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Health education and communication

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community medicine

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Health education and communication

  1. 1. Health education DEPT of Community Medicine ESIC MC GULBARGA
  2. 2. Topic division 1. Need for Health Education 2. Definition of Health Education 3. Aims and objectives of Health Education 4. Principals of Health Education 5. Area or contents of Health Education 6. Places of Health Education 7. Materials of Health Education 8. Methods of Health Education 9. Planning and evaluation of Health Education 10.Measures of Health Education
  3. 3. Need for Health Education • It is the essential tool for the community education • It is a step of healthy living as majority of diseases preventable if people prepare to learn protective healthy living. • It is the concept that binds the bricks of health services. • It brings about change in KAP in health and health related diseases. • Bring along in behavior change towards health.
  4. 4. Dr V.Ramakrishnan father of health Education • Health education is nothing but when it is connected with public health programmes it is something, and when associated with the community it is everything. • Health education is translation of what is known about health into desirable individual, family and community behavior pattern by means of education process.
  5. 5. • Education dEf: It is a process by which behavioral changes take place in an individual as a result of series of learning experiences which he has undergone • LEarning dEf: it is the process of acquiring knowledge • KnowLEdgE: Knowing things, objects, events, persons, situations and every thing in the universe. Or it is the collection and storage of information or experiences. (the means of acquiring the knowledge by brain is by perception) • Motivation: a combination of forces which initiate direct and sustained behavior towards a goal. • BEhavior: Voluntary movements and the passive acts arising out of decision taken by the individual.
  6. 6. diffErEncEs: • Learning is positive and incidental while education is deliberate effort. • Learning is wealth to the poor and honor to the rich an aid to the young and support and comfort to the aged,
  7. 7. • hEaLth Education is the door into the twentieth century, the means of improving the quality of life achieving social mobility and participating in the world affairs. • attitudE: A mental habit acquired from serial experiences that predisposes us to specific objects, persons or situation in a definite way. • or: It is relatively enduring organization of belief around an object or situation predisposing one to respond in some preferential manner • { Attitude = Knowledge + Feeling }
  8. 8. • coMMunity: it is group of people lining in social organization and group in which people share varying degree of political, economical, social and cultural characters as well as interest.
  9. 9. ALMA ATA DECLARATION 1978 DEFINITION “The Process Aimed At Encouraging People To Want To Be Healthy, To Know How To Stay Healthy, To Do What They Can Individually And Collectively To Maintain Health, And To Seek Health When Needed.”
  10. 10. Changing concepts: • Historical information TO  • Prevention of disease TO • Modification of individual TO  behavior • Community participation TO • Promotion of individual TO  and community • Change in human behavior. • Promotion of healthy lifestyle. • Modification of social envt in which the individual lives. • Community involvement. • Self reliance.
  11. 11. aiMs and oBjEctivEs:
  12. 12. Aims • To encourage people to adopt and sustain health promoting lifestyle and practices. • To promote the proper use of health services available to them. • To arose interest provided new knowledge improve skill and change attitudes in making rational decision to solve their own problems. • To stimulate individual and community self reliance and participation to achieve health development through individual and community involvement at every step from indentifying problems to solving them..
  13. 13. Objectives • To inform to come out from prejudge, ignorance misconception • To motivate them to change their KAP and also to guide for health educational personnel to use health facilities, judiciary, luxury • To take active part in community • To make the national program a success.
  14. 14. Principals of Health Education Success of health education depends upon effective utilization of principals of health education. 1.Credibility: It is the degree to which the message to be communicated is perceived as trust worthy by the receiver i.e. based on facts with local culture education system and social goals. Unless the people have trust and confidence in the communicator no desired action will be ensured after receiving the message.
  15. 15. Principals of health education 2. Interest creation i.e. it should be felt need of the community and slogan orientate. This is based on psychological principal that people are not interested to listen to those things which are not to their interest e.g. Formula for happy family formula to long life “ learn how to stop worry 3. Opportunity for participation: It is the key word of health education it is based on the psychological principal of active learning i.e. involve people to come out with suggestion with better acceptant.
