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Case study (health strategies)

Case study (health strategies).

Introduction.

            Health promotion is a very important issue in every society.  Countries cannot develop if their citizens are unhealthy, since a strong workforce is an integral part of economic development.  Many countries are increasingly facing challenges in the health care sector due to inadequate resources to cover the health needs of citizens.  The increase of new diseases in the modern times has further compounded the situation.  These diseases are mostly attributed to unhealthy eating patterns of the people, as well as the adverse effects of pollution in the environment.  The spread of sexually transmitted infections, especially HIV/AIDS has dealt a heavy blow to the health care systems of almost all countries in the world.  This problem is worse in developing countries, especially those located in Africa.  Millions of people have died from this disease and millions others are infected, yet it still has no cure.  It is therefore important that all countries formulate plans to effectively deal with HIV/AIDS in order to reduce infection rates.  The people who are already infected should also be cared for, and they should have access to appropriate anti-retroviral treatment to prolong their lives.

            In line with these objectives, Uganda and Bolivia

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undertook a campaign to increase awareness on reproductive health in order to ensure that the population is aware of the two issues affecting their health. This paper aims at analyzing the various strategies which the two countries undertook to ensure the success of their campaigns.  It aims at comparing the two approaches used in the campaigns and analyzing the similarities and differences in their approaches.  The paper also analyzes the design strategies and tools which are used in each case.  Finally, the paper also gives recommendations on any improvements which may be undertaken to ensure the success of such campaigns and strategies in future.

            In formulating a plan, there are several processes which one should follow to ensure the success of the strategy or campaign.  The first process involves problem identification and this is aimed at analyzing the nature and extent of the problem, in order to come up with an appropriate strategy to  achieve the desired goals (Nadler 2004: 25-33).  The second process involves formulation of an appropriate strategy and this is done to ensure that the strategy which is implemented is both practical and workable.  Finally, the final process involves the development of appropriate evaluation procedures to measure the success of the strategy.

Important similarities and differences in the campaigns.

Similarities.

            One of the major similarities between the two campaigns is that both were aimed at health education and promotion.  This is a campaign which involves making members of the public aware of certain health issues which affect the community.  Due to the challenges which face the society, many countries use campaigns to inform citizens about various health issues, in order to empower them to make informed decisions regarding health care issues.  The Bolivia campaign focused on increasing awareness on reproductive health issue whereas the Uganda campaign focused on increasing awareness on HIV/AIDS in family settings.  Although the two campaigns targeted different issues, they were both were aimed at increasing awareness on health education and promotion.

            The second similarity between the two campaigns was that both of them used the cooperation between the private and public sector.   This is very important, if the message being delivered is to reach a larger number of people.  This is due to the reason that both the private and public sectors reach different segments of the society.  The government may not have elaborate access to the lower social class which resides in slums and rural areas.  The private sector may reach these people through NGOs which are already present and are based in these areas.   In the Uganda campaign, the Ministry of Health partnered with the United States Agency for International Development and the University of North Carolina.  On the other hand, the Bolivia campaign had more government support, with it coming from the president and the health ministry.  The government similarly collaborated with the private sector, which included the United States Agency for International Development and other private institutions.

            A third similarity between the two campaigns is that both of them used gap analysis in collecting the information.  This is a type of analysis which is used to compare the potential goals with what has been achieved so far.  It is an analysis which is aimed at analyzing the current environment in relation to the goals which the campaigns are meant to achieve.  Both the Bolivian and Ugandan approaches used this analysis although it was slightly different in terms of the attributes which were being analyzed.  In the Ugandan approach, both qualitative and quantitative approaches were used, and this information was acquired from Uganda Baseline Survey, in depth interviews and focus groups.  In the Bolivian approach, both qualitative and quantitative approaches were also used, and these included a baseline household survey.

