Himalayan Institute Cameroon

TOTAL HEALTH EDUCATION 2013 Pilot Program

Himalayan Institute Cameroon • Established in 2007, the Himalayan Institute Cameroon is our model

community center

• It is an integrated hub for a range of rural empowerment projects, all of which support one overarching goal—to fight poverty, illiteracy, and inequality through education, healthcare, and environmental regeneration

• Five main humanitarian projects have been undertaken to achieve this goal:

• Total Health Program (Health Center & Health Education)

• School for Carpentry and Construction

• Public Library

• Sacred Link Jewelry

• Water Projects

Background – Total Health Center • Opened in 2007, the Health Center uses a combined approach

of medicinal herbs, health products, yoga therapy, behavioral counseling, and public health education and outreach

• Major components include: consultations, pharmacy, mobile health clinics, certified consultant affiliates, self-treatment kiosks, health consultant training, and herbal medicine production

Background – Total Health Education • Our educational approach is

to help people develop a strong health foundation, focusing on the basics of good health, by teaching practical, culturally sensitive and appropriate information that anyone can apply

• Major activities under this program are: health classes, awareness, outreach, community health educator training

• In 2013 a new Health Education program was launched called the Total Health Revolution

• This was a far-reaching, dynamic program which included aspects of both Health Education and Health Center activities

• It allowed us to most effectively address the healthcare and health knowledge development needs of the community

Population Statistics

• Cameroon population: 21.5 million

• Bui region: 320,000 people

• Kumbo: 80,000 people

• Average life expectancy at birth: 52 years

• Age structure:

• 0-14 (40%)

• 15-24 (20.3%)

• 25-54 (31.9%)

• 55-64 (4.3%)

• 65+ (3.4%)

Himalayan Institute Cameroon Located in the town of Kumbo in Bui

Health Statistics

• Maternal mortality: 690 deaths/100,000 live births

• Infant mortality: 58.51 deaths/1,000 live births

• Fertility rate: 4 children born/woman

• Contraceptive Prevalence: 23.4%

• Percent of population with access to: • Improved sources of drinking

water (ex. piped water, bore wells, tube wells): urban (95%) rural (52%)

• Improved sanitation facilities (ex. flush toilets or ventilated improved pit toilets): urban (58%) rural (36%)

• Common health problems and causes of death include: • HIV/AIDS

• Influenza and pneumonia

• Stoke

• Heart disease

• Diarrheal diseases

• Skin rashes/infections

• HIV/AIDS: adult prevalence 5.3%

• Obesity: adult prevalence 10.3%

• Children under 5 years old underweight: 16.6%

Why the need for a health revolution? • Health knowledge and education

is greatly lacking in the general population

• For those living in rural areas or who are too poor to seek care there is no other access to health education

• A majority of deaths are due to communicable diseases linked to poverty and other controllable lifestyle factors

• More often than not, individuals avoid seeking care until their case is severe due to fear, lack of knowledge, and financial concerns over the cost of diagnosis and treatment

A children’s ward in a local hospital

The mountainous Bui region

Your Health is Your Wealth • The Total Health Revolution brings health knowledge and education into

the community because without stable health, it is extremely difficult to escape poverty. Health, economics, and education work hand-in-hand.

BUIDLING A STRONGER AND MORE VIBRANT COMMUNITY AND COUNTRY

EDUCATION INFORMED HEALTH CHOICES

BETTER HEALTH OUTCOMES

INCREASED TIME AND ENERGY TO WORK

MORE STABLE INCOME $

ABILITY TO INVEST IN HEALTH AND EDUCATION OF FAMILY

Total Health Revolution • Driven by local community members and demand from health

center patients, the Total Health Revolution was born.

• The Total Health Revolution pilot program was officially launched on August 10, 2013.

• This campaign was the first of its kind in this town and surrounding region, if not the entire nation.

Program Model: • Training

• Education

• Awareness

• Outreach

• Mobile Health Clinics

Grand launching event on August 10, 2013

Goals of the Campaign •The Total Health Revolution was designed to be a

dynamic and integrative health campaign with the aims of:

•Significantly improving health knowledge in the region

•Expand the reach and utilization of Total Health Center services leading to a greater number of people receiving safe, affordable, and accessible healthcare

•Expanding awareness of the Total Health Program and other Himalayan Institute Cameroon humanitarian projects

Training

• In order to implement this ambitious campaign we needed a local team who could engage with the community and a unique curriculum to prepare them to become certified Community Health Educators (CHEs)

• A curriculum was developed particularly for this population and focused on 9 main areas ranging from basic public health and first aid, to women’s health and stress and emotional health

• The curriculum provided the Community Health Educators with a strong health foundation and practical tips and knowledge that the general public could easily understand and apply

• Over the 1 week course, students came to understand each focus area in great detail, discussing practical application and cultural sensitivities surrounding topics, and learning communication and teaching skills

• Upon completion of the training course and practical examination 12 students were certified as Community Health Educators (CHEs)

• These CHEs were then offered 1 week internship positions during which they travelled with the Total Health team, taught community classes, and participated in mobile health clinics

Community Education • Wide-spread education and community engagement was a main

goal of this campaign

• In order to achieve this goal we partnered with over 100 groups—social groups, traditional groups, women’s groups—schools, businesses, and traditional and government leaders who invited our team to come speak to their members

