Health Education- Dr.Anzil K S Ali

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1930’s
Educare/Educere – to bring out
Education : learning process or a series of learning
experiences through which an individual informs &
orients himself to develop skills & intelligent action
Altering attitude & behavior
Health promotion

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Definitions
Health:
It is a state of complete physical, mental and social well
being and not merely the absence of disease or
infirmity
- WHO, 1948
Health Education:
Health education, like general education, is concerned
with changes in knowledge, feelings & behavior of
people. In its most usual forms, it concentrates on
developing such health practices as are believed to
bring about the best possible state of well being
- WHO, 1969

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Definitions
A procedure which involves the translation of what is known
about health into desirable individual and community
behavior patterns by means of the educational process
- Grout
The process by which individual and groups of people learn
to behave in a manner conducive to the promotion,
maintenance or restoration of health.
- John .M. Last
A 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 help when
needed
- Alma Ata Declaration, 1978

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Aims & Objectives
Encourage people to adopt and sustain health promoting life
style and practices
Promote proper use of health services
Arouse interest, provide knowledge, improve skills and change
attitude
Stimulate individual & community participation

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Process Of Communication In
Health Education
Ability to influence others depends on communication Skill
“without communication an individual could never become a
human being, without mass communication , he never
becomes a part of modern society”
Communication: two way process of exchanging or
shaping ideas, feelings and information
Cognitive
Affective
Psychomotor

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Process Of Communication In
Health Education
Sender
Receiver
Message Channel
Awareness Interest Evaluation Adoption

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Process Of Communication In
Health Education
Sender
His objectives clearly defined
His audience: it’s interests & needs
His message
Channels of communication
His abilities & limitations
Receiver
Controlled – common interest
Uncontrolled/ free - curiosity

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Process Of Communication In
Health Education
Message
In line with the objectives
Meaningful
Based on felt needs
Clear & understandable
Specific & accurate
Timely & adequate
Fitting the audience
Interesting
Culturally & socially appropriate

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Process Of Communication In
Health Education
Channels of communication
Interpersonal communication
Mass media
Traditional/folk media
Feedback
Reaction of the audience
Provides opportunity to modify the message

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Types Of Communication
One- way communication (Didactic method)
Knowledge is imposed
Learning is authoritative
Little audience participation
No feedback
Doesn’t influence human behavior
Two – way communication (Socratic Method)
Learning is active & democratic
More likely to influence behavior

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Types Of Communication
Verbal communication
Loaded with hidden meanings
Persuasive
Non-verbal communication
Formal & informal communication
Visual communication
Charts, graphs, pictograms, tables, maps, posters etc.
Telecommunication & internet

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Barriers Of Communication
Physiological Difficulties in hearing, expression
Psychological Emotional disturbances, neurosis,
level of intelligence, language or
comprehension difficulties
Environmental Noise, invisibility, congestion
Cultural Illiteracy, levels of knowledge &
understanding, customs, beliefs,
religion, attitudes, economic &
social class differences, cultural
difficulties b/w foreigners, b/w urban
& rural population

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Approach To Health Promotion
Legal / Regulatory/ Coercive approach
Eg: -The child marriage restraint Act
Simplest & quickest method
Can't eradicate the cause
Can’t regulate the areas of personal choice
Require vast administrative infrastructure & expenditure
Counter to the basic tenet of health education

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Approach To Health Promotion
Service approach
Basic Health Services 1960
Providing all the health services at their door step
Failure: Not based on felt – needs
Health education approach
People will be better off if they have autonomy over their lives
Informed, educated & encouraged to make their own choice
Consistent with the democratic philosophy
Results are slow, but enduring
Behavior is easily controlled / developed in young population

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Approach To Health Promotion
Primary health care education
New approach
Participation & active involvement of people
Necessary guidance in identifying health problem &
finding a workable solution
Objective – making people self reliant

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Health education Vs Propaganda
Education Propaganda
Knowledge & skills actively
acquired
Knowledge instilled in the minds of
people
Makes people think for themselves Prevents thinking
Disciplines primitive desires Arouses & stimulates primitive
desires
Develops reflective behavior Develops reflexive behavior
Appeals to reason Appeals to emotion
Develops individuality, personality &
self expression
Develops a standard pattern of
attitude & behavior
The process is behavior centered Information centered