            Another similarity between the campaigns was that both of them experienced cultural barriers.  Cultural barriers are normally experienced in societies which are not open to change, or in traditional societies which follow traditions and cultural practices in various aspects of social life.  These barriers are also experienced in modern societies when people are opposed to change.  In the Uganda case study, one of the barriers which was experienced includes resistance in the use of contraceptives and this arose from several factors.  These include fear of side effects which are associated with contraception, dislike from the partners, prohibition from religion and the lack of knowledge about contraception.  The culture in Uganda advocated for large families which represented a status symbol associated with wealth.  Contraceptives prevented the Ugandan people from achieving this objective and this is one of the reasons why it faced resistance from some people.

            On the other hand, Bolivia faced similar challenges in explaining the importance of reproductive health to the local people.  The population’s in Bolivia had limited information on family planning methods, a fact which hindered the effective communication on the reproductive issues.  The religion in Bolivian also prohibited family planning, a fact which proved to be a challenge when educating people on the importance of family planning.

Differences.

            However, there were a few differences between the strategies and approaches which were used in Bolivia and Uganda.  One of the major differences was the goals which had been set for the campaigns.  In Bolivia, the major goal of the campaign was improving the knowledge that people had regarding reproductive health.  On the other hand, the major goal of the campaign in Uganda was improving knowledge that people had regarding HIV/AIDS transmission with an aim of reducing the spread of the virus.

            Another difference between the campaigns in the two countries was in the target population.  The campaign in Uganda targeted 80% of the population and most of them lived in the rural areas.  The age group of the target audience was between twelve and forty five years, and it targeted people of all classes.  The Bolivian campaign targeted the people who lived in urban areas, and specifically seven cities.  These were the people in the lower and middle social class.  The age group of the target audience was between eighteen and thirty five years.

            In implementing the project and advertising, the two countries used different strategies, with the Uganda strategy showing little participation by key leaders in the government and in the private sector.  In Uganda, the most active people were the district representative and reproduction health organizations.  In contrast, the Bolivian campaign was very active, with different stakeholders in government and the private sector participating in the campaign.  A popular politician was incorporated into this campaign and this attracted a lot of people to it, thereby contributing to its success.  Finally, Uganda used a five year strategy whereas Bolivia used a three year strategy.

Tools, analysis and processes used in each campaign and suggestions on improvements.

            In implementing the strategy, Uganda used various processes.  The first process was problem identification an this involved analysis of the prevailing problem which was supposed to be rectified.  The Ugandan government used a survey to establish the extent of the HIV/AIDS problem since this was the issue of the campaign.  The survey revealed that there was a low prevalence of contraceptive use.  The prevalence rate of STDs was found to be relatively high, with 108,000 hospital visits by patients revealing a prevalence rate of 19%.  The maternity mortality ratio in Uganda was also found to be very high in comparison to other countries in the world.  The second process involved the formulation of a campaign strategy which was suitable for the goal.  In order to come up with an effective strategy, the government carried out a SWOT analysis to determine the current strengths and weaknesses, so that they may be exploited or rectified in order to meet the required goal.

            The SWOT analysis is a tool which is used to reveal the strengths, weaknesses, opportunities and threats in the current environment.  It is very important to carry out a SWOT analysis before implementing any major project or strategy in order to evaluate the strengths which one possesses, the weaknesses inherent, opportunities which should be grabbed and the threats to the implementation of the project (Kushal 2004: 57-63).  When one has information about all these aspects, he or she will capitalize on the strengths and minimize the weaknesses, in order to create an efficient strategy.  The person or body implementing the project should also analyze the opportunities and threats to the implementation of the project in order to grab the opportunities and make the project grow.  There is need to take steps to minimize the impact of the threats to the strategy, project or campaign in order to ensure the survival of the same.

            In the SWOT analysis which was carried out, the strengths were found to be the experience and knowledge in running successful campaigns, and this was attributed to experience gained from prior family planning programs.  These previous campaigns also had the advantage of increasing knowledge on family planning in the society.

