Needs-based assessment
Health education is best implemented after the real needs of the community have been assessed and identified.
Before involving any individual or group within your community in health education activities you should try and discover the felt needs of the community. There is no use making an effort conducting health education on issues that are not relevant for your local community because your activities will be wasted.
Take a moment to think of a health education activity that would be wasted in your community if you have not found out about community needs.
Imagine you want to raise awareness on HIV/AIDS in your local secondary school; your health education session might be wasted unless you identify what it is that the students want to learn. Another example is that there is no need to tell a lay person about all the latest research on a particular health problem when they may only be interested in knowing simple facts about what the problem is and its solutions. In fact overloading them with facts and figures might actually put them off.
Health Education activities should start from a place people are starting from themselves. Activities should consider current cultural beliefs and norms and slowly build up talking points to avoid any direct clash of ideas. This will allow people to become understanding and lead to the appreciation and the ability to take on fresh ideas.
Imagine that in the area you work in you conducted a health assessment and found that female circumcision or female genital mutilation (FGM) is very common. You know that female circumcision is a harmful traditional practice and want to change this. To change people's perceptions and prevent this practice happening in the future is a complex issue — where do you start?
This is such a difficult and sensitive subject and should always be approached with great care. However, in general the Health Extension Practitioner should ideally try to understand the culture of the community and introduce novel ideas with a natural ease and caution. Using opposing statements that may be contrary to existing local beliefs, culture and practices of your community should be avoided. However such traditional harmful practices should be appropriately addressed (Figure 1.8).
FGM is very common and you will encounter it and it is a major topic in the Adolescent and Youth Reproductive Health Module.