Research Article
The Obstacles to the Learning in Health, Hygiene and Nutrition: Situation in some Literacy Centres in Burkina Faso
Institut Des Sciences Des Societes (INSS/CNRST), 03-BP 7047, Ouagadougou 03, Burkina Faso
No country can develop without a schooled and literate population. According to the last general census of the population and housing (RGPH) (Statistics and Demography National Institute, 2006), illiteracy reaches about 70% of Burkinabè. One of the consequences of this situation is that a large majority of the population is without knowledge and skills necessary to meet their basic needs. Youth and adult peoples literacy is considered as an inescapable complement of schooling to take up the challenge of Education for All (EPT) (UNESCO, 2005) and of Millennium Development Goals (MDG) which aim at reaching literacy rate of 40% in 2010 and 60% in 2015 in Burkina Faso. In addition to the quantitative requirements, there are also the qualitative ones. In the monitoring report of Education for All (EPT) of UNESCO (2005) titled quality requirement, the problematic of the quality is raised as a sine qua non condition of the achievement of the objectives which are fixed (EPT, OMD). However, an analysis of the statistics of the literacy shows that the losses are enormous, i.e., about 59% in 2005. This report leads us to raise the question of the obstacles which hamper the participation and the success of literacy despite multiform efforts provided (Traore, 2009).
Further to the training courses given, the impact on the learners socio-economic life is less noteworthy. This situation could be partly explained in the teaching skills of the training courses (Faundez and Mugrabi, 2004; Gagliardi, 1995; Giordan, 2004; Mugrabi and Cota, 2004). In fact, the learner even adult, is more often managed as a thing on which knowledge is given without taking into account living conditions, problems met and the needs. The sustainable alternative is to improve the knowledge, the know-how, the inter-personal skills of these communities because the learner is the author of his own apprenticeship. Diseases related to hygiene and sanitation, the nutrition problems, mother and childs health, are among others, the evils prevailing in the rural communities in Burkina Faso (Poda et al., 2003). The fight against the health issues, in particular those related to hydraulic installations on the bordering populations, was approached by several researchers (Birley, 1993; Hughes and Hunter, 1970; Hunter et al., 1994; Parent et al., 1997). This fight must integrate a shutter training in health, hygiene and nutrition which should contribute to improve the knowledge and know-how and leaving quality of life. That is why the health-hygiene-nutrition section occupies a good part in the curricula of sciences of life and earth of the literacy centres. The aim is to develop the learners abilities to the understanding of health, nutrition, hygiene in view of a change of mentality and behaviour for the improvement of the living conditions. How such an approach could facilitate learning in the field of management of health-hygiene-nutrition for a quality of life? An evaluation research was conducted in literacy centres in order to reply to this question; it was lined on the competences as well at the learners and post-literate peoples level as at trainers like the Provincial Directors of Basic Education (DPEBA) and the training trainers in order to identify the obstacles and the difficulties concerning the contents of the curricula and the presentations.
First, a documentary review consisted in collecting the secondary data from the Provincial Directions of Basic Education and Literacy (DPEBA) of the Direction of Research and Innovations in Literacy (DRINA), Association for Non Formal Education (APENF-Burkina) and also the NGOs working in the sector.
In the framework of this survey, the chosen sample comprised 113 learners and neo-literate people of the literacy centres and 20 supervisors and training trainers.
The survey took part in ten Provincial Directions of Basic Education and Literacy (DPEBA) representing four regions of Burkina out of thirteen. The target regions are those of the Centre (DPEBA of Oubritenga and Ganzourgou), of Centre West (DPEBA of Bulkiemdé and Sanguié) of South West (DPEBA of Bougouriba) and Central Plateau (DPEBA of Kadiogo). These DPEBA are located respectively in the towns of Ziniaré, Zorgho, Koudougou, Réo, Dédougou and Ouagadougou.
Two questionnaires were elaborated to serve as aid for the data collection; one for the supervisors/trainers and the other for the learners/neo-literate people and the post-trained. Each questionnaire comprised 8 questions; only the formulation of the first question makes the difference between the questionnaires.
First, through these questionnaires, it was a matter of exploring the perceptions and attitudes of the field stakeholders on the assets and obstacles which hamper the success of literacy in health-hygiene-nutrition in the literacy centres. Secondly, the results (constraints, obstacles and suggestions) of the learning in instrumental knowledge and in health-hygiene-nutrition as well as the impacts in the daily life of the literate people were analyzed.
