WORLD HEALTH ORGANIZATION

R ...... IOHlc. lor It.. f •• '.r .. Maclit.rr .......

ORGANISATION MONDIALE DE LA SANT~

Bur.au "'glonel ......r I. M'dlterra .. b on.nt".

December 1977 ENGLISH ONLY

WOJU(SOOP ON HEALTH EllIiCATION ASPECTS OF FAMILY HEALTH

Alexandria, 7-15 November 1977

WHO EMRO

I lNAUQWRAL SESSION

El'<;McH/l)2 ~;1lEp/48 page 1

The meeting was opened by Dr M.O. Shoib~ Direotor Health Services, who weloomed the partiCipants on behalf of the Regional Director. Dr A.H. Tab!. Dr Shoib emphasized that the subJect of the meeting was of great interest to a variety of health programmes and personnel endeavouring to improve the health of the communities and that maternal and child health are important and essential elements of family health. He invited any oomments and suggestlc:-,s on the provisional agenda whioh was reviewed and adopted. He mentioned that since It was a workshop kind of meeting. there need not be election of Chairman or Vice-Chairman. but two Rapporteurs for plenary sessions would be desirable; for these he suggested two names (Dr M.A. El~P.al::l;b1 and Dr A. El Tnln) and invited ::l;:-.y ether c:;;;r.lnents and suggestions. The two Rapporteurs were unanimously agreed upon by the group.

The introduction to the meeting was given by Dr S.A. Zafir, Regional Adviser on Family Health and Secretary of the Workshop. Dr zafir drew attention to the objectives of the meeting. the agreed agenda and the related specific items of the programme (see Annexes I, II and III) which all mention that during the Workshop the participants should be able to prepare suitable outline programmes for health education activities in support of family health. specifically in respect of their identified areas of needs and problems and primarily in the context of their own individual countries. The nature of the meeting was, therefore, that of a workshop in which participants would do their main work in small groups and by country-teams. hut would meet in plenary sessions to exehange views. identify key areas of needs and problems, get aoquainted with a suggested methodology of project or programme formulation (systems approach of planning by objectives) and health eduoation methods and. later, present Some country proposals for inviting comments and suggestions. A brief review of family health programmes and proJects in the Region was also carried out.

II OOUNT.RY-~M PRESEN!ATIONS

In the next plenary session, which was the first technical session, the partioi­pants introduced themselves individually and were invited to add some personal infor­mation about other professiona~ interests or hobbies. This seemed a useful approach to braak the ice and make the group more communicative and cohesive. This was followed by eight country presentations by respective teams, which were well discuased so that a little more time was required than soheduled. The participants (twenty) came from nine countries and were aSSisted by several resource persons included in the Workshop Secretariat (see Annex IV).

III IDENTIFIcATION OF KEy AREAS OF NEEDS

An important item of the agenda was taken up on the second day, namely the iden­tification of "key areas of needs requIring health education activities in the broad field of maternal and child health and f'Bmily planning". The participants were very forthcoming in making their own listing of such key arees individually, and on conso­lidating the list it was no~ed that there were conSiderable similarities. However, during the discussions it became quite clear to the group that suoh an identification should be tased an soma reliable available data or. in the absence of such data, assessment of nBeds surveys in the cOllll'lunity should be suitably planned and 08M'ied out.

EM/MCH/132 EM/HEP/48 page 2

WHO EI'lRC

)viere incidental observa t.l ons or clinic-data were not enoUgh. An a 1 terna t,j ve metL:"Id of Identifying areas of needs was broug;ht to the attention of the p:roup al~d wa:; well received. Thjs approach uses the cross-matching of conventional cnrono::"og:cal phases of needs of mothers and children as the maIn recipient::> or service", 011 o;,e axis, with the conventional type:;; of family needs vI' problems e.g, crowt~) and development. nutrition, diseases etc. 01. U--,." ;:;1.her axis 'p::'ease see j"nnexes V 3:Jd V!) •

The main purpose of this interlude on methodology of about a day and a r.alf ~n plenary sessions and some individual or group work, was to make the particIpants familiar with the systems approach of project formulation as well as the healt.h education methodology. This activity was supported wiLh carefully planned hand'Juts, demo.'1stroticn of examplCG written out on flip cr..art1'. and di~cusslon~ 1n ',.rlich th .... partIcipants were encouraged and became actively involved. On the whole, it was felt that they grasped sufficiently the principles of the process of project formulaLloll and health education methods and were also assisted during group work to clarify any remaining doubts and remove difficulties, liowever, it was net.ed fr(l'l; day to day evaluative feedbacks that some participants needed more time for' better ur.derstandjnp;; it was attempted to provide this to the extent possjble.

