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Tina Tarazi1,Faiza Yasin1, Ben Many2, Julia Drubinskaya1, Foundation for International Medical Relief of Children1Department of Life Sciences, 2Department of Psychology , College of Liberal Arts & Sciences, University of Illinois at Urbana-Champaign

Health Education to Instigate Change in Health Behavior in Bududa, UgandaHealth Education to Instigate Change in Health Behavior in Bududa, Uganda

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Bududa district is located in eastern Uganda on the border of Uganda and Kenya. The district is currently served by one hospital and several smaller health centers. However, access to these facilities remains a challenge for many residents. In 2005, the Foundation for International Medical Relief

Objectives 1. Demonstrate the use of community health education as a tool for improving health knowledge and behaviors 2. Determine the strength of the FIMRC program in encouraging preventative health care 3. Establish that education motivates individuals to take responsibility for their health

Fieldwork

1. Health Education

Observed Outcomes

1. Health Education Outreach: CHE’s noted improvements in a. Sanitation b. Attitudes towards well-being c. Treatment-seeking behavior and preventative measures 

Clinic/ Pavilion: a. Provided a center to gather and socialize, creating a greater incentive for community members to consistently come to the clinic

Schools: a. FIMRC education provided in schools encouraged students to participate in FIMRC clinic activities. b. Students remembered previously taught FIMRC lessons, showing that the education was retained. c. Students were not only able to recall information, but also utilize it in a meaningful way.

 2. Clinical Services

3. Additional Outcomes a. The combination of local and international personnel was key to successful education. Local residents create community connections, while international volunteers create a sense of urgency, leading to a rooted and structured health program. b. CHE training instilled a sense of passion and empowerment in CHEs to fulfill their role as community educators. c. Community members who attended weekly seminars often wanted to volunteer as CHEs. d. Based on positive feedback from community members, the FIMRC clinic continues to gain popularity.

Eastern Region (%)1

Symptoms of acute respiratory infection at time of study (children under age of 5)

17.4

Up-to-date immunizations (children under 5) 48.6

Contraceptive use (modern method) 16.6

Access to improved water source 62.7

Topics Addressed

Family Planning HIV/AIDS Malaria Sexual Education De-worming Sanitation Dental Hygiene Immunization

Distribution Methods Outreach: CHE’s travel into the community to discuss these topics with about fifteen families per week. Unannounced home visits follow this initial visit every few months to evaluate progress and encourage locals to attend weekly health seminars at the FIMRC clinic. Clinic/Pavilion: The clinic hosts weekly health lessons for targeted groups, such as “Maternal to Infant Health,” “Young Boys/Young Girls Club,” and “HIV Post-Test Club.” Additionally, CHE’s educate patients while they await their appointments.  Schools: FIMRC volunteers, with the assistance of CHE’s, present lesson plans to children in local schools.  2. Clinical Services Onsite staff includes a nurse practitioner, physician assistant, lab technician, and rotating physician.

Capabilities include Malaria testing HIV testing Immunizations Birth control injections General checkups Drug distribution 

3. Experimental Community Health Insurance Program (CHIP): CHIP is a newly implemented study by FIMRC. This study is “designed to improve health knowledge, health behaviors, and ongoing preventative health care in the community”2 CHIP compares groups that receive health education and CHE contact with a control group.

Educators: Members of the Bududa community, called Community Health Educators (CHE’s), are professionally trained to discuss pertinent healthcare issues. The CHEs attend weekly training sessions to reinforce and expand their knowledge base. The delivery of their lessons is often accompanied by international FIMRC volunteers.

A CHE educating on progression of HIV to the HIV post-test club

At a follow-up visit, a HIV-positive women greeted us by enthusiastically saying, “I’m HIV and living pos-it-ive-ly!”, which she learned from CHE counseling.

Maternal to Infant Health club listening to a lesson

We observed that patients arrived at the clinic before emergency needs developed. This indicates that patients who receive education regarding treatment seeking behaviors appeared to utilize the clinic in a preventative manner.

Abstract Sustainability

Bududa, Uganda, illustrates the effects of basic medical education on a rural community. Its function as a case study demonstrates how health education is an empowering and sustainable tool for positive change in health behavior. The principal message of the Bududa-FIMRC partnership is that approaching serious health concerns with simple educational messages creates a lasting and significant impact.

A special thank you to Elena Phoutrides, Karine Nankam and the Beatrice Tierney Health Center in Bududa, Uganda. Thank you to everyone at FIMRC headquarters and the University of Illinois at Urbana-Champaign, especially Dr. Noreen Sugrue, and Dr. Laura Hastings.

Sources1. Uganda Bureau of Statistics (UBOS) and Macro International Inc. 2007. Uganda Demographic and Health Survey 2006. Calverton, Maryland, USA: UBOS and Macro International Inc.2. Nankam, Karine, and Phoutrides, Elena. Community Health Improvement Program. Diss. 2010. 3. "FIMRC." FIMRC: Foundation for International Medical Relief of Children. Web. 21 Feb. 2010. <http://fimrc.org/projects/project-bumwalukani-uganda>.

Conclusion

Acknowledgements

The FIMRC clinic is designed to integrate clinical and health education programs and encourage community members to be more proactive about their health.

Background

of Children (FIMRC) responded by establishing the Beatrice Tierney Clinic Health Center II in Bududa.  Many health indicators for eastern Uganda remain low compared to the national average. Table 11 summarizes several of these health indicators.

FIMRC staff and volunteers

•Financial Viabilitya. steady source of charitable donationsb. money donated to specific programsc. Strong network, recognizable brandd. University FIMRC chapters

•Transferabilitya. Bududa model can be transferred to different countries and across cultural boundaries

•Strong Partnershipsa. Bududa-FIMRC partnership

In 2005, the Foundation for International Medical Relief of Children (FIMRC) founded the Beatrice Tierney Clinic Health Center II in Bududa, Uganda. Healthcare in Bududa is often reactionary instead of preventative due to low levels of health education and misperceptions of health care. FIMRC uses health education and community action to positively change health behavior and knowledge at both the individual and family level. We found that treatment-seeking behaviors and health preventative measures increased as a result of outreach and education by empowering individuals to take responsibility and become more proactive in their health.