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Effective Public Education
Session Guide
SESSION GUIDE
EFFECTIVE PUBLIC EDUCATION
Effective Public Education
SESSION GUIDE
PURPOSE AND CONTENT
While prescribers play an essential role in the choice of medicines, the role of the
consumer (the patient) is equally important. Public knowledge, attitudes, and
perceptions regarding the use of medicines influence the decision to seek health care,
from whom, and whether the proposed treatment is followed. In some countries, more
than 50 percent of medicines consumed (including prescription drugs) are bought over
the counter, often from unauthorized sources, and often in response to aggressive
commercial marketing.
This session will focus on the need for public education on the use of medicines, how to
develop and implement a relevant strategy, and discuss possible constraints. It will also
review some of the initiatives currently taking place in different parts of the world and
discuss principles of effective public education.
OBJECTIVES
This session will develop your ability to—
1. Understand the role of public knowledge, attitudes, and practice in the use of
medicines.
2. Identify major drug use 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 session on “Principles of Face-to-Face Persuasive Education.”
2. Read Chapter 33 of Managing Drug Supply 2nd edition.
FURTHER READING
A substantial list of further readings and resource materials can be found in Annex 1.
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SESSION NOTES
In emphasizing the prescriber's role in promoting rational drug use, it is easy to lose
track of the importance of the patient. To do so is a serious mistake. The knowledge,
attitudes, and education of the general public are crucial determinants in the decision to
seek health care, the choice of provider, the use of medicines, and the success of
treatment.
THE PATIENT'S ROLE
Patients are actively involved in the therapeutic encounter and in treatment. In the final
analysis, it is the patient who will decide whether to go ahead with a treatment or not.
Patients go through a series of five decisions before a treatment is self-chosen or
prescribed:
1. People who are ill have to believe that there is "something wrong" with their health.
This perception is to some extent culturally defined.
2. People have to decide whether this problem is significant enough to seek help, or if
the symptoms will go away without treatment.
3. Once they have decided that help is needed, people choose where to seek help.
They may go to a hospital, primary health care center, private physician, pharmacist,
market vendor, traditional healer, relative, or other member of the community. They
may decide—although this assessment may not be accurate—that the symptoms
are sufficiently minor or that they are familiar enough with the required treatment to
directly self-medicate with a modern pharmaceutical or a traditional remedy.
Figure 1. Community Drug Distribution Channels: An Example from the
Philippines
Town
Clinics 2%
Drugstore 35%
Hospital 1%
Neighborhood
Store 40%
Doctor 7%
MEDICINES
(n=1324)
Neighbors and
Relative 5%
Household Stocks
and Free Clinics 8%
Neighborhood
Source: Hardon 1991
Source: Hardon A. Confronting ill health: medicines, self-care the and poor in Manila, HAIN, Huezon City 1991.
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This figure is based on weekly interviews on health problems and treatment practices
during a five-month period with 126 families in two urban slums in Metro Manila. The
arrows illustrate the relative importance of the various routes that pharmaceuticals
follow before reaching users. In this example, health centers only account for a fraction
of drug supply. The majority of drugs are purchased in neighborhood stores and/or in
pharmacies, together accounting for around 80 percent of total drug purchases.
Think about the situation in your own country:
Where do sick people go for help?
Where do they obtain their medicines?
See the example from the Philippines (Figure 1).
4. Once they have a prescription, patients decide whether to buy the drugs or not;
whether they are going to buy all the items recommended in the prescription, or only
some of them; and which drugs to buy. In doing so, they decide what items are
important and worth buying.
5. Patients decide whether and when to take the medicines; whether to continue taking
them if side effects occur or if their symptoms disappear; and what to do with any
medicines that remain unused.