~everal t~ndouts were distributed :In support of the mini-workshop, which are not atta<.:hed here, hut -..;111 be included in the full report, no-..; being f1nallzcd.

At the end of the mini-workshop on methodology, it was clarified and generally agreed that the methodology is to be used as a tool to formulate projects on areas of needs already jdentified, which should not be lost sight of or unduly simplified to su:lt the methodology. In short, the methodology should flt the content require­ments of areas of needs and problems rather than the reverse.

V GROUP-WORK AND PR.EPARA'I'ION OF COUNTRY-PROPOSALS

After becoming conversant with methodology, the partICipants divided into four sub-groups of five each by their own choice and some suggestions, As was mentioned on the first day in the introduction to the workshop, the group-work in relation to the obJec1.-ives of the workshop and to Agenda item 8 was to be thtl mortl important part of the meeting. Each of the four sub-groups comprised two country-groups to help improve group dynamics and facilitate discussions, but it was clearly understood that separate proposals were to be prepared for each country by the respective country teams, The arrangement was found to be generally convenient and workable.

A short briefing in a plenary seSSion was gl ven to the sub-groups and opportuni ty was provided for questions and clarifications. At this time the sub-groups were select.ed and were asslgned "key" areas of MCH,/Family Planning needs as identified by

them on the second day of the meeting and each sub-group was assigned one or two resource persons to assist (see Annex VTI).

WHO EMRO EM;1<cH/132 m./!lEp/48 page 3

The available time for group work was shortened by about half a day due to the extra needs of the participants for proper understanding of methodology in the mini-workshop. However. this shortage of time was amply compensated by the high level of commitment of the participants who spent two additional evenings on Friday and Saturday to oomplete the grouP work and the country-proposals.

Most of the country-proposals were prepared and submitted for typing by the evening of Saturday and a few remaining were submitted on the morning of Sunday. These were typed. reproduced and distributed to the participants on the morning of Monday and were reviewed by the respective groups.

Later, in a plenary session, two country-groups were invited to make presentations fOL' tl:l.e rest of t..'1e p:u'tluip:ints to cormn~nt upon and discuss. pakistan and Sudan country-groups volunteered. The presentations were very well received and discussed by all the partiCipants. This process also helped other groups to review and self­evaluate their own proposals.

After a short break, another plenary session was held in which the participants were invited to make five individual suggestions or recommendations for general consideration. These were listed on flip charts and oonsolidated, and from them were drawn the general conclusions and recommendations of the workshop.

VI EVALUATION

The evaluation of the workshop was done concurrently with or soon after the plenary sessions by the participants themselves, but anonymously to give them the opportWlity for clear and frank responses. There were three such feed-backs from the partiCipants in a structured form which showed that they had well appreCiated the identification of !rkey" areas of needs and problems in MCH and FP and generally Wlderstood and grasped the methodology of project formulation by systems approach and the health education methods to be used in the country proposals.

VII CONCWSIONS AND ~TIONS

A. Conclusions

1. In the majority of countries represented at the meeting, there is considerable similarity in the pattern of health problems in general, as evidenced by the leading causes of morbidity and mortality reported in country statements; and also in the "key areas of needs" in Family Health requiring health education support. as identified by the partiCipants during the meeting. However. priorities for action vary in each country and in areas within countries, according to health Situations, programmes, available resources and national policies.

2. Five broad areas of health problems and needs were identified as "key areas'; namely: nutritional problems of mothers, infants and children and familieS as a whole; diseases of children (including EPI), and mothers (e.g. maternal deple~ tion); health aspeots of family planning; Wlder-or over-utilization of available health services; and environmental health problems as they affect women and children particularly.

EM/MCH/l)2 EM/HEP/48 page 4-

l'iHO EJi'!RG

3. During di::;cu::;::;ior.:3 in plenary sessions 8S well as in Gorne sub-grQup~ later. participJnt::; took keen intere"t in and advantage of exchanginC ir.foI'mation and views regl3;rdinC; different stages of developnent ann experier,c~3 in health aspects of famjly plannjnp; programme::; which were helpful ::':1 cevclcpir:g country-proposal".

