INFORMATION,EDUCATION AND COMMUNICATION(IEC)

IEC APPROACH IN COMMUNITY HEALTH NURSING
M.sc Nursing
Institute of Nursing Education, Mumbai.

1. AIM- At the end of seminar on Information, education and Communication the group will be able to apply knowledge on promoting the health of population and prevention of diseases . Objectives- the group will be able to Define IEC,and concept of IEC Explain aims and scope and approaches of IEC. Discuss strategy planning of IEC. Describe sources of health information . Explain different approaches to health education. Explain principles of health education. Explain communication process. Discuss types and barriers of communication. Discuss tele-medicine and tele-nursing.

2. Introduction The Information, Education & Communication (IEC) strategy aims to create awareness and disseminate information regarding the benefits available under various schemes/ programmes of the Ministry and to guide the citizens on how to access them. IEC initiatives are based on the concept of prevention and primary health care, largely concerned with indiduval behavior change or reinforcement, changes in community and social norms. Its helps in sustaining health, changing bad habits and promoting health status.

3. Definition of IEC IEC can be defined as an approach which attempts to change or reinforce a set of behaviors in a target audience regarding a specific problem in a predefined period of time . -WHO

4. Concept of IEC Information, Education and Communication are interrelated . Education is obtained through information and communication; while education is a great source of information on other hand communication is a link for education and information. So the application of IEC,all steps that is planning, implementation monitoring and evaluation should be used with care. T he ultimate aim of s of IEC; behavior change and promotion of health status can be achieved. Target audience should be given due importance during IEC process.

5. AIMS AND SCOPE OF IEC The main aims of IEC are; 1. To change the health behavior of indiduval, family and community. 2. To prepare background or basis for change in health behavior. 3. To change the norms of community. 4. To facilitate education for audience about public health and to create awareness in public opinion. 5. To obtain or garner social, political support for health activities.

6. The important scope/fields in IEC in relation to health are as follows. Primary health care Prevention of disease/control on communicable disease. Reproductive health/maternal and child health services. Family welfare Nutritional services. Personal hygiene.

7. Strategy: Planning, Implementing Monitoring and Evaluating Make comprehensive strategy . This means clear objectives, client-centered designing, conducting appropriate research, undertaking audience segmentation, carefully crafting and testing messages, knowing and selecting appropriate channel(s) and planning for monitoring and evaluating . Give emphasis on long term capacity building. Plan sufficient time, to foster changes in social and behavioral norms. (Keep in mind, changing behavior is not an easy or quick task). Link the IEC programme with health care service delivery programs. Plan for any type of reward, if people learn new behavior in a best manner.

8. Implementing a Strategy •Take support of community leaders. The use of opinion leaders and decision makers can enhance the success of an IEC project. Involve the target audience actively in the design, implementation and monitoring of project. Listen to local language, customs and experiences . Establish linkage with traditional healers, local NGOs and local support groups. Actively involve them and share their information. The interaction between health care providers at all levels and client (people) is an important element for successful IEC intervention.

9. Logos and symbols should be pretested before launching. These should be according to the need and understanding of the audiences. The use of logos and symbols in advocacy campaigns has been proved successful. This is the outcome of IEC campaign that Red Ribbon symbolizes the international struggle around HIV/AIDS, while the White Ribbon raises awareness about safer pregnancy and childbirth . Only meaningful messages should be used and they should reach to relevant segments of target population

10. Monitoring and Evaluation of Strategy As a part of Management Information System (MIS), documentation of IEC programme inputs and experiences is important for knowing the successes and failure. Evaluation of IEC campaign should be considered from the very beginning, when projects are being planned and not just after they are underway or completed. Although evaluation of IEC efforts is a complex task . Inexpensive methods like observation can be used for monitoring the campaign.

11. Health information Definition of Health Information Health information is an integral part of the national health system. It is a basic tool of management and a key input for the progress of any society. A health information system is defined as: “a mechanism for the collection, processing, analysis and transmission of information required for organizing and operating health services, and also for research and training".

12. Components of a health information system The health information system is composed several related subsystems. : (1) Demography and vital events; (2) Environmental health statistics; (3) Health status: mortality, morbidity, disability quality of life; (4) Health resources: facilities, beds, manpower. Utilization and non-utilization of health services attendance, admissions, waiting lists; (6) Indices of outcome of medical care; and (7) Financial statistics (cost, expenditure) related to the particular objective.

13. Uses of health information To measure the health status of the people and to quantify their health problems and medical and health care needs; For local, national and international comparisons of health status. For such comparisons the data need to be subjected to rigorous standardization and quality control For planning, administration and effective management of health services and programmers, For assessing whether health services are accomplishing their objectives in terms of their effectiveness and efficiency; For assessing the attitudes and degree of satisfaction of the beneficiaries with the health system; and For research into particular problems of health and disease.

