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Risk Communication

In
Obstetric Practice

Risk Communication in
Maternal Care

Definition
Principles of Risk Communication
Process of Risk Communication
Intervention
Evaluation
Perception
Soft skills training

What is Risk Communication?


The purposeful exchange of information
about the existence, nature, form, severity
or acceptability of health risks between
policy makers/health care providers and
public/media with the intention of changing
behaviours and inducing action to
minimise/reduce the hazard.

Risk Communication
Interaction with internal and external
stakeholder groups about risk.
Aims at mobilizing action. Is evidence of an
organizations commitment to health and
welfare

Principles Of Risk Communication


Effective risk communication (RC) is an
essential element of Risk Management
(RM)
RC and RM are inextricably linked
Understanding how people perceive risks
and how to communicate risk information e
effectively are keys to improve risk
management

Principles of RC
Interactive and participatory approaches
offer greater risk reduction.
Critical elements are:

trust and credibility of message source,


quality and clarity of message,
effective and efficiency of delivery channel,
and involvement of target audience

Principles of RC
Relevant agencies have an important role.
Individuals and communities have a right to know
about the risks to which they are exposed and to
participate in decisions that affect their lives and
property.
RC is no substitute for regulation or action
Risk communicators are accountable to the public
and should base their actions on principles of
ethics.
RC is often an exercise in Public Relations

Process of Risk Communication


.

Situational analysis
Research the high risk mothers

Who are they?


Where do they come from?
What is their educational background, occupation?
What is their mode of communication, channels?
How do we reach them?
Where do they meet us?
What are the resources available for intervention?
What is their K, A, Practice, Perception, Motivation
towards the risk?
Who influences them in their decision making?

Risk Communication Process


Problem diagnosis

Demography
Psychography
Behaviour contributing to risk
Education, knowledge, attitude
Perceptions and motivation
Cultural practices
Belief system
Community Resources
Communication channels and the various local vehicles
Identification of Opinion Leaders

Objectives: Addressing the gap


General Objectives:
To ensure effective communication to
mothers at risk and those who influence
them to reduce risk
To contribute to effective management of
risk to reduce morbidity and mortality

Objectives
To disseminate accurate and timely information.
To maintain and strengthen credibility of the
health care providers and MOH
Motivating individuals to act.
To get immediate feedback and to take
appropriate remedial actions.
To resolve conflicts/threats in managing patients

Specific Objectives
Must be measurable for purpose of
evaluation
Addressing the gaps in knowledge, attitude,
perceptions, motivation and actions by
quantifying
Stated in the form of who, what, when
where, how.

Strategies
Strengthening existing plan of action
Develop new strategies in keeping with
current trends especially the trend from
education to promotion (Ottawa Charter
1986)
Laws governing maternal deaths
Policies
Social support

Strategies
To seek the cooperation of related
government agencies and non-government
organisations (NGOs) involved in maternal
health
To provide accurate, timely,
comprehensible information through the
use of appropriate technology and channels
of communication utilised by the mothers

Strategies
To coordinate flow of information to
internal and external stakeholders. This
includes relevant government agencies and
NGOs.
To obtain feedback of mothers at risk from
the program managers, health care workers
and researchers so as to provide the relevant
information to the target groups.

Strategies
To develop effective partnership with
groups who have the support of the high
risk mothers
To provide in-house training programmes
in communication to health care providers
handling high risk maternal cases

Communication Model

Source
Channel
Message
Feedback

Message Sources:
To identify relevant personnel who communicate
with the mothers to work as a team and provide
needed assistance
Specialists, Registrars, MOs, Interns
Hospital nursing staff
Public health personnel who have contact with
mothers
Spouse, Family members, influential community
members

Message Sources:
Webpage
Creation and updating of MOH
Webpage: The mothers as well as
health care providers would be able to
gain the latest information on maternal
care

Website
Growing trend of DIYDS playing little doctors aided by
the advent of the internet. 136 million Americans access
the net for health information.
They research their own symptoms, diagnose their own
illness and administer their own cures. Some buy their own
machines and monitor their fetuses every night. No need to
visit the doctor
Increase in over the counter drugs
Increase in Complementary and Alternative Medicine 1 in
3 Americans resort to CAM
Mark J. Penn Microtrends 2007 pgs 91-95

Message Design: Educational


materials
The development and dissemination of
relevant messages and educational
materials on maternal health such as
personal health care diary
This covers both for the internal and
external stakeholders and should be easily
readable and have personal relevance to the
target group.

