Author: Centre for Health Education, Ministry of Health (Vietnam)
According to the National Survey Data in 1995, trachoma has reduced in general but it remains high in northern provinces and mountainous areas. 8.5 - 17% of school children are suffering active trachoma there. 13 UNICEF targeted districts in 8 provinces (namely Thanh Hoa, Hai Duong, Vinh Phuc, Ha Nam, Thai Binh, Ninh Thuan, Yen Bai, and Binh Phuoc) are among the epidemic areas (data by National Institute of Ophthalmology in 1999). A comprehensive, specific and timely measure should be taken to address the issue. Such communication interventions as providing and improving people's knowledge and attitude, instructing people to have good practices based on their potentials and available conditions, are considered to be positive solutions for trachoma that will bring longterm and sustainable efficiency.
Purpose / Objective
To set a firm foundation for effective health education and communication interventions and to be able to assess the trachoma prevention project efficiency after the interventions, the Centre for Health Education-MoH (CHE), with UNICEF support and collaboration with the district health centres of 13 UNICEF targeted districts, conducted a baseline survey of knowledge, attitude and practice of mothers having children under 15 in preventing trachoma.
The survey's objectives are to:
Assess knowledge, attitude and practice of mothers with children under 15 on trachoma prevention
Identify main causes, barriers and favourable conditions for mothers in taking behaviour of trachoma prevention
Interviews of mothers with children under 15 years old were conducted. The survey was taken in 13 UNICEF targeted districts in eight provinces: Thanh Hoa, Hai Duong, Ha Nam, Vinh Phuc, Thai Binh, Yen Bai, Ninh Thuan, and Binh Phuoc. In each district, three communes were selected, with 40 mothers interviewed from each commune. A total of 1,560 mothers were surveyed.
This survey used the questionnaire developed and field tested by the Health Education Centre in consultation with the National Institute of Ophthalmology. Interviewers were the staff of district health centres who were trained before the survey.
Key Findings and Conclusions
1. It was found that of the 74.7% of mothers who had heard about trachoma, 64% were able to mention trachoma symptoms. Most of the mothers (85.6%) knew that trachoma is contagious. Over half of mothers interviewed (54%) were able to identify the main causes of trachoma. Observation showed that only 11.9% and 64.4% of families owned a personal basin and towel respectively for face washing. It is also reported that 54% of mothers interviewed washed their face three times a day. 94% of interviewed mothers reported that they did remind their children to wash their hands. Quite a few families had the habit of sharing a pillow. Mothers' knowledge about symptoms, causes, bad effects and prevention of trachoma is poor, especially in southern districts. This knowledge is correlated with mothers' education and occupation.
It was reported that 52.2% of the families use water from hand-dug wells, 22.5% from rainwater, and 12.2% from drilled wells. Flies, the most important transmission agent of the disease, were found in 63.1% and 74.9% homes inside and outside, respectively. 20% of the families did not have a latrine. Of those having one, 45.4% were not found in good sanitary conditions. Observation among children under five showed that 18% of them looked unclean.
2. Mothers reported that they did not use private basins and face towels as they did not have the habit 50% and they did not find it necessary 25%. Financial problems were named 21.4% of the time. Mothers still do not know the benefits of using private pillows to prevent trachoma.
The major source of information on trachoma for mothers was health workers at 36% followed by Women's Union staff at 35%. Mass media was also an important source and the interviewees preferred this source. TV was found in 65.2% of the families surveyed and radio cassettes in 36.8%.
A baseline survey is needed to evaluate trachoma prevalence and classify the disease by screening. Then, a comprehensive picture of the disease can be drawn as the basis to assess project effectiveness later.
Additional education is clearly necessary. To be more effective, interventions in two environments should be taken at the same time: i) the schools and ii) through families with children under 15. Materials should be developed for the following groups: school children, community communicators, mothers, and general audience. Target audiences should also be reached through mass media such as loudspeaker, TV, radio and cassette tapes.
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