A review of the health educational strategies for a sustainable guinea worm eradication programme in the Tolon-Kumbungu District of the Northern Region, Ghana

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At its 44th conference, the World Health Assembly endorsed a goal of eradicating dracunculiasis (Guinea Worm) by the end of 1995. The assembly recommended the establishment of National Guinea Worm Eradication Programme Offices in all endemic countries of which Ghana was one. In Ghana the burden of the disease was heavier in three regions Brong Ahafo, Northern and Volta Regions, with Northern Region reporting the highest number of cases. Tolon Kumbungu District has been recording the most cases since the eradication campaign started in 1989, probably because of its deprived and poverty stricken characteristics as the disease is associated with poor communities in rural areas without safe water supply and a high illiteracy rate. (The Carter Center 1998). Poverty and ignorance notwithstanding, former President Jimmy Carter stated that, other communities have eradicated the disease without digging a single borehole; all they did was to change their attitude and practices of handling water for domestic purposes. This is why the central theme of the Guinea Worm Eradication Programme (GWEP) is on Health Education for behavior change initiated by individuals and communities themselves with the technical message being formulated and disseminated through strategically chosen channels that target the most vulnerable population. This exploratory study, sourced both qualitative and quantitative data to examine the educational strategy and methodology of the GWEP in effecting the desired change in behavior that could lead to the eradications of the disease in Tolon Kumbungu, where it is expected that school children can have a continued stay of uninterrupted school years, farmers can stay on their fields all year round ,and general morbidity and incapacitation will be eliminated, only then that the people can live a dignified life free of poverty and disease Data was collected from 139 respondents comprising, community members, field officials of the GWEP, opinion leaders of communities and key informants from the Ghana Health Service, and those in management within the GWEP. The background information of the people revealed that they were predominantly illiterate whose main occupation is subsistence farming and the disease was most prevalent among people between the ages of 30-40 years. Generally, Knowledge about the disease and its mode of transmission is high. The findings revealed that majority of the people and community’s source of drinking water was dams which are on the average more than 5 kilometers away from the community it .The dams usually dry up during the long dry season period. Though the study showed that majority of people filtered their water before use ,it was observed that procedures for filtering water was not followed carefully, which revealed some socio cultural practices like religion, funerals, festivals and beliefs as the main contributors. Over 90% of respondents had the opinion that GWE campaign should continue, but it should be specific on GW eradication with the village volunteer spearheading the campaign in their various communities. This study concludes that the GWEP campaign of educating people to change their attitude is appropriate, but that the educational messages should be designed “in the community” by the community” instead of “for the community”. The channels of dissemination should be reviewed using a carefully planned mix of all channels to suit the individual or group audience because of the effect of Multi Flow Model. It also concludes that government should perform its social responsibility of providing safe water to all communities. The Ghana Health service should re train village volunteers, with emphasis on the meaning of volunteerism. It is recommended that the community should be involved in assessing its needs, planning and executing its education program and evaluating them. The study recommends that partners in the GWE effort should help communities to implement the Household Mutual Water Handling and Usage Project, to cultivate the communal approach towards water
A thesis presented to the School of Graduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi in partial fulfilment of the requirement for the award of a Master of Science degree in Health Education and Promotion, 2006