CONCEPTS OF DISEASE ETIOLOGY
If we ask a physician what causes a certain disease—diarrhea for example—the answer
could be "eating food contaminated with bacteria or virus which produces toxins that
lead to a disturbance in the electrolyte absorption at the small intestine." Yet, if we ask
an illiterate villager the same question, the answer could be: "Evil eye leads to
weakening resistance and enables spirits to hurt the patient."
Before any attempts are made to design a health education program, it is important to
understand the popular concepts of disease etiology in the community. For example, a
study in Jamaica revealed that most illnesses are believed to be caused by (1) "cold,"
(2) "gas" or "wind," (3) "heat," (4) "bile," (5) "blood imbalances," and (6) "germs."
Etiological explanations involving heat, cold, bile, and gas/wind are applied mainly to
symptoms in which there is a feeling of pain, heat, or chill, or where there is discharge.
Those involving imbalances of blood are applied to internal conditions and changes in
the skin; those involving germs are applied primarily, but not exclusively, to venereal
diseases.
In Java, as another example, many mothers perceive diarrhea as a normal
consequence of physiological growth of the child. This often lead them to underestimate
the condition before it becomes more serious.
What are some popular concepts of disease etiology in your country?
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CONCEPTS OF CURE
A commonly held belief is that "symptoms" are equal to "disease." Therefore, if there
are no symptoms, it is assumed that a person is well. When symptoms are present, they
are the disease itself. For example, a skin lesion, caused by diabetes, is considered the
disease itself. By this reasoning, diabetes is considered cured if the lesion goes away.
This may explain why it is sometimes difficult to convince diabetic or hypertensive
patients to continue taking their medicine even after the symptoms have disappeared.
CONCEPTS ABOUT THE THERAPEUTIC VALUE OF DRUGS
Some patients may value drugs according to—
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Mode of administration
Packaging
Rapid/slow action
Cost
Taste
Color
Source (prescriber)
Generally, a medicine that quells a symptom is considered "good," and one that does
not is considered ineffective. This may explain why some patients, and even physicians,
are reluctant to use ORS for childhood diarrhea; the symptoms do not immediately
disappear after its use. Often, patients demand or prescribers prescribe more drugs for
acute diarrhea, since ORS is not considered a drug (by not stopping the diarrhea).
EFFECT OF PROMOTION AND MARKETING ON DRUG USE
Drug promotion plays an increasingly important role in shaping utilization patterns. With
over 50 percent of all medicines bought directly by the consumer, direct promotion of
OTC drugs to the consumer is common in almost all countries of world. In a few
countries, such as the United States, direct advertising of prescription drugs is
permitted. In areas where legislative and regulatory control of pharmaceutical promotion
is weak (the case in most developing countries), uncontrolled advertising may be
misleading and can contribute to inappropriate drug use with major financial and public
health implications for the individual and the community. One study in Yogyakarta,
Indonesia, showed that most consumers do not know the active ingredient of the most
commonly used commercial products. They often relate the indication only with tradenames, due to misleading advertisements. This may lead to the use of different
commercial products with the same active compounds at the same time. Or, certain
products may be used for the wrong indication, e.g., paracetamol for symptoms of
weakness.
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Think about the methods of drug promotion that exist in your country:
 How accurate is the information presented?
 What are the most frequent types of drugs advertised?
 What is the effect on drug utilization?
See Annex 2 for some examples.
SOCIAL MARKETING
Traditionally, health education has been a low priority in national public health
strategies, sometimes seen as a soft subject without rigor of other more quantifiable
scientific disciplines. Another reason is probably the traditional medical model, which
holds the patient to be a passive recipient, rather than an equal partner in a health care
interaction. Until recently, health education (as traditionally practiced) has often suffered
from a lack of comprehensive planning. Health educators have too often pushed down
messages, in inappropriate language through weak communication channels, and failed
to reach or affect the target audience.
Health education materials often failed to take into account that all human behavior is
integrated into a cohesive cultural context. What may seem irrational in terms of
Western scientific understanding may often be perfectly rational in terms of an
individual's culture and framework of reality.
