program gave the communities the opportunity to enrich their knowledge on urinary schistosomiasis, its causes, treatment, and prevention. As evidence, hand-dug wells and toilets were constructed and the residents in the communities cleaned riverbanks. Health education also made the people realize that Bilharzia is a curable and preventable public health problem.