INFORMATION, EDUCATION AND COMMUNICATION (IEC)
For
accelerating the Family Welfare Programme the need for information,
Education and Communication is well recognised. The success
of the Family Welfare Programme depends mainly on the voluntary
and widespread acceptance of the concept of small family
norm. The efforts undertaken so far through mass education
and media activities have helped to create almost hundred
percent awareness among the people of Family Welfare.
By
the constant and continuous utilisation of educational methods
and media, it has become possible to remove the deep-rooted
attitudes, beliefs and misconceptions which were detrimental
to the acceptance of health and family welfare programmes.
Strategies of different types have been evolved and implemented
with a view to achieving behavioural and attitudinal changes
among the resistant groups. Efforts are continued to convert
the existing widespread awareness into acceptance, and use
of Family Planning methods by dissemination of information
and education.
Community participation and involvement
The success of implementing every programme depends
on the involvement and participation of the community. Propagation
of small family norm among the eligible couples, removal
of misconceptions and misunderstandings are effectively
done through individual contact and group approach with
the participation of Non-Governmental Organisations like
Mahila Samajams, Youth Clubs and similar Socio-Cultural
Organisations.
Mahila Swasthya Sangh
India is committed to the twin goal of “Health for All”
and ‘Net Reproduction Rate of Unity” by the year 2000. These
goals are recognised to be intimately intertwined and further
their achievement contributing to the improvement of the
condition of women and children. It was realised that a
major component of Family Welfare Programme is related to
health problems of women and children and these groups are
vulnerable to health disorders and diseases. In order to
mobilise community participation and to create a viable
support structure within the community to sensitise rural
women and to increase demand for integrated Health & Family
Welfare Services available, the scheme of M.S.S was launched
in 1990-91 in selected districts of Kerala.
To overcome various problems like low age at marriage, risk
factors during pregnancy, unsafe and unplanned deliveries
and high rate of child mortality, it was desired that women
may be educated, motivated and persuaded to accept programmes
to increase demand for services.
The scheme called Mahila Swasthya Sangh (MSS) was designed
to include some of the village level functionaries already
working with Social Welfare Department and Directorate of
Health Services at state level. Besides the above 10 to
15 women members of the village called “Community leaders”
were to be involved with the programme.
Initially
the scheme was introduced in the state in 1990-91, constituting
888 MSSS. Subsequently based upon the feed back the scheme
was extended to all districts. According to the design,
it was planned to constitute MSS in villages having population
more than 1000 to 2000 house holds. Those C.D. Blocks which
were covered by the Social Welfare Department having adult
education centre under ICDS projects were involved so that
co-ordination with the female functionaries of these departments
is obtained effectively. The members of MSS serve as a link
between the community and local health functionaries.
The
programme is still continuing. The total number of MSS functioning
in the state till 1996-97 is 3440. It was decided that an
evaluation should be carried out by an independent agency
about the functioning of MSS and its utility during the
previous years. Consequently the Institute of Management
in Government has done an evaluation study and the result
showed that the functioning of MSS satisfactory.
Training
of Mahila Swasthya Sangh members and other grass root level
functionaries at sub-centre level.
For developing communication skills, enriching the knowledge
and to bring about coverage of related activities at the
grass root level, training was imparted to MSS members on
to topics viz. Child Survival & Safe Motherhood and spacing
methods for family planning, saturation of weak areas with
multimedia and local-specific interactive scheme.
IEC
efforts need to be focussed and targeted for specific beneficiaries
in demographically weak districts by utilising local specific
folk media as interactive mode of communication. Specific
and innovative cultural activities such as street plays,
folk dances, dances, mimicry, puppetry, oppana were organised
in identified weak districts having high CBR and IMR with
the objective of creating awareness amongst all eligible
couples regarding the various family welfare programme.
For
saturation of weak districts, troops/registered folk parties
etc. were identified to give song and drama performances,
under local specific interactive scheme.
