U HEALTH EDUCATION AND COMMUNICATION.pdf

health education in community

1. NAZNEEN VOHRA
CLINICAL INSTRUCTOR
MTIN, CHARUSAT, CHANGA

2. Contents
•Introduction(Concept)
•Definitions
•Aims & objectives
•Principles od health education
•Process of health education
•Approach to health education
•Method of health education
•Level of health education
•Practice of health education(scope of health
education)
•Health educators
•Opportunities for health education
•Success stories

3. Introduction(concept)
Health education forms an important part of the
health promotion activities.
These activities occur in schools, workplaces,
clinics and communities and include topics such as
healthy eating, physical activity, tobacco use
prevention, mental health, HIV/AIDS prevention and
safety.
Health education is an active learning process, which
aims at favorably changing attitudes and influencing
behavior w.r.t health practices

4. Introduction
•It has become the integral part of various
national health programs such a RNTCP,
RMNCH+A, and many communicable and
non-communicable diseases.
•Health literacy is an outcome of effective
health education, increasing individuals’
capacities to access and use health information
to make appropriate health decisions and
maintain basic health.

5. Definition
•Health education is any combination of
learning experiences designed to help
individuals and communities improve their
health, by increasing their knowledge or
influencing their attitudes (WHO)

6. Health + Education

7. Definition
Healtheducation:
‘‘Aprocessaimedatencouragingpeopleto
wanttobehealthy,toknowhowtostay
healthy,todowhattheycanindividually
andcollectivelytomaintainhealth,andto
seekhelpwhenneeded’’
Alma-Ata
declaration(1978)

8. Aims
(a)To encourage people to adopt and sustain health
promoting life style and practices
(b)To promote the proper use of the health services
available to them
(c)To arouse interest to provide new knowledge
,improve skilled and change attitudes in making
rational decisions to solve their own problems
(d)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.

9. OBJECTIVES
•INFORMING PEOPLE: people are informed
about the different diseases, their etiology and
how to prevent them.
•MOTIVATING PEOPLE: concerned with
clarifying/ changing or forming
attitudes,beliefs,values or opinions. After health
information is given it is necessary to motivate
them alter their lifestyles so that it becomes
favorable to promoting health and preventing
disease. Motivation is defined as “a combination
of forces which initiate, direct and sustain
behavior”

10. PRINCIPLES OF HEALTH
EDUCATION
•1.CREDIBILITY
•2.INTEREST
•3.PARTICIPATION
•4.MOTIVATION
•5.COMPREHENSION
•6.REINFORCEMENT
•7.LEARNING BY DOING
•8.KNOWN TO UNKNOWN
•9.SETTING AN EXAMPLE
•10.GOOD HUMAN RELATIONS
•11.FEEDBACK
•12.COMMUNITY LEADERS
•13.SOIL, SEED, SOWER

11. CREDIBILITY
It is the degree to which
the message is perceived
as trustworthy by the
receiver
It should be scientifically
proven, based on facts and
should be compatible with
local culture and goals

12. INTEREST
•If the health education
topic is of interest to the
people, they will listen
to it.
•Health educator should
identify the “felt needs”
of the people and then
prepare a program that
they can actively
participate in to make it
successful

13. PARTICIPATION
•Health educator should
encourage people to
participate in the program
•Once the people are given
a chance to take part in the
program it leads to their
acceptance of the program
•Methods like group
discussion, panel
discussions etc. provide
opportunities for people’s
participation

14. MOTIVATION
•“the fundamental desire
for learning in an
individual”
•Health education can be
facilitated by the
motivation provided by
the desire to achieve
individual goals
•Eg:-for a teenager,
esthetics might be a
motive to take care of his
teeth whereas for an
adult, the expenses of
undergoing restorative
care

15. COMPREHENSION
•Level of understating of
the people who receive
the health education
•Should first determine
the level of literacy and
understanding of the
audience and act
accordingly
•words that are strange or
new to the people should
not be used
•Use of technical terms or
medical terms should be
avoided

16. •Eg:-A statement saying “Eat food items that
are cariogenic” may not be comprehensive
to the layman. A better way of explaining
would be “ Avoid food stuffs which are
sweet and which stick to your teeth like
toffees and pastries. Eat food items like
fruits and raw vegetables which in addition
to being healthy, also help in keeping your
teeth clean.