  16. 16. Cont…. 4. Stimulation for motivation: Motivation is a awakening desire to learn. Types: Primary in born desire or forces to accept and practice. Secondary desire created by auricle forces in the form of incentive. Incentive praise or love, rewards or recognizable or revelry. 5. Comprehension: It should be comprehensive and precise up to the capacity to understand in their language the people speak and in simple words which they are familiar 6. Reinforcement: It is like a booster dose by repeated telling to remember practices.
  17. 17. Cont…. 7. Chances for learning by doing: If I hear I forget if I see I remember if I do I know. E.g. creep bandage in varicose veins. 8. Asses the knowledge before you starts. i.e. From known to unknown. To understand in a better way. Go in search of people begin with what they know and built with what they have. E.g. Level of understanding. Their education. Literacy status of audience 9. Setting an examples: The health educator should set a good example in the things he is teaching e.g. smoking ,FP.
  18. 18. Cont…. 10.Should be on Good human relation: Be kind and sympathetic to those who come and ask. Kindness is such a language which the deaf can hear and the blind can read. 11. Feedback : One of the key component of health education . Helps to modify elements of the system
  19. 19. Cont…. 12. Search for leader: he who makes the thing happen for group ace for health. Practice search for leader and convenience the leader first because we learn best from whom we respect and regard: “there are three kinds of people in the world those who don’t know what is happening those who watch were is happening and those who make things happen”
  20. 20. coMMunication • Communication can be regarded as two way process of exchanging or shaping idea feeling and information. Broadly it refers to the countless ways that human have of keeping in touch with one another. • Communication Is Defined As Direct Or Indirect Exchange Of Information Or Idea As A Means Of Understanding And Education.
  21. 21. • The ultimate goal of all communication is to bring about a change in the desired direction of the person who receives the communication. • This may be. ▫ Cognitive level ---- increase in knowledge ▫ Affective ------- changing existing pattern of behavior and attitudes ▫ Psychomotor -------- acquiring new skills • Our ability to influence others depends on our communication skill e.g. Speaking, writing, listening, reading and reasoning.
  22. 22. Elements of communication Communicator  Message  Media Receiver Feed back Awareness Interest Evaluation and Adaptation
  23. 23. COMMUNITER • He is the originator of the message • He should know what he wants to communicate • He should know to whom is he communicating i.e. the needs and interest and ability or capacity of the audience • He should know the importance and usefulness of his message • He should know how he is communicating or channel if his communication
  24. 24. Message • It is the information a communicator wishes his audience to receive, understand and accept and act upon. • A good message should be: ▫ In line with the objective ▫ Simple, Clean, Accurate and Specific or ▫ In tune with mental, social and economic level of the audience ▫ Significant, Applicable or Practical ▫ Attractive, Appropriate and timely
  25. 25. CHANNEL OF COMMUNICATION • It may be anything used by the sender of message to connect him with the receiver or audiences: ▫ It may be interpersonal ▫ Mass Media or ▫ Traditional folk Media
  26. 26. Audience • These are the consumers of message without them message is mere noise ▫ Controlled type or target population: i.e. one who are held together with common interest ( ANC ) ▫ Uncontrolled Type or Total population: it is one gather from motive or curiosity. This may poses a challenge to the ability o the educator • More homogeneous the audience greater are the chances of an effective communication outcome. i.e. audience can accept or reject or remember or forget it.
  27. 27. Feed back • It is the flow of information from audience to the sender. It provides an opportunity to the sender to modify his message and render its acceptability. • It is generally obtained through option polls, attitude survey and interviews. • It can rectify transmission errors.