World Population day
The
rapid increase in population is a cause of major concern
to all developmental efforts. It is estimated that the present
rate of growth of population of the country will be crossing
one billion mark by the end of this century.
Keeping this in view, 11th of July every year is observed
as World Population Day. The observance of the day is a
grim reminder of the World Population increase which touched
five billion mark on 11th July 1987. The objectives of observance
of the day is to organise Mass Media Campaign and to take
effective steps to bring the population growth rate to a
sustainable level. All media and field organisations are
to be harnessed to put the message that the only choice
before humanity is to reduce the number.
Enhancement
of the role of the NGOs in Family Welfare and Health sector
The
Government of India policy statement on the National Family
Welfare Programme spells out the need to promote Family
Planning as a people’s movement. The association of voluntary
organisations in the Governments’ programme ensures greater
acceptability of the Family Welfare activities among the
people. This is so because the voluntary organisations enjoy
greater credibility and are closer to the community than
the Government staff. The supplementary and complementary
role played by the voluntary sector in the propagation of
the small family norm is therefore vital for the success
of the family welfare programme.
In
order to involve voluntary organisations in the implementation
of the Family Welfare Programme, and to make it a peoples’
movement, Government have evolved a policy for financial
assistance to these organisations for their projects.
SCOVA (Standing Committee on Voluntary Action)
To
consider applications received from voluntary organisations
working at the grass-root level in the rural areas and urban
slums for setting up family welfare projects relating to
MCH, Family Planning, at state level, a Committee (SCOVA)
consisting of State Government Officials, representatives
of established Voluntary Organisations in the state and
the Regional Director of Health and Family Welfare was constituted
in the State.
The
Committee is to recommended projects in FW from the voluntary
sector for funding from the centre. The Standing Committee
on Voluntary Action (SCOVA) have sanctioned model schemes
for promotion of small family norm and population control
by encouraging spacing methods and sterilization.
Swathya
Mela
In
remote and difficult areas, provision of health services
particularly to the vulnerable groups have been very difficult.
To ill the gaps in delivery of health services created by
inadequate infrastructure, and to increase accessibility
of health services to the community relating to prevention
of diseases and their cure, as well as for promotion of
a healthy way of life, a Mela approach has been introduced.
Wide
publicity is required for ensuring a large turnout for seeking
health services during these Swathya Melas. Counseling is
another area taken up n the melas. Couselling has a district
advantage in leading to informed choice in contraception,
assisting individuals in acting upon health information
received by them, increasing access to give points of service
delivery, promoting good relation between service providers
and clients.
Special
School Health Check-up Programme
A
special school health checkup of students in primary schools
was carried out in 1996 using the health workers, AWWs and
Volunteers. An effective IEC campaign was organised by the
State, giving emphasis to create awareness among the parents
to send their wards to schools on the checkup day and to
provide wide publicity regarding referral cards and referral
services.
Pulse
Polio Immunisation Campaign
Pulse
Polio Immunisation campaign are carried in December and
January. Intensive social mobilisation campaign and media
announcements is a unique feature in all Pulse Polio Immunisation
campaigns. Awareness is created through IEC efforts on the
benefits of PPI and why fully immunized children also should
receive OPV during this campaign.
Target
Free Approach in Family Welfare
Communication
programmes aim at generating demand and better utilisation
of health and family welfare services in the community and
empower people to take care of their health. Now it is being
realised that the IEC programmes have to be area specific
and addressed to the problems of the area. This warrants
decentralised planning approach in designing IEC programme.
Another important dimension of the IEC programme is based
on needs of the area. The proposed IEC strategies are:
1.
identify the communication needs to plan IEC activities.