            The weaknesses in the current environment included the lack of materials which were to be used during the promotion.  Another weakness was that family planning services were not available in rural areas, which undermined the success in the campaign in these areas.  Other weaknesses which were revealed included the lack of enough staff, facilities and drugs which would ensure the success of the campaign.

            The major opportunity found was the ability to incorporate family planning services with the HIV/AIDS campaign.  The pregnant mothers needed family planning services which were directly related to HIV/AIDS prevention, which meant that the same forum could be used to advocate for the prevention of HIV/AIDS.  The government was the largest planner and supporter of HIV/AIDS activities and also family planning services, which is convenient, since it would be able to perform both roles when giving family planning services.

            Finally, one threat present in the current environment was seen to be the religious beliefs which were against the use of contraceptives.  Another threat was the refusal by TV and radio channels to promote contraceptive products.  There was also very little information on the contraceptives, and this threatened the success of the campaign.  The culture of polygamy which was entrenched in most communities was also identified to be a threat to the success of the campaign, since this is one way which facilitated the spread of HIV/AIDS.

            The second step was the designing of a strategy to use, which proved challenging due to the limited information available on male and female health, reproductive decisions and issues.  In designing strategy, gab analysis which was earlier mentioned was used.  The Uganda Baseline Survey conducted in 1993 and the Uganda Demographic and Health Survey which was conducted in 1988, was used to provide information on the current environment.  This survey revealed the fertility preference and rate, exposure risk to pregnancy and the mortality rate.  Further qualitative research from other sources was also used in designing the strategy.  This step enabled the Ugandan government to get a clear picture on the situation on the ground in order to know which areas needed more attention and the strategy to use in different areas.

            In the Bolivian strategy, the goal created was promotion of healthy reproductive practices and increase in usage of modern family planning methods.  This campaign aimed at taking advantage of the past success in planning.  As opposed to carrying out a SWOT analysis of the environment, the stakeholders identified the likely challenges which could affect the realization of the set goals.  These problems included lack of knowledge about family planning methods, unmet family planning service needs, and limited information on contraceptive use.  Due to the long duration between the previous survey taken and the current period, the developers of the strategy required more information on  personal attitudes, knowledge, practice and media attitude of the targeted population. A gap analysis was subsequently carried out to identify this information.  Other information was retrieved from previous research and surveys carried out in 1994.

            Both campaigns made use of the necessary tools required for effective implementation of the strategy.  However, in addition to using the SWOT analysis, I would recommend the use of a PEST analysis which provides a deeper analysis of the present environment.  PEST analysis further analyzes the political, economic, social and technological factors which have effects on the implementation of a strategy or project.  I would also recommend the use of researches and surveys carried out in more recent years, since relying on research carried out many years back may lead to inaccurate findings.

Design strategies used in each case.

            Both campaigns used a communication strategy since this is the most viable when encouraging behavioral change.  In the Uganda case, there were several objectives and some of them included prevention of HIV/AIDS for youths, family planning campaigns, advocacy of practice of safe sex, and clearing misconceptions on modern methods of family planning.  The messages which were used in the campaign were diverse and included using condoms, being faithful, resisting peer pressure and having non-penetrative sex.

            In the Bolivian case, the design strategy used hinged on taking advantage of the past success of family planning services.  The past successes showed that similar strategies could also lead to the success of the current campaign.  The goal designed in this campaign was promotion of healthy reproductive practices and increase in use of modern family planning methods.  A management structure run the campaign, and it was composed of four subcommittees.  These committees were responsible for research and training, and service provision regarding information, education and communication of the campaign goals.  They met regularly, worked together and represented the face of the campaign.

            The objectives set in this campaign were specific and had clear targets.  For instance, one objective was to make sure that at least 64% the audience who would be targeted recalled the campaign, at least 33% should have knowledge on availability and use of reproductive health, and at least 41% should have knowledge on more than one benefit of reproductive health.  The message used in the campaign centered on family planning and was more objective.  It included the information on family planning, concept of reproductive health and pro-active family planning.

