education-entertainment

Promoting food and nutrition literacy using multi-media education-entertainment

More than 70% of South African women and 39% of men are either overweight or obese, according to the latest national survey conducted by Statistics South Africa. Most live in disadvantaged communities, especially in periurban townships characterised by economic constraints, where a lack of information about food and nutrition lives alongside an obesogenic food environment that makes it difficult to make healthier food decisions. The South African government has outlined strategies for the control and the prevention of obesity and its consequences, considered non-communicable diseases (NCD). The strategies focus largely on health promotion, encouraging the curbing of behavioural lifestyles such as smoking and binge drinking plus promoting interventions to reduce body size like making better food choices and engaging in physical activity. Health workers who operate in low- to middle-income communities are not immune to obesity and the associated NCDs, and tend to lack information about food and nutrition. It is particularly important that community health workers (CHWs) are well-informed, as they serve as liaisons between health services and the community and, as such, can engage in health promotion activities, providing community nutrition education, social support and healthy food advocacy.

Multi-media entertainment-education tools

Substantiated international evidence suggests that various forms of media are important modalities for promoting health, especially messages to prevent and manage obesity. These range from formal media (like television and magazines) to social media (such as WhatsApp and FaceBook). Using media creatively can reinforce new and old health messages, support health changes, encourage maintenance of change, and keep health issues on the public agenda.

Growing evidence also suggests that to reach very large audiences effectively, health messages need to be entertaining.

This project therefore sought to develop entertaining healthy food and nutrition messages through using short stories in the form of comic booklets and videos. These would be disseminated through different media, especially SMS messages and WhatsApp both of which are accessible to the majority of CHWs who operate in disadvantaged communities.

Main aims of the project

The overall aim of this two-year project, then, was to develop and validate a multi-media education-entertainment (MM-EE) programme designed for CHWs who operate in Gugulethu, Nyanga and Kensington in Cape Town. The intention was to improve their food and nutrition literacy and their body image, both in their own interests and so that they can demonstrate and promote these ideas to the communities in which they work. This was part of a larger project whose main aim was to improve food and nutrition literacy with a view to curbing obesity in disadvantaged communities of South Africa. CHWs who were working for the St John non-profit organisation and who were offering health promotion services in these communities were approached to participate in the study. They had to be 19 years or older. Of the 96 CHWs chosen, the majority was then assessed as obese and had risky eating behaviours. They welcomed information on meal planning, food choices (including reading food labels), as well as food preparation – and were keen on getting health messages in entertaining forms and directly from health specialists. What the project did

Baseline data on nutrition literacy collected from the CHWs informed the development of seven two-page comic booklets and seven animated video clips. The idea was that the CHWs would access these comics and videos through text messages and WhatsApp, first to inform themselves and then to inform the communities with whom they worked. The project ran for 24 months and its effectiveness is now being assessed. This entails analysing the final data collected from the CHWs to ascertain what changes in knowledge there may have been, which will be a measure of the effectiveness of this health promotion intervention. Academic dissemination

Some of this work formed the basis of an MPH student’s mini-thesis. Titled ‘Determining body image, food and nutrition literacy of community health workers operating in three Cape Metropole townships in the Western Cape, South Africa’, Asiphe Ketelo graduated in December 2020. A poster presentation on the outcomes of the baseline data was delivered at the Public Health Association of South Africa (PHASA) conference in 2019. The outcomes of the analysis of the post-intervention data will be published in an ISI-accredited journal during 2021. This project was undertaken in partnership with the University of Antwerp, and Katholieke Universiteit (KU) Leuven, with financial support from VLIR-UOS (Belgium, Flanders).

Yes, having a healthy diet is so good, but exercising is also important for your body.