  28. 28. Barriers of communication • SEMATIC PROBLEMS: Words are merely symbols used to convey certain meaning and they are often found to be in exact. The meaning attached to words is likely to differ from place to place and from time to time. New words are continuously being derived originating in certain groups and some of them eventually become common. The tone the way words are uttered the gesture and the simultaneous facial expression tend to give new significance to a word • DIFFERENCE IN PERCEPTION: Difference individual differ in their perception frame of reference attitude experience etc. The interpretation of the message and attaching meaning to it therefore varies from individual to individual. They cannot look beyond their own limited sphere of activities or specialization and see things in the wider or difference perspective. • STATUS IN HIERARCHY: Upward communication filtered to make it more acceptable an in line with the expectation of the superior . unpleasant or incrimination aspects tend to get deleted in upward communication.
  29. 29. Cont… • Physiological: Difficulty in listening, visualizing, speaking expressing habits, stress and stains • Psychological: Emotional disturbances, nervousness, instability lack of concentration pre occupation • Environmental: Overcrowding, poor lighting, noise, thermal discomfort, bad odors, ill maintained channel of communication • Social cultural: Poor knowledge of customs, practices, attitudes, habits and belies, language, level of understanding and illiteracy. social economic class difference, cultural difference, rural and urban, as well as national and international.
  30. 30. AIDS: - Materials of Health Education • Three types of materials ▫ Audio: - Spoken words , public audio system, radio, micro phone amplifier ear phone ▫ Visual : -Written words, Pictorial presentation: posters, flannel graph, flash cards flip charts photograph exhibitions ▫ Audio visual materials/ Combined A.V Aids: - TV, Films, slide tape combination
  31. 31. Criteria for audio visual aid: ▫ They are only tools and end result not dependent on it ▫ Its selection is based on program objectives ▫ Suitable for groups ▫ Scientifically accurate in their content ▫ Should have good eyes for appeal
  32. 32. • Advantages :- ▫ They created and maintain interest ▫ Motivation can be achieved ▫ Information can be given in short time and methodically ▫ Continuity of thought and information can be maintained • Disadvantage: - ▫ Educator can become dependent on it ▫ It is not easy to correct the wrongly stated massage, as incorrect information can lead to in correct motivation ▫ Expensive ▫ Inexperienced handling can damage of aids ▫ Educate looses confidence in education
  33. 33. Topics of health education • Human biology: Structure, system, need of exercise, sleep and rest and also effect of bad habits on health system. • Nutrition: Guide to choose nutritive food, nutritive value, food storage preparation services etc, to make best use of available food. • Hygiene: it is the science of health and embraces all factors which contribute to healthful living. Personal, environmental[Domestic and community], Food hygiene.
  34. 34. Cont…. • Family health care: MCH, IMM, nutrition and other related activity and population dynamics. • Control of Communicable diseases: mode of spread of diseases and prevention. • Mental health: to learn to live with others and to enjoy the life. Stress situation leading to mental breakdown such situation should be handled with sympathy understanding and social contact. • Prevention of accident: If accident is a disease than health education is vaccine for it. • Effective use of health service facilities:
  35. 35. Places of Health Education: • Private and public dispensaries and PHC center: causes of diseases importance and modes of spread. • Hospitals: stay regularity of treatment and rehabilitation • Schools: community hygiene, sex, nutrition disease prevention, parent care. • Factory: Prevention of accidents and occupational diseases. • Maternal and child clinics: Mother crafts, New child care and Immunization. • In National health programs: All National health programs have health education and failure of program is due to lack of health education.