17. REINFORCEMENT
•This is the principle that refers to the
repetition needed in health education
•It is not possible for the people to learn new
things in a short period of time
•So repetition is a good idea
•This can be done at regular intervals and it
helps people to understand new ideas or
practice better
•“booster dose in health education”

18. LEARNING BY DOING
•If the learning process
is accompanied by
doing new things it is
better instilled in the
minds of people
•“if I hear, I forget; if I
see, I remember; if I
do, I know”

19. KNOWN TO UNKNOWN
•Before the start of any health education program, the
health educator should find out how much the people
already know and then give them the new knowledge.
•The existing knowledge of the people can be used as
the basic step up on which new knowledge can be
placed
•Eg:-A health education program with the aim of
introducing a toothbrush to a rural population will be
better appreciated if the communicator start the
program with “what are you using to clean your teeth
at present” and then going in to details like “why
•are you using it” and then connecting it to the tooth
brush and then providing details about the tooth brush

20. SETTING AN EXAMPLE
•The health educator
should follow what he
preaches.
•He should set an
example to others to
follow
•Eg:-A health educator
who participate in a
program highlighting the
ill effects of tobacco
should not be seen
smoking since it sends a
wrong signal and
seriousness of the
situation is lost

21. GOOD HUMAN RELATIONS
•This principle states that the
health educator should have
good personal qualities and
should be able to maintain
friendly relations with the
people
•The health educator should
have a kind and
sympathetic attitude
towards the people and
should always be helpful to
them in clarifying doubts or
repeating what is not
understood

22. FEEDBACK
•For any program to be
successful it is
necessary to collect
feedback to find out if
any modifications are
needed to make the
program more
effective

23. •GUIDING IN TO ACTION: concerned
with development of skills and action. A
person who has obtained health information
might be motivated to change his behavior
and lifestyle. However he might need
professional help and guidance so as to
bring about these changes and to sustain
these altered lifestyles

24. COMMUNITY LEADERS
•Community leaders can be
used to reach the people of the
community and to convince
them about the need for health
education
•Leaders can also be used to
educate the people as they will
have a rapport and will be
familiar with the people of
their community
•The leader will have an
understanding of the needs of
the community and advice and
guide them

25. SOIL, SEED, SOWER
•Soil is the community
•Seed is information
•Soweris the person giving the information

26. APPROACH IN HEALTH
EDUCATION
1.Regulatory Approach(Managed
Prevention)
2.Service Approach
3.Educational Approach
4.Primary health care Approach

27. •Any governmental intervention, direct or indirect,
designed toalter human behaviour.
•Eg: Child marriage act in India, Seat belts rule in
cars etc.
•Advantages: Simple , Quick
•Particularly , be useful in times of emergency or in
limited situations such as control of an epidemic
disease or management of fairs and festivals
Legal or Regulatory Approach

28. Limitations :
•In area of personal choice (alcohol , exercise
etc.) no govt. can take away their right of
freedom
•Difficult to enforce laws without a vast
administrative infrastructure and considerable
expenditure.

29. Service Approach
•Intends to provide all the health facilities
needed by the people at their door steps on
the assumption that people would use them
to improve their own health.
•Limitation :not based on the felt-needs of
people
For example, when water seal latrines were provided, free of cost, in
some villages in India under the Community Development Programme,
people did not use them. This serves to illustrate that we may provide
free service to the people, but there is no guarantee that the service will
be used by them.

30. Educational Approach
•Most effective
•Gives autonomy towards their own lives
•Components :
1. motivation
2. communication
3. decision making
•results slow , but permanent and enduring.
•Sufficient time for an individual to bring about changes and
learning new facts as well as unlearning wrong information
as well.

31. •Radically new approach starting from the people
with their full participation and active
involvement in the planning and delivery of
health services based on principalsof art health
care via community involvement and inter-
sectoral coordination
•Individuals helped to become self-reliant in
matters of health
Primary health care approach

32. •It can be done if the people receive the
necessary guidance fromhealth care
providersin identifying their health
problemsand finding workable solutions.
•This approach is a fundamental shift from
the earlier approaches.

