Abstract
Indonesia is a country of many different ethnic groups and cultural norms. Despite this fact, most health education materials in Indonesia have been designed for an overall national audience. These materials rarely take into account local cultural perceptions and ideas about disease causation and appropriate treatment. Once materials are developed, they are rarely pretested to ensure that they are understood and accepted by the communities for which they are intended. We believe that educational messages and illustrations should be based on thorough research and analysis, not only of the health problem, but also of the perceptions, beliefs, and cultural practices of the target audience.
In order to develop a culturally sensitive health education campaign on appropriate home case management of diarrhea, we first conducted formative research with mothers of young children and health care providers in West Lombok, Indonesia. This research showed that the people recognize four different types of diarrhea according to signs and symptoms and perceived etiology. Based on the results of the formative research, a flipchart was designed incorporating five messages. The flipchart was then revised on the basis of two pretests. The pretest results showed that visual messages about child health, the course and treatment of diarrheal diseases, and the preparation of oral rehydration solutions were often misinterpreted or not considered in accordance with local cultural norms. Most of the respondents understood the messages but felt that several of the illustrations did not accurately reflect their ways of living. After changes were made, the materials were easily understood and accepted by respondents. To maximize the benefit of educational materials, the national health education sector should be more flexible in the adaptation of materials to local customs and perceptions.
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