Hi Rishi

Really exciting to read about your program from my office in Melbourne
Australia!
I have no hands on personal experience with the sort of project you are
talking about however several ideas come to mind. Peer education has been a
popular and successful model used in health education of young people and
ethnic women in Australia.
This would require you to select several enthusiastic leader types from the
communities in question and then train and resource them to spread the
message in their communities. Picture books or posters have worked well
especially if they have been developed by people who understand the social
and psychological barriers to complying with the treatment. These
suggestions may sound naive. I just want to encourage you in your efforts as
much as your email encouraged me this morning!


Cheers

Sharyn Young
Working Systems Solutions Pty Ltd
Level 2, 313 Burwood Road
Hawthorn 3122
Victoria, Australia
-----Original Message-----
From: Health Promotion on the Internet [mailto:[log in to unmask]]On
Behalf Of Rishi Ram Parajuli
Sent: Thursday, 13 September 2001 3:35 PM
To: [log in to unmask]
Subject: Motivation for patient education


This is my first time in the [log in to unmask] I am working in the National
TB control programme of Nepal for last 6 years. Nepal has achieved very
encouraging result in this programme after implementation of  DOTS (Directly
Observed Treatment, Shortcourse) strategy from  1996. We provide treatment
from primary health care facilities of government health care system, NGO
and private practitioners as well. Our national cure rate is gradually
increasing every year and is around 85%. This 85% is the national target as
well. However,  we have high rate of defaulters and have not very effective
defaulter tracing system. We know that the high number of defaulters could
be prevented by an effective health education  to the patients at the
beginign of treatment because TB needs to 8 months long treatment in our
country. We realise that patient education that is being provided  by the
health workers is not found effective and adequate enough to make the
patients to complete their treatment. The health workers usually complain
that they do not have enough time to teach the patients due to limited
number of staff  and high nunber of patients in  some of these facilities.
But we think this is not only the reason for poor or ineffective patient
education. It is found that  most of the health workers are not patience to
teach patients who are illiterate villagers.   My question to you who are
involved in the TB programmes is that, how can we encourage those health
workers to teach their patients an effective way so as to reduce the
defaulters to make the programme success.What makes the health workers
motivate for  quality health education? Could  you please give me some
examples and success stories about this issue so that we could practice
those tips in our country?

Rishi Ram Parajuli
National TB Center
Thimi, Bhaktapur
Nepal