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Developing Localized ICT-enabled Content for e-Health The Molave WASH Experience ANGELO JUAN O. RAMOS, MD. MPH 6 September 2006.

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Presentation on theme: "Developing Localized ICT-enabled Content for e-Health The Molave WASH Experience ANGELO JUAN O. RAMOS, MD. MPH 6 September 2006."— Presentation transcript:

1 Developing Localized ICT-enabled Content for e-Health The Molave WASH Experience ANGELO JUAN O. RAMOS, MD. MPH 6 September 2006

2 Water, Sanitation and Hygiene for All (WASH) The Millennium Development Goals (MDGs) adopted by the UN World Summit on Sustainable Development in Johannesburg in 2002 have firmly established Water and Sanitation issues on the global agenda.

3 WASH as Entry Point Water, Sanitation and Hygiene education is an important entry point in providing health-related content for ICT- enabled Distance Non-Formal Education. Water, Sanitation and Hygiene issues are pressing concerns for many communities, But to be effective, people should have access to relevant and appropriate content that is sensitive to the needs of the users and community as a whole.

4 The Project “Technology-Supported Distance Non-Formal Education on Water, Sanitation and Hygiene (WASH)” -A two-year project funded by IDRC (Canada) -Determine the effectiveness of using Information and Communications Technologies (ICTs) as a tool for teachers and students to teach and learn, through distance education, about WASH issues -Effect changes in the knowledge, attitudes and practices of people with regards to proper hygiene and sanitation using E-Health Learning Materials on WASH

5 Components Baseline studies on water, hygiene and sanitation in the study sites, consultations with community leaders and other stakeholders Development of E-Health Learning Materials on WASH through Writeshops and Creative Briefings Testing the Learning materials in both urban and rural locales Development of new E-Health materials based on the health needs of the community.

6 Project Partners Alternative Learning Services, Dep-Ed Manila Sandiwaan Learning Center Department of Science and Technology – Caraga Region Barangay Maguinda, Butuan City Maguinda Multi-purpose Community Tele- Center

7 Project Beneficiaries Students of the Alternative Learning Services from Smokey Mountain Community Members from Barangay Maguinda, Butuan City

8 WASH Module Produced in collaboration with the Teacher Community Coordinators (TCCs) of the Alternative Learning Services of the City of Manila Guided by recommendations made by SEAMEO- INNOTECH (2001) on how to improve modules of ALS A baseline study of the ALS communities determined the need to develop learning materials on common waterborne diseases prevalent in these areas

9 WASH Module Contents were developed using a bottom-up approach, through a Writeshop Participants were composed of ALS Teachers, Health Practitioners, Students and Community Members The writeshop allowed ideas from all participants to be incorporated, taking advantage of the diverse experience and expertise of all present. The process enabled the content and materials to be conceptualized far more quickly than what it will take using traditional avenues.

10 WASH Module The first WASH Module has 6 sub-modules on the following topics: Personal Hygiene Dengue Fever Diarrhea Scabies Typhoid Fever Environmental Hygiene

11 WASH Module Information such as disease causation, symptoms and prevention were discussed through the use of multi-media elements such as music, voice, flash-based animation, and video clips. These were rendered in a conversational and lively mood, enhancing the learning experience and making the learning process more enjoyable, even for adults.

12 WASH Module A simple point and click system of navigation using a mouse, and voice narration and music makes the module user-friendly and uncomplicated even for first time users or users with no previous experience with a computer. From the original Filipino Language version, the WASH Module was also translated into English and Cebuano, the dialect used in Maguinda.

13 Beta Testing and Focus Group Discussions Participated in by ALS clientele from other districts To assess the effectiveness, user-friendliness and appropriateness of the produced ICT materials To assess the readiness of the learners in using the ICT-learning materials Comments and suggestions from the Beta Test and FGDs were incorporated into the module

14 Project Implementation The WASH modules were tested to the 2 project sites, - Smokey Mountain - Bgy. Maguinda, Butuan City Quantitative Data was collected using survey forms, spot checks and structured observations to measure if there were changes in knowledge and attitudes and behaviors, Qualitative Data was gathered using Focus Group Discussions to determine changes in the learner’s practices after being introduced to the learning modules.

15 Research Evaluation To assess the changes in knowledge, attitude and practices in hygiene and sanitation of the non-formal education clientele brought about by the ICT materials in the urban site and rural site.

