Shadow Puppets and Neglected Diseases (2): A Qualitative Evaluation of a Health Promotion Performance in Rural Indonesia

Abstract

Performing arts used as a method of spreading health information dates back to the origins of storytelling. However, interventions in developing, non-Western countries typically utilize Western entertainment forms. This qualitative investigation assesses responses to an intervention designed around traditional Javanese shadow puppetry (wayang kulit). Semi-structured interviews provided in-depth responses from a sample (N = 12) of villagers. Responses analyzed both cross-case and within-case, focused on perceptions of the music and storyline, responses to the intervention, and the perceived appropriateness of wayang kulit for disseminating a health message. Wayang kulit was considered to be interesting and easy to remember, but concerns remained regarding the reliability of information provided through the drama. The fusion of traditional and modern music and story elements were perceived positively. Some participants were inspired to improve their hygiene practices, although the lack of motivation, or belief that they were unable to change was noted. The performance was generally received positively in terms of the nature of the intervention, the fusion of traditional and Western music and story elements, as well as the use of wayang kulit to spread health information. The study provides guidance for modifications to the production, prior to scaling up.

The Contribution of Community Health Education to Sustainable Control of the Neglected Zoonotic Diseases

“…It has been used to convey educational messages using the characters and storylines of the traditional shadow puppets, but in Rama and the Worm the researchers modified it to create a new narrative that still uses the familiar characters but puts them in a new situation that pertains to the education objective for the project. It was also shortened to 30 min in comparison to several hours to keep viewers engaged, although this was mentioned by at least one member in the focus group that the film was too short and should be at least 1 h long (48). Another significant change to the traditional show is the inclusion of Western instruments, combined with the traditional gamelan instrument to create a rock fusion soundtrack (47)(48)(49).…”

“…It was also shortened to 30 min in comparison to several hours to keep viewers engaged, although this was mentioned by at least one member in the focus group that the film was too short and should be at least 1 h long (48). Another significant change to the traditional show is the inclusion of Western instruments, combined with the traditional gamelan instrument to create a rock fusion soundtrack (47)(48)(49). In focus group discussions after the viewing, there were comments that it would benefit some villages, but was unnecessary for their own village citing that open defecation was not an issue in their community (48).…”

“…Another significant change to the traditional show is the inclusion of Western instruments, combined with the traditional gamelan instrument to create a rock fusion soundtrack (47)(48)(49). In focus group discussions after the viewing, there were comments that it would benefit some villages, but was unnecessary for their own village citing that open defecation was not an issue in their community (48). Focus group members stated that the performance could be improved with the addition of a presentation by a health professional and materials, or a health message to be shown before the film (48).…”

“…In focus group discussions after the viewing, there were comments that it would benefit some villages, but was unnecessary for their own village citing that open defecation was not an issue in their community ( 48 ). Focus group members stated that the performance could be improved with the addition of a presentation by a health professional and materials, or a health message to be shown before the film ( 48 ). More than half of the people surveyed in the area lived in a house that did not have a latrine with a majority of those surveyed responding that they relied on public latrines.…”

Model validation for a knowledge and practices survey towards prevention of soil-transmitted helminth infections in rural villages in Indonesia

“…Health promotion and health education focusing on STH have been found to be cost-effective and affordable measures for disadvantaged communities, in combination with other intervention strategies. Health education programs can be designed to reduce contamination of soil and to promote the use of latrines and individual hygienic behaviour, thereby helping to prevent transmission and re-infection by STH 11 – 14 .…”