The Need for Knowledge: Maslow’s Hierarchy of Needs Applied to Rural Communities in Africa

Dr Juliet A.V. Waterkeyn
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Although literacy rates in developing countries have improved substantially in the past few decades, vertical health promotion programmes for rural communities still tend to pitch their messages at a low comprehension level, promoting only a few simple key messages usually to prevent only one identified disease (Loevinsohn, 1990). The overall literacy level in Zimbabwe is around 86% (Unicef, 1999) although 50% of those over 60 are illiterate (Auret, 1990).

A recent study in Zimbabwe (Waterkeyn and Cairncross, 2005) has piloted an approach using Community Health Clubs to promote a culture of health by improving health knowledge and hygiene behaviour. Interviews with members indicated that the popularity of Health Clubs was largely due to a strong interest in acquiring knowledge. Consistently high attendance rates suggested that women were prepared to invest considerable effort to learn. A post intervention survey found that good knowledge of Malaria amongst health club members was 34% higher than non-members, and for Tuberculosis it was 58% higher (Waterkeyn, 2006). Taking an average of nine different topics, there was 47% difference between intervention and control areas (0>0.0001).

Maslow’s Hierarchy of Needs (1954) was used to categorise suggestions from the community as to their main needs, using a method of pair-wise ranking on a matrix. In a random sample of ten community health clubs, 20% voted their highest priority as Knowledge, whilst the remaining 80% ranked Knowledge in second place, only slightly less important than their Need for Safety. These findings indicate that semi-literate communities have the capacity to assimilate multiple messages and through group decision-making can significantly change their hygiene behaviour, acting on a broad range of health issues. By addressing all preventable diseases in a more holistic approach to health, programmes would be more cost-effective and appropriate to the needs of rural communities.

Keywords: Community Health Clubs, Health Promotion, Rural communities, Women, Hygiene, Behaviour Change, Africa, Zimbabwe, Knowledge, Cognitive Need, Maslow
Stream: Psychology, Cognitive Science and the Behavioural Sciences
Presentation Type: Paper Presentation in English
Paper: A paper has not yet been submitted.

Dr Juliet A.V. Waterkeyn

Director, Community Health Promotion, Africa A.H.E.A.D. Association
Cape Town, Western Province, South Africa

A consultant sociologist in public health promotion, for the past 20 years, mainly in East and Central Africa with extensive field work with rural women in Kenya, Tanzania, Uganda, Zimbabwe and Sierra Leone. Main focus is the social-psychology of hygiene behaviour change and the development of sustainable strategies for improved community health. Work experience includes provision of training in public health promotion and the design and management of holistic development programmes. Developed and researched a cost-effective training methodology for achieving sustainable hygiene behaviour change and produced much culture-specific training material for participatory (PRA) activities. In 2001, awarded a Fellowship of the Royal Society for Tropical Medicine and Hygiene. A PhD thesis entitled ‘Cost-effective Health Promotion and Hygiene Behaviour Change through Community Health Clubs’ was successfully submitted at the University of London (London School of Hygiene and Tropical Medicine) and results published in the Journal of Social Science and Medicine in 2005. (61. p.1958-1970). Founding Co-Director of Zimbabwe AHEAD Organisation (1995), a Trust founded to pilot the Community Health Club Model,and later Africa AHEAD (2005), an association to disseminate the approach.

Ref: I06P0060