  36. 36. Methods of Health Education One way (didactic) method: It is based on assumption that the “learns is more or less an empty vessel into which information is poured” so that he will then integrate, interpret, reproduce : i.e. the flow of information is one way from the communicator to audience E.g. lecture method in class rooms. • Disadvantages: ▫ Passive learning or knowledge is imposed ▫ Learning is autonetave ▫ Little audience participation ▫ No feed back ▫ Does not influence human behavior
  37. 37. Two way (Socratic) method: • Based on the feeling that people already posses information, feeling, interest and belief which profoundly influences the learning process and which must be taken into account before they can be modified or even left alone. • Advantages: ▫ doubts can be cleared, ▫ active learning and democratic ▫ motivation to think talk and participate • Disadvantages: time consuming
  38. 38. Individual approach • Advantages :- ▫ One get acquainted with individual to deal more effectively with health problems ▫ One can discuss argue and peruse the individual to change his behavior ▫ It provides opportunity to ask questions in terms of specific intrest • Disadvantage: - ▫ Educator can given it only to those who come in contact ▫ It reaches only small number of people ▫ Message spreads slowely
  39. 39. Group Approach • Lectures: defined as carefully prepared oral presentation of facts organized thoughts and ideas by a qualified person. • Demonstrations: it is carefully prepared presentation to show how to perform a skill or procedure. • Group discussions: it is an aggregation of people interacting in a face to face situation
  40. 40. Con… • Panel discussion: 4-8 qualified persons talk in front of a large group on a given topic one after the other. There is no specific agenda no order of speaking and no set speeches. The successes depend on chairman. After main aspect of the subject are explored the audience is invited to take part • Symposium: it is a series of speeches on a selected subject subjected unlike panel discussion. Each person presents an aspect of the subject briefly there is no discussion among members and at the end audience may raise their questions. The chair-man makes a comprehensive summary at the end of the entire session
  41. 41. Cont…. • Work shop: it consists of a series of meetings i.e. 4or more where emphasis on individual work within the group with the help of cosultants and resource personnel. • Role playing: or social drama based on the assumption that many values in a situation cantn’t be expressed in words and the communication can be more effective if the situation is dramatized by the group • Conferences and Seminars: this category contains a large component of commercialized continuing education they cant be head at regional. State or National level
  42. 42. Planning and evaluation of Health Education • Steps of planning 1.Survey and Identification of problems and deciding on priorities and setting up of goals. 2.Definition of objectives 3.Assessment of resources procurement of Man Money and Material 4.Preparation of plan of action 5.Implementation of plan or campaign proper 6.Evaluating 7.Reassessment 8.Measures of Health Education
  43. 43. SOCIAL MARKETING • PhilosoPhy behind social marketing “if you can sell a tooth paste why can’t you sell good health” • The first social marketing of contraceptives started in 1967 with NIRODH condom program in India • Kotler and Gerald Zaitman 1971 1st presented the idea of social marketing
  44. 44. Definition • The design, implementation and control program aimed at increasing the acceptability of a social idea or practice in one or more group of target adopters. • Social marketing is the systematic application of marketing, along with other concepts and techniques, to achieve specific behavioral goals for a social good
  45. 45. TYPES • Emphasis on selling a product: - Eg, sale of social beneficial product like condom, OCPS etc • Emphasis on selling an Idea or social advertising i.e. no object to sell / money to transfer but rather there is a traditional education strategy to reflect a consumer orientation eg: stop smoking, eat less salt, self examination of breast etc
  46. 46. ADVANTAGE • Govt. takes care of products and hence available at almost cheaper rate • Accessibility is made • Takes away inhibitions gradually and improve acceptability • Underprivileged and target group get free of cost
  47. 47. Difference between social and commercial marketing Marketing Social Commercial Controversial ideas More Less Complexity of products More Less Consumers LSE class HSE class Literacy Low High Utilization rate High Less Consumer satisfaction Less High Examples Mala D, Women Hygiene kit Nirod Ice cream, Pizza, etc
  48. 48. Planning and evaluation of Health Education Steps of planning Survey :Before the campaign survey is to be conducted for following information:  The location of the place: its topography conditions of the roads and the availability of on all weather approach road  The size of the population and its age and sex composition  People beliefs and customs and taboos in general  Their KAP with reference to the subject concerned  The names and addresses of the local leaders and the extent of their influences on the people  Place where and the and time when people congregate and place where public meetings can be held or films exhibited or the important or auspicious days  Base line data i.e. vital statistics like births deaths maternal and infant mortality preventable communicable diseases existing health facilities and its utilization etc
  49. 49. Identification of problems and deciding on priorities and setting up of goals • Planning is an administrative instrument to provide rational basis for decision making • Objective is planned end point of all activities • Goal ultimate desired state towards which all objectives and resources are directed. • Educational diagnosis study of level knowledge of understanding attitude and belief • #######
  50. 50. Definition of objectives: • The next step is the definition of the objectives in terns of what exact changes in the behavior of people are the envisaged and within what period. • This will depend on the subject of education and current practices. E.g. if education is about ANC coverage and currently only 30% of pregnant women are attending the ANC clinic the objective may be defined as within 6 months of the campaigning the % of pregnant women attending the ANC clinic will be raised by 50% . this will go up to 80% with in one year and to 100% in 2 years.
