An Applied Investigation Into Effective Health Education: Creating an Educational Toolkit to Raise Awareness of Schistosomiasis Among Children Living in Zambian Peri-Urban Slum Communities

Abstract

Purpose: Poor water sanitation and waste management in the peri-urban slum compounds of Lusaka, Zambia have directly contributed to a significant schistosomiasis prevalence rate of 20.72%. According to the rational model and other international education-based health initiatives, a school-based health education campaign dedicated to raising awareness can potentially serve as an effective form of disease prevention. We are thus investigating the components necessary to empower teachers of young elementary students to serve as health educators about schistosomiasis in the setting of impoverished slum communities. Methods: A training workshop focused on the topics of water sanitation, waste management, and schistosomiasis was held for teachers from six of Zambia’s peri-urban slum communities. Teacher knowledge attainment and perceptions were assessed. Lesson plans stemming from the workshop were implemented in the classroom setting, accompanied by student knowledge assessments. A literature review was subsequently performed to understand the foundations of health education, identify verified teaching techniques, and evaluate the role of cultural, age-based, and personal learning differences. An educational toolkit was ultimately developed incorporating the needs and preferences of the Zambian teachers and the literature review findings. Results: The average percentage of the pre- and post-training teacher knowledge questionnaires rose from 49% to 59% (p=0.29). More notably, the pre-training percentages ranged from 15% to 74% and the post-training percentages ranged from 26% to 79%. After the implementation of classroom lesson plans, the students showed statistically significant increases in nine of fifteen knowledge questions. Qualitatively, teachers asked for additional workshops, classroom resources, and help with basic teaching skills. Literature review supported the potential of health education campaigns, discouraged any emphasis on cultural variations or learning styles, and emphasized teacher preparation as fundamental to successful curricular implementation. Conclusions: In consideration of varying levels of educational achievement among the teachers and a resource-limited setting, three factors were identified as necessary for empowering teachers to propagate schistosomiasis awareness: teacher training workshops, appropriate teaching aids, and comprehensive lesson plans. For future endeavors, an educational toolkit was synthesized that, if validated, may serve as a model for analogous peri-urban slum communities suffering from high rates of schistosomiasis.