CEMA-community to Improve Knowledge and Skills in Evaluating Medicine Advertisements Chairun Wiedyaningsh Nunung Priyatni Siti Munawaroh Sri Suryawati Centre for Clinical Pharmacology and Medicine Policy Studies, Universitas Gadjah Mada INDONESIA Presented in Third International Conference for Improving Use of Medicines, Antalya, Turkey, November 14-19, 2011

2 Non-prescription medicines are advertised in printed and audiovisual media Consumers may receive information from advs which tends to give misleading, inaccurate or unbalanced information Self-medication for minor ailment is allowed to improve community health care Medicine advertisements influence self - medication Inappropriate use of medicines can be harmful Indonesia government officially (2009) reported that about 20% of non-prescription medicine advertisements did not comply the regulation Knowledge and skills to evaluate medicine information and advertisements are very important

3 PKK as agent for implementing CEMA-community method Coordinator at central government Coordinator at province Coordinator at district Coordinator at sub-district Village Community/ Dasa-Wisma (ten-house hold group) The mechanism of PKK coordination The PKK is a nation-wide organization The family welfare movement team is made at each level The members of PKK are all women live in the village. Village Previous study targeted to medical students (Essential Drugs Monitor, 1997: 23; 23) showed success in improving knowledge and skills to critically assess medicine advertisements. The study might be feasible to be implemented for community empowerment by modifying on the content and the inclusion of local regulation

4 Ten PKK programs: 1) the practice of Pancasila principles in daily life 2) fostering the spirit of mutual assistance 3) ensuring adequate food 4) ensuring adequate clothing 5) ensuring proper housing 6) ensuring education geared to employment 7) ensuring good health 8) joining a cooperative movement 9) practicing good planning in daily life 10) maintaining and improving the environment. PKK has been very active as government counterpart in various health programs such as family planning, diarrhea, childhood mortality, vaccination, malnutrition, etc As PKK has been actively involved in many health programs, their role as agent for change in empowering mothers to critically evaluate advertisements is essential

PARTICIPANTS: -PKK family welfare movement team in Yogyakarta -Meeting with stake holder -FGD & in –depth interview -Designing guidelines & research instruments -Reviewing and validating guidelines & research instruments Evaluation of the implementation Materials development Pilot StudyEvaluation Flow of activity: -lecture: 60 min -discussion: 45 min -a brief lecture: 45 min -small groups discussion, with facilitators: 60 min control Intervention (CEMA-community) -Data collection: baseline, immediate, 2, & 4 weeks after intervention -Knowledge data: close-ended questions -Skills data: worksheets Setting:

6 Materials development FGD & in depth interview TV was the most popular source of medicines information. Brand name medicines were more familiar than the active content Materials & instruments Ads code TV/Radio/ printed ads findings of misleading, incomplete or incorrect information Audiovisual and printed advertisement materials Guidelines Questionnaires & Worksheets

The effect of CEMA-community on knowledgeThe effect of CEMA-community on skills A significant improvement on knowledge and skills after CEMA-community intervention. Knowledge: otc; active compounds; information in advertisements. Skills: critically evaluate adv (misleading; inaccurate; unbalance; incomplete) information. 7 Pilot study

8 The CEMA-community was interactive and enjoyable method. The activity duration was too short to evaluate the three (television, radio, printed material) kinds of media They preferred to evaluate television medicine advertisements The activity depends on the availability of equipments The CEMA-community could be implemented at grass-root organization The CEMA-community could be implemented at grass-root organization. Evaluation

Community empowerment activity through community-based organization is a viable strategy to improve use of medicines The CEMA-community is effective approach for empowering communities to recognize inappropriate advertising for medicines Women’s empowering interventions, integrated with health educational sectors, have shown significant increased on knowledge and skills, therefore may improve child and family health The availability of guidelines, printed and audiovisual materials is also a key factor for success in intervention study with problem-oriented approach 9 Lesson learnt

10 Conclusion - This study was funded by World Health Organization-SEARO and in collaboration with PKK Yogyakarta -Further -The CEMA-community is a promising training model which is potential to become a standard tool for consumer empowerment program Recommendation -Pharmaceutical advertisements regulation need to be reviewed -To success in intervention with community empowerment, it is important maintain working relationships and encouraging community-based organization that actively involved in health programs -The study may be expanded to evaluate impact of incomplete information on medication error/adverse drug reaction