March 26, 2023
Tesfaye F.
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Tesfye F. (BSc, MPH, Assistant Professor)
Email: tesfayefeleke33@gmail.com

Learning Objectives
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At the end of this class; you will be able to:
 Recognize the concepts of Health Education
 Describe the aims and principles of Health Education
 Identify the role of Health Education in Primary Health
Care
 Familiar with the Health policy of the country as related to
Health Education

Historical Development of HE/HP
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 As a practice as old as human being.
 The concept of educating about health has been
around since the dawn of humans.
 As a profession in the world ~>100 years – USA
 Health belief model 1966: the oldest model
 As a course: Gondar Health science ~ 1954
 As a profession in Ethiopia: JU <10 yrs

Evolution/developmental process of HE/HP
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There have been three revolutions in public health:-
The First Public Health Revolution
 Fight against communicable/infectious diseases, malnutrition and
environmental factors over which people had little control (water,
basic sanitation, food security)
 Health Education had already been taking part during this first
revolution
The Second Public Health Revolution
 Fight against non-communicable diseases over which people had
some personal control, when social conditions and context were
favorable (obesity/healthy diet, sedentary lifestyles/exercise,
addictions, abuse, mental health, risky behaviors)

Evolution of HE/HP…
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The Third Public Health Revolution–the ‘Birth of Health Promotion’
(since 1974)
 Health promotion is viewed as a strategic activity to
promote health as a “resource for every day life”
 Health promotion focuses on wellbeing and quality of life,
for which it is necessary to empower communities for action

Brainstorming
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 How do you define health?
 Define health education?
 Describe health promotion?
 Differentiate health information and health education?
 Describe the role of health education in public health?

Introduction
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Health: is “a state of complete physical, mental and
social well-being not merely the absence of disease or
infirmity” (WHO 1948)

Health Education
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“Any combination of learning experiences designed to facilitate
voluntary action conducive to health”
 Combination: it emphasizes on the importance of matching multiple determinants
of behaviors with multiple learning experiences or educational intervention
 Designed: distinguishes health education from incidental learning experiences as
systematically planned and organized activity
 Facilitate: creating favorable condition such as predispose, enable, reinforce
 Voluntary: with full understanding and acceptance of the purpose of the action
 Action: behavioral steps/measures taken by individuals, groups or
community to achieve the desired health effect.

Health Promotion
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 To reach a state of complete physical, mental and social well being it
is beyond the activity of health education and even health sectors
 “A combination of educational approach (health education) and
the ecological /environmental approach (political action) for
actions and conditions of living conducive to health.”
Components of health promotion
 Health education
 Political environment
 Social environment
 Economic environment
 Organizational environment

Health Education Vs Health Information
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Health Education Health Information
Baseline information or current level
of Multiple determinants of behavior
are necessarily required
Baseline information or data are not
necessarily required
Appropriate for old problems (problems
known to the people for long period of
time)
Appropriate for newly emerging health
problems and during epidemics
Required at all stages in behaviors
change Continuum
One time telling facts provided that the
information reaches at all the intended
audiences and understanding takes place
Encourage people to make their own
choices for healthy life
Merely telling people to follow healthy
behaviors
Use a variety of methods or educational
Strategy as appropriate
May not use a variety of methods
Focus on the reason behind behaviors Blind to the reason behind behaviors

Rationale for health education and Health Promotion
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 The continued existence and spread of communicable
diseases.
 such as malaria, TB, HIV/AIDS
 About 75% of childhood illnesses are preventable
e.g. measles by immunization, malnutrition and
diarrhea, promoting breast feeding up until age of
two.
 Need the involvement of the community members and
environmental interventions.
 For some diseases health education is the only
practical choice:
 In order to prevent the spread of the disease or to
lead a normal life. E.g. HIV/AIDS.

Rationale …
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 The tendency of increasing magnitude of chronic
conditions and other emerging agendas/new: starting to
appear, arise, occur, or develop, which required the
cooperation of individuals to lead with the problem. E.g.
Hypertension.
Human behaviors are almost the single causes for the
development of such currently emerging health problems
and also the main solution.
Many people do not seek treatment until it is too late.
Ignorant, access, afraid of seeking treatment

Rationale …
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Prevention is better than cure:- is a statement which is
generally true especially for non-communicable diseases
Increasing threats to the young from new and
harmful behaviors E.g.. tobacco use, teen-age pregnancy,
substance use etc.
Increased awareness of people on chronic health
problems and the need to know preventive actions.

Objectives of health education
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 Ultimate goal of health education is to promote, maintain and
improve individuals and community health.
Educational objectives of health education
 To provide appropriate knowledge: provision of correct
knowledge, facts and information.
For example, facts about CVD, HIV/AIDS.
 To help develop positive attitude: has a lot to do with changing
opinions, feelings and beliefs of people.

Objectives of health education…
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 To help exercise health practice/behavior: concerned with
helping people in decision-making and actually performing.
 For example helping people choosing alternatives (weather
to abstain, be faithful, or use condom)
 Decision-making: means choosing between and/or among
alternatives in the future about health.