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Models Of Health Education
Medical Model
Transfer of Knowledge to achieve behavioral change
Recognition & treatment of disease
Technical advancement
Social, cultural & psychological factors were ignored
Motivation Model
Stage of awareness
Stage of motivation
Stage of interest
Stage of evaluation
Stage of decision making
Stage of action
Stage of trial
Stage of adoption

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Models Of Health Education
Social intervention Model
Considered the importance of social environment in
shaping the behavior
Highlights the importance of group support
Knowledge of sociology & understanding of cultural,
biological, social environment

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Content Of Health Education
Human Biology
Understanding
Structure & function of the body
Need of exercise, rest, sleep
Effect of deviation from healthy life style
UNICEF 1989
Child spacing
Breast feeding
Safe motherhood
Immunization
Weaning
Child growth
House hygiene

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Content Of Health Education
Nutrition
Guide people to choose healthy & balanced diet
Remove prejudices
Promote good dietary habits
Value of breast feeding
Misconception about weaning
Ignorance of appropriate diet
Intervention for the prevention of malnutrition
Promotion of health
Improve quality of life

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Content Of Health Education
Hygiene
Personal
Bathing, clothing, washing hands, dental care
Should start in early age
Environmental
Domestic
Fresh air, light, ventilation, hygienic storage of food ,
disposal of wastes, need to avoid pests
Community
Water supply, disposal of wastes, vector control, food
sanitation & housing

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Content Of Health Education
Family Health
Strengthen and improve family health as a unit
Maternal & child health care, family planning, immunization,
nutrition
Disease prevention and control
Provide elementary knowledge about the nature of
disease & method of prevention
Encouraged to participate in disease control
Mental Health
Help people keep mentally healthy
Enjoy relationship with others
Live & work without mental break down
Mother after child birth, child at entry into school, decision
about future, starting new family, widowhood

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Content Of Health Education
Prevention of accidents
Home, road, work place
Enforce certain rules
Provide safe environment
Use of health services
Inform people about health services available
Screening programmes, Immunization. Family planning

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Principles Of Health Education
Credibility
Message should be perceived as trustworthy
Based on facts
Consistent & compatible with
scientific knowledge
Local culture
Educational system
Social goals
Interest
Should be based on felt - needs

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Principles Of Health Education
Participation
Should work actively in identifying & solving health
problems
Creates a sense of involvement, acceptance & decision
making
Provides maximum feedback
Motivation
Primary motives – driving forces
Secondary motives – created by outside forces
Praise, reward, love, recognition, punishment, rivalry

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Principles Of Health Education
Comprehension
Communicate in the language people understand
Never use new & strange words
Teach within the mental capacity of the audience
Reinforcement
Repeat the message in different way
Learning by doing
If I hear, I forget
If I see, I remember
If I do, I know

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Principles Of Health Education
Known to unknown
“from the concrete to the abstract”
“from the particular to the general”
“from easy to the difficult”
Setting an example
Good human relations
Feedback
Can modify the contents & channels

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Principles Of Health Education
Leaders
Understands the need & demands of the community
Provides proper guidance
Takes initiative
Receptive to the views & suggestions
Identifies himself with the community
Self less, honest, impartial
Easily accessible
Possesses skill & knowledge of eliciting cooperation ,
coordination

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Practice Of Health Education
Educational material
Focus attention
Facilitate interpersonal & group discussion
Reinforce/ clarify prior knowledge & behavior

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Practice Of Health Education
Audiovisual Aids
Simplify unfamiliar concepts
Bring about understanding
Reinforce learning
Avoid monotony
1. Auditory Aids
Radio, tape-recorder, microphones, amplifiers, earphones
2. Visual Aids
Not requiring projection: Chalk –board, leaflets, posters,
charts, flannelgraph, exhibits, models, specimens
Requiring projection : slides, film strips
3. Combined
Television, sound films, slide-tape combination