33. Practice of Health education
•1. Audio visual aids
–Audio
–Visual
–Audio Visual
•2. Methods of health communication
–Individual / Family
–Group
–General public(Mass communication )

35. Combination of Audio-Visual Aids
•Sound & sight combined together to create
a better presentation
televisions
tape and slide combinations
Video Cassette Players and Recorders
Motivation pictures or Cinemas
Multimedia Computers

36. Practice of Health education
•1. Audio visual aids
–Audio
–Visual
–Audio Visual
•2. Methods of health communication
–Individual / Family
–Group
–General public(Mass communication )

38. METHODS OF HEALTH
EDUCATION
•1.Individual approach
•2.Group approach
•3.Mass approach

39. Individual and Family Health
Education
Personal interviews
1.Personal contact
2.Home visits
3.Personal letter
4.Health Counseling
–Public health supervisors, nursing staff and health
visitors
–visit hundreds of homes;
–opportunities for individual teaching

40. •INDIVIDUAL APPROACH
•When an individual comes to the dental
clinic or health centre because of illness, the
opportunity should be used to educate him
on matters of interest such as the cause and
nature of his illness, its prevention,
beneficial diets, oral hygiene etc.
•This approach can also be used by public
health personnel, since they will be visiting
homes and can interact with the individual
and their families

41. •Advantages
•Can be done in a dentist’s consultation room
•Discussion, argument and persuasion of an
individual to change his behavior is possible
•Opportunity for the individual to ask questions
and clearing doubts
•Disadvantages
•Small number can benefit
•Health education is given to only who come in
contact with the dental surgeon or with public
health personnel

42. Methods of Group Health
Education
LecturesDemonstrations
Discussion
methods

44. 1.LECTURES
•CHALK AND TALK (LECTURES)
•“A carefully prepared oral
presentation of facts, organized
thoughts and ideas by a qualified
person”
•Should have an opening statement
•Group should not be more than 30
people
•Duration of talk should not exceed 15-
20 minutes
•Should be based on topics of current
interest
•Its effectiveness depends on ability of
speaker to write and draw legibly

45. •1.Flipchart 2Flannelgraph 3.Exhibits 4.Films and
charts
Demerits:
•students are involved to aminimum extent;
•learning is passive;
•do not stimulate thinking or problem-solving capacity;
•the comprehension of a lecture varies with the student;
the health behavior of the listeners is not necessarily
affected.
•one way communication ,learning is passive

46. •2.DEMONSTRATIONS
•Procedure is carried out step-by-step in
front of snaudience
•Method involves the audience in discussion
and has a high motivational value
•The audience can then carry out the
procedure themselves with expert help

47. Merits:
•Dramatization help arousing interest
•persuades the onlookers to adopt recommended
practices
•upholds the principles of "seeing is believing“
and "learning by doing", and
•can bring desirable changes in the Behaviour
pertaining to the use of new practice.
Demonstrations

48. •have a high educational value in programmes
like
•environmental sanitation (e.g installation of a
hand pump, construction of a sanitary latrine);
•mother and child health (e.g. demonstration of
oral rehydration technique) and control of
diseases (e.g., scabies).
•has ahigh motivational value.
Demonstrations

49. -Group discussion -Panel discussion
-Symposium -Workshop
-Conferences -Seminars
-Role play -Brain storming
-Colloquy -Campaign
-Focus group discussion -Delphi method
3.Discussion methods

50. •GROUP DISCUSSIONS
•A group is an aggregation of people
interacting in a face-to-face situation
•Process of identifying problems and
finding solutions collectively by
members of group
•Consist of 6-12 members
•Participants are seated in a circle
•Group leader initiates the subject,
prevents side conversations,
encourages everyone to participate
and sums up the discussion
•There should be a recorder who
prepares a report on issues discussed
and agreements reached

52. •PANEL DISCUSSIONS
•Panel of 4 to 8 experts sit
and discuss a topic in
front of an audience
•Headed by a chairman
who opens the session,
introduces the speakers
and keeps the discussion
going
•Audience are allowed to
ask questions
•Chairman sums up the
different views presented

54. •SYMPOSIUM
•A series of speeches on a selected topic
•Each speaker presents a brief aspects of the
topic
•There is no discussion among speakers
•In the end, the audience may ask questions
•The chairman makes a summary at the end
of the session

55. •WORKSHOP
•It consist of series of meetings with
emphasis on individual work with the help
of resource persons
•Total work shop is divided in to small
groups and each groups will select a
chairman and a recorder
•The individuals work, solve a part of the
problem, contribute to group discussions
and leave the workshop with a plan of
action for the problem

56. CONFERENCES OR SEMINARS
Program range from half day to one week
Held on a regional, state or national level
They usually have a theme

