Every year since its inception, the Food and Drug Administration’s National Committee of Rational Use of Medicine in Iran have used public education activities and projects to improve the rational use of antibiotics.
As access to effective antibiotics is necessary for all aspects of modern health care, an informational campaign was developed targeted at the general public. In 1999, the National Committee of Rational Use of Medicine started a campaign focusing mainly on women and children with only 20% of the educational programs targeted specifically at men. This was decided as women and children were seen to be more accessible and also in Iran, women are responsible for the family. By educating the women, they could continue spreading the messages within the family.
Educating women and children
Women were recruited in health facilities when they went for regular check-ups, and also through Health Houses, organizations under the supervision of the municipalities in the different provinces. Lectures for women were held in cultural and health centers to educate the women about the rational use of antibiotics. Experts working at the university or at different high schools were asked to be health volunteers, who would focus on this topic and be trained to educate the public. In order to overcome limitations in human and financial resources, they used a training of trainers model where the first group of health volunteers was trained by the campaign directors and they in turn educated subsequent groups of volunteers.
Children were also targeted because they are the future decision makers in the country and a reduction in childhood infections would result in a reduction of antibiotic use. Children were recruited and educated in their schools. The committee developed an educational resource for primary school students aged 9-12, covering microbes and their spread, treatment and prevention of infections.
The material was based off the E-Bug project but translated and adapted to the Iranian setting by a pharmacist. The resources included lesson plans, student worksheets and activities that included out of school excursions and using storytelling, storybooks, animation and puppet shows as teaching methods. Common issues brought up during the different workshops were: Good and bad microbes, the difference between bacteria and viruses, the importance of antibiotic resistance, and spread of infection through inadequate hand washing, coughing and sneezing.
Spreading messages through art
Art was identified as effective means to spread messages due to its great impact on people regardless of their race, gender and age; therefore, the campaign directors gathered children’s book authors, animators, and radio- and television directors to develop an artistic and creative campaign. To explore which methods would have the greatest impact, many different approaches were taken to spread the message about rational use of antibiotics. Bulletin boards and banners were set up around the city for various occasions such as health week, one of the messages being “Don’t force your doctor to prescribe an injection”. Educational cards were placed on busses, tailored so passengers could read one card in the distance between two bus stops. Posters were placed in waiting rooms at hospitals and doctors offices. Experts in different districts were involved to be able to gather the material needed to make these cards and posters. Radio and TV programs were held where the public could call in and ask questions to a pharmacist or doctor. Animated TV programs were shown on the national channel during health week in 2012 when WHO announced antibiotic resistance as a global threat. The topic of the animations was rational use of antibiotics.
The educational programs for children were implemented to a larger extent than the programs targeting women. Therefore, children’s knowledge was evaluated before and after the interventions by using questionnaires developed by a small group of statisticians together with one medical educational professor. Students who were involved in any of the workshops completed questionnaires before and after the workshop to test their knowledge and results showed that knowledge was significantly increased in posttest group in comparison to pretest group.
“One of the best approaches to target adults appeared to be using television in the education. This also seemed to be an effective means to reach out to children, as well as using games. While any approach to raising awareness in society has a cost, the television programs were seen as a more expensive intervention.”
-Fatemeh Soleymani, National Committee of Rational Use of Medicine
The work in Iran is still ongoing and furthermore, an evaluation for women to measure knowledge after this type of intervention is currently under development. Continued educational programs for the public are needed to change behavior, increase knowledge, and enable the public to make good decisions regarding the use of antibiotics.
|Educational programs in rational use of antibiotics in Iran||Online slideshow by the National Committee of Rational Use of Medicine in Iran that conducted educational programs in rational use of antibiotics.|