2. Involve community and NGOs through unified messages.
3. Effective use of mass media for back up.
4. Strengthening inter-personnel communication.
Moving
from Family Welfare to Reproductive Health
New direction in the Family Welfare Programme towards a
client – oriented reproductive health approach has major
implications for IEC. As is evident from the services identifying
as components of an essential reproductive health packages,
the range of activities which IEC must now take-up are considerably
broader in scope than before. In addition to prevention
of unwanted pregnancies and the promotion of childhood immunization,
IEC strategies are concerned with safe abortion (Medical
Termination of Pregnancy) safe motherhood, prevention and
management of RTIs/STIs, sexuality and gender information
education and counselling.
The
goals require a strategic approach to IEC identifying meaningful
segments of the target audience, promoting a number of new
behaviours that are closely linked but complex, identifying
messages, and using a mix of communication channels to effectively
reach these various audience segments.
Thrust
areas have been identified for Family Welfare Programme,
for which audience-specific message and use of suitable
media were to be discussed and finalised from individual,
group and mass approach point of view. The situation analysis
reveals the following thrust area for designing IEC Programmes
·
Reproductive Health of Adolescent girls
· Counselling of adolescents entering the reproductive age
group for Family Life education
· Women’s education
· Higher age at marriage
· Early Ante-natal registration and care
· Nutrition during pregnancy and lactation
· Institutional delivery
· Vaccine preventable diseases
· Protected water supply
· Diarrhoea and ARI management
· Low birth weight
· Birth interval, birth spacing
· Medical Termination of Pregnancy
· Childhood disability
· Breast feeding.
Health
Education
Health
Education is a wide as Community Health and it is a process
which effects changes in the health practices of the people
and in the knowledge and attitude related to such changes.
It includes imparting knowledge about health, removing superstitious
beliefs, building favourable health habits and attitudes
and effecting the necessary changes in the health practices.
As health education is an essential tool of the community
health it becomes the responsibility of the Government to
assist and guide the health education of the general public.
Hence in 1956 in the Central Ministry of Health, a Health
Education Bureau was established with the assistance of
the Technical co-operation mission of the United States
of America. Subsequently in 1958 a School Health Education
Division was established following which in 1959 a scheme
for State Health Education Bureau with central assistance
was formulated. In Kerala reorganising the existing health
education facilities, the State Health Education Bureau,
on modern line was set up in 1960. In 1971, District Health
Education Bureau were established by winding up the Regional
Health Education unit in all the districts. Besides the
central and state District Education Bureau there are official
agencies such as the Directorate of Advertising and Visual
Publicity, the Press Information Bureau and the AIR and
TV etc. which are engaged in health education work. Health
Education is a complex activity in which different organisations
play a part.
The
organisational divisions under these are as follows
1.
Administrative Division
2. Media and Publicity Division
3. Editorial Wing
4. Training Unit
5. District Health Education Unit
The State Health Education Council with the Hon’ble Minister
for Health as the Chairman, reviews and guides the activities
of the State Health Education Bureau in general.
The State Health Education Bureau is functioning at the
Directorate of Health Services with the Assistant Director
of Health Services or Deputy Director of Health Services
in charge as the programme officer, assisted by a Technical
Officer, School Health Education Officer, Social Scientist
and Sub Editor with supporting staff. The Central Health
Education Bureau is giving guidance and leadership for the
activities besides providing education materials. A library
is functioning under the bureau at the Directorate of Health
Services.
The
Media and Publicity Division of the Bureau is concerned
with the planning of the activities of the Bureau and purchase
and distribution of materials, whereas the District Health
Education Unit guides and assists the regular public health
personnel in organising health education, film shows, exhibitions
etc. The Editorial wing of the Bureau brings out the quarterly
health journal ‘Susthithi” besides of posters and folders.
The field study demonstration and training unit under the
bureau takes up demonstration and study projects and organises
periodically in service training programmes in health education
and allied subjects for health workers. This unit at Neyyattinkara
functions as the field laboratory to the State Health Education
Bureau. The training unit provides job orientation training
in health education for paramedical staff.
