Download - Risk Communication in Maternal Care
Risk Communication in
Maternal Care
• Definition
• Principles of Risk Communication
• Process of Risk Communication
• Intervention
• Evaluation
• Perception
• Soft skills training
What is Risk Communication?
• The purposeful exchange of information
about the existence, nature, form, severity
or acceptability of health risks between
policy makers/health care providers and
public/media with the intention of changing
behaviours and inducing action to
minimise/reduce the hazard.
Risk Communication
• Interaction with internal and external
stakeholder groups about risk.
• Aims at mobilizing action. Is evidence of an
organization’s commitment to health and
welfare
Principles Of Risk Communication
• Effective risk communication (RC) is an essential element of Risk Management (RM)
• RC and RM are inextricably linked
• Understanding how people perceive risks and how to communicate risk information e effectively are keys to improve risk management
Principles of RC
• Interactive and participatory approaches
offer greater risk reduction.
• Critical elements are:
– trust and credibility of message source,
– quality and clarity of message,
– effective and efficiency of delivery channel,
– and involvement of target audience
Principles of RC
• Relevant agencies have an important role.
• Individuals and communities have a right to know about the risks to which they are exposed and to participate in decisions that affect their lives and property.
• RC is no substitute for regulation or action
• Risk communicators are accountable to the public and should base their actions on principles of ethics.
• RC is often an exercise in Public Relations
Situational analysis
Research the high risk mothers
• Who are they?
• Where do they come from?
• What is their educational background, occupation?
• What is their mode of communication, channels?
• How do we reach them?
• Where do they meet us?
• What are the resources available for intervention?
• What is their K, A, Practice, Perception, Motivation towards the risk?
• Who influences them in their decision making?
Risk Communication Process
• Problem diagnosis – Demography
– Psychography
– Behaviour contributing to risk
– Education, knowledge, attitude
– Perceptions and motivation
– Cultural practices
– Belief system
– Community Resources
– Communication channels and the various local vehicles
– Identification of Opinion Leaders
Objectives: Addressing the gap
General Objectives:
• To ensure effective communication to
mothers at risk and those who influence
them to reduce risk
• To contribute to effective management of
risk to reduce morbidity and mortality
Objectives
• To disseminate accurate and timely information.
• To maintain and strengthen credibility of the
health care providers and MOH
• Motivating individuals to act.
• To get immediate feedback and to take
appropriate remedial actions.
• To resolve conflicts/threats in managing patients
Specific Objectives
• Must be measurable for purpose of
evaluation
• Addressing the gaps in knowledge, attitude,
perceptions, motivation and actions by
quantifying
• Stated in the form of who, what, when
where, how.
Strategies
• Strengthening existing plan of action
• Develop new strategies in keeping with current trends especially the trend from education to promotion (Ottawa Charter 1986)
• Laws governing maternal deaths
• Policies
• Social support
Strategies
• To seek the cooperation of related
government agencies and non-government
organisations (NGOs) involved in maternal
health
• To provide accurate, timely,
comprehensible information through the
use of appropriate technology and channels
of communication utilised by the mothers
Strategies
• To coordinate flow of information to
internal and external stakeholders. This
includes relevant government agencies and
NGOs.
• To obtain feedback of mothers at risk from
the program managers, health care workers
and researchers so as to provide the relevant
information to the target groups.
Strategies
• To develop effective partnership with
groups who have the support of the high
risk mothers
• To provide in-house training programmes
in communication to health care providers
handling high risk maternal cases
Message Sources:
To identify relevant personnel who communicate
with the mothers to work as a team and provide needed assistance
• Specialists, Registrars, MOs, Interns
• Hospital nursing staff
• Public health personnel who have contact with mothers
• Spouse, Family members, influential community members
Message Sources:
Webpage
• Creation and updating of MOH
Webpage: The mothers as well as
health care providers would be able to
gain the latest information on maternal
care
Website
• Growing trend of DIYDS playing little doctors aided by the advent of the internet. 136 million Americans access the net for health information.
• They research their own symptoms, diagnose their own illness and administer their own cures. Some buy their own machines and monitor their fetuses every night. No need to visit the doctor
• Increase in over the counter drugs
• Increase in Complementary and Alternative Medicine 1 in 3 Americans resort to CAM
– Mark J. Penn Microtrends 2007 pgs 91-95
Message Design: Educational
materials
• The development and dissemination of
relevant messages and educational
materials on maternal health such as
personal health care diary
• This covers both for the internal and
external stakeholders and should be easily
readable and have personal relevance to the
target group.
Educational Message Design:
Drafting a fact sheet
Content of fact sheet eg.