Starting in the 1970s, a number of developments broadened the view of how health
education could and should be practiced. In 1978 in Alma Ata, WHO initiated a
fundamental change in public health thinking, moving from an emphasis on disease
eradication to one stressing prevention and the needs of the rural poor and social
equity. This strategy centered on the core empowerment of the community through
education and participation in decision making.
Health educators and communicators began to look for workable and proven strategies
that would enable public health communication to take place within a comprehensive
and viable framework. One area was commercial marketing practice, since it was
obvious that such marketing must be successful in influencing behavior. Companies
would not spend billions of dollars a year in advertising and promotion if it were not
worthwhile. In the field of drugs, for example, promotional budgets can be as much as
20 percent of the turnover. This led to using the techniques of commercial marketing to
promote social ideals.
Social marketing models, first articulated by Philip Kotler and based on commercial
marketing practices, show that the consumer (target audience) should be the central
focus for planning and conducting a program. The program's components focus on what
are known as the 4 Ps:
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Price: what the consumer must give up in order to receive the program's
benefits. These costs may be intangible (e.g., changes in beliefs or habits) or
tangible (e.g., money, time, or travel)
Product: what the program is trying to change in the target audience
Promotion: how the exchange is communicated, (e.g., appeals used)
Place: what channels are used to reach the target audience (e.g., mass media,
community, interpersonal)
The formulation of price, product, promotion, and place have to be determined on the
basis of research with consumers to decide what benefits and "costs" they would
consider acceptable, and how they might be reached. Lessons learned from social
marketing stress the importance of understanding the target audience and designing
strategies based on their perceptions, wants, and needs.
However, it must be recognized that most social marketing campaigns, particularly
those sponsored by international development agencies, have as their start a given
product or behavior to be promoted. They then use research into local social norms
and culture to determine how best to “market” their “product,” which may be a
contraceptive or an immunization campaign, for example. For this reason, social
marketing is sometimes criticized as not being truly participatory.
Another psychosocial model developed to identify what people believe and why they
believe it is the Health Belief Model, which explains health behavior through
expectancies. Used as a tool for analyzing health-related behavior, its key variables are:
 Perceived susceptibility: individual’s or group's subjective perception of the
risk of contracting a health condition and susceptibility to illness in general
 Perceived severity: feelings about the seriousness of contracting an illness or
of leaving an illness untreated. It includes perception of the medical and clinical
consequences (death, disability, pain) and social consequences (effects on
work, family life, social relations).
The above two categories can be combined into a perceived threat.
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Perceived benefits: beliefs regarding the effectiveness of various actions in
reducing the disease threat or the perceived benefits of taking certain health
actions
Perceived barriers: potential negative aspects of a particular health action (the
perceived barriers) may act as impediments to undertaking the recommended
behavior. Individuals may unconsciously weigh an action's effectiveness against
perceptions of expense, danger, unpleasantness, inconvenience/disruption, or
time-consumption.
Self-efficacy: the conviction that one can successfully execute the behavior
required to produce the outcomes, often over a prolonged period.
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Reviews of this model in the last 10 years found that it is valid for explaining many
health behaviors. Perceived barriers were found to be the most powerful single predictor
of behavior, and perceived severity the least powerful predictor.
These and other behavioral theories are very helpful when developing communication
strategies. They have at their core the fact that behavior modification is based on a
complex web and analysis of personal and societal factors that must be investigated
and taken into account in the communication strategy. This process is very far removed
from the classical health educator's job: deciding on a slogan and commissioning a
graphic to be reproduced on 10,000 posters. It focuses on where the consumer is
coming from, not the educator.