4, The main area of Family lIealtn, namely Jl'lCH includi:lg family plannir.g, \'1a.; seen to be a priori ty health need in all the countries, as it concerns a majority of total populations (abOll't 66;~ jn most c[)untries of the H.el:ion;, ar.d affects the vulnerable groups of children and women in reproductive ages. It was also nnted f'rom a circulated doc.:ument (Technical Discussions un Healtl1 Education with particulDr rcfcrc:lce to the Primary Health Care .A,pproach, :'It

the 'rwenty-Seventh .Session of the rtebional (;omr:littee) and felt by the p;r;)Up that this area being the e::;"entlal component of "primary health care" .'lpr;roaci:l, it could receive 'Jrgent attention through c'Jmmunlty partlcip3.tiun and early mobilization of all available communtty r"sourc,,::;.

5. Although t:1ost COllntri"s have ~omc kind of :nealtl1 educatior: w,its at ce:1tral. and sometime:;; at intel'merllate level, the m.'ljori ty of the 0.01mtri ,,!:i n"edt"ci asslgnment of health erlucation 5peciali~t:;; at central level and in large or :IIQri"'-rately large coulitrie~ a1'OO at intermediate levels. 1'he 1'01" ot' heal"t" euuca-tiun specil3;lists was ~onsldered to be: ldentificatiun of priority needs .'In:j problem..; for heal L~, educa t~ on in consul ta tion wi t.h hea 1. th OIdmini ::;trD tor~, plannini; the hea~th enucatior. activilics 8nd tlleir impl8J:len'Wtion. and to promote, carry out awl ,",o-ordinate related trairdng, supervjsjon 1:md r":;;"Clrcn.

D. Hecomm~ndationG

For con~ideratlon of Governments:

1. Health bducation activities in support of Family Health shuuld be carried out in the context of the healtn education proe;t'amme as a whole and ir. co-ora"iniJ­tion wlth its varioUS components, with approprlate emphasis and in accordll.r.ce with national policles. A list of key areas of needs for health educCltion act1vitie.::; wa.:;, identified by the group, which was used for country proposals already prepared and is recommended for further consider3'tion, development ann use in accordallce with country-needs.

'='. There appears to be an obvious need for ::;trO;;:llglh8lllng 8xl:;,lill/:S eElrit-L"al health education units by mean::; of "ultalJle staff and funds. in a majority of countrie", and a clear need for establishing such illli t" i:1 those countries where they do :lot exist. l'hcse wllts would be responsible for planning, implementation and evaluation of hel3;lth education activities, and to lJe effective they should enjoy equal status with oLher health departments, and representation in the national health planning bollrds or commi tt.ees.

WID EMRO EM,IMCH/l)2 EM/f!EP/48 page 5

3. In large or moderately large countries, the need is increasingly felt for establishing "intermediate level" health educa t!on un! ts with enough delegation of responsibility and allocation of resources to enable them to function effeotively. These units should be able to give better attention to local level health education activities and to promote their integration in primary health oare with a view to improving the coverage and delivery of health care services.

4. At central and intermediate levels~ the health education units should be headed as far as possible by health education specialists.

5. The performance of actual health education activities should be an integral part of the functions of all health workers - especially those who do home­visiting, such as health-visitors. Special efforts should be made to involve indigenous health workers such as traditional birth attendants (dayas). throUgh training and incentives.

6. In addition to health workers, support and involvement should be invited and received from national leaders, community elders, teachers and local voluntary agencies, especially for solving difficult health education problems.

7. Wi th regard to education and training. the group made the i'ollowing recommendations:

(a) all undergraduate curricula for health workers and other related pL'ofessiUi16 shuulu include knowledge aliu skills in dellve;r."lng health education;

(b) in-service training in health education should be undertaken to fill the gaps in this area, and for developing team-spirit;

(c) post-graduate training in hsalth education is necessary for the training and preparation of health education specialists.

8. Assessment of health education needs in each country and in defined areas within a country should be done in a systematic manner through:

identification of problems/needs; setting priorities; developing objectives; planning strategies and their implementation; evaluation and replanning~

9. Well planned educational materials are very useful, and as far as poSSible they should be locally developed and pretested for their effectiveness, before introducing them widely in the cOl1llluni ty.