16 Conceptual Framework

17 Variables Knowledge –Average % correct answers from a 30-item T or F quiz, pre- and post-intervention Attitude –Average of weighted scores in a 14-item, 3-point Likert scale, pre- and post-intervention Behavior –Average of total scores in a 6-item spot check form taken at baseline, and 1 and 2 months after intervention

18 Research Design Urban Site: Smokey Mountain, Manila (Sandiwaan, ALS-Manila)

19 Research Design Test Subjects N=50 Baseline survey, Knowledge pre-test, Attitude survey Knowledge post-test, Attitude survey Implementation of WASH Module Pre-implementation Focus Group Discussions Post-implementation Focus Group Discussions, Key Informant Interviews, Story-telling Rural Site: Maguinda, Butuan City, Agusan del Norte (DOST-Caraga, Maguinda Bgy. Council)

20 Research Results – Urban Site Table 1. Age and Gender Distribution of Participants, Smokey Mountain - Traditional and ICT Groups GroupAllMaleFemale Traditional Mean  Std. dev. Median (Min – Max) n=350 22.1  5.7 21.5 (12 – 30) n=116 19.3  4.7 18 (13 – 30) n=234 23.4  5.6 25 (12 – 30) ICT Mean  Std. dev. Median (Min – Max) n=151 17.1  4.4 16 (12 – 30) n=93 16.1  3.6 15 (12 – 30) n=58 18.8  5.0 17 (12 – 30)

21 Knowledge


23 The proportion of males in the ICT group (53%) with post-KT scores > pre-KT scores is less than that of the males in the TG group (67%). The proportion of females in the ICT group (59%) with post-KT scores> pre-KTscores is less than that of the females in the TG group (64%).

24 Attitude The proportion of males in the ICT group (25%) with post-attitude scores > pre-attitude scores is greater than that of the males in the TG group (44%). The proportion of females in the ICT group (55%) with post-attitude scores> pre-attitude scores is greater than that of the females in the TG group (45%).

25 Behavior Table 2. Results of three Spot-Check Observations in ICT Group (n = 92) (Note: Maximum spot-check personal hygiene score = 6) RoundMeanSD 1 (baseline)3.3586962.141077 2 (1 month after intervention)4.4782611.410154 3 (2 months after intervention)5.434783.7887164 Variance between samples99.34 Residual variance2.40 F statistic41.42 P-value0.000000 Table 3. Analysis of Variance (ANOVA): Epi-Info results

26 Behavior Based on the Analysis of Variance, the p-value of 0.000 indicates that the means among the three spot check periods are statistically different. Therefore, there has been a significant improvement in the personal hygiene practice scores of household members who learned about WASH using ICT-enabled distance learning technologies.

27 Issues and Problems Encountered (Rural Study Site) Bandwidth – Because the modules contain graphics coupled with accompanying audio & video, it required considerable download time. The frequent power interruptions in Maguinda interfered with the the learning schedules. Unreliable Satellite Internet access – deteriorating weather conditions during the project implementation affected internet connection.

28 Issues and Problems Encountered (Urban Study Site) Lack of internet connection in Smokey Mountain - the alternative was to produce an off-line version which was accessed through an Intranet Web Server. Network Congestion – Simultaneous access to the Modules via the intranet resulted to slow response times, particularly with the video content.

29 Issues and Problems Encountered (Urban Study Site) Political issues – the Senate inquiry on the legality of the existence of the permanent housing site, delaying the transfer of the Sandiwaan computer facilities to the new area. Most students (and some teachers) were lacking in computer literacy.

30 Learnings Community involvement plays a significant part of success The community has the capability to generate resources and willingness to plow these resources back for the good of the project Health education is a good entry point for ICT- related development initiatives. Volunteers and info-mediaries play important roles in the telecenter & e-learning delivery of services

31 Learnings Educational content in the dialect are most appreciated, understood and preferred. Filipino (Tagalog) is also accepted Teachers are very effective resources for appropriate content development The Community has the capacity to build content When content is in rich media, access time and connectivity speed matter in sustaining interest among learners

32 Learnings Internet as an information resource is secondary to SMS messaging, radio or face-to-face transactions E-learning can work in rural, non-formal setting Providing access to e-learning content contributes to empowering the poor with information technology, giving them the necessary skills to contribute to the knowledge economy

33 Learnings Our shared efforts and the outcomes can be a basis for advocacy, in promoting e- learning, especially in non-formal education for the poorer members of our society

34 Recommendations Technical and Student Support should be well- developed and integrated in e-learning systems. E-learning should be localized and customized to the learner’s needs and skills Involve teachers more in research initiatives, content development and testing Further research on how accessibility can improve learning for non-formal education students, and ways of improving e-learning

35 Recommendations An ICT-based learning module will be more effective if combined with teacher- student interaction and other learning resources (blended learning) Design and produce learning materials that are user-friendly, appropriate, challenging yet enjoyable to use for both learners and teachers through a bottom- up, community-based approach

36 Recommendations Government should provide an encouraging policy environment for initiatives in e-learning, distance and non- formal learning, as a way to bridge the information gap. Government, along with the telecoms industry, should strive to increase and lower the cost of access to broadband internet technologies.

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