Shadow Puppets and Neglected Diseases (2): A Qualitative Evaluation of a Health Promotion Performance in Rural Indonesia
Abstract
:1. Introduction
2. Methods
2.1. Study Context
2.2. Study Design
2.3. Participants, Materials and Procedure
Ravana, a demon devotee of the warrior god Shiva, is angered by the noise and laughter made by an industrious town. His assistant suggests enlisting the help of parasites [here, the concept of Soil Transmitted Helminth (STH) was introduced], and so Ravana casts a spell allowing him to shrink, and bargain with the parasites. Prince Rama, an avatar of the god Vishnu who had been exiled into the forest, came across this village, which had been laid waste by STH. A villager pleads with Rama for help, and so Rama investigates, and discovers the source of the problem. [The causes for the increase in parasites—i.e., village growth, open defecation, poor personal hygiene—is taught by Rama here]. Rama shrinks, goes inside one of the children to confirm the diagnosis, and finds Ravana inside the boy’s stomach. Rama and Ravana fight, and losing, Ravana hides with the worms. Rama battles a giant STH [more information on STH is provided here], eventually defeating several worms and Ravana. Rama leaves the boy’s stomach, returns to normal size, and explains what has happened to the villagers. Rama then gives a call to arms, instructing the villagers in how to protect themselves from worms in the future by following his three main messages.
3. Results
3.1. Effectiveness and Appropriateness of ‘RAMA and the Worm’
It’s not sure that the story on the video is not correlated with our daily activities mba [nickname for older woman]. Not sure that all people will understand the video, because the story of wayang is like not sure, so, people just watch it and so … they do not know if the story is for real.(Male participant, age 43)
3.2. Participants’ Habits and Intentions to Change
3.3. Perceptions of the Music
Nowadays, teenager must be lazy and bored to watch wayang with gamelan music. They heart would be happy to watch wayang with jazz music that was played yesterday … I think I prefer combination of gamelan and jazz music… Ya, the music that was played yesterday is very good mas [nickname for older man], because make me feel back to young again.(Male participant, age 29)
I think, we live in Java right? Ya, the wayang usually use gamelan, even more we live in the village, so, it should be using gamelan and Javanese language. Maybe will be more different when it’s national scale, it will be good using modern way, the modern music and using Bahasa language… We should adapt, like using Bali language when we are in Bali, and so. We are in the village, so we should use native language.(Male participant, age 29)
3.4. Perceptions of the Story
3.5. Effect of Age and Gender on Reception and Efficacy of RATW
3.5.1. Gender
3.5.2. Age
4. Discussion
Firstly, you must ensure that poo goes in a place where it is contained, not just out in the open. This is most important. If you do this, the parasites will be trapped and unable to move around in your environment. Secondly, you must wash your hands whenever you go to the toilet. And always make sure your hands are clean before you touch any food you wish to eat. Thirdly, fresh food and water needs to be clean, to make it harder for the worm to return. Make sure you get water that is clean and fresh, sometimes it may need to be boiled first to make sure the invisible germs are gone.
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Glik, D.; Nowak, G.; Valente, T.; Sapsis, K.; Martin, C. Youth performing arts entertainment-education for HIV/AIDS prevention and health promotion: Practice and research. J. Health Commun. 2002, 7, 39–57. [Google Scholar] [CrossRef]
- Singhal, A.; Rogers, E.M. The Status of Entertainment-Education Worldwide. In Entertainment-Education and Social Change: History, Research, and Practice; Singhal, A., Cody, M.J., Rogers, E.M., Sabido, M., Eds.; Routledge: Chicago, IL, USA, 2003; pp. 3–20. [Google Scholar]
- Moyer-Gusé, E. Toward a theory of entertainment persuasion: Explaining the persuasive effects of entertainment-education messages. Commun. Theory 2008, 18, 407–425. [Google Scholar] [CrossRef]
- Chesterton, P. Evaluation of the Meena Communication Initiative; UNICEF: Kathmandu, Nepal, 2004. [Google Scholar]
- Piotrow, P.T.; de Fossard, E. Entertainment-Education as a Public Health Intervention. In Entertainment-Education and Social Change: History, Research, and Practice; Singhal, A., Cody, M.J., Rogers, E.M., Sabido, M., Eds.; Routledge: Chicago, IL, USA, 2003; pp. 39–60. [Google Scholar]
- Millions mark UN hand-washing day BBC News: BBC; 2008. Available online: http://news.bbc.co.uk/2/hi/south_asia/7670855.stm (accessed on 17 December 2017).