10, In under-served areas such as remote rural areas~ well organized mobile health eduoation teams accompanied by or co-ordinated with some minimal health services can be reasonably effective. However. their use needs to be carefully plalUled,

J:l'l;i"iCH/l)2 It.'He, Er,r.':'-E~1/HEP/48 page 6

11. Re~eo1'(;h il; variC)u" operoticn£ll f).:';P!;;ct" of' .~.e1;l1th eGUcDtj,")n liS :'ro:oc;,u,,;:!.c.­required and should be carefully planned and carried out to r"ax1r:.1se !'es0:' ',_, health education act1vlt1e:::;. ~;ome examples ;Jf neeoer. re:-;eflr~(; are T,r,S f:)-,-~ .'.·::_r::~

aSGeGGment of c;ommur,iLy nced::;; evaluation of he.'l.l th education impact; preteGtinl:5 of educational metilod," alld mater1als; cost-benef1 ts n1' c0st,-effecti vene,,:::; of he!> 1 th ed\lcu t i on prol,rc.-nmes.

12. A :;;eparotc and rea:.;onablc. ouugCLary' allocaLlorl :.;r;ou-,-u be oval--,-at;~(; V; central health education Wli':.s (and intennediflte level units, W;1ereV"r 11f'<ei:'S_sar:i for organizing !lealtn eO-.lcation programme:; ond a(;tlvll..lc':' at u.il lcvc~.;, 0..;

appropriate,

13. Proposals prepared hy country-team:o during the Work"hop !lI::cd Cl'..-lC CO:l"j:;'.:rw­

'I..~on of re5fJect~ve Government,s for futher development if ;Jece,;siiry; i'lnc: ['-_,r funding ann imj):"ementat1()t'.,

For consjderation or win

14, The group fell.. very encouraged by "'IHO's role in ore;anizing this 'd:Jrt;,:on-)~, "l:-;j

recommended further support (;l:ld colla bar'o'l..ion wi Lh t.hc :.cOWl tr'l c.:, cf t.:,8 F\C1!;lOI. in ttl.;;: followin!5 areas:

(a) Cont~nulns t.o bring 1;0 the attention ()f Governmen1.~, e:oreciui"y the M1n:l5trie" of HealUI off1clalG concerned, the imporVlr,ce of the n:;>le ~If

health education in support of' health programme:;; in general 2r:<.i. >lro1!;I'3mrr.c::' :ouch a" Family Health for the vulnerable groups of population in ptlrti0.11ldr, a is was recently none i:l the Hegiorl£Jl Carnmi t. t.ee in 5upport of Pr1mar.)/ Heal:.:, Care.

(b) Prov1ding re.50urce persons, advisers or cons1.l1tants as r,ce:leo, rer guidance in curriculum developrnel1t. at variou:o levcl:o of w:oic -\.r·a':'l,lr;g, in establishing field 'l..ralning areas and programmes, in prepan:Jt,lon of educational materi.'l.ls, and not '1east in carrying out :.;omc rolovor;t. operational roseardl.

(c) Providing o;uVV...)rt to trElininS, loc.<llly and t,hrOUe;h f'ellowsh~r" fnr training abroad, and sponsor:lng workshops and (;ou1'::;oo; on the hea::..tll eciuca­ti on methodology.

(d) :";o-o1'llinatlng health education activities in countries ot' tbe I-\cgion and providing stimulating opportunl ties for Inter-country sharing of experien(;cs.

(e) Stimulating and co-ordinatio[:'. the inter-sectoral effort.:.; of diffoI'e[-lt ministries in the countries, sucb Q::; of education or higher education Hnd of food and Olp;riculture, 11l addition tu the l>1inistries of Health.

(f) Co-ordinating t,he col1aboration and aSSistan(;c In cOWltrlec:; of othe:>r 1nter-national agencies, especially Un:lted Nation" Agencies, in the fielci of health eduoatjon.

WHO EMRO

Long-tam ob,lective

OBJECTIVES OF THE woRK.SHJ p

EM;MCH/132 EH/HEP/48 Annex I

1. TO help contribute to the general improvement. of the health of the respect ... ve popuJ.ations~ especially to tile health of' vulnerBnle gro\4l3 of children al1..l women iu reproductive life~ tnrough better understaw:Lng, acUve pa~ tlcipatiol1 and balanced utili~ation of integrated maternal "nd child health and family plonning ser-yices.

