APPLICATION OF INTERPERSONAL COMMUNICATION TO COMBAT NUTRITIONAL DISORDERS AMONGST STUDENTS OF EBONYI STATE UNIVERSITY STAFF SECONDARY SCHOOL



OUTLINE:
-           INTRODUCTION
-           REVIEW OF NUTRITIONAL DISORDERS
-           THE ROLE OF INTERPERSONAL COMMUNICATION USING ACADA MODEL
-           CONCLUSION
-           REFERENCES

INTRODUCTION:
Communication can be regarded as a two-way process of exchanging of shaping ideas, feelings and information. Broadly it refers “to the countless ways that humans have of keeping in touch with one another”.

Health communication is the adoption of communication strategies to enlighten the public on health related matters and influence individual, government or community decisions that positively impact on health.
            It is relevant in disease prevention and health promotion in many ways e.g Health professional-patient relations, individual’s exposure to or search for or use of health information, individual’s compliance to recommended clinical regiments, the construction of public health messages and campaigns, dissemination of individual and population health risk information, image of health in the mass media and culture at large, education of consumers about how to gain access to the public health and health care system.
            Whether talking to individual patients or groups of people, health workers must strive to be effective communicators. They must learn how to explain technical information in simple language that is easily understood.
            Health communication in the process caters for the following, needs; information, education, motivation, persuasion, counseling, raising morals, Health development, and organization.

Review of Nutritional Disorders
            Nutrition disorders are a serious problem everywhere especially in tropical developing countries.
Malnutrition is an important public health problem that is caused by a deficient or excess intake of nutrients in relation to requirements. Under nutrition (Nutritional deficiency) is the prevalent type of malnutrition in tropical developing countries. At most risk are the poor and disadvantaged, particularly women of reproductive age and young children.
Under nutrition reduces immunity, physical activity and work productivity, and in children, retards growth and psychological development.
            Obesity (nutrient, excess) and its comorbidities are less widespread in developing countries but the rates are increasing.
            Poor diets and diseases are the immediate causes of malnutrition. Underlying causes are food insecurity, in adequate care of women and children, unhealthy living conditions and poor health services. In turn, these result from lack of resources, the low status of women, environmental degradation and, sometimes abnormal weather or conflict and violence.
            Secondary school students fall into the adolescent group, who are between 10-19 years, and is the second decade of life. During this phase of life, significant physical, physiological, psychological and emotional changes occur, which have bearing on the individual, community and the nation.  
Healthy adolescence is a goal. Adolescents gain 50% of their Adult weight and more than 20% of their adult height between 10-19 years, which we call as growth spurt. For healthy growth and development of adolescents, adequate diet is essential, and here proper communication is not only important but essential, not just to the students but to the managers of the school (the management Board, principal and teachers, and the Non-tutorial staff of the institution), as well as the parents.
            Low height and weight, exophthalmia (dry eye) refers to all the ocular manifestation of Vit A deficiency, Nutritional anemia, and the emerging obesity, can all occur.
Observation has shown that the majority of EBSU secondary school students who slumped in school and were rushed to the Medical Centre, had not eaten before coming to school. Some of the reasons being poverty (with the consequent inability to afford 3 square meals a day by parents), lack of parents living up to expectations (like when the mother rushes out early morning without preparing meals for the children), some especially girls say they do not want to be fat but to have figure 8 and therefore skip some meals, especially breakfasts, and some religious zealots who fast to the detriment of their bodies etc. For those looking for “shape” and ending up starving, they could end up with unacceptable “figure I” (instead of “figure 8”), peptic ulcer disease, anemia, immune deficiency and the associated risks of infection, various developmental anomalies that may become the sequel in future.

Justification for Choosing Interpersonal Communication.
Interpersonal communication is a warm open and intimate interaction between two or more people. The people involved may just be as small as two or  small (micro group), or it could be large group (macro group) of people. As interpersonal communication is personal and direct, it is more persuasive and effective than any other form of communication. It is important in influencing the decisions of those who are undecided.

Justification for Choosing “ACADA” Model.
            Development and behaviour change (our objective in the Nutritional disorder amongst Ebonyi State University Staff Secondary School) are achievable when the right communication process are applied.
ACADA which stands for - Assessment, Communication Analysis, Design and Action- is a tried and trusted communication planning and implementation model designed by UNICEF.
It throws into relief the vital steps/procedures that must be followed in order to achieve set goals/targets in a clearer, scientific manner.
 
