Health Education Principles and Strategies

Basic Concepts, Roles and Principles of Health Education (HE)

Health Education
•     The process by which people learn about their health and more specifically, how to improve their health.
•      Comprises 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

Concepts of Health Education
•      Physicians have a responsibility to educate people about their health as well as to treat them.
•        In fact, achievement of health for all requires that people become educated about immunization, nutrition, family planning, and environmental sanitation.
•        The goal of health education is to change behaviour by changing attitudes.
•        Health education encourages self-reliance and motivates people to make their own health-related decisions.
•        In order to reach patients, physicians must bridge the social gap created by the gulf between technical priorities and what is really possible for people to achieve.
•       The process of health education moves from the sender to the message to the channel to the receivers to the effects.
•        Appropriate methods can be used for individual or group communication and methods can focus on information provision and/or behaviour change.
•       Participatory methods are effective in changing behaviour and include group analysis of a situation, group dialogue, persuasion, and educational games.
•       An effective strategy for individual instruction is woman-to-woman or child-to-child communication, which depends upon the identification of key women and children.
•       Development of a community-based health education strategy relies on community participation and the involvement of influential members of the community.
•       After a message has been transmitted, innovators will begin the new practice, early adopters will follow, and slow adopters will wait and watch.

*      The innovators and early adopters can help reduce resistance to the innovation. While it is a slow process, health education can improve attitudes and behaviour.

Principles of Health Education
•      Know what to change decide what the key problems are
•      Know your audience
   o   Attempts to introduce new practices may fail if they are incompatible with local beliefs and practices.
    o   Changes advocated by health educators who are based centrally may be unrealistic locally, so a comprehensive strategy of health education both locally and nationally is necessary.
    o.  Any proposal for a change should be simple to put into practice with the existing knowledge and skills in the community.
          Fit in with existing life style and culture and not conflict with local beliefs;
Not require resources of money, materials, and time that are not available locally;
Meet a felt need of the community.
            Be seen by the people to convey real benefits in the short term, not in the distant future.
•        Know the environment for health education
    o   Conducive environment is needed for effective HE, spacious and quiet
    o   Clinics, health centers(HCs), outpatient department (OPD) and hospitals
     o   Community centers, religious centers and schools
     o   Home visits
•         Timing for HE
     o    Convenient time for the audience
     0    Should fit with peoples’ circumstances
•          Know what to talk-to
      o    Prepare a health talk considering the time available, language, and audience mix

Characteristics of Effective Health Education, Roles and Purposes of Health
Education

Characteristics of Effective Health Education
•     Directed at people who have influence in the community
•      Repeated and reinforced over time using different methods
•      Adaptable, and uses existing channels of communication -for example, songs, drama, and story telling
•      Entertaining and attracts the community's attention
•       Uses clear simple language with local expressions and emphasizes short term benefits of action
•       Provides opportunities for dialogue and discussion to allow learner participation and feedback on understanding and implementation
•       Uses demonstrations to show the benefits of adopting practices

Roles of Health Education
•    Promoting good health practices, for example, sanitation, clean drinking water, good hygiene, breast feeding, infant weaning, and oral rehydration;
•    Promoting use of preventive services for example, immunization, screening, antenatal and child health clinics
•    Promoting the correct use of medications and the pursuit of rehabilitation regimens for example for tuberculosis and leprosy respectively;
•     Enhances recognition of early symptoms of disease and promoting early referral
•     Promotes community support for primary health care and government control measures

Purposes of Health Education
The ultimate aim of health education is to change behavior in a positive way by:
•    Positively influence the health behaviour of individuals and communities, as well as living
and working conditions that influence their health
•     Promote, maintain, and improve individual, family, and community health
•     Increases knowledge of people on health and health related matters
•     Modifies beliefs and clarifies attitude and values
•     Enables people to change behaviour
•     Attainment of the above would help or result into
      o Improvement of the health status of individuals, families, communities, states, and the nation
     o Reduces disease morbidity and mortality
     o Enhances the quality of life for all people

