Contents

• Introduction
• Definitions
• Approach to health education
• Principles of health education
• Contents of health education
• Practice of health education
• Health educators
• Success stories
 Introduction
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.
 Introduction
• Health education + educational ,
motivational, skill-building and
consciousness-raising techniques >>>>
building individuals’ capacities
• Healthy public policies provide the
environmental supports >>>>encourage
and enhance Behaviour change.
• By influencing both, brings about meaningful
and sustained change in the health of
individuals and communities can occur.
 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.
 Health education
Health education has been used
interchangeably with
• Behaviour change communication
• Information, Education &
Communication (IEC)
 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)
 Behaviour Change
Communication
• Is a process of working with
individuals, families and communities
through different communication
channels
• to promote positive health
behaviours
• and support an environment that
enables the community to maintain
positive behaviours taken on.
 Information Education
and Communication
• Is a process of working with
individuals, communities and
societies to develop communication
strategies to promote positive
behaviours that are appropriate to
their settings.
Health promotion model
Relationship between major health
concepts
Health Education Propaganda

Knowledge and skills actively Knowledge instilled in the minds of the

acquired(active thinking) people(facts)

Develops reflective behavior .Trains Develops reflexive behavior; aims at

people to use judgement before acting impulsive action

Appeals to reason Appeals to emotion

Develops individuality ,personality and Develops a standard pattern of attitudes

self expression and behaviors according to would used

Knowledge acquired through self reliant Knowledge is spoon fed ad received

activity

The process is behavior centered aims at The process is information centered – no

developing favorable attitudes , habits change of attitude or behavior designed
and skills
 Aims and Objectives
(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.
 APPROACH IN HEALTH
EDUCATION
1. Regulatory Approach(Managed
Prevention)
2. Service Approach
3. Educational Approach
4. Primary health care Approach
 Legal or Regulatory Approach\

• Any governmental intervention, direct or

indirect, designed to alter 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
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.
 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.
 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.
Primary health care approach

• Radically new approach starting from

the people with their full participation
and active involvement in the planning
and delivery of health services based
on principals of art health care via
community involvement and inter-
sectoral coordination
• Individuals helped to become self-
reliant in matters of health
 Primary health care approach
• It can be done if the people receive
the necessary guidance from health
care providers in identifying their
health problems and finding
workable solutions.
• This approach is a fundamental shift
from the earlier approaches.
 APPROACH IN HEALTH
EDUCATION
• Since individuals vary so much in
their socio-economic conditions,
traditions, attitudes, beliefs and level
of knowledge
• A single approach may not be
suitable.
• Combination of approaches must be
evolved depending upon local
circumstances
 CONTENTS OF HEALTH
EDUCATION
• Human Biology: The effects of alcohol, smoking,
resuscitation and first aid are also taught.
• Nutrition: Eighth WHO Expert Committee on
nutrition stated that education in nutrition is a
major strategic method for the prevention of
malnutrition.
• Hygiene: PERSONAL HYGIENE includes bathing,
clothing, washing hands and toilet; care of feet,
nails and teeth; spitting, coughing, sneezing,
personal appearance and inculcation of clean
habits in the young.
 CONTENTS OF HEALTH
EDUCATION
• ENVIRONMENTAL HYGIENE:
• Objectives
• (a) to educate the people in the
principles of environmental health
with a view to bring about desired
changes in health practices
• (b) to secure adoption, wide use and
maintenance of environmental health
facilities, and
 CONTENTS OF HEALTH
EDUCATION
• (c) to promote active participation of
the people in planning, construction
and operational stages of
environmental improvements.
• Family Health Care: The aim of health
education is to strengthen and improve
the quality of life of the family as a unit
so that it can survive the vicissitudes of
rapid and complex social changes.
 CONTENTS OF HEALTH
EDUCATION
Control of Communicable and Non -
communicable Diseases:
• People are encouraged to participate
in programmes of disease control,
health protection and promotion.
• Mental health::The aim of education
in mental health is to help people to
keep mentally healthy and to prevent
a mental breakdown
 CONTENTS OF HEALTH
EDUCATION
• Prevention of Accidents:
• occur in three main areas: the home, road and
the place of work.
• Safety education should be directed to these
areas.
• It should be the concern of the engineering
department and also the responsibility of the
police department to enforce rules of road safety.
• Management must provide a safe environment,
and promote general order and cleanliness.
 CONTENTS OF HEALTH
EDUCATION
• Use of Health Services
• inform the public about the health
services that are available in the
community, and how to use them.
• They should not be misused or
abused
Principles of Health Education