GLOBAL PUBLIC EDUCATION INITIATIVES RELATED TO DRUG USE
Until recently, national health education focusing on the proper use of medicines was
rare in both developed and developing countries. A few consumer organizations have
conducted campaigns, usually against unethical marketing of individual drugs. However,
escalating cost of medicines, the wasted resources resulting from their misuse, the
increasing amounts of self-medication, and the influence of advertising has led to a new
focus on an informed consumer, particularly in countries with a diminishing budget for
public sector drug supply. This reality led to the development of national public
education strategies. Another factor has been the growing awareness that a
patient/prescriber encounter is an interactive process in which each can influence the
other. Some prescribers excuse bad prescribing practice by claiming that patients insist
on receiving a certain drug (e.g., an antibiotic) or mode of delivery (e.g., an injection)
and will go elsewhere if they do not get it.
Increasingly, consumer organizations are at the forefront of education activities and
campaigns. Members of the consumer network Health Action International, which
includes over 100 public interest nongovernmental organizations throughout the world,
have recently held campaigns targeting the removal of dangerous drugs from the
market, unethical promotional practices, the need for national drug policies, and
effective regulation.
Many ways or channels in the community can convey education and share information:
for instance, through women's organizations, social gatherings, religious
leaders/groups, at the outpatient unit or health care facility, and performances of drama,
or song. In Indonesia, a training module on over-the-counter (OTC) drugs has been field
tested and disseminated through community women's organizations with a self-active
learning process using drug package inserts. The activity is carried out in small groups
and has proved to be effective in improving the appropriate use of OTC medications.
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DEVELOPING A PUBLIC EDUCATION STRATEGY
Public education cannot compensate for poor products or inadequate health services or
staff. However, it can provide the consumer with a better understanding of the benefits
and the potential dangers of drug use, and safe sources of drug information and supply.
An informed and empowered consumer is able to act in his or her own and in the
community's best interests.
Changing people's behavior or habits is not an easy task and generally requires a longterm strategy based on the behavioral principles outlined earlier in the Health Beliefs
Model. A behavioral modification intervention has to be undertaken with knowledge of
the social and cultural context in which it is based.
Figure 2. Process of Effective Communication
Six Steps Toward Effective Communication
Step 1: Investigate
Step 2: Plan
Activities
Step 3: Develop
Materials
Step 6 : Evaluate and
Reassess Activities
Step 5: Implement
and Monitor Activities
Step 4 : Test and
Revise Materials
©1997 Kumarian Press excerpted from Managing Drug Supply, Management Sciences for Health and WHO
1997 Kumarian Press, excerpted from Managing Drug Supply, Management Sciences for Health and
WHO.
Effective communication involves a number of steps (see Figure 2). It is essentially a
process that continually evolves and is modified as monitoring takes place.
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Step One: Investigate
The investigatory stage is essential and at the core of the communication process. It
should address the following issues:
1. What is already known about the problem?
In the case of drug use, studies may already have been carried out (e.g., reports from
health workers, NGOs, prescribing data) indicating problems such as heavy commercial
marketing of irrational or dangerous drugs. Which related activities, such as EPI or ORS
campaigns, have taken place? What organizations (e.g., UNICEF, NGOs, national AIDS
programs) have undertaken public educational activities in health areas?
2. What new kinds of information are needed?
*
What are the characteristics of the target audience?
- Demographic characteristics
- Socioeconomic status
- Individual literacy and household literacy rates
- Language patterns
- Community decision and leadership process
- Sources of drugs
- Health services usage patterns
- Characteristics of prescribers and users: knowledge, attitude and
practices
*
What communication networks are there?
- What sources of information about drugs are most credible to the
target audience? To whom do they speak and listen? And for what
types of information?
- What channels of information reach users most effectively, including
mass media?
*
What development communication resources are there?
- Research
- Education/training
- Production and distribution of information
- Social mobilization
3. How should these data be generated?
A combination of qualitative and quantitative research methods can be used.
Quantitative methods, such as household surveys, provide useful information on
levels of knowledge and on the practice and beliefs prevalent in a given population.
