AVAILABILITY AND USE OF INFORMATION, EDUCATION AND COMMUNICATION (IEC) MATERIALS BY HEALTH WORKERS IN IBADAN METROPOLIS

Abstract

Health education is a major responsibility of most health facility staff. Information, Education and Communication (IEC) materials such as posters, and flipcharts are designed to make the health workers educational role more effective. IEC materials are produced by governments, non-governmental organisations, donor agencies and private companies in large numbers on numerous current topics including nutrition, communicable diseases, and road safety. Rarely do the producers of these materials determine whether their products reach front-line health staff and whether these staff actually use the materials. The objectives of this research were to assess the availability of IEC materials in lbadan, determine whether health staff possess the skill, training, opinions, and self-confidence to use the materials and to document the pattern of use of available materials. The study was exploratory and cross-sectional in design. Eight of the 11 LGAs in Ibadan were selected, and all LGA health facilities in those LGAs were studied. The nearest private clinic to each LGA facility were included. A total of 95 facilities responded, wherein each functional service unit was visited, yielding a total of 195 units, At least one health worker in each unit was interviewed, and 243(97.2%) of the 250 approached agreed to respond. An observation checklist

was used to record the availability, condition and source of lEC materials in each service unit. A questionnaire was used to determine health worker characteristics, and their experiences, skills and perceptions concerning IEC materials. A four-point checklist was used to measure poster use skills, and a 16-point scale was developed to document perceived self-efficacy in IEC material use. A total of 899 IEC materials were found in 178 (91.3%) of the service units, while 17 (8.7%) of the units had none. There was no significant difference (p = 0.93) in the presence of materials in units between private clinics (91.0%) and government facilities (91.7%). The average number of materials was significantly more on average (5.5) in government units than in private ones (3.9)(p=0.0027). Posters were the most common form of IEC material (69.5%). The majority of units in both public (85.7%) and private (83.5%) of units had at least one poster. Over half of the respondents reported that they had used the materials recently, that is "today" (18.9%),"yesterday" (14.4%) or "within the week (22.6%). Skills were tested by giving each respondent a poster for National immunization Days and asking him or her to demonstrate its use. Using a 4-point skill checklist, the researcher found that recent use was associated with skill (p=0.002), ranging front 1.3 average points for those who used materials "today" to 0.7 for people who had not used materials in the past 6 months. Different cadres also showed significant variations in skill (p=0.002), with physicians average 1.4 points, and auxillary nurses scoring only 0.3. The ninety-seven (39.9%) respondents who reported receiving in-service traing (IST) in IEC scored significantly better (1.2 points) than those who had not (0.8) (p=0.00002). A greater proportion of those who had IST (28.9%) report they had used IEC materials "today" compared with those having no IST (12.3%) (p=0.0008). A 16-points self-confidence scale was developed. A significantly higher mean self-confidence score was attained by those who reported use of materials "today" (13.4) compared to those who had not used materials in the past 6 months (11.6) (p=0.00005). Less than half of the respondents 108 (44.4%) said that their co-workers encouraged them to use IEC materials. Thirty four (37.9%) of those who used IEC materials "today" reported encouragement, compared to 10 (12.2%) who had not used them in the past 6 months (p=0.00001). This study has documented that while IEC materials are available at local health facilities, their recent use is low. Furthermore skills, self-confidence, encouragement, and opportunities for IST were found to be factors that enhanced the use of IEC materials. From the foregoing, it is recommended that practical IST on IEC materials be organised at the LGA level and that follow-up encouragement and supervision be provided to facility staff by the LGA and State Health Education Unit Staff.