Trachoma and health education in primary schools in Tanzania: a pointer to community action

Abstract

Purpose -The primary aim of the work reported here is to determine whether a low cost teaching approach which had been successfully used in one region of Tanzania (Tanga) could be introduced to other teachers in a different region by teachers, rather than outside experts. A second aim is to determine whether changes occurred in children's knowledge and behaviour and a third aim is to determine if the work was sustained. Design/methodology/approach -The study was carried out in ten randomly selected schools in the Dodoma region, where there is a high prevalence rate of trachoma, with the teachers being taught active methods by colleagues from Tanga. Local staff from Helen Keller International had an input in teaching about trachoma itself. Data in the form of environmental, educational and clinical observations and were collected at the beginning, the end and during the programme and information on children's knowledge was obtained at the beginning and the end. Findings -The results were encouraging in showing that teachers were effective in passing on their skills to other teachers, who in turn were enthusiastic in putting their new knowledge into practice. Equally encouraging was the way in which children's behaviour changed as well as their knowledge. A follow up four years later showed that the work has continued in all ten schools and has and spread to 27 others. Teaching on trachoma will be included in the new national curriculum for primary schools. Originality/value -It is suggested that teachers should be considered as a significant part of any community based trachoma programme.

Children as messengers of health knowledge? Impact of health promotion and water infrastructure in schools on facial cleanliness and trachoma in the community

“…Specific active teaching methods recommended by ITI include coming up with short and simple mottos, incorporating health education messages into popular tunes and songs, organizing story-writing competitions with a prize for the best story containing correct health messages, having discussions to reinforce correct health messages, and study tours around village markets to identify health risks and mitigating measures. Many of these active teaching methods have been taken up by health promotion programs in schools [20,22,30], although the effectiveness of these approaches in changing long-standing practices in the community and in eliminating trachoma has not been confirmed. In our survey, we did not probe the teachers about how the gourds were used exactly, or if other active teaching methods were employed.…”

“…Therefore, health messages communicated in a school environment have the potential to reach school-aged children in most households from diverse socio-economic backgrounds. Several studies have found that primary school students showed improved trachoma-related knowledge and face-washing behavior after the implementation of health teaching in schools [19][20][21]. In one study, the prevalence of clean faces increased among students after a school-based trachoma curriculum [19].…”

Milestones in the fight to eliminate trachoma

“…By adopting the SAFE strategy, WHO made clear that a medical model of surgery and antibiotics would be insufficient to eliminate trachoma; countries would need to provide evidence that water and sanitation programmes were underway, including efforts at behaviour change. School health programmes began to include improving facial cleanliness, as well as hand washing, as part of their curricula . Country trachoma programmes were urged to include the water and sanitation sector in their plans for the district.…”

“…School health programmes began to include improving facial cleanliness, as well as hand washing, as part of their curricula. [38][39][40] Country trachoma programmes were urged to include the water and sanitation sector in their plans for the district.…”

Using Photovoice as a Community Based Participatory Research Tool for Changing Water, Sanitation, and Hygiene Behaviours in Usoma, Kenya

“…Thus, the provision and promotion of low cost WASH technologies—at the individual, household, and community levels—are regarded as a key strategy for reducing water-borne and water-related diseases in resource poor settings, particularly in low and middle income countries [ 7 ]. Examples of such interventions that have been found to have an impact on water-borne and water-related diseases include hand washing with soap [ 8 , 9 ], integrated water supply and sanitation [ 10 ], household and village level treatment, water storage and hygiene education [ 11 – 13 ], and face washing [ 14 – 16 ]. In addition, it is well recognised that, for “hardware” interventions to have significant impacts on population health and contribute to global health, technologies need to be complemented by “software interventions” such as sustainable behaviour changes over time [ 7 ].…”