They measure what is happening. These methods are most useful as pre- and postintervention evaluation tools.
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Qualitative methods, such as focus group discussions, and in-depth individual
interviews, yield substantial information about specific behaviors, as well as the reasons
and motivations underlying them. They measure how and why things are happening.
The focus group is a research method borrowed from commercial marketing. Focus
groups are very useful in opening people up to talk more freely, particularly about
sensitive subjects. They generate a lot of ideas and provide language to use in
communication materials.
Step Two: Plan Activities
The communication plan provides the road map for communication activities. When it is
first written, it is quite broad. Its primary purpose is to establish clear and feasible
objectives and outline how they are to be reached. However, the communication plan
should be adjusted or revised over time as more information on the audience is
obtained through research, pre-testing of communication materials, and monitoring.
A communication plan should include—
- Target audience
- List of behaviors to be adopted/changed
- Constraints
- Facilitating factors
- Communication objectives
- Approaches to change: power/sanctions, logic/facts, appeal/emotion,
- incentive/reward, facilitation/remove obstacles, fear or danger/emotion
- Communication channels to be used to deliver the messages
- Media mix: usually a combination of channels to maximize exchange,
audiovisual aids (posters, flyers, pamphlets, brochures), mass media (radio,
television, newspapers); and interpersonal (or face-to-face) contacts (wellinformed or trained agents at the community level, such as health workers,
school teachers, community leaders, shopkeepers, community organizations)
- Collaborating institutions: to enhance visibility, potentially increase impact,
and act as general advocacy for rational use concepts and the national drug
policy
- Monitoring and evaluation
The communication plan should include a timetable and a budget, plus the source of
financing. Overestimate, rather than underestimate, the time and costs required.
Approval of the plan will be needed, which may entail government ministries, such as
health, education or information; broadcasting authorities; and participating NGOs.
Getting the plan formally approved by key authorities helps elicit their commitment and
minimizes any possible confusion about objectives and implementation.
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Step Three: Develop Communication Materials
Formative research should provide the data needed to decide on approaches,
communication channels, and the messages to be conveyed. It should also provide
indications of the language and expressions to use.
Step Four: Test and Revise
The materials and products are tested on representatives of the target audience to
ensure that they are understandable, appropriate, and attractive.
Testing should answer the following questions:
- Does the target audience understand the materials?
- Do they feel that the materials apply to them or to other people?
- Is there anything offensive or culturally inappropriate?
- Based on responses from the audience do the messages or their format have
to be changed?
Pretesting the materials is essential and will often produce surprising results. A picture
may be completely misunderstood, particularly if it uses a stylized design convention in
a society relatively inexperienced in graphic images. For example, an ORS poster in
Honduras initially showed a sequence of four boxes with the correct sequence for
mixing. The sequential numbers included in each box were interpreted by the target
audience to mean that one cup of water was to be added to the packet, two corners torn
off, three packets emptied into the bottle, and the bottle shaken four times. See the
session on “Designing Effective Printed Materials” for more information on developing
and pretesting materials.
Step Five: Implementation and Monitoring
When implementing a public education campaign, all human and material resources
must be fully prepared. This may mean stockpiling posters, pamphlets, and video
materials; booking venues; and arranging for staff well in advance. Monitoring is
essential to ensure that all is going to plan, with no hold-ups or other problems.
In monitoring, you need to ask the following:
- Are the target audiences receiving and in contact with the program materials
and messages?
- Are they using the materials and learning from the program messages?
- Is the program on schedule? If not, why not?
- Will program delays have implications for other activities?
As the program progresses, you may need to modify the original plan on the basis of
monitoring indicators.
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Step Six: Evaluate and Revise
Evaluation:
- Were the program objectives met? Pre- and post-intervention quantitative
research will help measuring the impact.