A health class for the local king, family members, and guests at the palace

Classes • Each group was comprised of at least 50 members

• Classes lasted between 1-2 hours and covered key topics based on the demographics of group members

• Classes included lecture, interactive demonstrations, Q&A sessions

• Depending on the group classes were taught in either English, Pigin, or Lamso (the local tribal language)

• Each CHE was given a teaching guide to ensure that all class participants received correct and uniform information

• Classes were designed to be informative and give people a basic health foundation but also leave them with practical knowledge that they could share with their families and friend, and apply in their daily lives immediately

Key points: hand washing, brushing teeth, balanced diet, reducing alcohol consumption, practicing safe sex, managing stress

• 2-4-6 ½ Challenge

• A one month challenge given to all class participants and to those listening in on the radio

• Brush teeth 2 times/day

• Wash hands with soap at least 4 times/day

• Drink 6 cups of water/day

• Cut consumption of alcohol and soda by ½

Standard Educational Message

Focused on actionable points

Radio Classes • Radio classes allowed us to reach thousand of individuals who

would otherwise be unable to attend classes due to transportation or financial restrictions

• A series of 5 classes were held over Bui Community Radio which has a coverage range of 22 miles

• The classes were taught in English, Pigin Englsih, and Lamso to ensure that all listeners were able to understand our 30 minute health talks

• At the end of the class listeners were able to call in and ask our experts their health questions live over the air

Map of Class Locations

Classes were held in every subdivision of Bui with a majority concentrated in the Kumbo region.

We travelled to nearly a dozen locations outside of Bui to communities who were eager to be a part of the Total Health Revolution.

Awareness

• In addition to the community classes we also initiated an engaging public awareness campaign in an effort to sensitize the general population to our health education and broadly increase public health knowledge

• We utilized a number of awareness tools including: flyers, posters, loudspeaker announcements, and public service announcements

Educational Poster Series

Outreach • This campaign was able to utilize the un-paralleled social

infrastructure that the Himalayan Institute has built in Cameroon over the past 7 years

• Partnerships were developed with over 100 groups, schools, traditional leaders, and local and national government officials

• These partnerships helped create a sense of community ownership over the program

• Local business and partner groups were proud to post the “Official Partner of the Total Health Revolution” sign on their doors and act as a health resource for their community members

Mobile Health Clinics • Aside from providing educational information during the community

classes, we also offered free health consultations and set up a mobile pharmacy with low-cost natural medicines

• At the end of each class, participants had the option of meeting with our Total Health consultant and receiving a customize health plan involving herbs, homeopathy, diet and nutrition counseling, and other lifestyle advice

• Mobile health clinics brought health care to the people and

provided:

• Free consultations: all patients are welcome to consult for themselves or their children, receive free eye exams, and have a comprehensive health check-up done

• Affordable medicine: products are very low cost and can be purchased in individual doses or courses depending on spending ability

• Safe medicine: Total Health Products are all natural and safe. Patients report excellent results without unpleasant side-effects experienced when taking pharmaceutical drugs

Mobile health clinics were hugely successful treating between 20-50 patients at each event!

Why Mobile Health Clinics Are Important

Impact •The Total Health Revolution pilot program had very

positive impacts

• 8,000 people were reached directly through community classes

• 80,000 were reached indirectly through the awareness campaign and first-hand knowledge dissemination by the class participants

•Major impacts were made in three categories

•Knowledge

•Awareness

•Utilization

Knowledge • Overall health knowledge improved allowing people to make better and more

informed health decision for themselves and their families

• Actual health knowledge improved based on survey results

• There was a greater percentage of correct responses to questions regarding hand washing, brushing teeth, risks of alcohol, and basic diet and nutrition in the post campaign survey

• Based on the results of a pre-post campaign survey of 1044 individuals randomly questioned we found the following:

Perceived Health Knowledge

0.00% 10.00% 20.00% 30.00% 40.00%

Excellent

Very Good

Good

Fair

Poor

15.80%

19.73%

35.10%

22.20%

7.12%

6.90%

10.10%

34.70%

31.50%

16.50%

Pre-Campaign

Post-Campaign

Awareness

• Health awareness was improved in the region due to this campaign

• Based on the results of a survey of 1044 random individuals 73% reported either having attended a class, read a poster or flyer, or listened to a radio class

• Due to increased recognition of Total Health products we have been able to expand access points in the region through partnerships with pharmacies and certified consultant affiliates

• Individual interest in and engagement with the Himalayan Institute has also grown as seen by growth in memberships now totaling over 300 people

Utilization • Health Center consultations have increased by 50% since the

launching of the Total Health Revolution

• Approximately 60% of visits are by individuals from the 110 groups that participated in the community health classes

• The Mobile Health Clinic has also expanded its network to include 30 groups/villages who receive regular visits every 3 months

• New groups are reaching out for health classes and mobile health clinics each month

Conclusions •Overall the Total Health Education pilot program was

hugely successful in engaging the community and laying the groundwork for even more educational and health services activities

• Invaluable partnerships have been made and awareness and demand for Total Health Programs has increased significantly leading to the need to expand activities

•We have learned that culture plays a key role in successful behavior change especially for something as personal as health

What the pilot program has begun, and will continue working towards, is building a

culture around health.

A culture in which people believe they deserve to live a healthily life, see the

possibilities for improving their condition, and feel empowered to make positive

health decisions.