Immediate objectives

?l To strengthen the existing, or .help establj 8h new~ heal th education acti vi t1 es in ::;upport of integrated maternal and child health/family planning ::>ervices, in the cmte,xt of general health services and develo~ent (including illt.egrated rural development) programmes of the country and in coordina~ion with other health eduuation activities.

2.2 To provide the pac'ticipants opportunity tu snare experience::> and exchange views among themselves and wi th WHO staff and con;;;ul tants for helping datermine for themselves .. by cotmt:ries, the most suitable health educatJ.on activities in QUppcrt of exHting or anticipated integrated maternal and cnild health/family plctnning activittes.

2.3 The participants mould be able to prepare SUitable outline programmes fur health education activities in tams of identifying needs, problems, SUggesting solutions and proposing a single or alternative strategies f'or actiun. using the systems analysiS approach.

2.4 To deSign methods of evaluatlo/j for these progranmes so as to ensure their future implementa1bn wi"th due corrections and improvements, as appropriate, in the health delivery systems, especially maternal and child health/family planning services, of respective countries,

WHO D<1R0

ANNEX II

PR.)v:tsrbNAL AGENDA

1. Opening of the Workshop

2. E!ecti~~ of Officers

3. Adoption of Agenda

4. Introductory remarks by the Secreta.r-ia t

4.1 Administrative procedure, tim1ng~ etc. 4.2 ObJeotives of the Workshop in relation to the usual components

of a national health education programme

EM/MCIl/132 >WHEp/48 Anne:x II

5. Review by partiCipants of health education activities in general and in relation to family health projects ortrogrammes in respective countries

6. Identification of key areas of TlNeedS" requiring health education activities in the broad field of maternal and chIld health(family planning

7. Mini-workshop on methodology for:

7.1 System analYSis approaoh 7.2 Health education methods

8. Group work on priority subjects as perceived and agreed by partiCipants and preparation of group and/or country proposals

9. Plenary presentation and discussion of group/country reports and proposals

10. Preparation, presentation and discussion of general conclusions and recommendations 1..'1 plana...-j s~aslon

11. Adoption of provisional report and recommendations

12. Closing session

WHO EMRO

ANNEX III

PROyISIONAL PROGRAMME

EM;MCH/132 EM/HEP/48 Annex III page i

Site : Eastern Mediterranean Regional Office, Alexandria

1t()Nn\Y I 7 November 1977

OS.30 a.m. 09.30 a.m.

09.30 a.m. 10.30 a.m.

10·30 a.m. 11.00 a.m.

11.00 a.m. 12.30 p.m.

12.30 p.m. 12.45 p.m.

12.45 p.m. 02.00 p.m.

TUESDAY, 8 November 1m

09.00 a.m. - 11.00 a.m.

11.00 a.m. 11.30 A.m.

11.30 a.m. 01.30 p.m.

05.00 p.m. - 07.30 p.m,

WEDNESIYl.Y, 9 November 1'lf7

09.00 a.m. - 11.00 a.m.

11.00 a.m. 11.30 a.m.

11.30 a.m. 01.30 p.m.

Registration of participants

Opening of the Workshop

Inauguration by Dr M.D. Shoib, WHO Director, Health Services, on behalf of Dr A.H. Tabs, WHO Director, Eastern Mediterranean Region

IntrodUctory remarks by the Secretariat

Recess

Country-team presentatioas

Recess

Country-team presentations (cont1d)

Identification of key areas of uNeedsn requiring health education activities in the broad field of maternal and child health/family planning

Recess

Identification of key areas of uNeeds" requiring health education activities ln the broad field of Htiternal and child hea.lth/family plcuuur18 (oont1d)

Mini-workshop on methodology of systems analysis approach

Methodology of systems analysis approach (M1n1-workshop cont'd)

Recess

Methodology of health education (Mini-workshop cont'd)

EM/McH/l,2 EM/HEP/48 Annex III page li

THURSDAY, 10 November 1977

09.00 a.m. _ 11.00 a.m.

11.00 a.m, 11.30 a.m.

11 .. 30 a.m. 01.30 p.m.

05,00 p.m. - 07.30 p.m.

FRIDAY, 11 November 1977

09.00 a.m. - 11.00 a.m.

11,00 a.m. " "11'\ ... .... /V c<.lLJ.

11.30 a.m. 0)..30 p.m.