There campaign also made the use of popular politicians in order to popularize it and make sure that many people are aware of its activities.  There was more visible participation of stakeholders in the government and private sector in the campaign, and these became the face of the campaign.

            As opposed to the Bolivian strategy, the Ugandan strategy did not make the use of popular social figures to popularize the campaign.  These was also limited visibility of government and private sector stakeholders associated with the campaign.  This is a potential weakness which makes the campaign lose popularity and people are not likely to take it very seriously.  In future, the government and private stakeholders should be more visible during the campaign, since most people associate with them and are likely to take it seriously.  This will increase the involvement of people in the campaign and will lead to its success.

How research evidence impacted the strategy.

            Research evidence is very crucial in the implementation of any strategy.  This is due to the reason that the research will reveal the situation as it is on the ground, and what needs to be done in order to achieve the required goals.  The research which was conducted in Bolivia and Uganda aimed at analyzing the extent of the problem in order to determine the appropriate measures to take.          In Uganda, the research which was used revealed information about fertility preference and rate, mortality rate, exposure to pregnancy risk, marriage and other aspects which were very important in formulation of the strategies.  Since there was limited information on male and female reproductive health in Uganda, this research was useful in understanding issues regarding reproductive health which was essential in formulating the strategy.

            For instance, the research revealed the statistics of HIV/AIDS in different parts of Uganda, and this was useful in determining the areas where efforts more would be concentrated.  The research also revealed the cultural practices of the people, and this was very important in carrying out the campaign in a way which did not undermine the culture of any person.  The fertility preferences and rate was also important in assessing the family planning needs of the people as well as determining the people who are at higher risks of contracting HIV/AIDS.  This is very important in determining the strategy to use, and areas which need greater attention in the fight against this disease.

            In Bolivia, research done in previous years was used to obtain information on attitude, knowledge, practice and media attitude of the targeted population.  This research had similar effects on the design of the strategy to the Uganda case study.  It revealed the attitude of the target population, which was important in designing the strategies to correct any misconstrued beliefs and attitudes.  The information on availability of knowledge on reproduction issues is useful to strategy developers in determining the strategy to use, and areas which need greater attention with regards to campaigning for awareness on reproductive health.

How strategies were monitored and suggestions on improvements.

            There were several strategies which were used to monitor the progress of the information, education and communication of the campaigns initiated by Uganda and Bolivia.  One of the strategies involved the incorporation of IT, and specifically an information system, which proved to be very useful in monitoring the progress of the campaign.  The information system was used to monitor the number of patents and their progress in the health center visits, before and after the campaign.  The information collected was then stored in database which could be used to analyze the impact of the campaign in totality.  This helped in revealing if the campaign had any effect on the attitude which the people had on health care.  If the campaign is found to be unsuccessful, then other interventions would be applied to attract the desired outcomes, or a new campaign would be developed (Irving and Tourish 1994: 53-57).  The Bolivian strategy involved the use of a survey in evaluating the success of the campaign.  This survey analyzed the number of people who were aware of the campaign logo, and family planning methods.  The campaign also analyzed whether there was an increase in communication between partners regarding health issues and also the number of people who seek information on reproductive services.  In future, the evaluation should include goals which can be quantified in order to clearly identify if the campaign has been a success or not.  This is because evaluating qualitative measures is very difficult.

Lessons learned from this activity in making future strategies or campaigns.

            The case studies have been very useful as far as the implementation of campaigns or strategies is concerned.  The two case studies have enabled me to learn two different strategies to use in implementing a campaign, and the results which I am likely to get from each strategy.  I have also learned the processes in developing a campaign or strategy, and these are illustrated below; The first process is the statement of the problem since this is what defines the goals of the campaign or strategy.  The statement of the problem enables one to know the impact and nature of the problem which is key to finding the solution to the problem (Brown 2008: 1-9).  The processes which are involved in the formulation of an effective process have also been explained, and their importance stated.  I have learned that it is important to carry out a SWOT analysis before coming up with an effective strategy, since it guides the planner on the strategy to use through taking advantage of the present strengths and improving the weaknesses.

