Participatory learning materials for health promotion in Ghana - A case study

This paper reports on operational research carried out by the Kumasi Health Education Project in Ghana to study the utilisation of participatory/empowerment learning methods for health promotion. The Project used community-based workshops to develop an extensive range of participatory materials on child health and followed these up with in-service training of 367 teachers and 157 public health workers (nurses and environmental health officers). A simple random sample of about half (262) of the participants was taken 6 months later and these personnel were asked to complete a self-reporting questionnaire to evaluate the format, content and usefulness of the materials. Results were compared with focus-group discussions with mothers attending well baby clinics, at home, in market-places and with pupils at school. The field agents reported a high degree of satisfaction with the training and claimed to be utilising the methods. However, this contrasted with the interviews with target groups who reported a low level of exposure to the materials. Those who had been exposed to materials reported a high level of satisfaction and recall of messages. Further focus-group discussions were carried out with field agents and their managers, and four sets of reasons for low utilisation emerged: the quality of participatory learning materials; personal attributes of the users and the impact of training; situational factors including the location and timing of educational sessions; and the support from peers/supervisors. The experiences in Kumasi are critically assessed and indicate that uptake of participatory/empowerment methods for health promotion depends on the quality of the materials and the selection, training and support provided to field staff.