Effectiveness of Communication Strategies of the Urban Health Extension Program in Bringing Behavioral Change in Habits of Hygiene and Sanitation: The Case of Woreda 1 (Kebele 01/18) of Lideta Sub-city – Addis Ababa
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Date
2013-01
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Addis Ababa University
Abstract
These days, health is taken to be the product of the individual’s continuous interaction and
interdependence with her/his ecosphere. Based on this belief, enabling people to increase control
over and improve their health has been considerably given attention in health policies made
nationally and internationally. One method to achieve this goal is a strategic health
communication. This study is, therefore, primarily focused on the communication strategies
employed by the Addis Ababa Health Bureau’s Urban Health Extension Program (UHEP) to
bring behavioral change in the habits of hygiene and sanitation. Woreda 1 of Lideta Sub-city, in
Addis Ababa, is deliberately chosen because it is one of the highly congested slums of the city
where poor hygiene and sanitation is a severe problem.
The major issues raised in this study are the communication strategies employed by the UHEP to
change the community’s unhealthy hygiene and sanitation habits, and their effectiveness in
building the audience’s self-efficacy and thereby developing healthy behaviors. Qualitative
research method was basically used to deal with these issues, and an attempt to complement it
with a quantitative one was made. Data were collected through semi-structured in-depth
individual interviews, participant observation and a questionnaire filled out by the UHEP’s target
audience. Albert Bandura’s Social Cognitive Theory (SCT), and especially his concept of Self3
efficacy, was used to analyze and discuss the data collected. The self-efficacy level of the targets
was also measured by using Shwarzer and Jerusalem’s Generalized Self-Efficacy scale (GSE).
As a result of the analysis, the study indicated that the major communication strategies of the
UHEP are interpersonal channels assisted by demonstrations. Though mass media channels
were also taken as part of the strategy, priority was given to printed materials like brochures.
These materials were also found to be with very poor quality to appropriately transcend the
messages they contained.
Regarding their effectiveness, the communication strategies were found to be ineffective in
building their target audience’s self-efficacy and thereby in achieving the intended change in
behavior. This is attributed to the contents and the approach of the communication strategies.
The majority of the UHEP’s models were found to have very low level of self-efficacy because
the contents were informative in nature that they cannot build self-efficacy, and the approach
was in a classroom lecture format.
The study recommends exploitation of other channels like peer-to-peer and traditional
communication channels, adequate budget allocation for mass media, and modification of
contents in a way they would increase self-efficacy in order to make the program effective in the
hygiene and sanitation package.
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Communication Strategies of the Urban Health Extension Program