Our action plan for this program consists of:
Recruit the team.
Provide costumes, musical instruments, and other materials needed.
Train the team in the presentation and performance methodology.
Identify and assess the public health needs of the area.
Create, schedule, and conduct the presentations and associated village outreach based on the assessment. (Although the specifics are left to the local assessment, examples of probable topics are: better health through sanitation; best childbirth practices; HIV/STD awareness; overview of area health services; participate in determining the health services to be provided by Wunlang Village Health Center to open later this year; the importance of taking all doses prescribed for diseases like malaria and TB.)
Document performances with photos and video.
Interview area clinicians to see if performances are leading to desired health practices and empowerment.
Make improvements and repeat the program cycle for future health teams.
The program will engage one performance team of 10 health workers in Year 1. The first team will serve as co-leaders in the formation of two new teams in Year 2 with new participants reaching new citizens in the community. Likewise, the Year 1 & 2 teams will help four new teams to extend the reach of the program even further in Year 3. Each team will develop and conduct 12 performance-based presentations in the health issues and advocacy needs of the community based on their assessments. The lessons learned by the participants will inform the improvements needed for future work.
The Director will monitor the progress and measure the impact of the program, seeking the involvement of the local health committee and others. Measurements will look at results in terms of: number of health topics addressed, performance attendance, awareness of health risks, and adherence to healthy lifestyle practices.
What will it take for your project to be successful over the next three years? Please address each year separately, if possible.
To be successful, the Village Public Health team must reach as many people as possible with its presentations and performances. In addition, the health teams themselves must become a leadership component of health promotion within the community. For these reasons, our program cannot rely on just one team or operate for a short period of time. Diffusion of this innovation will require a sustained, long-term effort, and the teams must constantly monitor the health needs of the community and make adjustments to the composition of the teams, the topics addressed in their presentations, and target audiences to whom they reach. An outbreak of a particular disease, for example, would likely affect the team’s work and priorities.
Each health team must include both women and men who represent a cross-section of the community and its families targeted by their presentations and outreach.
Sufficient funds must be available to pay stipends to the village health workers who join the teams and carry out the work of the program. Additional funds are needed for materials and equipment the teams will need to make their performances, monitoring, and documentation successful.
The Director must communicate with and lead the teams successfully and help them organize and present effective performances. The Director must be supported by the nascent village health committee, the Ministry of Health staff, the Director of Alternative Education, and the supervising staff of the village health center – all partnerships seen as critical to our success with this program.
Finally, program success relies on the enthusiastic participation of the villagers, something we have had much success with in all of our work in South Sudan. Not only must the citizens attend the performances and heed the health practices presented, but they must become engaged as active participants in the organized public health efforts of the region and the country.
What would prevent your project from being a success?
Insofar as this is a multi-year program that starts small and builds on past lessons learned as it expands, some possible constraints to be managed are:
Lack of start-up funds. Although Public Health, including initiatives such as this, should ultimately be funded by the governments involved, much suffering in remote villages in South Sudan can be relieved with a short-term, grass roots program that can be easily implemented now with our help.
Failure to incorporate performance-based village health education into government-sponsored public health administration.
A disruption of peace in the villages supported. Remote villagers suffered through many years of civil war before the peace agreement took effect in 2005. While some semblance of this program could be implemented even in conflict areas, priorities in an emergency situation may direct resources elsewhere.
Failure of the program to evolve flexibly, adapting to the changing public health situation in the communities served.
Reticence about discussing STDs and other health issues in public, although this can best be resolved by villagers (single-sex audiences for some presentations, medical emphasis on its importance).