Evaluation is also critical but often neglected. It is the only way to determine the impact
of your work and whether the approach has been effective. A recent public education
study by the WHO Action Programme on Essential Drugs found that evaluation was the
exception rather than the rule. Even where programmes reported doing evaluations,
they were rarely available in documented form.
Feedback:
-
Why did the program work or not?
Are there program changes or improvements that may increase its success?
Are there lessons to be learned that would help to make future programs
successful?
Fully document communication activities not only to facilitate proper monitoring and
evaluation, but also to ensure that people planning future communication programs can
learn from your experience. It is often very difficult in developing countries to find reports
of even large-scale communication activities. This leads to unnecessary "reinventing the
wheel" and waste of experience and resources.
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ACTIVITY ONE
Designing a Public Education Program
RATIONALE
This activity will help you to apply a systematic planning approach to designing a public
health education project aimed at tackling a drug use problem in your program.
Instructions
1. Divide into small groups.
2. Using the attached Worksheet 1, identify a common drug use problem in your
community; answer the questions included which will help you to develop a
strategy, test it for implementation, and evaluate its impact.
3. Work on the details of how you will deliver the message. For example, you
might choose one of the following interventions:
• patient education in hospital outpatient departments
• training of mother's groups
• community education via religious organizations
• mass media campaign
4. If time permits, work on aspects of pre-testing, financing, monitoring and
evaluation.
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ACTIVITY 1 WORKSHEET 1
Designing a Public Education Program
PROBLEM
1. State the drug use problem.
AUDIENCE
2. Who is the target population?
3. What additional information would you like to have about the target population?
4.
How will you obtain this information? (Briefly describe methodology and identify
institution/department that can undertake this work).
5.
What are the potential channels of communication? (e.g., TV, radio, women’s
groups, traditional theatre, printed materials)
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Which channels of communication would have the most impact and why? (e.g.,
cost-effective, appropriate, influential, media reach, etc.)
INTERVENTION
7.
What is the overall goal and what are specific objectives of the education
campaign? (If possible, place also within a broader national context, e.g.,
national drug policy.)
8. What constraints do you expect to face (put in order of importance)?
9. What facilitating factors do you count on (put in order of importance)?
10. What is the specific message that you would like to deliver to the public?
11. What methods are you going to use to deliver the message?
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12. How will you pretest materials and with whom?
13. What will be the timeframe for activities?
FINANCING
14.
Who will finance the activity? List potential sources of financing, such as
government, NGOs, or international organizations.
15. What potential collaborating partners exist?
Monitoring and evaluation
16. How are you going to monitor implementation and evaluate the impact of your
program?
17. How will you share information to build on what has been accomplished?
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ANNEX 1
Further Readings and Resource Materials
Planning information, education, and communication programs
US Department of Health and Human Services. Making Health Communication
Programs Work: A Planner's Guide, NH Publication No. 89-1493, Washington, 1989.
World Health Organization, Diarrhoeal Diseases Control Programme. Communication:
a Guide for Managers of National Diarrhoeal Disease Control Programs, Geneva, 1987.
World Health Organization. Guide to Planning Health Promotion for Aids Prevention
and Control, WHO Aids Series No.5, Geneva, 1989.
Zimmerman M., Newton N., Rumin L. and Wittet S. Developing Health and Family
Planning Print Materials for Low-Literate Audiences: a Guide. Program for Appropriate
Technology in Health, Washington, 1989.
Elkamel F. Developing Communication Strategies and Programs: a Systematic
Approach, UNICEF Mena Regional Office, 1986.
Rasmuson, M.R., Seidel, R.E., Smith, W.A., and Booth, E.KM. Communication for
Child Survival. HEALTHCOM. Project conducted by the Academy for Educational
Development for USAID, Washington, D.C, 1988.
Seidel R. Results and Realities: a Decade of Experience in Communication for Child
Survival. HEALTHCOM. Washington, D.C., 1992.
Molvaer, R.K. Education for Better Health: a Manual for Senior Health Educators.