57. •ROLE PLAYING/SOCIO
DRAMA
•Size of the group should be
25
•The audience should take
part
•Situation is dramatized to
make communication more
effective
•It is followed by a
discussion on the problem
•Puppet shows is a type of
socio drama
•Useful for children’s health
education

58. Conference
•It composed of two to fifty persons representing
several organizations, departments, or points of
view within an organization, meet together exhibit a
common interest and present two or more sides of
their problems.
•They gather information and discuss mutual
problems with a reasonable solution as the desirable
end.
•The various phases of the problem may be presented
by co-operative or hostile groups

59. Brain storming
•It is a type of small group interaction designed to
encourage the free introduction of ideas on a
restricted basis and without any limitations as to
feasibility.
•Participants are encouraged to list for a period of
time all the ideas that come to their minds
regarding some problem and are asked not to
judge these ideas during the session.
•Judgment of the ideas will come at a later period
in which all contributions will be sorted,
evaluated and perhaps later adopted.

60. COLLOQUY
•A Colloquy is an informal method of discourse
which is a modified form of the panel, using one
group of three to four persons from the audience
and another group of three to four resources persons
or experts on the subject to be considered.
•The panel members elected from the audience
present the problem and the experts comment on
various aspects of it.
•The general audience and panel members
participate whenever they so desire under the
guidance of a moderator

61. CAMPAIGN
•A campaign is an intensive teaching activity
undertaken at an opportune moment for a brief
period, focusing attention in a concerted
manner towards a particular problem so as to
stimulate the widest possible interest in the
community.
•Campaign methods can be used only after an
advocated practice & is found acceptable to the
local people through method or result
demonstrations or other extension methods.

62. Focus Group Discussions (FGD)
•It is a group discussion of 6-20 persons guided by a
facilitator during which group members talk freely
and spontaneously about a certain topic or health
problem.
•The purpose of a focus group discussion is to
obtain in-depth information on concept,
perceptions and ideas of group on a particular
topic.

63. •Thetopicshouldbenarrowlyfocused
•Selectionofparticipantsisalsofocusedby
targetingindividualswhomeetspecific
criteria
•Topicshouldbeofinteresttoboththe
investigatorandrespondents.
•Theemphasisshouldbeoninteraction
betweenoramongthegroupmembers.

65. Delphi technique
•Delphi techniqueis “a judgmental forecasting
procedure for obtaining, exchanging, and
developing informed opinion about future
events”
Or
•a method for structuring a groups’
communication process so that the process is
effective in allowing a group of individuals as
a whole, to deal with a complex problem”

66. •The Delphi Technique typically includes at least
two rounds of experts answering questions and
givingjustificationfor their answers, providing
the opportunitybetween rounds for changesand
revisions.
•The multiple rounds, which are stopped after a
pre-defined criterionis reached, enable the
group of experts to arrive at a consensus forecast
on the subject being discussed
Delphi technique

67. Delphi technique

68. Delphi technique
The tasks that the Delphi can help to
address are:
•determining priorities, setting goals,
establishing future directions
•designing needs assessment strategies &
improve service delivery
•evaluating programs or alternative plans

69. Delphi technique
Successful communication as :
•Avoids domination of one or more members of
the group;
•Avoids pressures to conform to the group’s
opinion;
•Avoids personality or interpersonal conflicts;
and
•Avoids the difficulty of two opposing
individuals of power

70. Mass communication
•Mass communication literally means
communication that is given to a community
where the people gathered together does not
belong to one particular group.
•Communication is given to a community
where the people gathered together do not
belong to one particular group

71. •VARIOUS MASS MEDIA USED ARE
•Television
•Radio
•News papers/press
•Documentary films
•Posters
•Health exhibition
•Health magazines
•Health information booklets
•Internet
•mobile telephone message
•satellite television
These are emerging and being adapted rapidly in the movement
toward modernization.
Mass communication

72. •Method used to educating general public are
called as mass media
1. Television: it’s a one –way method
It is excellent method to change people’s
attitude, views and behaviour regarding health
concern
2.Radio: it reaches to large population
Discussion about any health related topic can
reach to remote areas

73. 3. Internet
•Health related information can be collected
from ministry of healthandfamily welfare gov
of indiaand WHO
4. Newspaper
5. Printed materials
•Ex-magazines, pamphlet, booklets and hand-
outs prepared by different organizations and
govt