Strategies for Health Education
•       Information, education and communication (IEC)
    o A technique used to communicate important information by employing a wide range of communication media aiming at changing behaviour by providing information to individuals and communities through, mass media, print, electronic, sermons, drama.
•        Behavior change communication (BCC)
      o A process for developing messages and approaches using a mix of communication channels to encourage and sustain positive and appropriate behaviour at individual, small groups, community level.
•       Advocacy, communication and social mobilisation (ACSM)
Considerations for Effective Strategies for Health Education
•        Status of audience
    o In terms of sex, age, education, social-economic status and language to be used, cultural beliefs and taboos.
•        Reason for educating the audience
    o Short time benefits/gains to the audience is more ideal to the audience than long term gain.
•        Information needed by the audience
    o Information or health education should fit with people’s circumstances for example, education about nutrition should be based on foods that are available locally.

Also the information should address the felt needs of the community.
•      Media of communicating to the audience
    o This will depend on the characteristics of the audience in terms of number and geographical coverage.
    o For example, when giving HE to a small group one may use health talk of face to face but when you need to give HE to the whole population you may need a radio or television.
•      Application of strategy in terms of time and place
     o Availability of time will determine the type of strategy you use, if time is limited, to reach as many people as possible will require a mass media but this will also be influenced by the place you are.

Roles of Health Care Providers in Health Education

•    Educate patients about medical procedures, operations, services, and therapeutic regimens.
•    Create activities and incentives to encourage use of services by high risk patients.
•    Educate service providers about behavioral, cultural, or social barriers to health.
•    Promote self-care to provide high-quality care and avoid burnout.
•    Develop activities to improve patient participation in clinical processes through individual health education.
•    Protect, promote or maintain patient health and reduce risky behaviours through appropriate health education messages.
•    Make community-based referrals by providing correct information.
•    Assist communities to identify health needs and find solutions to improve health.
•     Conduct community organizing and outreach, coalition-building, and advocacy.
•     Mobilize resources to develop, promote, implement, and evaluate health programmes, strategies, and campaigns.
Health Education Media
•      After having health communication messages ready, there is a need to select appropriate communication media in order to communicate the messages effectively.
•       The following are various media used for communicating health messages:
     o Traditional media
Spoken word (talking, meetings, stories)
Performance (local dancing, plays, and shows)
     o Print media Posters, leaflets,
banners  Exhibitions

     o Mass media
√ TV, video, film
√Radio
√Newspapers
Information, Education and Communication (IEC)
• IEC uses educational techniques to communicate important information
• It employs a wide range of communications media
• The goal of IEC is to change behavior by providing information to individuals and
communities
Steps of Creating IEC Messages
•    Needs assessment
•    Plan of action, including
o Goals
o Objectives
•     Use of communication based on sound educational techniques
•     Periodic monitoring and evaluation based on goals and objectives
Effective IEC Messages
•     Should be clear and creative
•     Capture both the mind and the heart
•     Stimulate the audience to take the intended action
•     Are positive and give hope
•     Are appealing and persuasive through careful positioning

Effective strategies Should Consider
•     Communicate a benefit: what does a person or community stands to gain?
•      Communicate a promise: If you take this action you are more likely to…
•      Provide supporting points: data or evidence from someone who has benefitted
•       Lead to the desired action response
•       Identify the source (medium) of the message
Effective IEC messages
•    Are well planned
•    Appeal to the target population
•    Are positive, attractive and call for attention
•    Avoid themes that can encourage discrimination or stigma
•    Are sensitive to tradition, culture, norms and values
•    Address social conditions of the target audience
•    Use appropriate channels for the message

How to Know if Message is Effective
•    Messages can be pre-tested with a small group before being shared at a community level
•    Make sure that the message is carefully implemented by conducting monitoring and evaluation:
•    Check regularly on how the message is received
•    Did it have the intended effect?

   How can the message be improved?
•     Consider ways to make it more clear
IEC messages related to TB/HIV care and treatment can:
•     Reduce the stigma associated with TB/HIV
•     Improve case detection
•     Enhance adherence to long-term treatment
•     Strengthen disease prevention and control
Challenges to Communication of HIV Messages
•     People can get tired of the same messages
•     Many sources of messages: different groups provide different messages
•     Messages may go against norms and religious or cultural beliefs
•     HIV information changes daily and it is hard to keep the public informed as information changes.

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