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Trainer's Guide
Effective Public Education
EFFECTIVE PUBLIC EDUCATON
TRAINER'S GUIDE
TRAINER'S GUIDE
Effective Public Education
OBJECTIVES
1. Understand the role of public knowledge, attitudes and practice
in the use of medicines
2. Identify the major drug utilization problems in your community
3. Identify the components of a comprehensive public education
program for rational drug use
4. Identify the various channels that exist in the community to
convey consumer education
PREPARATION
1. Study the module Principles of Face to Face Education.
Read Chapter 33 of Managing Drug Supply 2nd edition
VISUAL AIDS LISTING
1. Title Slide
2. Objectives
3. Patient's Role
4. Patient's Role
5. Where do Patients get Medicines
6. Concept of Disease Etiology
7. Concept of Cure
8. Concept about Drugs
9. Effect of Promotion and Marketing on Use of Drugs
10. Social Marketing Component 4P's
11. Health Belief Model
12. Global Public Education Initiatives on Drug Use
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TRAINER'S GUIDE
13. Developing a Public Education Strategy
14. Six Steps toward Effective Communication
15. Developing a Public Education Strategy
16. Developing a Public Education Strategy
17. Developing a Public Education Strategy: Develop
Communication Materials
18. Developing a Public Education Strategy: Test and Revise
Materials
19. Developing a Public Education Strategy: Implementation
20. Developing a Public Education Strategy: Monitor, Evaluate and
Revise
21. Activity 1
ORGANIZATION AND KEY POINTS OF SESSION
First Component: Why public education in RUD is needed
VA l to 8
Time 70 minutes

Briefly review the objectives.
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Visual aids are available for the discussion of patients’ role, through to concepts
about drugs. If you want to make the session very interactive - which is best don’t use these visual aids at the beginning of the discussion because they will preempt active participation from the group. It is better to keep them as a back up or to
show for a brief review at the end of each discussion.

Point out that health professionals tend to consider themselves at the prime force of
decision-making about illness and treatment; in fact it is not the health
professionals which take the key decisions it is the community itself as this session
will show. The community will sometimes, but not always, choose to share this
decision-making process with health professionals.
1.
THE PATIENT’S ROLE
Highlight that in both developed and developing countries patients choose to use a
variety of health providers. Patients go through a series of decisions before a
treatment is chosen.
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The first decision is whether they are ill or not, Explain that this is not a foolish
question because illness is partly culturally defined. Ask the group for examples.
Second people decide whether they need help and third where to turn for help.
Ask the group where people go for help in their own country. Then ask where
people obtain medicines. Discuss the VA from the Philippines “Where do people
get medicines” and point out that this study was undertaken by Anita Hardon in
Manila over one year and highlights the many different sources of drugs
Ask what decisions people may make when they take their prescription to the
pharmacy. Highlight that many prescriptions contain four or five drugs. Patients
may not be able to afford them all and may not know which to choose.
Discuss patient adherence to treatment, which is the fifth decision. Research
shows that 50% of patients do not take drugs as prescribed.
2. CONCEPTS OF DISEASE ETIOLOGY AND CURE
When discussing concepts of disease aetiology elicit suggestions from participants
about cultural beliefs in their own society which don’t match the biomedical model,
such as cancer being contagious or spirits being responsible for disease.
Recognise that concepts of cure also vary greatly in different settings.
3. CONCEPTS OF THE THERAPEUTIC VALUE OF DRUGS
Elicit and discuss some of the common problems and highlight their public health
and economic implications.
4. DRUG PROMOTION
Ask what problems – if any – exist in participants’ countries. Usually many hands
will go up here.
When discussing the effect of promotion and marketing draw on some of the
reported work that shows unethical promotion to be common in developed and
developing countries, particularly the latter. A resolution of the 1999 World
Health Assembly (Revised Drug Strategy WHA5219) had drawn attention to the
problem as had two WHO recent roundtables, one on the WHO Ethical Criteria for
Medicinal Drug Promotion, the other on collaboration with public interest nongovernmental organizations.
Point out that everyone has a role to play in combating unethical promotion and
promoting access to independent drug information. Ask participants for ideas of
what they could do. Discuss some of the approaches currently being used:


educational modules for medical students to evaluate promotional materials
(including videos)
consumer group campaigns
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TRAINER'S GUIDE
monitoring of drug advertising by professional groups, such as MaLAM
monitoring the claims of drug representatives, such as the monitoring
network set up by La Revue Prescrire in France
promoting awareness and use of the WHO Ethical Criteria for Medicinal Drug
Promotion
Second component: Approaches to public education
VA 9-11
15 minutes

Lead into a discussion about the need for consumer education. Begin by
reviewing the history of health education, starting from the authoritarian approach of
telling people what programme managers and policy makers think they need to
know. This approach was unsuccessful. The 4PSs approach comes from
commercial marketing sources not from health educators.

When discussing the health belief model stress that the different component neded
to be present and that this makes change difficult. Point out that of the five factors
that of “perceived barriers” is the most important in determining behaviour and that
severity is the least important. The implication of these findings is that when
planning a health education campaign it is crucial to identify possible barriers.

When discussing public education initiatives ask participants to describe what
different experiences they have had. Point out that changing awareness,
knowledge and practice may have to be phased and that behavior change is the
most difficult. The global experience includes discussions of Australia (peer drug
educators for the elderly), Bolivia (community networks) and the Philippines
(posters related to the generics drug law).
Third Component
VA 12-29 Time 20 to 30 minutes

Start by reviewing the different steps on VA 13. When discussing preliminary
research emphasize the importance of using qualitative methods. When discussing
the plan, give examples for each component describing the different words e.g.
facilitating factors, communication channels, media mix. Explain the more focused
the campaign (target audience and behavior change) the more likelihood of
success. Point out the importance of making a realistic timetable. Things usually
take longer than you think. Repeat the message of the printed materials session
that all materials and campaigns should be pilot tested and that printed materials
alone are unlikely to change behaviour although they may increase awareness.
Warn the artist and fellow workers to expect modifications. Then discuss the
importance of monitoring when implementing the work to avoid any nasty surprises.
Conclude by emphasizing the importance of evaluation.
Fourth component
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ACTIVITY ONE - DESIGNING A PUBLIC EDUCATION PROGRAM
45 minutes for discussion. 30 minutes for presentations

For this session circulate around the groups keeping them on track and giving
warnings on the time available. Encourage them to focus on a very clearly defined
target audience and problem. Help them to be realistic about what can be achieved
within modest budgets.

Ask the groups to summarise their key elements rather than reporting every aspect
of the worksheet
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