SATURDAY, 12 November 1977

09.00 a.m. • 12.00 noon

MONDAY, 14 November 1977

09.00 a.m. - 11.00 a.m.

11.00 a.m, - 11.30 a.m.

11.30 a.m. - 01.30 p.m.

TUESDAY, 15 November 1977

09.00 a,m, - 10.30 a.m.

10.30 a.m. - 11.00 a.m.

10.)0 a.m. - 11.00 a.m. Recess

WOO EMRO

Group work on priority areas of maternal and child health/family planning as perceived and agreed by participants f:Jr health edu,cation. and preparation of group and/or country proposals

Recess

AbQve group work by subjects (priority areas cont 'd)

Above group work by sUbjects or country groups (cont'd)

Group work on priority areas of maternal and child health/family planning as perceived and agreed by participants and preparation of group and/or country proposals (by country groups)

Reces.5

Above group work (by country groups) cont'd

Above group work (by country groups) cont'd

Plenary seSSion - presentat10n and discussion of group and/or country reports and proposals

Rece~~

Group and/or country proposals (cont'd)

Preparation of general oonolusions and recormnendations

Plenary session- presentation. discussion and adoption of general conclusions and reoommendations

Closing session

WHO EMRO

AFGl-V\.NISTAN

lJFM)CRATIC YEMEN

ANNEX IV

PRUVISIONAL LlS1' OF ?ARTICIPAN'}'S

Dr A oA 0 Oquab Director Family Health Division Basic Health Services Mln,Lstry of Puhll.c Health ~

Dr A.S 0 Ahmadi General Director Health Education Public Heal th Institute Kabul

Hr j,;.jVl o Nohmat General Director, EID Afghan ~arnily Guidance

Association Kabul

Dr A oM. AI-Shaiba Director Maternal and Child HEl!llth/Farnily

Planning Mini~try of Health Aden

Miss A.A. Abdul-Rub Instructor Tutor Midwifery Minl~try of Health Aden

Er'VMCH/l)2 EM/HEp/48 Annex IV Dllge i

EM/MCH/132 EH/HEP/48 Annex IV page 11

IRAN

JORI'\N

pAKISTAN

Dr A.A, Sa 1 errJ Director Maternal and Child Health

Departm~nt

tUnistry of Public Health Cairo

Miss N.A, El-Said Act.ing D1 'l'"e(lt.nr Nursing Schools ,section General Departmen l;. of Manpower

Training Ministry of Publ~c Health

~

Dr A. Matin Director General for Training

and Educatiun population and family Planning Ministry of Health and Welfare Teheran

Dr R. Mousavl General f'llanager for Heal th and

Welfare Regional Health and Welfare

Organization Ministry of Health and Welfare Ahwaz

Dr M.A. EI-H.31abi Directol' ~-1aternal ami Child Health

tJection Mini stry ot' Health Amman

Dr M.H. DaJanl Director Envlronmenta 1 Health Ministry of Health A_n

1>11' A.!:',. Chaudhry Heal th Education AJviser Health Division Ministry ot Heal th and ?opula tion

Planning T <;1 arne bad

WHO EMHO

WID EMRO

PAKISTAN (cont'd)

SUIlA_

SYlUA

Dr JI'l.M.R. Khan Senior Scientific Officer

(Clinical) Nutrition Division National Health Laboratories Islamabad

Dr M. Wazir Director (Technical) Popu1a~ion Planning Office Peshawa.r

Dr S.A. Ali Director Health Education Department Ministry of Health Khartoum

Dr A. El Tom Head Department of Community Medicine Faculty of Medicine University of Khartoum Khartoum

Mrs U .M. Abdel Regal Nursing Educator Khartoum Nursing College Khartoum

Dr A.D. Da::;ha:;;h Head Department ai' Comnunity Medicine Faculty of Medicine Univer:;;ity of Damascut, Damascus

Dr M.T. 3iibri Director Maternal and Child Health Ministry of Public Health Sana 'a

Mrs ~.A. Orner Senior Nurse Educator Health Manpower In3titute ~Jana I a

J<M;MCH/132 EI</HEp/48 Annex IV page iii

EM/MCH/l)2 EM/HEP/48 Annex IV page Iv

')1' ilI.O. Shoib

Dr .'lhuhbar Tiam:m

Dr G. ::1i11<8.

