In the behavioural conceptual model of health education, behavioural pattern is placed first in the chain of events which can lead from health to disease. If such a model is acceptable, it implies that primary health education must be directed at those behavioural patterns that pre-dispose to diseases. There are obviously numerous behavioural patterns that one is familiar with which would pre-dispose to diseases. The paper discussed some of the more important examples to illustrate the role of behavioural patterns in the causation of disease and the consequential need for health education directed at such behavioural patterns. In relation to nutritional diseases, behavioural patterns in many areas of the developing world are a major contributory factor to the prevalence of protein calorie malnutrition. Such dietary restrictions may even cause the sick individual to be denied the very food he requires. Examples of behavioural patterns in relation to communicable and non-communicable diseases and to medical care were also discussed.
A cohort of90 infants born in March 1979 in Kedah, Pahang and Malacca were followed up to find out the feeding practices, preventive health care and medical care practices during infancy. A high proportion of infants were breastfed compared to the urban population. However, early introduction of solids was very common. Parents were well aware of the immunisation schedule and attended government clinics for immunisation. However, attendance for health appraisal was not made according to schedule. Cough and cold,fever, diarrhoea, measles and skin conditions were the common ailments. Medical care for cough and cold, fever and diarrhoea was sought from general practitioners, clinics, and hospitals. Practice of buying analgesics and penicillin cream for self treatment for fever and sores was a common practice. Help was soughtfrom traditional healers for measles. Fever and diarrhoea were thought to be signs of health by some and nothing was done. Mothers were well educated on the importance of breast feeding but were not aware that introduction ofearly solids is not satisfactory. Education with regards to introduction of solids by health staff was not done timely. Health staff were mentioned as injluentials for feeding practices and immunisation, but were not mentioned for medical care. Some recommendations for infant care are also mentioned in the paper.
Even though Malaysia is a relatively prosperous country amongst the developing nations, it is still be set by problems of a rapidly increasing population. The economic cake is also unevenly distributed and there are pockets of poverty in the slums surrounding the towns as well as in the rural areas. Added to that is the problem of ignorance and superstition especially amongst its adult population. It is due to these problems that the Child-to-Child programme has found special application in Malaysia. The Child-to-Child has been introduced through either the government agencies or the voluntary organizations. Through the Ministry of Education, the concept has found its ways through the schools and the state department of education. The Ministry of Information and Broadcasting has also introduced the concept of Child-to-Child in the media. The voluntary organizations have also introduced the concept of Child-to-Child in their projects. The Sang Kancil project has to some extent used the idea in the running of its activities. The Health and Nutrition Education House have found that by applying the concept and using older children to help in running its activities, its over all objective which is the improvement of the health of the children in the slums could be reached more easily.
This report highlights some of the educational aspects on nutrition and tropical diseases. Health conditions in most of the countries in this region has improved but not at the same pace as the progress in medical sciences. The slow progress in tackling this problem has been partly due to the failure of understanding psycho-social, cultural and economic patterns. Many of the health workers and educators who are involved in the control of tropical diseases emphasize on practice rather than research. Due emphasis should be given to training and research in health education involving not only the professionals and auxiliary staff but also political leaders, policy makers and community leaders at grassroot level.
A morbidity survey was carried out on a sample of eight longhouses in the Entabai area of the Sixth Division, Sarawak. Of the 645 respondents interviewed, only 148 (22.9%) had experienced at least one spell of illness during the one month prior to the survey.A total of 161 spells of illness was reported, giving a rate of three spells per person per year for the community. Most of the complaints were mild in nature, with fever and aches being the commonest reported. About two thirds of the illnesses were seen by the village aide or at the klinik desa, while the remaining preferred to be treated by the manang. A sub-sample of 49 heads of household were interviewed on their views of the causation, prevention and spread offive common conditions. About 14-43% of the respondents had no knowledge of the causes of fever, cough, diarrhoea or worms. Among those who mentioned some causative factors, only a portion had correct concepts of the various aspects of diseases. Food taboos associated with the five conditions were not too numerous or extensive enough to affect dietary intakes. However, this is not so during the post-partum period where the mother is not allowed to eat many vegetables and meat which are common items in their everyday diets.
Modern concepts concerning the development of breastfeeding programmes are given, with special reference to maternal reflexes, the need for information and the health and nutrition of mothers. Motivation and education are needed for health professionals, families and administrators. Some successful programmes are mentioned including small-scale hospital activities and national programmes, notably the one developed in Brazil.
For any health education to succeed, the people's perception of the disease, their beliefs and cultural practices are of utmost importance as these have tremendous influence on their acceptance of new ideas. It is therefore essential to develop appropriate health education packages based on the understanding of the traditional and socio-cultural belief systems of the people. Thus on the basis of anthropological studies, health education packages were developed for the leprosy control programme in Sarawak, aimed at both adults and children. Newspaper articles, cartoon tape-slides, cartoon story books as well as posters were developed for both Chinese as well as other groups such as Malays, Ibans and Kayans. These were field tested and are now used in the Rejang Valley of Sarawak.
In 1984, in Sarawak, there were a total of 1,099 recorded cases of leprosy for a population of 1.3 million. However, for each case recorded, it is estimated that two others remain undiagnosed as a consequence of the stigmatization associated with leprosy. For the five year period, 1979-1983, an average of 29 new cases were detected each year of which 8.6 (30%) were deformed due to the late stages at which it was being reported. To increase the case-finding rate, human behavioural research was applied to the leprosy control programme so as to develop culture-specific health education packages aimed at self diagnosis and self referral in order to detect the large pool of undiagnosed cases hidden behind the veil of aversion, fear and ignorance. This was achieved through anthropological studies to identify how the various major ethnic groups perceived leprosy and their attitudes towards leprosy. Taking into account these findings, health education packages aimed at adults as well as children were developed for the Chinese as well as the non-Chinese, and consisted of newspaper articles, cartoon tape-slides, cartoon story books and posters.
A study in Sarawak, Malaysia, revealed diverse opinions, prejudices and degrees of knowledge about leprosy among various ethnic groups. The information gathered was used as the base on which a health education package relating to the disease was established. It is intended that this will lead to the early detection and treatment of a higher proportion of cases than has previosly been possible
The multifaceted drug prevention education and rehabilitation system of Malaysia appears to have contributed to the steady decrease of the number of identified drug abusers in the country. In this article, those components of the Malaysian system that would be most applicable to the American effort were examined. In the same manner, because the fastest growing minority group in the United States are Asian Americans, in which a significant proportion involve persons from Southeast Asia, those components in the Malaysian system that are applicable to Southeast Asian Americans were examined.