Health Policy Issues and Health Programmes in ... - Amazon S3

IEC for Health Programmes in Uttaranchalthe adverse consequences of rapid population growth, or the “population explosion” approachto family planning, rather than catering to unmet need. In health care programmes as well,sporadic efforts have been made. IEC activities have been carried out to promote TB check-ups,emphasizing that TB is curable and encouraging people to sign up for treatment. Cataractoperation facilities to cure blindness have been promoted, and there have been print mediacampaigns in urban centres to persuade people to have regular cancer detection check-ups atfree clinics. Also, privately funded anti-smoking campaigns are not unknown. HIV/AIDSawareness activities have shot up recently because of the efforts of National AIDS ControlOrganization (NACO) and the State AIDS Control Societies.The budget for IEC activities has also been small—less than three per cent of the family welfarebudget, and lesser for health programmes. The quality of some of the IEC efforts is also dubious. Arecent HIV/AIDS awareness campaign in a major state, extensively relying on panels posted on theback of buses, used an unbelievable colour combination of brown, white, and grey for their panels,together with difficult language and long, boring text. Only an evaluation of the campaign willshow whether it helped to improve HIV/AIDS awareness or merely increased road accidents dueto motorists falling asleep. IEC activities, by and large, suffer from the following deficiencies.l Target audiences are not defined properly or sharply.l Almost no effort has been made to educate newly-weds and adolescents.l Choice of media is often arbitrary, not on the basis of its reach among target groups.l There is no emphasis on pre-testing IEC materials.l There is a lack of systematic monitoring of the implementation of the IEC activities.l Most IEC personnel lack proper knowledge and communication skills.l IEC strategies are designed at the central level, adopting the top-down approach with littleownership at the state, district, or sub-district levels.l Low priority, inadequate budget, and delay in the release of funds for IEC—programmes arepredominantly managed by medical personnel, often IEC positions remain vacant, andfunds are diverted to other activities.However, this is not to say that there have been no successful IEC activities. A good example wouldbe the national Pulse Polio Immunization Campaign, which included a national plan, guidance forstates and districts for the implementation of campaign activities, and material such as leaflets,posters, and spots. The state and districts have been able to use this total package to produceuseful and attractive messages at the local level. This campaign has also extensively used massmedia for disseminating messages; however, the use of non-traditional media such as folk mediahas remained limited. The extent and coverage of IEC activities in different states has also variedwidely as has the competence in managing and planning IEC programmes.90In 1995, the Government of India established IEC bureaus in eight of the country’s mostpopulous states to integrate all IEC, health, and education activities under one roof. In additionto strengthening IEC planning, the bureaus were expected to assume a leadership role in thetraining of health functionaries in IEC skills and in implementing, monitoring, and evaluatingvarious activities and campaigns. Although the establishment of these bureaus has strengthenedthe state governments’ ability to conduct IEC activities and produce attractive and useful