Assessment
This is also referred to as situation analysis.
            Information on Nutritional disorder in EBSU secondary school can be gathered through survey in the University Community from the students of the secondary school, the tutorial and non- tutorial staff, the University Medical Centre and the University at large, and the parents of the students. The survey will be carried out using interpersonal channel of communication to gather baseline information on the prevailing nutritional problems, knowledge, attitude and practice in the community. There are indications that more than 50% of those students who slumped and were rushed to EBSU Medical Centre, or who presented at the clinic for various complaints, have not taken morning breakfast, or when taken, it is usually inadequate. Having gathered the required information, objectives will be set and evaluation of indicators.
 
Communication Analysis
Interpersonal communication and Mass Media will be the best communication method to use in sending positive messages to these students. Here in particular, the EBSU secondary school magazine “The Erudite”, will be very useful. As said earlier, interpersonal communication will entail a warm and intimate interaction between 2 or more people. In this circumstance, the population will be fairly large. During the discussion, every individual freely shares intimation on the Nutritional problems and in the process one another’s feeling and situations, etc, are shared.
Mass communication will also be very useful. Information would be disseminated using- The erudite magazine mentioned earlier, radio, health talks, hand Bills, posters, etc. A play will also be organized to convey some important messages on Nutritional disorders.
 
Design
Bearing in mind that in designing, emphasis should be on the effectiveness of message format and content so that what is said is what is meant and what is meant is what is understood and what is understood is what is done and what is done is the desired action (Agba and Okoro 1995), the communication means will be well designed to be attractive to the students. The teachers they love most, especially the female ones to add some emotional touch as mothers, would be used. A good focal group discussion using 10 persons or less, in a conducive environment will be carried out. The questionnaire, which will be part of this design, will bear the following questions;  
-           Reasons why some students do not eat before coming to school
-           The good effects of not eating before coming to school, if any.
-           The bad effects of not eating before coming to school, if any
Beautiful banners, hand bills, posters would be employed with attractive writings like, “Eat to live”, “Starvation and diseases are husbands and wives”, “Eat well to get figure 8, starve to get figure I” etc. 
            A health talk on “benefits and adverse effects of malnutrition” will be carried out. Balanced diet will be taught the class;

Action
For the programme to achieve it’s objectives, it will take 2 days during which there will be lecture/workshop daily.
            The organization will be as follows;
Day     1:         10 am – 11 am-         Biometric measurements
(Height, Weight, Arm-Circumference)
                        11am – 12 noon- Clinical examination
                        12noon – 12 30pm- Introductory lecture on
Nutritional disorders.
                        12.30–1pm – Refreshment, then close for the day.

Day 2:            10am – 11am – Focused group discussion
                        11am – 11:30noon – Benefits of eating
appropriately and a balanced diet too.
                        11:30am – 12.30pm- refreshment, then dismissal

Personnels to be Involved
-           The researcher
-           5 research Assistants           -2 resident Doctors
                                                            -           Nurses
                                                            -           One counselor (psychologist)
Materials to be Employed
-           Stethoscope
-           Height and weight
-           couch for examination
-           Tables, seats,
-           Multimedia projector
-           Microphones
-           Flip charts
-           hand bills, Biros
-           White board, marker
-           Posters, computers
-           Banners
-           Marker, duster
-           Generator
-           Fuel
-           Plain sheets

Venue:          
Ebonyi State University Staff secondary school Hall – “CAS” Campus.

Conclusion:
Nutritional disorder exists in our school system and is long overlooked. It is high time the condition is addressed. If necessary logistics are available and approval given, the issue would be well addressed using the appropriate communication channel stated above, employing appropriate supervision and evaluation at every stage.

REFERENCES
-           Short texture book of public health medicine for the tropics by Adetokunbo O. Lucas and Herbert .M. Gilles – revised 4th Edition, page 264.
-           Park’s Textbook of preventive and social medicine by K. park. 20th Edition pages 552,.
-           Textbook of community medicine-preventive and social medicine by sunder LAL, Adarsh, Pankaj-2nd Edition, pages, 42, page 191.
-           Administrative committee on coordination, subcommittee on Nutrition (200a); Ending malnutrition by 2020; An Agenda for changes in the millennium ACCSCN, c/o WHO,   Geneva.accsn@who.ch.
-           Nutrition for health and Development WHO/NHD/006.who, Geneva.
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