Conduct of the Field Surveys
First, the questionnaires were tested and finalized. Field surveys took place from November 15 to 30, 2008 in the selected areas.
In total, 20 questionnaires filled and validated were obtained from the supervisors and trainers. Out of the 200 filled questionnaires from the learners, 113 were validated. Forty seven questionnaires (13 from Debag, 24 from Réo and 10 from Ziniaré) filled by the learners were excluded from the analysis because the centre and/or the guarantor were not clearly identified. The final sample of the learners comprises 43 men and 90 women.
The objective of this research was to set up the main barriers to the learning in Health, Hygiene and Nutrition in the literacy programmes in Burkina Faso. Specifically, it concerned: (1) the obstacles which limit the participation in literacy therefore to the programme of health-hygiene-nutrition; (2) what motivates the participants to engage in a literacy programme; (3) the interest of a health-hygiene-nutrition programme ; (4) the themes studied that the guarantors consider as important; (5) the important assets they estimate having stored up in the field of health-hygiene-nutrition; (6) the impact of literacy in health-hygiene-nutrition in the learners daily life; (7) the obstacles to the literacy in health-hygiene-nutrition; (8) the measures to take in order to improve the literacy in health-hygiene-nutrition.
This part presents first how the data were exploited, secondly, the replies to the eight asked questions and finally, the comments which emerge from these replies.
Exploitation of the Data
The processing of the filled questionnaires was done by taking into consideration the different categories of the guarantors: supervisors/trainers and learners/neo-literate people. The replies of the learners were analyzed according to the sex and the region.
What emerged is that the centres of Ouagadougou, on the initiative of Amicale des Forestières du Burkina (AMIFOB) and those of Ziniaré Gan Silmimossé and Gan Silmissin only comprise women. Those of Réo and Ziniaré Tampaongo comprise a majority of women; those of Debag, Bapla, Bapla Birifor and Zorgho comprise a majority of men (Table 1).
Generally, the replies obtained are various with strong tendencies which indicate the specificities according to the position, sex and the region.
Replies to the Questions
Question 1: Cite the Obstacles Which Hamper the Participation of the Populations in Literacy
This question was exclusively addressed to the supervisors and trainers. The guarantors underline on the one hand, the general obstacles like ignorance, poverty, insufficiency of awareness towards population and on the other hand, the practical obstacles such as the late opening of the centres which coincide with field work and the lack of support in nutrition (canteens).
Table 1: | Structures of the replies to the questionnaires submitted to DPEBA and literacy centres |
Question 2: Why Do Literacy?
This question was exclusively addressed to the learners (men and women). The motivations are the same for men as for women. They are: to learn how to read and write, to calculate, to acquire knowledge and develop. If we enter into the specificities of the centres, we can note as example the following motivations.
Ouagadougou: to fill the presence sheets during the meetings and not to forget our languages and traditions; Debag: to change behavior and to protect oneself against diseases; Réo, Ziniaré and Zorgho: to reduce rural exodus.
Question 3: Why Curricula Literacy in Health-Hygiene?
The supervisors and trainers replies to this question are of general interest. For example: to improve the conditions of living, to change behavior whereas the learners replies which go in the same line are more precise i.e., to fight against diseases and to improve food and body hygiene. We do not note particularities according to the regions.
Question 4: What are the Main Themes Which Seem Important to Treat in Health-Hygiene-Nutrition?
According to the supervisors and trainers, the main themes by order of importance are as follows; (1) food hygiene, body and clothing hygiene, (2) family planning and malnutrition, (3) diseases (AIDS, STD). This order is inverted with more precision with the male learners and female learners and according to sex. So, the female learners preoccupations concern excision, breast and womb cancer as well as family planning. As for the male learners, they underline the modes of transmission of STD. If we refer to the replies by regions, excision is mentioned at Réo, contagious diseases at Debag, cholera and polio at Ziniaré, cough, malaria and tuberculosis at Ouagadougou.
Question 5: What are the Important Assets in Literacy in Health-Hygiene-Nutrition?
For the supervisors and trainers, the assets by order of importance are: (1) the improvement of the conditions of living; (2) knowledge and prevention of diseases; (3) the interest of family planning. These replies are appropriate with the previous question on the main themes to treat. With the learners, we meet again knowledge and prevention of diseases, hygiene. There are differences according to sex with the female learners. In fact, the female learners underline the safe sexual intercourses and the male learners, the attendance of (CSPS) in case of disease. If we refer to the replies by regions, the learners from Réo mention the change of behaviour; those of Zorgho underline the question of drinking safe water and those of Ouagadougou, the interest of making the others aware.
