Health Promotion and Disease Prevention through Sanitation Education in South African Zulu and Xhosa Women

Abstract

Poor sanitation and hygiene facilitate transmission of environmental diseases and pose a threat to the health of South African residents. This study focused on identifying sanitation needs from the perspective of informal community residents, addressing need related issues, and empowering Zulu and Xhosa women. The study used a multistep approach to identify and access communities of interest, reflexive critique during data collection from 300 heads of households, and a reiterative process to identify major themes. A process, which impacted 1,467 residents, was developed; it included culturally sensitive presentation styles and educational materials that facilitated understanding of sanitation concepts. Main sanitation themes were health knowledge and community role models. Educational sessions incorporated women. Using women as educators elevated their status and validated their community importance. Project participation added to the educational background of the Zulu and Xhosa women. It empowered them and provided an opportunity for them to articulate community needs.

Measuring the Impact of Health Education Modules in Cameroon, West Africa

“…A health education program must reflect cultural practices and resources. Lessons should be structured for individuals who are illiterate or semiliterate (Smith et al, 2004). Many health education and promotion programs in the developing world use conventional teaching methods that do not address social constraints of women or cultural issues related to teaching.…”

“…Smith, Garbharran, Edwards, and O'Hara-Murdock (2004), in their study of sanitation practices among Zulu and Xhosa women, addressed "multiple public health issues of which sanitation was an integral part" (p. 63). Environmental constraints need to be minimized and behavioral motivations understood in order to change previously ingrained hygiene habits.…”

“…Implementation strategies suggested in the abovementioned reviewed articles included pyramid teaching, which involved one community leader teaching health educators who then had a series of workshops (Smith et al, 2004), health clubs (Waterkeyn & Cairncross, 2005), and peer educators (Smith et al, 2004;Dieleman, 1999). As behavior change involves altering norms, a strong community structure needs to be created to reduce the risk of failure (Waterkeyn & Cairncross, 2005).…”

“…As behavior change involves altering norms, a strong community structure needs to be created to reduce the risk of failure (Waterkeyn & Cairncross, 2005). The impact of cultural beliefs and traditions must be considered in selecting dissemination strategies (Smith et al, 2004).…”

“…(p. 226) Dieleman (1999) stated that "[h]ygiene education is more likely to be effective when participatory methods are employed" (p. 436). Smith et al (2004) used skits, roleplays, and dance to communicate health messages. These teaching strategies are more appropriate, too, in highcontext cultures where people have shared understanding "of meanings and inferences" (Murray, Wenger, Downes, & Terrazas, 2011, p. 31).…”