14. Health education . Health education is the translation of what is known about health, into desirable individual and community behavior patterns by means of an educational process

15. Aims and objectives The definition adopted by WHO in 1969 and the Alma-Ata Declaration adopted in 1978 provide a useful basis for formulating the aims and objectives of health education, which may be stated as below : 1. To encourage people to adopt and sustain health promoting lifestyle and practices; 2. To promote the proper use of health services available to them; 3. To arouse interest, provide new knowledge, improve skills and change attitudes in making rational decisions to solve their own problems; and 4. To stimulate individual and community self-reliance and participation to achieve health development through individual and community involvement at every step from identifying problems to solving them.

16. APPROACH TO HEALTH EDUCATION Regulatory Approach Service approach Health education approach Primary health care approach.

17. Principles of health education Credibility Interest Participation Motivation Comprehension Motivation Reinforcement Learning by doing Known to unknown Setting an example Leaders

18. Methods in health education Individual approach Group approach - L ecture, group discussion,demonstration,role play, panel discussion,symposium,conferences and seminars. Mass approach - T.V.Radio , Internet,Newspapers,Printed materials. Direct mailing Posters, Health exhibitions and museums and Folk media.

19. C ommunication Communication can be regarded as a two-way process of exchanging or shaping ideas, feelings and information. Broadly it refers "to the countless ways that humans have of keeping in touch with one another" . Communication is more than mere exchange of information . It is a process necessary to pave way for desired changes in human behavior, and informed individual and community participation to achieve predetermined goals.

20. Communication process Communication which is the basis of human interaction is a complex process. It has the following main components (Fig. 1) : 1. Sender 2. Receiver 3. Message 4. Channel 5. Feedback

21. Communication process

22. Types of communication One way communication. Two way communication. Verbal communication. Nonverbal communication. Formal and informal communication. Visual communication. Telecommunication.

23. Barriers of communication 1. Physiological - difficulties in hearing, expression 2 . Psychological - emotional disturbances, neurosis, levels of intelligence, language or comprehension difficulties. 3. Environmental - noise, invisibility, congestion 4. Cultural illiteracy, levels of knowledge and understanding, customs, beliefs, religion, attitudes, economic and social class differences, language variations, cultural difficulties between foreigners and nationals, between urban education and the rural population.

24. Telemedicine Introduction: Secondary and tertiary medical expertise is not available in several areas of the world. Quite often, many patients are sent elsewhere at considerable expense. In a number of these cases the treatment could have been carried out by the local doctor with advice from a specialist . Even within a country there is a tendency for specialists to concentrate in the big cities making medical care in suburban and rural areas sub optimal Using a PC, a scanner, a digital camera networking, appropriate software and telecommunications it will be possible to transfer clinical data from any part of the world to any other part.

25. What is Telemedicine ? Telemedicine is use of telecommunication and information technologies in order to provide clinical health care at a distance. AIM : To deliver specialized medical care and advice with in reach of patient at distant places OBJECTIVES To provide specialized medical advice To monitor patient condition To guide other medical staff about treatment procedure Share patient data among institutions for research purpose

26. Specialties: Telemedicine covers a growing number of medical specialties such as:- Cardiology . Home Care. Radiology . Emergency Care. Surgery . Dermatology . Psychiatry . Oncology . Pathology . Ophthalmology .

27. Types Of Telemedicine: Telemedicine is practiced on the basis of two concepts: Two way interactive television Store and forward

28. Benefits to patients Access to specialized health care services to under-served rural, semi-urban and remote areas Early diagnosis and treatment Access to expertise of Medical Specialists Reduced physician’s fees and cost of medicine Reduced visits to specialty hospitals Reduced travel expenses Early detection of disease Reduced burden of morbidity

29. BARRIERS IN TELEMEDICINE Equipment costs Connectivity costs Physician or patients acceptance Remote areas Privacy and security issue Inadequate communication services

30. SUPPORT In India, telemedicine programs are being actively supported by: Department of Information Technology (DIT) Indian Space Research Organization NEC Telemedicine program for North-Eastern states Apollo Hospitals Asia Heart Foundation State governments Telemedicine technology also supported by some other private organizations

31. Summary and conclusion The Information, Education & Communication (IEC) strategy aims to create awareness and disseminate information regarding the benefits available under various schemes/ programmes of the Ministry and to guide the citizens on how to access them. The objective is also to encourage build-up of health seeking behavior among the masses in keeping with the focus on promotive and preventive health. The IEC strategy has catered to the different needs of the rural and urban masses through the various tools used for communication.