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Evaluation report

2010 Caribbean Area Office: Assessment of Use of H1N1 materials in Dominica & St. Lucia



Author: Corin Bailey (PhD.); Sir Arthur Lewis Institute of Social & Economic Studies, Cave Hill Campus, Barbados; Ministries of Health in Dominica & St. Lucia

Executive summary

 

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Background:
Many countries in the Caribbean had been working towards improving their capacity to respond to pandemic influenza and had developed National Influenza Pandemic Plans (PAHO/CIDA/USAID, 2009)3. The outbreak of H1N1 presented a challenge and UNICEF, Eastern Caribbean Office developed materials to support Caribbean countries’ efforts to prevent the spread of the virus. The material consisted of guidelines for schools, learning resources and guidance posters designed for pre and primary school education, that would help to prevent the spread of H1N1. Colourful posters provided information on the nature of the flu, its symptoms and means of protection. These materials were shared with all primary and preschools through the Ministry of Education in the countries covered by the UNICEF’s Multicountry Programme. Primary and pre-school children were the main target of the intervention, with parents and teachers as the secondary audience.

Purpose/ Objective:
It was considered useful to find how the materials were used, how useful they were in efforts to prevent the spread of H1N1 and their contribution to change in knowledge and behaviour. A further consideration was the role that UNICEF could play in future health related emergencies.

Methodology:
The UNICEF Barbados office covers ten islands in the Eastern Caribbean. A sample of two was selected for in-depth study (St Lucia and Dominica). The study was conducted in two phases.

Phase one consisted of a desktop/telephone review of Ministry of Education’s documentation in the two islands to determine the number of pre- and primary schools currently in operation.  This was done to facilitate sample selection and to determine whether or not the materials were in fact received by the schools.

Phase two represented the main method of inquiry and was carried out during the first three weeks of October 2010. A sample of 5 pre- and 5 primary schools in each island was selected. 
This resulted in a total of 20 schools across the sample:

St. Lucia
• Primary schools: Carmen Rene Memorial; Dame Pearlette Louisy; Bexon; Soufriere; Piaye Combined School.
• Pre schools: Dennery, Reunion, Entrepot, Hec Dec, Foundation.

Dominica
• Primary schools: Convent Preparatory; Mahaut; Salisbury; St. Martin's; Newtown.
• Pre schools: Mahaut, Oasis, Social Centre, Massacre, Sword

Schools were selected so as to have representatives based on two criteria.
1. Geographical region: As best as possible an attempt was made to include one rural and one urban school
2. Educational achievement: For the Primary schools, as best as possible an attempt was made to include the highest and lowest achieving schools in the island. This was based on the previous year’s GSAT results.

Findings and Conclusions:
Guidelines for respiratory etiquette were provided to the schools and a check list revealed that schools in Dominica were totally compliant in three areas and more rural schools were compliant than urban. In St. Lucia, total compliance was achieved in one area only.

The response to Principals and Teachers to the intervention varied. In general, the response from pre- and primary schools experiencing a seasonal flu outbreak was more positive than those that were not. Strenuous attempts were made to enforce the guidelines. However, administrators in most schools were concerned about the refusal of parents to keep children who were obviously ill at home.

From the questionnaire survey it was clear that most of the children had been exposed to the posters displaying the symptoms of flu and preventive methods but a fairly large minority in Dominica said that their teachers had not discussed the material with them. Students displayed a high level of awareness of the symptoms and preventive measures but they had a better grasp when the message was displayed in the form of pictures. The largest single group in both islands said that they had benefitted from the intervention but it seemed to have had a bigger impact in St. Lucia than in Dominica. Group discussions with the pre-school group revealed that they too, had a good grasp of the material.

Principals and teachers found the material appropriate, relevant and timely and thought that it probably hastened the decline of the seasonal flu outbreak. Some felt that more pictures, a different medium and more input from the Ministry of Health would have heightened the impact.

Recommendations:
Recommendations are made for less cluttered messages, more pictures especially when designed for pre-school children; more collaboration between ministries and schools, and an intervention that includes parents which should include a sensitization to the possibilities of an enlarged epidemic if sick children are sent to school.

 



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