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Methods Of Health Communication
Health Communication
Individual approach Group approach Mass approach
1. Personal contact
2. Home visits
3. Personal letters
1. Lectures
2. Demonstrations
3. Discussion methods
a) Group discussion
b) Panel discussion
c) Symposium
d) Workshop
e) Conference
f) Seminars
g) Role play
1. Television
2. Radio
3. Newspaper
4. Printed material
5. Direct mailing
6. Posters
7. Health museum
8. Folk methods
9. internet

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Methods Of Health Communication
Individual approach
On individuals visit to health center
On health visitor’s home visit
Advantage
Discuss, argue & persuade the individual
Specific interest can be discussed
Disadvantage
Reaches small number

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Methods Of Health Communication
Group Approach
Group approach
Choice of subject
Chalk & talk (lecture)
Carefully prepared oral presentation of facts, organized thoughts
and ideas by a qualified person
Not > 30
15-20min

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Methods Of Health Communication
Group Approach
Flipcharts – 25×30cms
Message on chart must be brief
Help to hold the attention of the group
Flannel graph
Maintain continuity
A very cheap medium
Easy to transport
Promotes thought & critcism

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Methods Of Health Communication
Group Approach
Exhibits
Objects, models, specimens etc
Films & charts
Disadvantages of lectures
Minimal involvement of audience
Learning is passive
Don not stimulate thinking/problem solving capacity
Comprehension varies with audience
Behavior not necessarily affected

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Methods Of Health Communication
Group Approach
Demonstrations
Arouses interest
Persuades

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Methods Of Health Communication
Group Approach
Group discussion
Free exchange of ideas, opinion & knowledge
Group - >6, <12
1. Express ideas clearly & consistently
2. Listen what others say
3. Do not interrupt
4. Make only relevant remarks
5. Accept criticism gracefully
6. Help to reach conclusion

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Methods Of Health Communication
Group Approach
Group discussion
Adv :
Decision is accepted easily
Limitations

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Methods Of Health Communication
Group Approach
Panel discussion

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Methods Of Health Communication
Group Approach
Symposium
Workshop

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Methods Of Health Communication
Group Approach
Role playing/Socio-drama

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Methods Of Health Communication
Mass approach
1920- printed matter
Reach remotest places, large number
Raising health conscious
Delivering technical messages
Popularizing health knowledge
One –way communication
Not effective in changing human behavior

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Methods Of Health Communication
Mass Approach
Television
The most popular media
Influence public opinion
Introduce new ways of life
Raise level of understanding
Familiarize with unknown
Radio
Much cheaper

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Methods Of Health Communication
Mass Approach
Internet
Direct & instant communication
Major health education tool in the future
News paper
Factual, detailed & statistical material
Reach only limited group
Printed materials
Magazines, pamphlets, booklets & hand outs
Convey detailed information

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Methods Of Health Communication
Mass Approach
Direct mailing
Folders, newsletters & booklets
Reach remote areas
The most personal of mass communication

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Methods Of Health Communication
Mass Approach
Posters, billboards & signs
Catch eye & create awareness
Not expensive
Humor & fear are introduced
Message should be simple,
short, direct
Right place & right time
Changed frequently

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Methods Of Health Communication
Mass Approach
Health museum & Exhibition
Can attract large number of people
Folk media

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Essentials Of Health Education
The aim of health education is to bring about a
change in health behavior
Health education should be factual
Tell only what is needed
Do not give conflicting information
Try to change only what needs to be changed

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Essentials Of Health Education
The educator should make himself acceptable
He should be friendly & be sympathetic
He should be knowledgeable
He should talk the language of the people
Choose a proper medium of communication
Use audiovisual aids whenever possible
Health education should be provided in graded
dosages

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Obstacles For Positive Dental Health
Chronic, recurrent, irreversible, cumulative and
prevalent
Attitude of people towards teeth
Artificial replacement is well accepted
Undramatic nature of dental diseases
Anxiety & fear towards dentistry

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Health Education Implications
In Dental Diseases
Dental caries & periodontal diseases
Adoption & continuation of prescribed oral hygiene &
nutritional practice
Periodic dental care
Application of community wide measure
Receive top priority
Epidemiological differences should be borne in mind

