Compared to outcome evaluation, very few studies focused on evaluating the process - thus leading to long-term sustainability problems. This is a “child-to-child” health promotion model for primary schoolchildren called the “Doktor Muda” (DM) where the children are empowered to give health education and conduct health promotion and education activities. After running for more than ten years, what made it self-sustainable?
Objective: to evaluate key factors responsible
for the sustainability of these programs. Method: Self-administered
sent to 2804 DM's.
Results: Over 90% agreed that it increased
their knowledge, contributed to self-development, enjoyable,
appropriate, effective, efficient and acceptable. Between 50-89%
said the program changed their attitude, they practiced healthier
lifestyle, can teach others, better perceived by peers, influenced
their career choice and the content was adequate. However less
than one-half (42%) still had lack confidence in public speaking. Qualitative
several focused group discussions (FGD) with 54 DM's corroborated
the findings while adding to better understanding of underlying
reasons. FGD on 41 parents, 15 teachers and 14 administrators
suggest that the program was self-sustainable because the process
of peer education freed teachers of much didactic teaching, promoted
self-esteem among DM’s, improved communication and public speaking
skills and enhanced the school image. The school’s health environment
improved from the DM’s surveillance report. These benefits are
over and above the increase in health knowledge which was the
main objective of the Health Education Unit. Thus the beneficial
impact was felt by all stakeholders.
Conclusion: The main reason for sustainability
was that the process satisfied the needs of all stakeholders who
see the results worthwhile. It is the development of the personal
character of the DM’s while teaching and helping other children
which were most appreciated by all.
Keywords: health education; health promotion; advocacy for
health; schoolchildren; healthy lifestyle.
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1) Nasruddin Jaafar - Professor, Dept. of Community Dentistry, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia.
2) K Omar, and J Ahamd - Head, Health Education and Promotion Unit, States of Kelantan and Pahang (respectively), Ministry of Health, Malaysia.
3) W S Wan Hussein - Lecturer, Dept of Policy and Business Strategy, Faculty of Business & Accounting, University of Malaya.
4) Z A Manaf - Professor, Dept. of Educational Psychology & Counselling, Faculty of Education, University of Malaya.