1. Community involvement in planning

health education is essential. Without
community involvement the chances
of any programme succeeding are
slim.
2. The promotion of self esteem should
be an integral component of all health
education programmes.
Principles of Health Education

• 3. Voluntarism is ethical principle on

which all health education
programme should be built without it
health education programmes
become propaganda.
• Health education should not seek to
coerce but should rather aim to
facilitate informed choice.
Principles of Health Education

• 4. Health education should respect

cultural norms and take account of
the economic and environmental
constraints face by people. It should
seek positively to enhance respect
for all.
• 5. Good human relations are of
utmost importance in learning.
 Principles of Health Education

• 6. Evaluation needs to be an integral part

of health education.
• 7. There should be a responsibility for the
accuracy of information and the
appropriateness of methods used.
• 8. Every health campaign needs
reinforcement. Repetition of messages at
intervals is useful.
 Practice of Health
education
• 1. Audio visual aids
– Audio
– Visual
– Audio Visual
• 2. Methods of health communication
– Individual / Family
– Group
– General public (Mass communication )
 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
 Practice of Health
education
• 1. Audio visual aids
– Audio
– Visual
– Audio Visual
• 2. Methods of health communication
– Individual / Family
– Group
– General public(Mass communication )
 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
 Counseling
• Counseling- a confidential dialogue between a
client and a health care provider aimed at
enabling the client to cope with stress and take
personnel decisions related to disease.
• The aim of counseling based on the needs of the
client.
• Purpose: three fold to >>help clients manage
their problems more effectively, >>to develop
unused opportunities to cope more fully, and
>>to help and empower clients to become more
effective self helpers in the future.
 Elements of counseling
G: greet the clients and make them
comfortable and give full attention.
A: ask/ascertain the needs/problem or
reasons for coming.
T: telling different
choices/options/methods to cope with
problem.
H: help the client to make voluntary
decisions.
Group Health Education
• an effective way of educating the
community.
• The choice of subject is very
important it must relate direct to the
interest of the group health.
• These methods are effective in
– promoting behavioral change,
– influences opinion,
– develop critical thinking
 Methods of Group
Health Education

Lecture Demonstration Discussio

s n
s
methods
 Lectures
• carefully prepared oral presentation of facts, organized
thoughts and ideas by a qualified person.
• Aids:
• 1.Flipchart 2Flannelgraph 3.Exhibits 4. Films and charts

Demerits:
• students are involved to a minimum 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.
 Demonstrations
• are carefully prepared presentation to show
how to perform a skill or procedure.
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
• 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 a high motivational value.
 Discussion methods
-Group discussion -Panel
discussion
-Symposium -Workshop
-Conferences -Seminars
-Role play -Brain
storming
-Colloquy - Campaign
- Focus group discussion -Delphi
method
 Group discussion
• Group is an "aggregation of people
interacting in a face to face
situation“
• very effective method of health
communication.
• Provides a wider interaction among
members than is possible with other
methods.
 Group discussion
For effective group discussion

• Group size - 6 -12 members.

• The participants are seated in a circle,
so that each is fully visible to all the
others.
• Group leader - initiates the subject,
• Helps the discussion in the proper
manner, prevents side-conversations,
encourages everyone to participate
and sums up the discussion in the end .
 Group discussion
Rules for members

