It is a means of enabling and empowering selected family members with certain healthy behaviours or with some important health messages so that they can enable and teach the rest of other community members. Training model families are one of the health extension worker‘s important strategies and is adapted from theories of mass communication/diffusion of innovation.

Using criteria based on social and economic status with the community, the health extension worker selects individuals who are likely to be early adopters of new behaviors. Moreover, the health extension worker train parents on health behaviors such as hygiene and sanitation, accessing services (e.g., early childhood immunization), family planning, infant feeding practices, and nutrition. The family uses these lessons to make changes to its home and health care, and then it can graduate and become a model family.

Health extension workers also work with communities to communicate health messages. They involve the community in different stages, from planning to evaluation. Health extension workers rely on traditional and modern associations to coordinate and organise the implementation of community packages, e.g. idir, mahber, ekub, schools, women and youth associations.

Implementation of the model family package using diffusion of innovation theory

1. Preparation phase

1.1 Select the eligible households for model family training package

Those family members who are active participants and those who are models in the daytoday developmental activities will be considered for the trainings. Moreover, the training is given by a health extension worker on all the packages, first to bring behavioral change and then to enable model families to teach the rest of the community members
The model family training package usually selects early adopters--this is because they are considered as opinion leaders and can influence the behavior of other community members. For example, community leaders, religious leaders, etc.

Criteria to include in the trainings----according to the criteria, a family should fulfill all or at least 50% of the following criteria to be included in the training:

a) Better access to education for the children.
b) Involvement in agricultural extension package.
c) Better exposure for the mass-media--good exposure for the international as well as national information.
d) Better educational status--at least can read and write.
e) Credibility in the community--influential or opinion leader
f) Better socio-economical status in the community.
g) Willingness and eagerness to participate in health development activities.

1.2 Pre-training phase--(After the selection, you need to do the following activities):

a) Baseline survey on family size, sex, age, environmental and personal hygiene, health status of the family through observation, water handling and proper utilization...etc of the model family. (Use baseline checklist on annex part of this module.)

b) The health extension worker and other kebele leaders should select and arrange appropriate time and place of training for about 100-150 households and introduce them the overall activities in the Health Extension program and model family package, finally receive feedbacks from the participants and come to the common consensus or decisions

1.3 Training phase-- a health extension worker should consider the following activities and then conduct the training session in three phases

a) The health extension worker should select the appropriate methods and materials for the training and should develop a lesson plan for each phase of the training (for an example, see Table 12.2)

Table 12.1. A lesson plan for developing a model family training package

	Title	Training objective	content	Training method	Duration of training	Place of training	Materials used	Remark

b) Determine the content and arrange the flow---based on the principle of the Health Extension package implementation guidelines, "start fromthe simplest then come to the complex one" and the training should be given in three phases as follows:

Table 12.2. Contents of training in phase 1

S .no	Title of training	Duration of the training		Training method	Training materials	Target audience	Indicator
S .no	Title of training	theory	practice	Training method	Training materials	Target audience	Indicator
1	Personal hygiene
2	Latrine construction and utilization
3	Water handling and utilization
4	ANC, delivery and PNC
5	Immunization
6	Breast feeding practices
7	Family planning services
8	Nutrition for ANC/lactating mothers
9	Infant health services
10	Prevention and control of malaria
11	HIV/AIDS prevention and control

Table 12.3. Contents of training in phase 2

	Title of training	Duration of the training		Training method	Training materials	Target audience	Indicator
	Title of training	theory	practice	Training method	Training materials	Target audience	Indicator
1	Food hygiene
2	Environmental sanitation
3	Refuse disposal
4	Solid waste disposal
5	Insects and rodents control
6	Preparation and feeding practice of balanced diet
7	Importance of supplementary feeding for infants
8	Management of the childhood illness and the illness behavior of the family
9	Adolescents and Youth reproductive health
10	Pre-marriage blood test
11	Importance of first aid
12	Early diagnosis and prevention and control of the outbreak

Table 12.4. Contents of training in phase 3

	Title of training	Duration of the training		Training method	Training materials	Target audience	Indicator
	Title of training	theory	practice	Training method	Training materials	Target audience	Indicator
1	Female genital mutilation(FGM)
2	Uvulactomy
3	Phlebotomy
4	Teenage pregnancy