Question 6: What is the Impact of Literacy in Health-hygiene-nutrition in the Daily Life of the Learners?
The supervisors and trainers replies are by order of importance what follows: (1) the attendance of the health centres; (2) the change of behaviour and mentality; (3) the use of mosquito nets. We find these replies with the learners according to orders of priority which are different. If we refer to the replies by region, prevention against diseases is underlined at Réo, hygiene of meals and nutrition at Debag, Zorgho and Ziniaré. Precisions such as: to avoid to drink dirty water is mentioned at Zorgho just as to avoid to buy street medicines appears at Ouagadougou.
Question 7: Quote Obstacles to Literacy in Health-Hygiene-Nutrition
The supervisors and trainers as well as the learners underline by order of importance: (1) insufficiency of teaching aids; (2) lack of training of the literacy trainers; (3) bad quality of teaching aids (badly bound, many mistakes, unreadable words). The female learners add the trainers lack of competence and the male learners the lack of food. If we refer to the replies by region, the female learners from Ouagadougou did not mention major obstacles. In addition to the previous obstacles, those of Zorgho note the lack of reimbursement of health expenses and those of Réo, the problem of religion and customary.
Question 8: Quote Measures to Improve the Literacy in Health-Hygiene-Nutrition
The supervisors, trainers and learners replies are by order of importance the following: (1) to simplify the content of the (teaching) document and make the words readable, (2) retraining and training of the operators and trainers by health agents, (3) awareness of the population and early opening of the centres. The learners add the building of the literacy centres. If we refer to the replies by region, the same measures are mentioned in the regions with precisions such as to get health centres at Zorgho, to conduct talks and exchanges at Ziniaré, to institute a canteen and a pharmaceutical depot at Ouagadougou.
Other Comments: What Powerful Messages (Suggestions) Have You to Deliver?
As suggestions, the supervisors and the trainers give by order of importance: (1) to make the population aware and to open the centres earlier, from January; (2) to support the learners in micro-projects; (3) thanks and encouragements of the initiators. We can find the replies with the male and female learners. The female learners precise the need for a canteen and the male learners propose to involve the local authorities. If we refer to the replies by region, we find the different messages; with the female learners from Ouagadougou, we find the need to improve and increase the themes on the mother and childs health, at Zorgho, the multiplication of the trainings in hygiene and nutrition. The female learners from Réo underlined the learners motivation and those from Ziniaré, the support in food for the infants to the operators.
The problems of health and nutrition even if they are not avoidable, can be contained within acceptable limits (Hughes and Hunter, 1970; Hunter et al., 1994; Parent et al., 1997). But, often the advances are checked both, by economic obstacles especially in the developing countries like Burkina Faso and by illiteracy which curbs the changes.
The learners being adults faced with the needs of knowledge (resort to health care in case of diseases, individual and collective hygiene, fight against malnutrition and deficiencies in micro nutriments) are the researchers of their own learning (Gagliardi, 1995). The perceptions conveyed by the words are more important than the words themselves (Gagliardi, 1987) so, the analysis is oriented in crescendo according to the recommended scientific solutions (Poda et al., 2003): (1) the motivations and the checks to the participation of the populations in literacy; (2) the main themes which focus the learners attention in health, hygiene and nutrition; (3) the assets and the impacts of the literacy in health, hygiene and nutrition; (4) the problems and the solutions for improving literacy, especially in health, hygiene and nutrition and finally (5) some suggestions for the rest of the study.
The Motivations and the Difficulties of the Populations Participation in Literacy Especially, in Health, Hygiene and Nutrition
In matter of education for health, hygiene and nutrition within and outside the health centres, is largely influenced by non formal education, statistics which more concern women, show that 13.31% are educated in nutrition, 12.76% on diarrhoea and therapies of oral rehydration and 35.36% for the other activities of education for health (Poda et al., 2003). The motivations for literacy in health, hygiene and nutrition refer to factors like fight against ignorance, poverty, disease, malnutrition and for the well-balanced development of the family and the community. This appreciation reinforces the PdT approach which puts the learners in the forefront, from their knowledge and the realities of their environment, in view of a change of mentality and behaviour for the improvement of the living conditions (Gagliardi, 1987). This passes through the previous knowledge of the learners know-how and his valorization in the process of learning through its judicious exploitation in the explanation approaches (Gagliardi, 1987; Giordan, 2004).