The Audio Visual unit attached to the Bureau conducts regularly
film shows and exhibitions and renders service in conference
and seminars. The art section with the assistance of the
statistical unit prepares materials like drawings, title
heads, charts, posters, display boarders etc for various
programmes.
In
short, no health programme, however useful it might be,
could be implemented successfully without the cooperation
of the public for which the only tool is Health Education.
School
Health Programme
The
Programme was introduced in Kerala in 1980-81. This programme
was formulated for providing comprehensive physical examination
and medical care to the entire school going children of
the state. The main objectives of the
school health programme are:
1. To reduce the morbidity among school children through
school health services.
2. To prepare children for adopting healthy life styles
(health practices) through health education
As part of achieving the goal of “Health for All by 2000
AD” School Health Education is given prime importance. It
is easy and useful to instill the desired health behaviour
through the syllabus, class lessons, group discussions,
education, competition etc regarding different aspects of
health education in the formative age group of 5-15 years.
During
the 8th Five Year Plan, one day orientation training was
conducted for school teachers at district level. First aid
kits, weighing machines and measuring tapes are supplied
to selected schools.
During
1996-97 the special school check up programme formulated
on a national level by the Government of India, was successfully
conducted in Kerala as per the guidelines issued by the
Government of India. It was a 6 days continuous programme
from July 22nd to the 27th and was a great success. Referral
camps were also organised at several places for giving further
medical care for the children having various health problems.
Nutrition
Programme
It
is well known that maintenance of health is greatly dependent
on adequate nutrition. Although the target of a number of
indicators of ‘Health for All by 2000 AD” have already been
achieved, malnutrition continues to be one of the major
public health problems in the state. Extensive diet and
nutrition surveys carried out in different parts of the
state have indicated wide prevalence of malnutrition among
pre school children, pregnant mother and lactating women
especially in poor socio economic strata of society. To
control and prevent malnutrition a number of nutrition programmes
are being implemented through different departments by the
Government.
The
nutrition division under the Directorate of Health Services
consists of three wings viz. State Nutrition Division, National
Nutrition Monitoring Bureau and Applied Nutrition Programme.
The state nutrition division is mainly engaged in conducting
diet survey and nutrition survey, besides conducting anaemia
survey, nutrition camps, cooking demonstration, nutrition
demonstration and training programmes and also preparing
of nutrition education materials.
Recently
a diet and anaemia survey was conducted among school children
of Thiruvananthapuram. The National Nutrition Monitoring
Bureau has carried out diet and nutrition survey in various
districts during 96-97 to assess the dietary intake and
nutritional status of various segments of the population.
Ignorance
of the people regarding various aspects of nutrition and
health is one of the major contributing factor to malnutrition.
One day nutrition education training camps were conducted
in all districts for SC/ST mothers of pre school children
as a means of imparting nutrition and health education to
the weaker sections of the population. Cooking demonstration
cum nutrition education programme is being carried out in
various districts by the mobile kitchen unit. The nutrition
camps and the demonstration programme are conducted with
a view to making the people more aware of the importance
of adequate nutrition in maintaining their health and also
to encourage them to improve the dietary intake of nutrients
by using available cheap and nutritious food materials.
Nutrition
education and medical checkup camps are conducted in hostels
for scheduled castes and scheduled tribes through out the
state to ensure better health of the inmates and also to
teach them basic principles of health and nutrition. These
camps helped to improve the nutritional awareness and personal
hygiene of the children and also environmental sanitation
of the hostels.
Per
capita net availability per day: Cereals and pulses in India
| Year |
Cereals |
Pulses |
Total |
| 1951 |
334.2 |
60.7 |
394.9 |
| 1961 |
399.7 |
69 |
468.7 |
| 1971 |
417.6 |
51.2 |
468.8 |
| 1981 |
416.2 |
37.5 |
453.7 |
| 1990 |
438.1 |
36.5 |
474.6 |
