Page 153 - Cultural Competence in Health Education

Developing Culturally Appropriate Needs Assessments and Planning 131

a common ground between the actual and the perceived needs or at least to attempt to
increase the community ’ s awareness of the evidence - based needs.
Through the needs assessment, health education professionals can also gain a bet-
ter understanding of the characteristics of the target population, including its demo-
graphic profi le, socioeconomic status, and health beliefs and practices. As mentioned
earlier, assessment of health beliefs is vital, as some of these beliefs often translate
into practices that infl uence people ’ s health. When working with culturally diverse
populations, it is important for health education professionals to recognize which prac-

tices have positive and which have negative effects and to encourage the first and try
to change the second. Pregnancy - related beliefs among Oaxacan indigenous women
are an example. Among other things, these women believe that taking prenatal vita-
mins will make them gain a lot of weight and have bigger babies and that this will
increase their risk of having a C - section. Likewise, although they value maternity
highly, they do not consider it necessary to have any type of prenatal care because the
common practice in their hometowns is to seek the assistance of a partera (lay mid-
wife) at the moment of delivery. Any health specialist attempting to develop a program
targeting Oaxacan indigenous pregnant women needs to know these cultural beliefs
and practices so he or she can successfully address them in the program. In this case it
would be important to reinforce the positive attitudes toward maternity and to build on
them to encourage women to access early prenatal care. Of equal relevance would be
using information to dispel the myths that prevent indigenous women from taking pre-
natal vitamins.
In addition to identifying the demographic and socioeconomic characteristics and
the health beliefs and practices of the target population, a needs assessment also helps
health educators to recognize priority needs not being met and promising interventions
not being conducted by any existing programs. Given the scarcity of resources — both
human and economic — that almost all health education professionals face, it is crucial
to avoid duplication of services and to ensure that new or revised health education and
promotion programs will really address highly relevant needs or problems among the
selected community or group.
Although some needs assessments require a comprehensive approach and a lot
of resources, often health planners do not have the time or resources to conduct such
comprehensive assessments. Nevertheless, they should not give in to any temptation to
skip the needs assessment phase and go directly into the design of the interventions —
not even if they have a theme that was selected by their funding stream or by the nature
of their organization — because the information that is gathered through the needs
assessment process is crucial for the success of the health promotion program.
Among many other things, a good needs assessment can help health planners to
avoid duplication of programs, to gain insight into the factors that will make for suc-
cessful interventions, and to identify the community ’ s priority needs and the subgroups
at major risk.
One of the core tasks that health education professionals must accomplish in the
needs assessment process is to collect primary and secondary data. Secondary data

7/1/08 2:54:48 PM
c07.indd 131 7/1/08 2:54:48 PM
c07.indd 131