Ministry of Health, Addis Ababa, 1989.
World Health Organization, Action Programme on Essential Drugs. Report of an
Informal Working Group on Educational Material for Patients. WHO/DAP, 1985.
Pan American Health Organization/WHO Regional Office for the Americas. Making
Health Communication Programs work in Latin America and the Caribbean: a Manual
for Action, Washington D.C.m 1991.
Hodgkin C and Hardon A. Towards Rational Drug Use in Southern and Eastern Africa:
Proceedings of Harare Seminar 1991. Health Action International, Amsterdam, 1992.
World Health Organization. Education for Health: a Manual on Health Education in
Primary Health Care.
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Green, L.W., Kreutscer M.W., Deeds S.G. et al. Health Education Planning: A
Diagnostic Approach. Mayfield Publishing Co., Palo Alto, 1980.
Kotler, P. and Andreason A.R. Strategic Marketing for Nonprofit Organizations: 3 ed.
Prentice-Hall, Englewood Cliffs, 1987.
Rogers E.M. Diffusion of Innovations, Free Press, New York, 1983.
Suryawati S. Practical Guideline: Improving the Knowledge and Skills in Selecting
Medicine Using CBIA Method. An intervention educational module for improving the
quality of self-medication. Department of Clinical Pharmacology, Faculty of Medicine
Gadjah Mada University, Yogyakarta, 1993.
IEC research methodology
World Health Organization, Action Programme on Essential Drugs. How to investigate
Drug Use in Communities, WHO/DAP/92.3, 1992.
Debus M. Handbook for Excellence in Focus Group Research. Academy for
Educational Development, Washington D.C., 1990.
Krueger, R.A. Focus Groups: A Practical Guide for Applied Research. Sage
Publications, Newbury Park, 1988.
Drug promotion and marketing
World Health Organization. Ethical Criteria for Drug Marketing and Promotion, Geneva,
1988.\
Health Action International. Promoting Health or Pushing Drugs? HAI, Amsterdam,
1992.
Chetley, A. and Gilbert D. Problem Drugs. Health Action International, Amsterdam,
1986.
Silverman M., Lee P.R. and Lydecker M. Prescriptions for Death: the Drugging of the
Third World. University of California Press, Berkeley, 1982.
Silverman KM., Lydecker M., and Lee P.R. Bad Medicine: The Prescription Drug
Industry in the Third World, Stanford University Press, Stanford, 1992.
Gupta A.S. (ed.). Drug Industry and the Indian People. Delhi Science Forum and
Federation of Medical Representatives Association of India, 1986.
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Studies of community knowledge, attitude, and practice regarding the use of
medicine
Hardon A. Confronting Ill-health: Medicines, Self-care and the Poor in Manila, HAIN,
Quezon City, 1991.
Tamang, A.K., and Dixit, S.B. Knowledge Attitude and Practice towards Health and
Essential Drugs in Rural Nepal, Bamako Initiative Technical Report Series No. 10,
UNICEF, New York, 1992.
van der Geest S. Self-care and the informal Sale of Drugs in South Cameroon.
Soc.Sci.Med. Vol.25, No.3, pp.293-305, 1987.
van der Geest S., Hardon A., Whyte, S.R. Planning for essential drugs: are we missing
the cultural dimension? Health Policy and Planning: 5(2): 182-185.
Abosede, O.A. Self-medication: an important Aspect of Primary Health Care,
Soc.Sci.Med.Vol.19, No.7, pp.699-703, 1984.
Robert C.F., Bouvier S. and Rougemont A. Epidemiology, Anthropology and Health
Education. World Health Forum, Vol.10, pp.355-64, 1989.
Donovan J. L. and Blake D.R. Patient Non-compliance: Deviance or Reasoned
Decision-making? Soc.Sci.Med. Vol.34, No.5, pp.507-513, 1992.
