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Health Education on Acute Encephalitis Syndrome
Two northern states of India, Bihar and Uttar Pradesh, are badly affected by Acute Encephalitis Syndrome (AES). The worse affected districts in Bihar are Muzzaffarpur, Patna, Gaya and Gorakhpur in Uttar Pradesh.
Encephalitis is an acute inflammation of the brain. Symptoms include headache, fever, confusion, drowsiness, nausea, vomiting and fatigue. Also, it is common to have seizures. The symptoms are caused by the brain’s defense mechanism, which is trying to get rid of the infection. AES spreads due to the mosquito bites which thrive in stagnant waters and unclean surroundings. Lack of drinking water and poor sanitation is a major problem in all the affected areas and has been associated with AES cases. Children of the age group 2 to 15 are the most vulnerable.
Assessment of the Affected Area
Since May 2012, 503 children have been hospitalized and 188 children have died due to the epidemic in the affected areas. Most of the reported cases and deaths are in children belonging to low socioeconomic groups.
Based on the key recommendation in the Need Assessment Report, AmeriCares India Foundation (AIF) capitalized the expertise by responding to this situation by decreasing the risk and subsequent consequences of AES epidemic in the area using the below strategies-
The Information, Education, Communication (IEC) materials (including Leaflet containing symptoms, causes and management of AES and key contact numbers of Hospitals and Doctors) were developed by AIF. With the support of local partner “Seva Sadan” AIF identified Musahari block of Muzzafarpur to disseminate the propose IEC materials in the villages, schools and health centers.
Followed by the implementation of the IEC dissemination project, AIF conducted health education on AES for school children. It was important to understand the perceptions of the community on the knowledge of AES and to reinforce learning.
- Health education was given through school children who would then communicate the key learning to their families.
- Nine schools from the area participated. All training was done in Hindi which is the commonly spoken language. 150 students and their teachers were imparted training in the common symptoms of AES and how the disease is transmitted. The mosquitoes that harbor the virus breed in rice fields, and standing water. It was reiterated to the children how only a clean environment will lower the risk of the disease. One of the recommendations was use of mosquito nets and if the latter were unavailable, simply “neem” leaves could be burnt in a small urn as the smell of the leaves would keep the mosquitoes away. It was emphasized that children should cover the body or use insect repellents, so as to minimise the risk of mosquito bites. Most important factor was early reporting of cases by rushing patients to the designated hospitals.
- Door to door dissemination of information through IEC material
- Conducted Male & Female group meetings where preventive measures and treatment were explained through the use of IEC print materials.
- Diagnosis, prognosis and management of AES were discussed. A list of hospitals in the vicinity where AES is treated was shared with the group.
- Impact assessment study was conducted with the use of tools like –
Solar lamps were distributed to school children, since electricity is a major problem in the rural areas. Children are not able to study as power supply may be available for not more than 2 hours each day. In some places, even that is not available and hence solar lights were given out. They were trained on how the solar need needs to be charged in the sun and then the lamp can be used for eight hours each day.
The IEC material was reached out to four districts (Muzaffarpur, Sitamarhi, Samastipur and Patna) of Bihar. Direct reach out to more than 7000 households for IEC was done in Mushari block of Muzaffarpur district and with the support of local partner (Seva Sadan), it was possible to reach out to other three districts covering 3000 households. Impact assessment on the knowledge and preparedness of AES was carried out on 24 groups of the same area. Generous effort from AmeriCares India Foundation ensured 150 households had light in the most needed hours of the day. This resulted in knowledge and smiles among the underprivileged.