The incidence of communicable and non-communicable diseases is rising globally in both developed and developing nations. New methodologies are required for reaching the general population and promoting preventative behavior. The objective of this chapter is to discuss the Focus, Organization, Management, Environment, Network, and Technology (FOMENT) process as a strategy and a tool to enhance the impact and efficiency of the diffusion process within public health systems and change agencies, especially in developing countries. FOMENT can be seen as an extension of Everett Rogers' Diffusion of Innovations Theory (DOI) and can be used by organizations to maximize the diffusion rate of health initiatives into a community. The understanding of individual variables from DOI and organizational variables from FOMENT, as well as their corresponding indicators will support the convergence approach to enhance diffusion capacity building (DCB) needed for the adoption of innovations and related behavior change.
TopIntroduction
According to the latest Millennium Development Goals Report, there is a continuing need to address existing and emerging health issues globally. Despite significant progress in meeting these goals by 2015, the report emphasizes some of the remaining problems worldwide, to include: the prevailing and universal levels of poverty; the lack of sanitation facilities for more than 2.5 billion people; the significant decrease in the world’s resource base with the continuing loss of forests, species, and severe impacts of climate change; and the remaining gaps in basic knowledge regarding communicable and non-communicable diseases (UN, 2013).
Although all of these issues deserve equal attention, the enduring and wide-reaching impact of communicable and non- communicable diseases has had a significant impact within the global community. According to the World Health Organization’s World Health Statistics 2012 report, recent trends in communicable and non-communicable diseases include:
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Sixty per cent of global deaths are a result of non-communicable diseases (WHO, 2012).
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Communicable diseases such as malaria, influenza, and hepatitis continue to increase dramatically in certain parts of the world (WHO, 2012).
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Communicable, maternal, neonatal, and nutritional causes remain the dominant reasons of years of life lost in sub-Saharan Africa (Lozano et al, 2012).
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Population growth, an increased average age of the world’s population, and largely decreasing age-specific, sex-specific, and cause-specific death rates combine to drive a broad shift from communicable, maternal, neonatal, and nutritional causes towards non-communicable diseases (Lozano et al, 2012).
In order to improve and expand the quality of life and avoid a continuing increase of communicable and non-communicable diseases, a transformation of behavior is necessary. Furthermore, especially in developing countries, the transformation needs to occur not only in individual communities but as a systemic change in the institutional implementation of various initiatives that may reduce disease burdens. Effective communications can be used within the context of demographic, economic, political, social, religious, and environmental factors to improve quality of life and meet the 2015 Millennium Goals.
The Rome Consensus, developed by The World Congress on Communication for Development in 2007 (World Congress on Communication for Development, 2007), endorses a better health promotion framework through enhancements made in communications methods and behavioral change models. Factors essential for this developmental process include:
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The right and possibility for people to participate in the decision-making processes that affect their lives.
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Create opportunities for the sharing of knowledge of skills.
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Ensure that people have access to communication tools so that they can communicate within their communities and with the people making the decisions that affect them (e.g. communication radio and other community media).
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Generate a process of dialogue, debate, and engagement, which can build public policies that are relevant, helpful, and have committed constituencies willing to implement them.
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Recognize and harness current communication trends occurring at local, national, and international levels for improved development action.
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Adopt an approach that is contextualized within a cultural framework.
By taking into account each community’s social and cultural schemas, health organizations can encourage and implement health strategies and programs that are tailored to the needs of the populations they hope to serve, and can be diffused among the society at a more rapid pace.