A Community Health Education System to meet the health needs of Indo-Chinese women

Abstract

This paper presents a Community Health Education System which is cost-effective, sustainable, strongly community-based, and directed at improving the health status of rural women in Indo-china (Kampuchea, Laos and Vietnam). The system is developed through a series of steps which are concerned with the education of Community Health Education Units (in national ministries of health) and, at the village level, among community health workers, women's groups, and other women. The ultimate aim is the establishment of a community health education program in Indochinese villages.

PIP: A proposed community health education system is described for implementation in Kampuchea, Laos, and Vietnam which addresses the problems of maternal care, improved nutrition, prevention of infectious diseases, and screening for breast cancer. Success of this proposal is dependent on cost effectiveness, the economic viability after donor funding ceases, sustainability through community interest, and adequate monitoring and evaluative procedures. Community participation is a major determinant in program success. The lack of participation may be due to a lack of community awareness and resentment of "topdown" messages, authoritarian behavior, and cultural insensitivity. The community health program initially requires national governments to provide salaries alone. Cultural sensitivity is achieved through involvement of primarily national health professionals, a few nonnationals who have been informed of Indochinese traditions, and a core of local people at the village level. The System 1) established and educates key persons (advisory team, community health education unit, community health workers (CHWs), and women's groups) in the system, 2) implements the programs, and 3) monitors and evaluates. The women's group is the most important for program success. 6 education modules make up the program, i.e., a medical module on maternal care (pregnancy and prenatal and postnatal care), proper nutrition, prevention of infectious diseases (germ theory, immunization, personal hygiene, environmental hygiene, and preventing sexually transmitted diseases), and screening for breast and cervical cancer. Other modules are on teaching methods, the use of teaching aids, revision of modules, female community health worker training, video production techniques, a national awareness media component, and evaluation techniques. The CHWs teach the women's groups and villages about health prevention and behavior. Women's groups provide feedback and modify the program and in return develop self-confidence in leadership roles in the family, community, and country.