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Health Education Implications
In Dental Diseases
Malocclusion & other dentofacial anomalies
Interception of habits
Preventive treatment
Tumors
Termination of chronic irritation, infection /continued
exposure to toxic substances
Early detection & prompt treatment

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Health Education Implications
In Dental Diseases
Trauma
Safety measures
Oral manifestation of systemic diseases
Awareness of public regarding dentist
Prevention of self medications

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Factors Affecting Dental Health Education
Accessibility of dental health services
Economic feasibility
Acceptability of dental health practices
Past learning experience

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Planning Dental Health Education
Collecting information essential for planning
Statistics of dental disease
Priorities given to dental health problems
Present & potential dental health services
Information about the people to be reached
Channels of communication
Possible conflict with other programmes

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Planning Dental Health Education
Establishing dental health education objectives
Actions desired of the people
Specific beliefs & attitude to be changed
Specific information to be given
Assessing & overcoming the barriers to dental health
education
Other interest of higher priority
Communication barriers
Geographical isolation
Capacity & economic ability of the people
Community attitude towards dental programme
Attitude toward the providers of dental care & dental education

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Planning Dental Health Education
Appraising apparent & potential resources
Organizations
Health department & other government agencies
Voluntary health agencies
Other related professional organizations
Medical, nursing, public health associations, educational
societies
People
The general public
Persons who can influence the community attitude
Health personnel

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Planning Dental Health Education
Material & equipment
Mass informational resources
Educational aids
Transport
Funds
Official agencies
Professional & voluntary organization
Industries

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Planning Dental Health Education
Developing detailed plan of operations Individuals
& groups need to be involved in planning the
programme
Specific information needed by these groups
Methods needed to secure the participation &
cooperation of the public
Educational aid needed
Use of all educational resources & coordination
Priorities to various aspect of the educational effort
When & where the programme will be initiated

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Evaluation of the programme
Evidence that will be used to measure the effectiveness
Base line data that will be established
Analysis & interpretation of the data

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Training Professional
For Dental Health Education
The dentist
Participate in a variety dental health education
programme during dental school
Understand the basic concept of health education
Other dental personnel
Dental hygienists, dental nurses, dental assistants
Developing & applying variety of educational
procedures
Educational concepts, behavioral principles

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Training Professional
For Dental Health Education
Related health & education personnel
Physician – trained in dental & oral health problems
Nurses, home visitors & social workers
Aware of opportunities for dental health education
Aware of community dental resources
School teacher
Should be part of general health education

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Role Of Health Care Provider
Provide opportunities to people to learn
Identify & analyse their health & health related problem
Set their own priority
Make information easily accessible
Access to proven preventive measures

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Community medicine -Park & Park
Text book of preventive & social medicine- Gupta &
Mahajan
Essentals of community & preventive dentistry – Soben
Peter
Education for health, A mannual on health education in
primary health care – World Health Organization,
Geneva
Community oral health – C.M pine
Dental public health – christine N. Nathe
Models of teaching – Bruce Joyce, Marsha Weil,Beverly
Showers

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Planning and Management
1. Collecting information on specific problem
2. Identification of the problem
3. Deciding on priorities
4. Setting goals & measurable objectives
5. Assessment of resources
6. Consideration of possible solutions
7. Preparation of plan of action
8. Implementing the plan
9. Monitoring & evaluating
10. Reassessment of the process of planning

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Social Science Concepts
In Dental Health Education
Fear Arousal
People need some level of emotional arousal before
they take action
Concepts of preventive health behavior
Prevention of dental disease is influenced by belief in
prevention of other diseases
Socioeconomic status

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The Major Components
Of The Educational Process
The educator
Dentist, teacher, mother
The learner
The behavioral goals
Factors affecting the outcome
The learners own dental health goal
Other goals which are of higher priority
The learner attitude toward the educator
Influence, other than planned education
Barriers that must be reduced/ removed
Communication difficulty, intrest of the learner, perception, past
experiences

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Health Communication
Information
Eliminate social & psychological barriers
Increase awareness
Influence people
Education