  51. 51. Assessment of resources procurement of Man Money and Material • The expanses to be incurred on the implementation of the program are estimated, sufficient funds are procured before the commencement of the campaign • All required health education materials like pamphlets leaflets and handouts etc. are procured or got prepared locally. Similarly the requirement of the amplifiers microphones projector vehicle etc are estimated and requisitioned • Adequate number of health educators is requited from the staff of PHC DHO or NGO. They are given training and briefed about the objectives of the campaign and their respective share in the implementation of the program.
  52. 52. • Consideration of possible solutions
  53. 53. Preparation of plan of action • Scheduling and phasing this is the final part of the preparatory phase and involves the framing of time table of activates giving for each day of the campaign i.e. what will be done? i.e. group discussion, film public meeting etc When and where it will be held and by whom? The people are then made aware of the details of the campaign and their co-operation in making it successful
  54. 54. Implementation of plan or campaign proper • Campaign proper begins with a formal inauguration ceremony. The work proceeds as per the schedule drawn. The person in charge of it ensures team sprit among the staff working in the field. He effectively supervises them and carries out checks to see if they are having any problem and offers constructive advice and guidance.
  55. 55. Evaluating: • The degree to which stated objectives have been achieved assessed periodically and the mid term evaluation and at the end of the campaign i.e. end phase evaluation may indicate the success of the campaign e.g. increase in ANC attendance going on satisfactorily or not etc. • Special survey in case of nutrition education done by repeated survey for decrease of prevalence of deficiency disease • Action: if mid term evaluation indicates that the program is mot succeeding the reasons for the non acceptance are determined and the campaign is suitable modified.
  56. 56. Reassessment • The area is revisited a year of so after or so the conclusion of education campaign and to way done to see whether the gain made during it are continuing or whether the people have reverted to their original practices.
  57. 57. Measures of Health Education • Effective index = p2-p1/100-p1 where p1= % of people who have adopted the sesired behavior before health education and p2= % of people who have adopted the sesired behavior after health education. • Cost benefit index: = EI ( B/N - C/N) • Where B = potential benefit measured in dollars • C= cost of health education program • N = number of people adopting delivered behavior
  58. 58. Dr I Amruta swati Assistant Professor Dept of Community Medicine
  59. 59. Definition • It is an educational program; provides for the study of the population situation in the family, community, nation and world with the purpose of developing in the students the rational and responsible attitude and behavior towards the situation
  60. 60. Need 1. To prepare young for adult life. 2. To bring about change in attitude and values that shape individual and social life 3. To introduce and encourage the idea of responsible parent hood and smaller family to both male and female before reproduction begins
  61. 61. Need 4. To prepare social leaders and officials of future by providing background information of population 5. Form major portion of population, 40% below 14 years 6. Legitimate subject concerned with society to improve the health, preserve the family value and environmental awareness
  62. 62. Need 7. Planning for population education: Depending up on the type of programme objectives and goals as given in needs which in turn depend upon the needs
  63. 63. Pre-requirements 1. Potential financially organizationally feasibility 2. Presents of National Population Policies 3. Govt. approval to start in school 4. Acceptability to the community and Govt. regarding content and grades 5. Resources
  64. 64. Pre-requirements 6. Availability of books, pamphlets, manuals, chats lesson out line 7. Inclusion in biological science curriculum (syllabus) 8. Co-ordination for all departments community and parents 9. Curriculum planning by team of experts
