1. Dr Mohan Lal
Associate Professor
Department of Community Medicine
Government Medical College
Amritsar

2. 1. Importance of Health promotion
2. Understand components of communication process
3.Behaviour Change Communication
4.Diffusion of Innovation
5.Strategies & Actions to achieve health promotion

3. Health
Heredity
Health &
Medical
Services
Lifestyle &
Behaviour
Biological, Social,
Economic,
Cultural
&
Environmental
Conditions

4.  Health behaviour is determined by two interrelated factors:
a person's perception both of threat of a health problem &
of his or her accompanying appraisal of a recommended
behaviour for preventing or managing the problem.
 For early detection for some conditions, such as infectious
diseases (malaria), that people might find frightening,
especially if they are uncertain about the effects of
treatment methods and therefore accept services.

5. " Science & art of helping people change their lifestyle
to move toward a state of optimal health”
(American Journal of Health Promotion,1986)
"The process of enabling people to increase control over
their health and its determinants, and thereby improve
their health, in addition to methods to change lifestyles.
(WHO's 2005 , Bangkok Charter ).

6.  Comprehensive social & political process,
 Not only embraces actions directed at
strengthening skills & capabilities of individuals
 Action directed towards changing social,
environmental & economic conditions
 To minimize impact of determinants on public &
individual health.
 Participation is essential to sustain health
promotion action.

7.  Provision of information &/or education to individuals,
families, & communities that-encourage
-Family unity,
-Community commitment,
-Traditional spirituality
Make positive contributions to health status by
changing behaviour & life styles.
 Promotion of healthy ideas & concepts to motivate
individuals to adopt healthy behaviours

8. Media
Receiver
Feedback
Sender
Own Feature Own Feature
Message Message
MessageMessage
Communication Process

9. Communication is a continuous process where sender sends
some message, concept or information through a medium
with specific objective to a receiver that create a kind of
reaction to receiver & accordingly latter reflects on that
message.
 Receiver is key in communication.
 Depending on the nature of receiver, message & media are
determined.

10.  Response or reply is what the receiver reflects after getting the
message in communication response is also significant.
 If response is not made communication is not complete &
objective of communication cannot be achieved.
 Only after getting response sender understands to what
extent his message is communicated & can initiate actions
accordingly.
 Response may be immediate or delayed.
 Important ingredients of communication together make
process of communication complete.

11. Sender Receiver
Feedback
receiver sender
Source: CGAP Direct

12. To change
behaviour
To get action
To ensure
understanding
To persuade
To get & give
information

13.  Health behaviour can be something that is done once, or
something that is done periodically—like getting JE
immunizations .
 It can also be something that one does only to oneself, such as
using medicated bed nets in malaria endemic area, or a
behaviour that affects others, like providing bed nets to others
so that children are protected from malaria.
 Sustained pattern of complex behaviour, that are called
"lifestyle" behaviours.
 A composite of various healthful behaviours is often referred
to as "healthy lifestyle."

14. Refers to systematic attempt to modify/influence
behaviour, or practices & environmental factors
related to that behaviour, which indirectly or directly
promote health, prevent illness or protect individuals
from harm.

15. The behaviour change communication (BCC) is a
process that motivates people to adopt & sustain
healthy behaviours & lifestyles.
Sustaining healthy behaviour usually requires a
continuing investment in BCC as part of an overall
health programme .
"A fully aware, well informed and properly trained
population is best guarantee of safety and of successful
response to any disaster."

16. Enhances awareness , address & promote
attitudinal & value changes
Informed decision-making & modification in
behaviour
Adoption of timely & Appropriate practices at
individual, family & community levels
Stimulates increased & sustained demand for
quality prevention
Health care services & optimal utilization of
available services.

17. Knowledge: (Provide information, personalize benefits & risks)
Approval: (create trust, information to appeal to head and heart)
Practice: (build skills)
Advocacy: (build social support, develop confidence to speak up)
Steps to Behaviour Change

18.  Various activities are carried out involving community
leaders in planning process.
 Role of community participation is to provide
facilities to community worst affected especially with
malaria by
 Providing medicated mosquito net,
 Synthetic Pyrethroids Indoor Residual Spraying (IRS)
 Guppy fish introduction, etc.

19.  Public Private Partnership (PPP) work as a bridge
between Government & community.
 Essential in removing myths & misconception in
the community.
 Their proposed area of operation is to see
treatment seeking behaviour of community, their
participation during indoor residual spraying,
feasibility study of social marketing and creation
of awareness in biological control of malaria, etc

20. Robinson's solution is to identify seven steps to social change:
1. KNOWLEDGE – knowing there is a problem
2. DESIRE – imagining a different future
3. SKILLS – knowing what to do to achieve that future
4. OPTIMISM – confidence or belief in success
5. FACILITATION – resources and support infrastructure
6. STIMULATION – a compelling stimulus that promotes action
7. REINFORCEMENT – regular communications that reinforce the original
message/s

21. THE DIFFUSION OF INNOVATION THEORY
(Rogers - 1962)

22.  The adoption of ideas in a community diffuses
among individuals in that community at varying rates
 Early in the introduction of a new idea, it is picked up
by ‘innovators’ (between 2 and 3% of the target
population) who are venturesome, independent,
risky and daring.
 They want to be the first to do things.