74. 6. Direct mailing
•Health dept ---village local leaders, literate
peoples, infomationregarding nutrition,
immunization,
7. Posters
8. Health museum and exhibitions
•Knowledge about the various health
problem and concern can be presented
thoroughealth museum and exhibition

75. mHealth
•mHealthinvolves using wireless technologies
such as Bluetooth, GSM/GPRS/3G, WiFi,
storage devices, and so on to transmit and
enable various eHealthdata contents and
services.
•Usually these are accessed by the health
worker through devices such as mobile phones,
smart phones, PDAs, laptops and tablet PCs

76. •Advantages:
•Large number of people can be reached
•People of all socio-economic status have
access to health education
•All people irrespective of their caste, creed and
religion are addressed
•Disadvantage :
•One way communication

78. HEALTH EDUCATOR
•People specialize in health education (trained
and/or certified health education specialists).
•Para-professionals and health professionals -
perform selected health education functions as
part of what they consider their primary
responsibility (medical treatment, nursing,
social work, physical therapy, oral hygiene, etc.

79. Responsibilities of health
educator

80. At Hospital
1.Out-patient department
Exbitingthe pictures, photos, charts and
models in waiting hall
Arrange group discussion
Pamphlets
Street play
2. In-patient department
OPPORTUNITIES FOR HEALTH
EDUCATION

81. •Information while looking after the patient
•Provide Health education to family member by live
demonstration and group discussion
•Family planning, prenatal,postnatal,
•Diet ,personal hygiene, nutrition, lighting, and ventilation,
health checkup, prevention of disease, health check-up
At home :

82. In community
•Health education regarding environmental
sanitation during community survey
•Schools, factories and home

83. 1. Human biology
anatomy and physiology
Importance of health
Effect of smoking, drinking and
drugs on the body
2. NUTRITION
Balanced diet
Nutritive value of food stuffs
SCOPE OF HEALTH EDUCATION

85. Diet for pregnant and lactating mothers and others
Food sanitation
Nutrition deficiencies disease and there prevention
Motivation of good eating habits
3. Hygiene (personal and environmental)
Personal hygiene
Environmental hygiene
Food hygiene

87. 4. Mental health
•Preventive measures against mental disorder, hyper-
exciability
Developmentofproperrelationshipwith
mothersandchildatbirth,atthetimechild
gototheschool,helpatthetimechoosinga
career
Guidanceandcounseling

88. 5. Prevention of disease and accidents
•Prevention of communicable Ex-TB, AIDS
and non communicable disease Ex-D.M.,
C.H.D
•Useful information about road safety

89. •Knowledge about accidents industrial area,
offices, and their prevention
•Education regarding self screening measures
•To detect and prevent cancer ex-Brest self -
examination
6. Utilization of health services
ToInformthecommunityaboutavailablehealth
services,voluntaryagencies,motivatethemto
participateinnationalhealthprogramme

90. 7. Family planning and maternal and child health
•Planned and unplanned family
•Immunization of pregnant women
•Growth and development of child, depression etc.
•Use of contraceptives
•To strengthen and improve the health of family as a unit rather
than as an individual

91. 8. Sex education
9. Health statistics
•Health habits
•Safety rules
•Basic (K) of disease & preventive measures
•Proper use of health services
•Special education for groups( food
handlers, occupations, mothers, school
health etc. )
•Principles of healthy life style e.g. sleep,
exercise
•Etc..

93. Concept map

94. ROLE OF NURSE IN HEALTH
EDUCATION

95. The nurse should consider following points during
health education:
To gain the confidence of people
To arouse the interest in people about good health
To motivate them to bring about chnagesin habbits
in healthy living
To develop sense of responsibility among people
towards good health of the whole community
Motivate or encourage them to use of health
services
co-operative feeling
Select the subject matter according to need
Nurses role/responsibilities as a health educator

96. Use appropriate audio-visual aids
Use opportunities of health education wisely
It should be planned and continuous and implementation based
on resources
Nurses should come forward and take Sufficient participation
and cooperation of government and voluntary agencies is
essential for health education
Effective communication should be maintain

97. SUCCESS
STORIES

98. Polio eradication
•Increased awareness about
the Vaccine
•Decreased the myths
regarding the vaccine
•Better sanitation and hygiene
•Information about the the
immunization days
•Tag lines such a “DO
BOOND ZINDAGI ke” -
very effective

102. THANK YOU