Educational Message Design:


Drafting a fact sheet
Content of fact sheet eg.
Nature of problem (eg, cause)
Management of the problem
Prevention
Important contact numbers

Delivery Channels
Obtained from Initial Assessment
Maximize effective and efficient
utilization of delivery channels in
terms of reach and frequency
Face to face in clinical settings
Home visits
Occupational settings

Target Audience: Feedback


To carry out analysis on all feedback
from mothers and others especially
frequently asked questions (FAQ) so as
to improve the information on
explaining risk

Organizational Activities
Human Resources: Training
Competence in communication skills:

Interpersonal skills
Persuasion, Motivation
Appealing to fear, emotional and rational
Counseling (on prevention of pregnancy,
anxiety)
Conflict resolution
Negotiation

Organizational Activities:
Training
Module
There must be a training manual, regularly
updated, with learning outcomes, content,
skill development and case studies

Community Organization
Communication should be targeted
towards relevant individuals, groups of
individuals, specific subgroups or
institutions.
The following should be taken into
consideration.

Community Organization:
Influential or Opinion leaders
Needless to say the time tested
communication method through such
leaders of communities should be
employed where and when considered
best and opinion leaders need to be
identified and utilized fully.

Community Organization:
Inter-agency collaboration
An integrated approach is sometimes the most
effective solution when individual persuasion fails
The need to collaborate and form partnerships
with women's group and to work together with
other relevant agencies should be made to discuss
strategies best suited.

Evaluation
Process evaluation (Formative)
to evaluate the activities.

Outcome evaluation (Summative)


to assess the reduction in morbidity and
mortality.
changes in knowledge, attitude and practice of
target groups.
attainment of communication objectives

Review and proposals for


change

Preparation of report
Distribution of report
Storage for later retrieval
Use of report for case studies and
research
Learning from past mistakes

Guideline for agency


spokesperson
Spokesperson should be good in presentation and
interaction
No names of the affected to be given until next of
kin informed.
Assure media results of the investigation will be
given.
Prepare press statement.
No exclusive interviews.
Be accessible.
Be calm.

Medias Role

Assist in education
Convey warnings.
Convey instructions.
Reassure public.
Defuse rumors.
Assist in the response effort.
Provide the agency with updated
information.
Solicit help from others.

Dealing with the Media


Prepare fact sheets, keep reporters updated.
Avoid jargon.
Respect reporters deadlines.Be polite and
straightforward.
It is good to tell the truth.
Have your own agenda.
Stick to facts you know. No opinions.
Relevance of message, make notes and
provide feedback.

Public Relations
Organization put under public spotlight,
management competence is questioned
Employees, public and media need to be
communicated
Difficult for managers to make god
decisions and to communicate well
PR practitioners, legal, technical experts
make a vital contribution

Effective risk communication


Depends on the providers and recipients
understanding more than the risks and benefits.
Background experiences and values also influence
the process.
The goals of the communication is advocacy,
education and decision making partnership.
Multidirectional
Debate instead of lecture

Our target group

Target Audience
If you do not listen to people, you cannot
expect them to listen to you.
Target group have their own interests,
information needs and channels, concerns and
priorities.
People need to be sufficiently motivated to
understand complex risk information
Information about the audience characteristics
can be obtained through surveys, focus group
discussions, demographic profiles and in-depth
personal interviews

Risk Perception
Conditions associated with increased public
concern are
Catastrophic potential
Unfamiliar mechanisms
Uncertainty
Uncontrollable
Involuntary exposure
Children specifically at risk

Public Risk Perception


Risk to future generation
Identifiable victims as opposed statistical
victims
Effects dreaded
Lack of trust in responsible institutions
Much media attention
Major accidents also minor
Inequitable distribution of risks

Public Perception of Risk


Effects irreversible
Individual personally at risk
Risk estimates based on human evidence
Origin caused by human actions or
failures

Different categories of people


Bandwagon: choosing the decision of the
majority.
Free riding: gain by the doing of others.
Altruistic: willing to take personal risks if
others will benefit from them.

Perception regarding risk


Health belief model:
Perceived susceptibility.
Perceived seriousness of the disease/issue.
Perceived benefits.
Perceived barriers.
Perceived threat of the disease.

Soft skills Training


Soft skills are something that you have or dont
But it can be developed as we go along
Soft skills separates a good doctor from a great
doctor
Soft skills include interpersonal skills and social
skills such as listening, diplomacy, goodwill,
flexibility, problem solving, smile, humour and
empathy towards a caring professional doctor
patient relationship (list is non exhaustive)

Methods used in soft skills training


Role play
Observation where the senior doctors
become their role model Marcus Welby
M.D., Dr. Kildare
Young doctors given handson experience
like breaking bad news to family members
Interaction with the senior doctors
Peer group discussion in sharing experience

Soft skills
Doctors with better interpersonal skills are
sued less

Thank You