Critical Review of Development and Current Situation of Health Education in Nepal From Central to Peripheral Level

1. Critical Review of Development
and Current Situation of Health
Education in Nepal From Central
to Peripheral Level
Presented By: Mohammad Aslam (MPH)

2. Concept and definitions of Health
Education
 “is a process of growth in an individual by means of
which he alters his behavior or change his attitude
towards health practices as a result of new
experiences he has had.” (Dorothy B.Nysewander, 1949)
 “Consciously constructed opportunities for learning
involving some form of communication designed to
improve health literacy, including improving
knowledge, and developing life skills, which are
conducive to individual and community health.”
(Oxford text book of public Health, 3rd edition)
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3. Cont…
 The WHO health promotion glossary describes health
education as not limited to the dissemination of
health-related information but also “fostering the
motivation, skills and confidence (self-efficacy)
necessary to take action to improve health”, as well
as “the communication of information concerning the
underlying social, economic and environmental
conditions impacting on health, as well as individual
risk factors and risk behaviours, and use of the health
care system”.
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4. Development of Health Education in
Nepal
 First five year plan (1956-61);
o Established Health Education and Sanitation Section in
1961 under DOHS.
o Emphasized on Sanitation and Hygiene.
 Second three year plan (1962-66) and third five year
plan (1965-70);
o Initiation of vertical projects: : Malaria eradication, Tb and
Leprosy control project, FP/MCH project, Small pox
eradication project etc.
o Health education and promotion had been priority
component of those vertical programs, but they had their
own health education unit being operated from the center to
the periphery within the project area.
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5. First long term Health Plan (1975-90)
 Nepal signed the Alma-Ata Declaration and adopted
PHC for achieving HFA by 2000.
 Education was the mean for prevention and control
of prevailing health problems.
 Health education program was given due priority for
health promotion and provided to people at doorstep
covering all components of primary health care.
 Ottawa charter for Health promotion (1986): The
three strategies; enabling, advocating and mediating
to achieve the goal HFA by 2000 were influenced by
Health Education.
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6. National Health Policy1991
 Given the mandate to contribute in attainment of the
highest level of health status of the people by means
of health education, information and communication.
For this, political workers, teachers, students, social
organizations and volunteers will be mobilized
extensively up to the ward level."
 Health Promotion, one of the areas addressed by
national health policy 1991. Health promotion and
education activities focus on hygiene and sanitation,
better nutrition, utilization of MCH and family
planning services, solid waste management,
empowering communities for involvement in health.
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7. National Health Education and Information
Communication Centre (NHEICC)
 NHEICC was established in 1993.
 The centre has been working as an institution for
planning, implementation, monitoring and evaluation of
advocacy, community mobilization and behavior change
communication programs of all health services and
programs at different levels in an coordinated approach.
 Playing its vital role to help achieve the goal, as an
integral component of health services considering the
national health policy in collaboration with different
government sectors, NGOs, INGOs and private sectors in
developing, producing, disseminating and distributing
health HEIC messages and materials.
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8. Cont…
NHEICC has role in maintaining the quality of HEIC program
by means of uniformity, accuracy, appropriateness and
adequacy of health messages and materials in use through the
network of health organization from center to periphery level
as follows;
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9. Major activities of NHEICC – Centre
Level
 Policies, strategies and programs development.
 Development of program guideline and directives.
 Development, production and airing of short
messages through FM, radio and television.
 Development, production and distribution of IEC
materials.
 Program orientation to regional and district level
Managers and focal persons.
 Public Private partners involvement for Public
awareness, IEC and BCC.
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10. Cont…
 Coordination – Organize Technical Committees
meetings
 Conduction of health communication researches.
 Supervision, Monitoring and Evaluation of health
communication researches.
 Implementation of Tobacco control act, Tobacco
control strategic plan.
 Conduction of environmental health, hygiene and
sanitation activities.
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11. Major activities of NHEICC – Regional
Level
 Establish Health Education section at Regional office
 Program orientation to district Managers and Focal
persons.
 Radio program airing from region (Radio Nepal).
 Sensitization programs for prevention and control of
epidemics.
 Distribution of IEC materials from regional medical
stores.
 Supervision and Monitoring of health promotion
activities.
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12. Major activities of NHEICC – District
and Peripheral Level
 Establish Health Education unit at DPHO.
 Strengthen IEC corner by supporting electronic
medias (District Hospital and PHCC).
 Production of IEC materials in need basis.
 Distribution of IEC materials in health facilities.
 Organize program orientations to HWs at district and
peripheral level.
 Production and airing of health programs/messages
through local FMs.
 Organize Exhibitions and community health
promotion Campaigns.
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13. Cont…
 FCHVs orientations and capacity building trainings.
 Collaboration with government offices, development
partners, local NGOs, CBOs, women and youth
groups.
 Sensitization program against gender based violence.
 Organize School health program.
 Support to organize Health mother group meeting.
 Promote environmental health, hygiene and
sanitation.
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14. Second long term Health Plan (1997-
2017)
 SLTHP (1997-2017) had mentioned that National
Health Education, Information and Communication
Centre (NHEICC) was a focal point for Ministry of
Health Population for planning, implementation,
monitoring and evaluation of health promotional
activities.
 The plan clearly stated that NHEICC was responsible
for the development, production, dissemination,
publication and distribution of correct health
messages through appropriate communication media
in collaboration with other departments, divisions
and centres.
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15. Nepal Health Sector Program:
Implementation Plan (NHSP:IP) 2004-9
 NHSP:IP had recognized and accepted health
communication as a cross cutting issue for all health
programs.
 It had stated that behavioral change communication program
to support Essential Health Care Service (EHCS) Package.
 The plan had also stressed on the importance of behavioral
change communication to address non-communicable
disease risk factors emphasizing on the reduction of tobacco
and harmful use of alcohol.
 It had mentioned about integrating information, education
and communication in all EHCS package and to use all
possible mass communication media for health promotion.
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16. Nepal Health Sector Program II (NHSP
II) 2010-2015
 Had prioritized and included public health promotion
programs under health education and communication
heading.
 Had emphasized on planning, implementation,
monitoring and evaluation of advocacy, social
mobilization and behavior change communication
programs in an integrated manner to promote and
increase utilization of all essential health services and
programs, and control communicable and non-
communicable diseases.
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17. National Health Communication Policy
2012
 Considering the health communication challenges,
Government of Nepal endorsed National health
communication policy 2012. which is a milestone for
health, health promotion ,education and
communication program under MoH.
 Goal: The goal of national health communication
policy is to sustain healthy lifestyle of mass citizens
by promoting health services, programs and healthy
behavior; by preventing and controlling disease and
by increasing accessibility and utilization of health
services.
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18. National Health Communication Policy -
Objectives
 Mobilize and use modern and traditional
communication multimedia and methods in an
extensive and proportionate manner to raise health
awareness, knowledge and promote healthy behavior
of mass citizens.
 Strengthen, expand and implement health
communication programs at central, region, district
and community level through clear and strengthened
cooperation, coordination and collaboration among
individual, community, relevant organizations and
communication media
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19. Cont…
 Generate collect and mobilize sufficient resources
for the effective implementation of health
communication programs at central, region, district
and community level.
 Prevent unauthorized dissemination and duplication
of health related messages or information and
materials of different issues by maintaining quality,
correctness, authorized, uniformity and
appropriateness.
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20. Cont…
 Enhance capacity on health communication in order
to develop, produce and disseminate quality, correct,
authorized, uniform and appropriate messages or
information, materials and programs.
 Provide quality health messages or information
through appropriate media and method to the
citizens, who have no access to health message or
information.
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21. National Health Policy 2014
 National health policy 2014 declared the provision of
quality health services as a fundamental right of citizens.
 The policy recognizes the importance of creating a
healthy environment and promoting healthy lifestyle
choices by people.
 Three policies; 6,7 and 11 are related with Health
promotion. Policy six (6) emphasizes on Promotion of
public health by giving priority to health education,
information and communication to people protecting
people's fundamental right to health information.
 Similarly, importance of health education has been
recognized simultaneously with other policies.
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22. Nepal Health Sector Strategy 2015-20
 Under the auspices of National Health Policy 2014,
Nepal Health Sector Strategy 2015-20 (NHSS) is the
primary instrument to guide the health sector for the
next five years, taking into account multi-sector
collaboration to address social determinants of
health, over the five-year period.
 The NHSS outcomes are aligned with policy
elements; promoting healthy life styles choices,
creating healthy environment, maintaining primary
health care approach and greater equity in health.
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23. Key areas of inter-sectoral co-ordination
for Health promotion/Education23
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24. Cont…
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25. Current context of Health Education
delivery
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 NHEICC is prime body for development, production and
dissemination of IEC/BCC materials.
 Health section under ministry of social welfare, Health
Offices and Health Section of M/RM.
 IEC corners at District hospital and PHCC, Adolescent
friendly corners at HFs.
 Health workers at peripheral level, FCHVs and HMGs.
 I/NGOs, LNGOs, CBOs and youth clubs.
 Health Education at School’s curriculum
 Adolescent friendly Learning centers at schools
 Others … Aslam Aman