Dr S.A. Zarir

Dr n. Cook

Dr D. Ford

Dr B. Tomic

Mr T. Ghafoori

Dr N. Kamel

UNrrED NATlOOS CHIIDREN'S FUND

Dr J. sayegh

mrERNATIONI\.L PIANNED pARENT"How FFDE'RA,TION

Mr othman Kef!

Director, Health Services

."Ublic :'loalth A.dmj ni:""tratGr, Sommun::I ty Health

Public rIealth AJ,llinL3 tra tOl-', '-l:ea2. til Organtzation

Regional Ariviscr Dr: Family Health and secret,ary or tbe Workshop

Regional Adviser on 1,1a ternal and Child Hea1th and Nutrition

Wit) EMRO

"R.esic.nnl Off]"c {'elr 'v',EO fu::otc.r'r ~~cdi terrane; n, Al ('x"-n'lric~

Pr'i"io~'" r,ff;-cp fc-r t 1-e '::;;""J'rr. I':edl tcr;'£l.n'O'an, ;, :'02;,o.n 1r1a

degior-al Orflce ';:\w the E-,,-.:;terr. r>~editen~arlei'i.n, A' exan(jT12.

Regional Office for the Easterr Mediterranean, Alcxanurio.

Regional Office for the Eastern Mediterranean, Alexandria

Scientist, Educational Regional Offi~e for the F.a5ter~ Planning and Technolo~ r~editerranean. Alexandria

Consultant

Temporary Adviser

Temporary Adviser

RESOURCE O~~'ICIALS

Director, Institute for Health Education SRS, nelgrade, YUgoslavia

Director General of Health Education, Ministry of Health and Welfare, Teheran, Iran

Head, Department of Public Health, Faculty 01' ['Ijedicine, Alexandria University, Alexandria

Coordinator on Primary Heal t..~ C~r=

UNICEF Regional Office for the Eastern Mediterranean, Beirut, Lebanon

Regional Information Education Offioer

and IPPF Middle East and North Africa Regional Office, carthage, Tunisia

WHO EMRO

CONFERENCE SERVICES

Mrs C. cartoudiS-Demetrio Conference Officer

f1rs I. A ref secretary

EM/MCH/D2 EM/llEr/48 Annex IV pElge v

Regional Office for the Eastern Mediterranean~ Alexandria

Regional Office for the Eastern Mediterranean, Alexandria

woo liMRO

~LTH EDUCATION DJ FArULY :LE'J',L':'H IDENTIFICATION OF KEY AREAS

EM;MCH/lj2 EM/HEp/48 Annex V page i

.The ess.ential role of health educa.tion in effective health care for motherz, children, and the family has been affiI"lTled repeatedly. As early as 1952, a ~lHO expert group stated that the object of mat~~nity care in the wider Gense, begins much earlier in measures aimed to promote the healt:n and ,-rellbeing of the young people who are the potential parents. and to help them to develop the right approach to family life and to the place of the family in the community. It should also irH'_ludl;l e;uid8.nc€\. in p"'r""nt-craft B.nd in problems associated ,..,ith infertility and family planning.

Recently, attention has been pa.-ti to the health effects of a changing environment, particularly how the forces of urbanization are affecting family, family life, and family form. The concern for the health of the family unit is not limited to only the immediate health problems of the mothers and children, but extends to prevention of the problems before they occur, and if they are seen to be determined by the social and physical environment to take careful note of the offending factors in the environment and to endeavour to modify them in coordination with other than health sectors, if necessary.

It 1s obvious that the family and the society are interdependent. The social milieu and the environmental problems of a community tend to affect the general characteristics of the community members and may be reflectcd in certain identifiable areas that could be usefully focussed upon for health education.

One suggested sCheme to identify these areas is to cross-matCh the conventional Chronological phases of needs of families (especially mothers and Children) on one axis, with the conventional types of family-needs or problems faced by them e.g. growth and development, nutrition, diseases, family planning, utilization of available health resources and environmental sanitation. The two axes can be further divided and elaborated, as appropriate.