- Déglise, C.; Suggs, L.S.; Odermatt, P. Short Message Service (SMS) Applications for Disease Prevention in Developing Countries. J. Med. Internet Res. 2012, 14, e3. [Google Scholar] [CrossRef] [PubMed]
- Eakin, A.; Connolly, P. A Formative Evaluation of the Animated Children’s Television Series Keremet Koch, Kyrgyzstan; Centre for Effective Education, Queen’s University Belfast: Belfast, UK, 2011. [Google Scholar]
- Bieri, F.A.; Yuan, L.P.; Li, Y.S.; He, Y.K.; Bedford, A.; Li, R.S.; Guo, F.-Y.; Li, S.-M.; Williams, G.M.; McManus, D.P.; et al. Development of an educational cartoon to prevent worm infections in Chinese schoolchildren. Infect. Dis. Poverty 2013, 2, 29. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bieri, F.; Gray, D.J.; Williams, G.M.; Raso, G.; Li, Y.S.; Yuan, L.P.; He, Y.; Li, R.S.; Guo, F.-Y.; Li, S.-M.; et al. Health education package prevents worm infections in chinese schoolchildren. N. Engl. J. Med. 2013, 368, 1603–1612. [Google Scholar] [CrossRef] [PubMed]
- Park, M.J.; Clements, A.; Gray, D.; Sadler, R.; Laksono, B.; Stewart, D. Quantifying accessibility and use of improved sanitation: Toward a comprehensive indicator of the need for sanitation interventions. Sci. Rep. 2016, 6, 30299. [Google Scholar] [CrossRef] [PubMed]
- Kurscheid, J.; Bendrups, D.; Susilo, J.; Williams, C.; Amaral, S.; Laksono, B.; Stewart, D.E.; Gray, D.J. Shadow puppets and neglected diseases: Evaluating a health promotion performance in rural Indonesia. Int. J. Environ. Res. Public Health 2018, 15, 2050. [Google Scholar] [CrossRef] [PubMed]
- Stewart, D.; Laksono, B. Helminth infection, human waste and appropriate technology: An Indonesian case study. Environ. Health 2002, 2, 46–52. [Google Scholar]
- McLeroy, K.R.; Bibeau, D.; Steckler, A.; Glanz, K. An ecological perspective on health promotion programs. Health Educ. Q. 1988, 15, 351–377. [Google Scholar] [CrossRef] [PubMed]
- Stewart, D.; Laksono, B.; Park, M.J.; Wang, D.X. An integrated approach to the prevention of Neglected Tropical Diseases (NTDs): The way forward? Athens J. Health 2016, 3, 179–185. [Google Scholar] [CrossRef]
- Park, M.J.; Laksono, B.; Sadler, R.; Clements, A.; Stewart, D. Household latrines to control environmental contamination and helminthiasis: An exploratory study in Indonesia. Int. J. Soc. Sci. Hum. 2015, 5, 429–435. [Google Scholar] [CrossRef]
- Park, M.J.; Laksono, B.; Clements, A.; Sadler, R.; Stewart, D. Worm-free children: An integrated approach to reduction of soil-transmitted helminth infections in Central Java. Rev. Environ. Health 2016, 31, 111–113. [Google Scholar] [CrossRef]
- Bendrups, D.; Stewart, D.; Susilo, J. Rama and the Worm: A Performance-Based Approach to Health Promotion in Rural Indonesia. In Music, Health and Wellbeing; Sunderland, N., Lewandowski, N., Bendrups, D., Bartleet, B.-L., Eds.; Palgrave Macmillan: London, UK, 2018; pp. 155–175. [Google Scholar]
- Guest, G.; Bunce, A.; Johnson, L. How many interviews are enough? An experiment with data saturation and variability. Field Methods 2006, 18, 59–82. [Google Scholar] [CrossRef]
- King, N.; Horrocks, C. Interviews in Qualitative Research; SAGE Publications: London, UK, 2010. [Google Scholar]
- Nutbeam, D. Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promot. Int. 2000, 15, 259–267. [Google Scholar] [CrossRef]
- Malterud, K. Systematic text condensation: A strategy for qualitative analysis. Scand. J. Soc. Med. 2012, 40, 795–805. [Google Scholar] [CrossRef]
- Boeije, H. Analysis in Qualitative Research; SAGE: London, UK, 2010. [Google Scholar]
© 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Williams, C.; Stewart, D.E.; Bendrups, D.; Laksono, B.; Susilo, J.; Amaral, S.; Kurscheid, J.; Gray, D.J. Shadow Puppets and Neglected Diseases (2): A Qualitative Evaluation of a Health Promotion Performance in Rural Indonesia. Int. J. Environ. Res. Public Health 2018, 15, 2829. https://doi.org/10.3390/ijerph15122829
Williams C, Stewart DE, Bendrups D, Laksono B, Susilo J, Amaral S, Kurscheid J, Gray DJ. Shadow Puppets and Neglected Diseases (2): A Qualitative Evaluation of a Health Promotion Performance in Rural Indonesia. International Journal of Environmental Research and Public Health. 2018; 15(12):2829. https://doi.org/10.3390/ijerph15122829
Chicago/Turabian StyleWilliams, Courtney, Donald E. Stewart, Dan Bendrups, Budi Laksono, Joko Susilo, Salvador Amaral, Johanna Kurscheid, and Darren J. Gray. 2018. "Shadow Puppets and Neglected Diseases (2): A Qualitative Evaluation of a Health Promotion Performance in Rural Indonesia" International Journal of Environmental Research and Public Health 15, no. 12: 2829. https://doi.org/10.3390/ijerph15122829