23. The second group of people, the ‘early adopters’ (about
14% of the target population) are very interested in the
innovation but they are not the first to sign up.
They wait until the innovators are already involved to
make sure the innovation is useful.
They are respected by others in the social system and
looked at as opinion leaders.

24.  The next group ‘early majority’ (about 34% of the target
population) may be interested in the innovation but will
need external motivation to become involved.
 They will deliberate for some time before making a
decision.
 The ‘late majority’ (also about 34% of the target population)
are next and it will take more time to get them involved for
they are skeptical and will not adopt an innovation until
most people in the social system have done so.

25.  The last group the ‘laggards’ (about 16% of the target
population are not very interested in innovation and would be
the last to become involved.
 They are very traditional and are suspicious of innovations.
 Laggards tend to have limited communication networks, so
they really do not know much about new things.
 This situation calls for different strategies for different
categories of people and at different stages of the adoption
process.

26. Cumulative
number or % of
adopters
Time
Innovators
Early adopters
Early majority
Late majority
Late adopters
Source: Green & MCAlister 1984.

27.  Assess health needs
 Assess social , environmental & cultural influences
on health behaviors
 Lifestyle modifications is a comprehensive
approach for effective change in heath promotion
behaviors

28.  Use of Senior Citizens for propagating Health messages.
 Use of executive members of the Residential Welfare Association.
 Announcement through mosque loud speakers.
 Preach through the priest in the temple.
 Preach during poojas/festivals
 Sending Leaflets regarding health messages through newspapers.
 Sending health messages through sales girls and boys.

29. · Lack of knowledge & non –availability preventive measures
·Non- Availability of field staff & Inappropriate use of anti-malaria drugs
· Poor felt need & utilization of health services
· Lack of effective strategies for community participation
· Reluctance of local self-government & shortage of budget;
· Local beliefs of people (belief in Tantra-Mantra, Jaadu-Tona, etc.)

30. Install and maintain screens on windows and doors.
Consider minimizing the amount of time you spend
outdoors from dusk to dawn.
Spray exposed skin & clothing with repellents
Eliminate mosquito breeding sites.
Support community‐based mosquito control programs

31.  Involves population as a whole in context of their every day life,
rather than focusing on people who are at risk from specific
diseases.
 Directed towards action on the determinants or causes of ill
health.
 Combines diverse, but complementary, methods or approaches.
 Aims for public participation.
 Health promotion is basically an activity in health and social fields
- and not a medical service, … but health professionals should work
outwards, in education and health advocacy.
(WHO, 1984)

33. Political process by an individual or a large
group which normally aims to Influence public-
policy & resource allocation decisions within
political, economic, and social systems and
institutions.
Activities undertakes include:-
- Media campaigns
- Public speaking
- Commissioning
- Publishing research.
 Lobbying (often by lobby groups) is a form of advocacy
where a direct approach is made to legislators/policy
or decision makers on an issue which plays a significant
role in influencing health of a community.

34.  Supports & promotes patient's health care rights
 Enhance community health & policy initiatives that
focus on:-
- Availability
-Safety
- Quality of care

35. Actions for Health
Promotion
Create
Supportive
environment
for health
Build
Healthy
Public
Policy
Strength
Community
Action for
health
Develop
Personal
Skills
Re-orient
Health
Services

36.  Environment & health are interdependent & inseparable, both be
made central objectives in setting of priorities for development.
 People living in extreme poverty and deprivation in an increasingly
degraded environment threatens their health, making goal of
health for all hard to achieve.
 Making environment- physical environment, social environment, &
political environment-supportive to health rather than damaging to
it.
 Everyone has a role in creating supportive environments for
health-policy makers, decision makers, and community activists in
the health and environment sectors.
 Initiatives have to come from all sectors that contribute to the
creation of supportive environment for health.

37.  Health promotion puts health on the agenda of
policy makers in all sectors and at all levels,
directing them:
 To be aware of the health consequences of their
decision
 To accept their responsibilities for health.
Aim of healthy public policy is to
create a supportive environment to enable people to
lead healthy lives.

38.  Effective community action in setting priorities,
making decisions, planning strategies in
implementing them to achieve better health.
 At the heart of the community action is
“Empowerment of the communities -
their ownership.”

39.  HP supports personal and social development through providing
information, education for health, and enhancing life skills.
 It increases the options available to people to exercise more
control over their own health and over their environment, and
to make choices conducive to health.
 Enabling people to learn throughout life, to prepare themselves
for all of its stages and cope with illnesses and injuries is
essential.
 Facilitated at schools, home, work and community settings
through educational, professional, commercial and voluntary
bodies.

40.  Role of health sector must move increasingly in a health promotion
direction, beyond its responsibility for providing clinical & curative
services.
 Health services should be sensitive & respect cultural needs.
 Need to embrace an expanded mandate that should support the needs of
individuals and communities for a healthier life.
 Open channels between the health sector and broader social, political,
economic & physical environmental components.
 Stronger attention to health research as well as professional education
& training.