The Main Themes Which Focus the Trainers and the Learners Attention
In the field of Sciences of Life and Earth (SVT) more than in many others, to apprehend a new knowledge, is to integrate it in a structure of thought already existing comprising of own knowledge prior to educative situation (Giordan, 2004). That is why a mediator who is the trainer is necessary. Often, they are the trainers more than the learners who generally, oppose consciously or unconsciously, to make the training themes evolve (Gagliardi, 1987; Giordan, 2004).
The solicitation of themes like excision, family planning at the interface of Sciences of Life and Earth and of Human Sciences and of language, especially bilingualism appeals to inter-disciplinarity as an interaction existing between many disciplines (Mugrabi and Cota, 2004) and there lies the relation between the trainer and the agents of development who work in the area (Birley, 1993). It is in such a situation that the approach of PdT invites to confront the scattered knowledge in order to guarantee a new configuration of the expectations (Mugrabi and Cota, 2004).
The Assets and the Impacts of Literacy in Health, Hygiene and Nutrition
In the case of health, hygiene and nutrition, we can observe a transfer of leanings in the daily life and benefits on personal, social and health levels. The replies go beyond the expectations and revealed for example (safe sexual intercourses, the resort to CSPS in case of disease and to avoid buying street medicines. The feminine specificity appears in food hygiene and the need for clean water. So, post literacy should enable neo-literate people, the consolidation and the practice of the assets of literacy in and through the activities of micro projects as suggested by the learners. Learning depends strongly on the context; it is always carried out in a socio-cultural environmesnt (Giordan, 2004) where documentation in health, hygiene and nutrition is available in health services and is often displayed for the needs of awareness of the general public. That is why an interaction is necessary with the health agents in order to reinforce self-confidence to achieve the interactive processes of construction and deconstruction (Gagliardi, 1987; Giordan, 2004; Faundez and Mugrabi, 2004).
The Problems and Solutions to Improve Literacy Especially in Health, Hygiene and Nutrition
The replies suggested by the trainers and the learners i.e., (1) to simplify the content of the document and make the words readable; (2) retraining and training of the organizers, trainers and founders, (3) awareness of the population and the early opening of the centres appeal all the actors of literacy to review the trainers abilities, the management of the literacy centres, the availability and the quality of the teaching aids.
The learners mentioned the necessity of micro projects; that can be considered either through the possibility of self-production of the centres for their own needs either through the situation of the neo literate people. In one sense or in the other, these initiatives are to enable the learners or the neo literate people to practice their competences, to increase and to exceed the acquired knowledge. These micro projects could consolidate the literacy assets, check illiteracy of return and serve as pathway to overcome poverty. It is there that literacy is at the centre of the fight against poverty and for the shared and sustainable development (Poda and Kam, 2003).
Some Suggestions for the Follow up of the Research
The messages formulated as well by the trainers as the learners, confirm that the learners are satisfied for having carried on with the training as well on the learning formal skills level as on the personal development level (Niameogo, 2001; Traore, 2009). In the follow up of the research, it would be interesting to measure, in comparison with the performance of the different approaches, especially those of DRINA, Tin Tua and of PdT approach, in terms of the learners abilities, loss rate (membership), impacts within the households and the communities with the post-literate people.
Among the obstacles to the promotion of health, hygiene and nutrition, two major factors are pointed out:
• | The lack of knowledge about the merits of the good practices by the populations in that matter and consequently, a less involvement of the communities in the management of their environment |
• | Low enrollment rate and the lack of integration between education and the community |
This first exploratory work is a starting point for detailed researches on the relation between literacy, health, hygiene and nutrition for human resources development in rural area, a key question of development. In Burkina Faso context, to insure health, nutrition and food security of the populations, it is obvious that we must pass through instruction and the appropriation of useful knowledge on the curative means, especially, the preventive ones enabling to control diseases and to eat safely. To that end, to take into consideration information on culture, the traditional knowledge on health aspects, the specific learning difficulties of the populations by the education systems, especially the non formal ones, falls within the synergy of actions for the achievement of the Millennium Development Goals and Education for All (EPT).
We are grateful to Development et Education Des Adultes (DEDA), program of the University of Ouagadougou for providing financial support through Project/02/DEDA/08. All the persons who contributed to the work, especially DRINAs workers who have contributed as participating investigators and the supervisors, teachers, learners of the literacy centers and the persons in charge of the DPEBA who answered the questionnaires. Without forgetting Poda J.-N., Research Director IRSS/CNRST who has to supervise work.