REACH is improving the capacity of individuals, families and communities to protect their own health. From training health providers in the communication skills they need to educate as well as treat, to producing a range of health education materials for use in homes, clinics and public spaces, to helping the Ministry of Public Health (MOPH) harness the media to deliver key health messages, REACH is changing behaviors and promoting health practices to create a healthier Afghanistan.

Training Community Health Workers (CHW), Nurses, Midwives And Doctors To Communicate Effectively With Those They Serve
As the first health care providers most Afghans see, CHWs are on the front lines of the Afghan health system. REACH has trained almost 6,300 CHWs, over 53% of them women, who operate health posts and regularly visit homes in villages and towns in 14 Afghan provinces. The REACH CHW Training Manual includes exercises to help CHWs develop the communication skills they need to educate, inspire confidence and demonstrate sensitivity to each client's needs and concerns. REACH refresher training for doctors, nurses and midwives, as well as training provided to new medical graduates, also emphasizes communication methods that can successfully educate patients as well as establish their trust and cooperation. An end-of-project evaluation of Refresher Training revealed good retention of skills among participants.

Producing Health Education Materials
REACH has developed, tested, produced and distributed a variety of health education materials carefully designed to educate a largely non-or semi-literate populace in how to create a healthier environment for their families, care for the ill, and prevent disease. Large, colorful posters displayed in health facility waiting areas and other public places convey key health messages on a variety of topics, such as the care of infants and children with diarrhea, the safe preparation and storage of food, the prevention of malaria, healthy pregnancy and preparation for childbirth. Smaller posters displayed in households reinforce key health messages and remind families to make healthy practices part of daily life.

The posters also reinforce health education delivered by health facility staff and CHWs, publicly affirming these health providers' knowledge and advice. To carry health education directly into the home, CHWs are equipped with sturdy flip cards promoting healthy practices and illustrating steps families can take to safeguard and improve their health. Larger, cloth flipcharts assist CHWs in teaching larger audiences in their communities. As of December 2005, REACH had distributed 81,123 small posters, 9,795 large posters, 6,568 flip cards and 2,259 cloth flipcharts to NGO-grantees operating health facilities and supervising CHWs and to Learning for Life, an accelerated, health-based literacy program for women and older girls.

Health Education in the Learning for Life (LfL) Initiative
Learning for Life (LfL) is a nine-month accelerated health-based adult literacy and learning initiative to qualify women and older girls in rural areas of 13 Afghan provinces for CHW and Community Midwifery training. LfL contributes to improving the health of women of reproductive age and young children in rural areas through health education and literacy activities that support the priority health messages promoted by the Ministry of Public Health. The more than 8,500 women participating in LfL classes build literacy and numeracy skills while learning good health and hygiene practices to apply in their everyday lives. Topics include personal and environmental hygiene, transmission and prevention of infectious diseases, immunization, nutrition, birth planning, and post and antenatal care. LfL also supports the MOPH Information Education and Communication (IEC) Department by using the same posters and flip charts on birth planning, personal hygiene, malaria, and control of diarrheal disease as used by health providers in REACH technically supported provinces. A field evaluation of the LfL initiative details results of this exceptional program.

Using Radio To Educate Listeners About Health
In Afghanistan, radio is reaching a growing number of people in both urban and rural areas with important health messages. REACH workshops for MOPH staff have produced radio spots and dramas in both Dari and Pushto that educate listeners on healthy practices and promote behavioural change. Covering a wide range of topics, including vaccination, hand washing, and the importance of birth spacing, these key health messages are being broadcast by radio stations throughout the country.