26. Challenges in Health Education/Communication
 Co-ordination and collaboration with State and non-
state Organizations. (integrated approach)
 Investment in Health Promotion/education.
 Illiteracy a major concern.
 Language barrier – too many ethnic groups and
languages.
 Difficulties to reach remote communities
 Challenges in operation of Community initiated
approach addressing sociocultural, geographical and
sustainability.
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27. Way Forward
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Though health promotion/education is recognized as
priority program in health policies and plan, more
efforts is needed to apply it in practice. For this;
 Evidence based health promotion policy formulation
and implementation.
 Community initiated approach addressing socio-
cultural, geographical, climatic, language diversity is
needed to achieve sustainability of health promotion
activities.
 Coordinated and integrated approach both between
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28. Way Forward
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 Strengthening public private partnership policy
through joint action.
 Allocation of rationale budget to health promotion
and education activities.
 Designing effective strategies to implement health
promotion in school, workplace and community so as
to promote health behaviour and healthy lifestyle.
 Establish follow up mechanism to sustain health
promotion activities and strengthen feedback
mechanism.
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29. Bibliography
 Pradhan HB. Textbook of Health Education & Health
promotion. Educational publishing house. 5th ed.
Kathmandu . 2014.
 Dahal A, A textbook of Health Management.Bhotahity
Kathmandu:vidyarthi Pustak Bhandar;2012.
 Health education: theoretical concepts, effective
strategies and core competencies; A foundation document
to guide capacity development of health educators, WHO
2012.
 Health Education, Information and Communication
(HEIC) Program in Nepal, 2060
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30. Bibliography
 National Health Policy, 2071
 NEPAL HEALTH SECTOR STRATEGY 2015 –
2020, MOHP 2015
 Ministry of Health and Population Nepal. Nepal
Health Sector Programme 2004-09.
 Ministry of Health and Population Nepal. Nepal
Health Sector Programme-II 2010-15.
 National Health Education Information and
Communication Centre, Ministry of Health and
Population, Nepal. National Health Communication
Policy 2012, Kathmandu, Nepal
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31. THANK YOU !!!
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