Sachs L. and Tomson G. Medicines and Culture - a double Perspective on Drug
Utilization in a Developing Country. Soc.Sci.Med.Vol.34 no.3, pp.307-315, 1992.
Wolf-Gould C.S., Taylor N., McCue Horwotz S. and Barry M. Misinformation about
Medications in Rural Ghana. Soc.Sci.Med.Vol.33 No.l, pp.83-89 1991.
Newsletters reporting on development communication activities
Development Communication Report, a quarterly newsletter available free of charge to
readers in developing countries: Clearinghouse on Development Communication, 1815
North Fort Myer Drive, Suite 600, Arlington, VA 220 : reports on IEC activities in all
fields of development communication
Essential Drugs Monitor, newsletter of the World Health Organization Action
Programme on Essential Drugs, published three times per year in English, French and
Spanish, free of charge to readers. The Monitor regularly includes reports on research
activities and public education campaigns related to the use of medicines.
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SESSION GUIDE
EFFECTIVE PUBLIC EDUCATION
Internet resources
http://www.who.int/dap-icium/posters/3B2_TXTF.html
http://www.who.int/dap-icium/posters/3B1_TXTF.html
http://www.who.int/dap-icium/posters/3B3_TXTF.html
http://www.who.int/dap-icium/posters/3C4_TXTF.html
http://www.who.int/dap-icium/posters/3F3_TXTF.html
http://www.who.int/dap-icium/posters/3A2_TEXT.html
http://www.who.ch/programes/dap/edm/edm18a.html
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SESSION GUIDE
EFFECTIVE PUBLIC EDUCATION
ANNEX 2
Public Education Campaigns on Drug Use
Australia
Public education work has centered around the role of the community pharmacist as a
reliable source of information about medicines; on the need for adequate
communication between the health professional and the client about prescribed
medicines; and about polypharmacy of the elderly and actions that older citizens can
take to monitor drug use. A school education pack has also been developed and widely
disseminated. Materials include videos, TV spots, and educational leaflets and posters.
Philippines
An active public information campaign has explained the rationale of the National Drugs
Policy through a widely distributed booklet, t-shirts, TV spots, and posters. The
campaign has also highlighted consumer rights, showing what should appear on a
properly written prescription, explaining the difference between a generic and a brand
name drug, and promoting the individual’s right to purchase a cheaper equivalent
product.
Malawi
After initial community research, the Government has adopted a comprehensive
strategy of public education on the rational use of drugs within the context of the
national drugs policy and essential drugs programme. This encompasses education for
primary school children in medicine use and the use of a variety of media such as
traditional theater, the literacy programme, the mass media, and graphic materials to
disseminate rational use messages. The campaign will also use interpersonal
communication through educational sessions on drug use in health centers and training
in communication techniques between prescriber/dispenser and patient, explaining both
responsibilities and rights to information.
Myanmar
After conducting formative research, the Myanmar Essential Drugs Programme is
implementing a public information campaign on the programme and the proper use of
medicines, using the mass media and printed materials.
Bolivia
Education activities have included an illustrated brochure explaining the essential drugs
concept and its contribution to health, safety, and saving costs for the community,
backed up by posters on the same theme and the broadcasting of more than 50 short
radio programs discussing various aspects of drug use and treatment of common
ailments.
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SESSION GUIDE
EFFECTIVE PUBLIC EDUCATION
United States
A campaign that has been conducted over more than a decade by the National Council
on Patient Education includes radio spots, resource packs for health professionals,
companies, community groups, and individuals. Each year activities are intensified in a
monthly campaign for which additional materials are produced on various
problems/solutions related to the use of medicines. The leitmotif of the campaign has
been the need for good communication between prescriber and patient, with materials
targeted to both groups. In 1989 the campaign focused on the special drug use
problems of the elderly.
France
An ongoing campaign urges French consumers not to “take drugs lightly” and includes
TV spots, posters, leaflets for pharmacies, and press articles.
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