• Nature of problem (eg, cause)
• Management of the problem
• Prevention
• Important contact numbers
Delivery Channels
• Obtained from Initial Assessment
• Maximize effective and efficient utilization of delivery channels in terms of reach and frequency
– Face to face in clinical settings
– Home visits
– Occupational settings
Target Audience: Feedback
• To carry out analysis on all feedback
from mothers and others especially
frequently asked questions (FAQ) so as
to improve the information on
explaining risk
Organizational Activities
Human Resources: Training
• Competence in communication skills:
– Interpersonal skills
– Persuasion, Motivation
– Appealing to fear, emotional and rational
– Counseling (on prevention of pregnancy,
anxiety)
– Conflict resolution
– Negotiation
Organizational Activities:
Training
Module
• There must be a training manual, regularly
updated, with learning outcomes, content,
skill development and case studies
Community Organization
• Communication should be targeted
towards relevant individuals, groups of
individuals, specific subgroups or
institutions.
• The following should be taken into
consideration.
Community Organization:
Influential or Opinion leaders
• Needless to say the time tested
communication method through such
leaders of communities should be
employed where and when considered
best and opinion leaders need to be
identified and utilized fully.
Community Organization:
Inter-agency collaboration
• An integrated approach is sometimes the most
effective solution when individual persuasion fails
The need to collaborate and form partnerships
with women's group and to work together with
other relevant agencies should be made to discuss
strategies best suited.
Evaluation
• Process evaluation (Formative)
– to evaluate the activities.
• Outcome evaluation (Summative)
– to assess the reduction in morbidity and
mortality.
– changes in knowledge, attitude and practice of
target groups.
– attainment of communication objectives
Review and proposals for
change
• Preparation of report
• Distribution of report
• Storage for later retrieval
• Use of report for case studies and
research
• Learning from past mistakes
Guideline for agency
spokesperson • Spokesperson should be good in presentation and
interaction
• No names of the affected to be given until next of kin informed.
• Assure media results of the investigation will be given.
• Prepare press statement.
• No exclusive interviews.
• Be accessible.
• Be calm.
Media’s Role
• Assist in education
• Convey warnings.
• Convey instructions.
• Reassure public.
• Defuse rumors.
• Assist in the response effort.
• Provide the agency with updated information.
• Solicit help from others.
Dealing with the Media
• Prepare fact sheets, keep reporters updated.
• Avoid jargon.
• Respect reporter’s deadlines.Be polite and straightforward.
• It is good to tell the truth.
• Have your own agenda.
• Stick to facts you know. No opinions.
• Relevance of message, make notes and provide feedback.
Public Relations
• Organization put under public spotlight, management competence is questioned
• Employees, public and media need to be communicated
• Difficult for managers to make god decisions and to communicate well
• PR practitioners, legal, technical experts make a vital contribution
Effective risk communication
• Depends on the providers’ and recipients’
understanding more than the risks and benefits.
• Background experiences and values also influence
the process.
• The goals of the communication is advocacy,
education and decision making partnership.
• Multidirectional
• Debate instead of lecture
Target Audience
• If you do not listen to people, you cannot expect them to listen to you.
• Target group have their own interests, information needs and channels, concerns and priorities.
• People need to be sufficiently motivated to understand complex risk information
• Information about the audience characteristics can be obtained through surveys, focus group discussions, demographic profiles and in-depth personal interviews
Risk Perception
• Conditions associated with increased public concern are
– Catastrophic potential
– Unfamiliar mechanisms
– Uncertainty
– Uncontrollable
– Involuntary exposure
– Children specifically at risk
Public Risk Perception
– Risk to future generation
– Identifiable victims as opposed statistical victims
– Effects dreaded
– Lack of trust in responsible institutions
– Much media attention
– Major accidents also minor
– Inequitable distribution of risks
Public Perception of Risk
– Effects irreversible
– Individual personally at risk
– Risk estimates based on human evidence
– Origin caused by human actions or
failures
Different categories of people
• Bandwagon: choosing the decision of the
majority.
• Free riding: gain by the doing of others.
• Altruistic: willing to take personal risks if
others will benefit from them.
Perception regarding risk
• Health belief model:
– Perceived susceptibility.
– Perceived seriousness of the disease/issue.
– Perceived benefits.
– Perceived barriers.
– Perceived threat of the disease.
Soft skills Training
• Soft skills are something that you have or don’t
• But it can be developed as we go along
• Soft skills separates a good doctor from a great doctor
• Soft skills include interpersonal skills and social skills such as listening, diplomacy, goodwill, flexibility, problem solving, smile, humour and empathy towards a caring professional doctor patient relationship (list is non exhaustive)
Methods used in soft skills training
• Role play
• Observation where the senior doctors become their role model Marcus Welby M.D., Dr. Kildare
• Young doctors given hands–on experience like breaking bad news to family members
• Interaction with the senior doctors
• Peer group discussion in sharing experience