Such a scheme of tabulation, as described above, with the matrix of possible areas of family health problems left blank, is attached for your review, comparison with the previous a.d n££ listing of "key areas", and for according them a priority

." grading t.\.:lrough t.lte application of 3uit~blc criterill,

ENCL. : as mentioned above

,

A SUGGESTED MA.TRrX FOR SE[.ECTlliG KEY AREAS FOR HEALTH EDUCATION IN THE FJELD OF FAMILY HEALTH

I Utilizs. tion GraMtn and Nutrition Diseasea Fam1ly Develo~ent Plann1ng of ~erv1ces

Prewar1 ta.l Precgngentlgnal

, ,

Mother

Antenatal

Natal

postnatal

~

Infant I i ,

1 to< 3 I

3 to < 5

School Ghlldren

Adolesc'mts and Youth

I

I

&in1tation ,I

,

!

i

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'g 5' ~~ '" "ill o ro

" 0 f-'. >u ::I! ..... <:',' 0;(;;

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@

WHO NmO

ANNEX. VI

ICEY A_a (NEBDajPROBLE>lll) As Identified by the Group on 8 November 1977

1. Nutri tion

Breast-Peeding <If" ,1'"(;".,: 1" defined ~upplementary feeding Weaning prohlems and practices Peeding pregnant wanen Feeding la cta .. ing women Food hBbits of preschool children Food ha bits of family

2. Diseases

ImmunizatJ.Oll Tetanus Whooping cough B.C.G. Measles Polio ~mallpox Tetanus toxoid - pregnant women

Personal hygiene Home accidents Me. ternal depletion (aLSO lhted below) Parasitic Infestation

3. Family Planning Spacing (snort interval) Frequency of pregnancy (too many) Age (too early~ too late) Risk group scr@@nip~ Contraoeptives - education and follow-up Maternal depletion Sub-fertility Norms~ beliefs and values

4. Util1zatioo of 1"Iervices

Awareness A ccepta bili ty Acce.sslbil1 ty

>M;McH/132 E!lVHEP/48 ~~;XiVI

Proper-, under-Jover-utilizatioo in antenatal. natal and postnatal care Well baby clinic Jl'&mi.J.Y planning

EM/Mc1l/132 ui/HEP/48 Annex VI page ii

5. Environmental ~ani tatioo

potable water Waste disposal Housing Food san! ta tion -Vector control Pollution - normal ccmmun1 ty life and industrial

'o'i][Q EMflO

\lmRlC3HOP ON HEALTH ID)CAT'..cN ASPECTS OF FAMILY HFALTH

Ale~~ndr1a, 7 - 15 November 1977 ANNEX VII

DIVISION INTO SUB-GROUPS

I Group No. I Names of Participants I Resellr,e persons *

Croup I 1. Dr. A.A. Oquab .. Afgr..anistan ,Mr. T. Ghafoori 2. Dr. A.S. Ahmadi, Afghanistan Mr. O. Keri (1/2 time) 3. Mr. M.M. Noi1mH. Afghanistan 4. Dr. A. Matin, Iran 5. Dr. R. Mousavi • .::ran

Group II 1. Dr. A.M. Al-S,hai'be. Democratic Yemen Dr. N. Kamel 2. Miss A.A. Abd"Lll-Rub, Democrat:!..c Yernt:r 3. Dr. M.T. Sabri. Yemen 4. Mrs. 3.A. Omer~ Yemen 5. Mr. M.H. Dajani, Jordan

Gra.lp III 1. Dr. A.A. Sa1~n. Egypt Dr. :. Sayegh 2. Miss N.A. El-.3aid, Egypt Mr. O. Keri -;1/2 time) 3. Dr. S.A. Ali, Sudan Dr. R. Cook (part-time -4. Dr. A. El Tom. Sudan when available) 5. Mrs. U .M. Abde! Regal, Sudan

Group IV I. Dr. M.A. Halabi. Jordan Dr. B. Tornic 2. Mr. A.S, Chud:n-y, Pakistan Dr. R. Cook (part-time 3. Dr. M.M.R. Khan. Pakistan when available) 4. Dr. M. Wazir. Pakistan 5. Dr. A.D. Dashash. Syria I

*

"lain Subjects7K'ey Areas I for Programme proposals i

1. Utilization of I Health Services

2. Family Planning I 3. Safe J'>1idwHery i

,

1. Environmental Health 2. Maternal Care and

Family Planning

,

1. ImrnWlizable Child- I hood Disuases (EPI) I

2. Family Planning I ,

1. Nutrition 2. Other than Immunizable

Diseases of Children (Parasi tic Infestations) I

~nd of Mothers _ j

Dr. 3.A. 28fir and Dr. D. Ford (when available) will rotate among all four groups

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