  65. 65. Content of population education 1. Current population situation 2. Basic demographic concept 3. The consequences of the population change and human reproduction, family planning, family life and size of family 4. Population and economic 5. Population and environment 6. Sex education 7. Population polices and programmes
  66. 66. In India it includes 1. Population trend and quality of life 2. Changing trend in population in India 3. Indian population in world prospective 4. Projection of population change 5. Influencing factors for population change
  67. 67. In India it includes 6. Relation between population and resources 7. Population and agriculture production 8. Population and nutrition 9. Population and resources 10. Population and environmental pollution
  68. 68. Muslim country avoid sex education Emphasis • Concern about family • Relation between parent and children’s • Need to preserve land for future generation
  69. 69. Levels of students It many be preferred to be both at primary and secondary level Because: • Primary : ▫ Better environment ▫ Many discontinue after primary ▫ Villages do not have secondary school ▫ Children are older compared to urban • High school ▫ Can understand in a better way ▫ Closer to child bearing age ▫ Ultimately decision making people for tomorrow ▫ Small in number
  70. 70. Teachers training 1. Face to face training: By export in short course or work shop to the head of the institute 2. Expert to principal to teachers to student By the time it reaches the students it is only definition level 3. Pear training: In this trained teachers train in return to other teachers. But it needs high motivation and better understanding among teachers 4. Self learning educational model. Book lets; modules; 5. Correspondences courses. Study population education training material
  71. 71. Hurdles  Many do not have confidence,  lack of knowledge, Afraid of student questions,  Large class,  Overburden poor facilities.
  72. 72. In India population education • Initiation in the year 1960, • Implementation limited to NCERT,( National Council And Educational Research Training). • Conducted seminar in 1969, and conclude to teach population education at all levels..
  73. 73. • Ministry of health passed circular stating “ It must be only to create a right attitude to family size, need of family planning and not to mix sex education and methods of family planning • 1970 Govt. brought pressure on all state to start and released fund to start ▫ State population education cell ▫ Prototype circular ▫ Publishing quarterly news paper ▫ Preparation of instructors to teach • 1980 ten states started and remaining in 1981
  74. 74. Evaluation • Teacher deleted this topic with fear of community • Many teachers felt un qualified to teach • In spite of awareness towards family size, problems of population still they prefer 3or more children • Lack of guidelines • Lack of time and founds
  75. 75. SOCIAL MARKETING • philosophy behind social marketing “if you can sell a tooth paste why can’t you sell good health” • The first social marketing of contraceptives started in 1967 with NIRODH condom program in India • Kotler and Gerald Zaitman 1971 1st presented the idea of social marketing
  76. 76. Definition • The design, implementation and control program aimed at increasing the acceptability of a social idea or practice in one or more group of target adopters. • Social marketing is the systematic application of marketing, along with other concepts and techniques, to achieve specific behavioral goals for a social good
  77. 77. TYPES • Emphasis on selling a product: - Eg, sale of social beneficial product like condom, OCPS etc • Emphasis on selling an Idea or social advertising i.e. no object to sell / money to transfer but rather there is a traditional education strategy to reflect a consumer orientation eg: stop smoking, eat less salt, self examination of breast etc
  78. 78. ADVANTAGE • Govt. takes care of products and hence available at almost cheaper rate • Accessibility is made • Takes away inhibitions gradually and improve acceptability • Underprivileged and target group get free of cost
  79. 79. Difference between social and commercial marketing Marketing Social Commercial Controversial ideas More Less Complexity of products More Less Consumers LSE class HSE class Literacy Low High Utilization rate High Less Consumer satisfaction Less High Examples Mala D, Women Hygiene kit Nirod Ice cream, Pizza, etc

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