Settings of health education :
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Health education occurs in a variety of places,
these include:
 Health facilities
 Schools
 Worksite
 Health departments
 Voluntary health agencies
 Communities

Settings of Health Education
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Setting Primary Mission Who is served
Hospitals Treat illness Patients
Community primary care
settings
Prevent, detect and treat
illness and trauma
Patients, clients and local
community
Schools Education Children, adolescents …
Worksite Produce good and
services
Consumer of products
and services
Health department Disease prevention and
control
Public
Voluntary health
agencies
Disease prevention and
control
Public

Principles of health education
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1. Principle of educational diagnosis
The first task in changing behaviors is to determine its
causes.
Just as physicians must diagnose an illness before it can be
properly treated, so in health education there must a
behavior be assessed/diagnosed before it can be properly
changed.
If the causes of the behaviors understood health educator
can intervene with the most appropriate and efficient
combination of education, reinforcement and motivation

Principles of HE…
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2. Principle of Participation
The prospect for success in any attempt to change
behaviors will be greater if the individuals, families,
community groups,, etc…have been participated in
identifying their own needs for change and have selected
the methods that will enable them to take action.
3. Principle of multiple methods
 This principle follows from the principle of educational
diagnosis. In so far as multiple causes will consistently be
found for any given behaviors.

Principles of HE…
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4. Principle of planning and organizing
 Planning and organizing are fundamentals for health
education which distinguishes it from other incidental
learning experiences.
 It involves deciding in advance the when, who, what, how
and why of health education.
 It also requires the planning for resources, methods and
materials to be used, identification of target groups etc.

Principles of HE…
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5. Facts
Health education is given based on scientific findings/facts
and current knowledge.
6. Segmentation
Health education should be designed for a specific group of
people/specific target groups
7. Need based
Health education is primarily educational and its purpose is
to ensure a desired health related behavior after real need
identification.

Principles of HE…
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8. Culture
Health education should not considered as artificial
situation or formal teaching –learning process.
One has to get into the culture of the community to
introduce new ideas easily
Rigid statements particularly contrary to existing belief,
culture, practices will not be liked.
Therefore HE starts from where people are and slowly
build up the talking point to avoid any clash of ideas
through the communication process

Principles of health education…
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9. Principle of motivation:
Motivation is mental direction /desire for doing or rejecting
something.
It is something that happens within the person, not
something done to a person by others.
10. Principle of feedback
It is a mechanism of assessing what has been happened
in the target Population after receiving the message..

The role of HE in primary health care
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What is PHC?
 Primary health care is essential health care made
accessible at a cost a country and community can afford,
with methods that are practical, scientifically sound and
socially acceptable.

Role of HE…
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HE is:
 A component of PHC
 Core principles of primary health care is “community
participation”.
Thus:
 Health education is central to primary health care
 All components of primary health care have health
education
 Informing the community is the first important step
towards community participation
 Facilitating inter-sectoral action
 Primary health care can not successfully implemented
without health education.

March 26, 2023
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Health policy of Ethiopia as related to Health
Education
Health policy
 A formal statement or procedure within institutions
(notably government) which defines priorities and the
parameters for action in response to health needs,
available resources and other political pressures.

Health Policy and Health Education
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1. General policy
 Development of the preventive and promotive components of
health care.
 Promoting and strengthening of intersectoral activities.
 Promotion of attitudes and practices conducive to the
strengthening of national self-reliance in health development by
mobilizing and maximally utilizing internal and external
resources.
 Working closely with neighboring countries, regional and
international organizations to share information and strengthen
collaboration in all activities contributory to health development
including the control of factors detrimental to health.

Health Policy and Health Education…
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2. Priorities of the policy
1st. Information, Education and Communication
(I.E.C) of health shall be given appropriate
prominence to enhance health awareness and to
propagate the important concepts and practices
of self-responsibility in health.

Health policy and Health Education…
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General strategies
Health Education shall be strengthened generally and for
specific target populations through the mass media,
community leaders, religious and cultural leaders,
professional associations, schools and other social
organizations for:-
 Inculcating attitudes of responsibility for self-care in
health and assurance of safe environment.
 Encouraging the awareness and development of health
promotive life-styles and attention to personal hygiene
and healthy environment.

Health policy and Health Education…
March 26, 2023
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General…
 Enhancing awareness of common communicable and
nutritional diseases and the means for their prevention.
 Inculcating attitudes of participation in community health
development.
 Identifying and discouraging harmful traditional practices
while encouraging their beneficial aspects.
 Discouraging the acquisition of harmful habits such as
cigarette smoking, alcohol consumption, drug abuse and
irresponsible sexual behavior.
 Creating awareness in the population about the rational use

March 26, 2023
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How do you describe the health education
program in Ethiopia?

References
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 TheodoreH, Tulchinsky, Elena A. Varavikova(2000) The new public health
 John Hubley 1993. Communicating health. An action guide to health
education and health promotion.
 Lawrence W. Green et al. 1980. Health education planning a diagnostic
approach
 Getnet Mitike 2003 health education for health science students. Lecture
note series. Addis Ababa University, Ethiopia.
 Randall R. Cottrell, James T. Girvan, James F. McKenzie 2006. Principles&
foundations of health promotion and education. Third ed. USA.
 John Hubley 1993. Communicating health. An action guide to health
education and health promotion.
 Health policy of the transitional government, 1993

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