What's Success

Before we proceed with any analysis of processes in  health and nutrition education programmes, we  must look at this vital question: How do we define success? 

Defining success is quite obviously related to our aims and objectives in interacting with the community. Do we just want to convey a message to the maximum number of people? Do  we decide to explore the reactions of people to messages-are they adopting it or not? Are  we moving  beyond this level and trying to actually promote and sustain action? 

It is now widely recognised that programmes launched by "outsiders" (i.e. people who are not members of a community) often ignore the  importance of community participation. This obviously reduces chances of success. On the other hand. programmes managed by insiders (i.e. community members) may be unsuccessful because they may cater to certain  vested interests or influential groups only. 

Hence organizing a successfd programme often begins with an outside agency spreading a message in a particular rural or urban area and  then evolving an action plan  with  members  more affected by a problem. The next phase involves encouraging people to act in order to overcome their own problems. Do you remember the concept of self reliance and independence we discussed in Unit 19? Community participation is a key indicator of this. In other words we should not  define success merely as the number of people covered by a programme but rather by whether the community can initiate and  sustain action using their own resources or with  help from outside agencies. 

Obviously this is difficult to achieve and takes time and effort. But there's no doubt that  it can be done! Experience has shown that programmes tend to be successful when they: 

• begin small and then grow, yet retain the  involvement of local people in decision making 
• enable the target group particularly the poor and disadvantaged among them to participate in determining priorities and taking action. 
• do not stick to a pre-determined plan  but remain flexible and  open  to change. 
• are lead by people who are committed to solving the problems of the poor and disadvantaged community members. - 
• adopt a holistic approach in improving the entire "way of life" rathtr than just concentrating on one aspect (rather like the concept of integration we talked about with reference to  ICDS). 

These points have been drawn from the introduction to  the book "Helping Health Workers Learn" by David Werner and Bill  Bower.