• express ideas clearly and concisely

• listen to what others say
• do not interrupt when others are
speaking
• make only relevant remarks
• accept criticism gracefully and
• help to reach conclusions
Good Group
discussion
 Panel discussion
• 4 to 8 persons – qualified - talk and discuss
about a problem or a topic in front of a large
group or audience .
• The panel comprises a chairmen or a
moderator from 4 to 8 speakers.
• Success of the panel discussion depends on :
• Chairperson to keep the train of thoughts of
track.
• Discussion should be spontaneous and
natural
 Symposium
• Series of speeches on a selected
subjects
• Each person or expert presents an
aspect of the subject briefly
• No discussion among the symposium
members.
• Chair person makes a comprehensive
summary at the end
 Work shop
• Consist of series of meetings, usually
four or more with the emphasis on
individual work, within the group with
the help of consultants and resource
personnel.
• Learning takes place in a friendly ,
happy and a democratic atmosphere,
under expert guidance.
 Role playing
• Socio- drama in which the situation is
dramatized by a group .
• audience is actively concerned with
the drama.
• Sympathetic attention to what is going
on ,or suggest alternative solutions at
the request of leader
• The size of the group 25.
• Best for schools.
 Seminars
• A group of persons gathered for the
purpose of studying a subject under
the leadership of an expert or
learned person.
• They are normally identified with
learning institutions.
• The participants bring with them a
background of training and
experience in the area.
 Conference
• A group usually 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
 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.
 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
 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.
 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.
 FGD
• The topic should be narrowly focused
• Selection of participants is also
focused by targeting individuals who
meet specific criteria
• Topic should be of interest to both
the investigator and respondents.
• The emphasis should be on
interaction between or among the
group members.
 FGD: Advantages

• Cost-effective
• Quality of data enhanced by
group participants
• Can quickly assess the extent to
which there is agreement or
diversity on an issue
• Enjoyable for participants
 FGD:Limitations
• Outside of natural setting
• Silences the minority view
• Responses by each participant may be
constrained
• Restricts number of questions that can
be asked
• Requires group process skills
• Confidentiality not assured
• Explores major themes, but fails to catch
subtle differences
 Delphi technique
• Delphi technique is “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
 Delphi technique
• The Delphi Technique typically
includes at least two rounds of experts
answering questions and giving
justification for their answers,
providing the opportunity between
rounds for changes and revisions.
• The multiple rounds, which are
stopped after a pre-defined criterion is
reached, enable the group of experts
to arrive at a consensus forecast on
the subject being discussed
Delphi technique
 Delphi technique
Avoid the following group
communication failures:
• domination of one or more members
of the group;
• pressures to conform to the group’s
opinion;
• personality or interpersonal conflicts;
and
• the difficulty of two opposing
individuals of power
 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
 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.
• Advantages
 large no. of people can be reached
 people of all socio-economic status
irrespective of their caste, creed and
religion are addresed
 Mass communication

• Medias
televisions, radios, posters, news papers,
internet and other advance
communication technologies such as
mobile telephone message and satellite
television are important channel for
health information communication.
• These are emerging and being adapted
rapidly in the movement toward
modernization.
 mHealth
• mHealth involves using wireless
technologies such as Bluetooth,
GSM/GPRS/3G, WiFi, storage devices,
and so on to transmit and enable
various eHealth data contents and
services.
• Usually these are accessed by the
health worker through devices such as
mobile phones, smart phones, PDAs,
laptops and tablet PCs
Good communication technique
• Source: credibility.
• Clear message.
• Good channel: individual, group & mass
education.
• Receiver: ready, interested, not occupied.
• Feed back.
• Observe non-verbal cues.
• Active listing.
• Establishing good relationship.
 WHO PROVIDES HEALTH
EDUCATION?
• 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.
Responsibilities of health
educator
Analyzing the Community
Community Health Status NGO ‘s
Backdrop Health Care System
and Support Systems

Writing the Final Report

(SWOT)ANALYSIS

“target communities”
Writing and disseminating the Action major health problem
Plan(Implementation Plan) other “felt needs”
Identify Methods and Activities for
Health Education

Assemble the Planning Consolidating Data on

Group / Coordination Council; Knowledge, Attitudes
Resource Analysis and Behaviors
Success Stories
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
 Achievements in RNTCP
through Health
Education
• Destigmatisation of TB by popularizing the fact
that TB is curable, by using cured patients to
motivate others;
• Making TB services more accessible to the
marginalised sections of society – women, tribal
and other marginalised groups through
awareness generation, and the promotion of
health seeking Behaviour;
• Greater collaboration with private health care
providers by popularizing availability of good
quality diagnostic and treatment under the
 Achievements in RNTCP
through Health
Education
• Ensuring completion of treatment by
patients by increasing their knowledge
about the disease and their treatment,
and also by creating patient-friendly
environments; and
• Making DOTS a familiar name among
different target audiences so that there is
an immediate association of the term
‘DOTS’ with TB and its cure.