            The importance of carrying out research before implementing a strategy has also been explained, and I have learned that previous researches can be used if there is no current research on the issues required for analysis.  Finally, I have understood the importance of evaluating a strategy or campaign after it has been implemented.  Evaluation helps one to know if the campaign or strategy has been successful, and the measures which should be taken if it is found not to be effective.  In future when planning a campaign or strategy, I would make sure that I have enough background information on the subject before coming up with a strategy.  The processes of formulating a strategy and evaluation of the campaign or strategy would also be included in the implementation.  This will motivate me in future to implement strategies or campaigns aimed at empowering the marginalized people which is my passion in life.

Methodology.

            This research used secondary sources of information which include academic books and journals.  The books and journals selected are only those which are written by scholars and they are highly credible.  Some benefits of this type of information include the ease of availability through the Internet, which makes it convenient as a source of information.  Another benefit of these sources of information is the availability of information on various topics, which have been analyzed from multiple perspectives, by the authors.  There is a wide variety of information in the Internet from academic journals and books, and this makes the research paper written from such sources to be comprehensive.

            There are also certain weaknesses which are associated with the use of academic books and journals.  One of these weaknesses is the fact that it is very difficult to obtain clarification on unclear issues from the author of the article since he or she is not physically present.  This means that any issues regarding certain topics which are unclear to the researcher may only be corroborated using other different sources.  This may leave the researcher with important questions which are unanswered and may affect the comprehensiveness of the research.  Another weakness is the fact that any weaknesses in the original materials which the researcher uses to do his or her research may be transposed to the research paper.  For example, if the original materials which the researcher relies upon for research are biased or have errors, this bias or errors are likely to be replicated to the research paper.  This may affect the validity of the research paper.

Summary and conclusion.

            The process of planning a campaign or strategy has been seen to be challenging due to the many steps which are required as well as other challenges present, such as limitation in information on the subject.  However, in spite of these challenges, it is possible to develop a practical strategy if all processes are followed accurately.  The statement of the problem has been seen to be the first step, and this is followed by a background study and SWOT analysis, which are aimed at analyzing the present environment with an aim of revealing the current strengths and weaknesses.  Research has also been seen to be crucial at this stage, since it will also be used in developing the strategy to be used.  These processes lead to the implementation of the strategy.   After the implementation, evaluation measures are taken to analyze the success or failure of the strategy or campaign (Bryson 2004: 65-69).  In case the campaign or strategy is seen to have failed, the process is started afresh, in search of a strategy which will work in the current environment.

            Since there are very many projects and campaigns being undertaken in different parts of the world, this information is very important to the stakeholders involved.  It is however important to note that the two strategies which have been analyzed in the paper should not be directly replicated in other projects, and only the practical aspects should be used.  This is because similar problems which face different parts of the world can only be solved according to the environment where they occur.  One solution in a certain part of the world may not be practical to a similar problem in another part of the world.  In conclusion, any successful campaign requires an appropriate design and evaluation process.

Bibliography.

Brown, T. 2008. Design Thinking. Harvard Business Review.

Bryson, J. M. 2004. Strategic Planning for Public and Nonprofit Organizations: A Guide to        Strengthening and Sustaining Organizational Achievement. Washington: Jossey-Bass.

Irving, P., Tourish, D. 1994. An Integrated Communication Strategy for Health Service             Managers. Journal of Management.  Vol 8.

Kushal, S. J. 2004. Business Communication. New York: VK PUBLICATIONS

Nadler, D. A. 2004. What’s the board’s role in strategy development?: Engaging the board in     corporate strategy.  Journal of Strategy and Leadership. Vol 32.

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