Primary health care Health education and promotion By Dr Isingoma Timothy Ndejje University Uganda

1. INTRODUCTION TO HEALTH EDUCATION
AND PROMOTION
By group 3
 Isingoma Timothy
Tumwesige Richard
Kagudde Nicholas
Tumuheki Racheal
Namwebe Sandra

2. objectives
Define Health.
Define Health Education.
State historical development of Health Education & promotion
Describemotives of Health Education.
State basicprinciplesof Health Education
. Define health promotion
Strategies of health education and promotion

3. Health
 is stateof complete physical, mental, andsocialwell being andnot the mere absence of diseaseor
infirmity
Health isa highly subjective concept.
Good health means differentthingsto differentpeople, andits meaningvariesaccordingto individualand
community expectationsandcontext. Many people consider themselves healthy if they arefree of disease
or disability.However,people who havea diseaseor disabilitymay also see themselves asbeing in good
health if they areable to managetheir conditionso thatit doesnot impactgreatlyon their quality of life.

4. Forms of health
• Healthy may be categorizedinto 3, ie
1. Physical health
2. Mental health
3. Social health

5. Physicalhealth
refersto anatomicalintegrityandphysiological
functioningof the body.
To say a person isphysically healthy:
 All the body partsshould be there.
 All of them arein their naturalplace andposition.
 None of them hasanypathology.
 All of them aredoingtheir physiologicalfunctions
 And they workwith eachother harmoniously.

6. Mental health
 is theability to learn andthink clearly. A person withgood mental health is able to handle day-to-day
events andobstacles, worktowardsimportantgoals,andfunction effectively in society
Social health
is the ability to makeand maintainacceptable interactionswithother people. E.g. To feel sad when
somebody close to you passes away.
Note ;
The absence of health is denotedby such termsasdisease,illness andsickness,which could possibly
meanthe samething however differentif definedscientifically

7. Cont….d
Diseaseis theexistence of some pathology orabnormalityof the body,which is capable of detection
using,accepted investigationmethods.
Illness is thesubjectivestate of a person who feels awareof not being well.
 Sicknessis astateof socialdysfunction: a role that anindividualassumeswhen ill

8. Education
 is a complex and planned learning experiences that aims to bring about changes in cognitive (knowledge),
affective (attitude, belief, value) and psychomotor (skill) domains of behavior.
Terms
 • Information: A collection of useful briefs or detailed ideas, processes, data and theories that can be used
for a certain period of time.
 • Communication: the process of sharing ideas, information, knowledge, and experience among people
using different channels.
 Social mobilization is a campaign approach combining mass media and working with community groups and
organizations.

9. CONT,,,,D
 Health extension is an approach of promoting change through
demonstration, working with opinion leaders and community based
educational activities.
 Nutrition education is education directed at the promotion of nutrition
and covers choice of food, food-preparation and storage of food.
 Family Life Education refers to education of young people in a range
of topics that include family planning, child rearing and childcare and
responsible parenthood.
 Patient education is a term for education in hospital and clinic settings
linked to following of treatment procedures, medication, and home care
and rehabilitation procedures.

10. CONT….D
 BehaviorChangeCommunication(BCC):Is aninteractiveprocess aimedat changingindividualand
socialbehavior,using targeted,specific messagesanddifferentcommunicationapproaches,whichare
linked to servicesfor effective outcomes.
 Advocacy:refersto communicationstrategiesfocusing on policy makers,community leadersand
opinion leadersto gaincommitmentandsupport. It isan appealfor a higher-level commitment,
involvement andparticipationin fulfilling a set programagenda

11. Health Education
the concept of educatingabout health has been around sincethe dawnof humans. It doesnot stretchthe
imaginationtoo farto beginto see howhealth educationfirsttook place duringpre-historicera.Some one
may haveeaten a particularplant or herb andbecome ill. That person would then warn(educate)others
againsteatingthe same substance.
Conversely, someone may have ingesteda plant or herb that produceda desiredeffect. That person would
then encourage(educate)others to use this substance

12. CONT…D
At the time ofAlma Ata declarationof PrimaryHealth Care in 1978, health educationwasput as one of the
components of PHCand it wasrecognizedas a fundamentaltool to the attainmentof health forall. Adopting
this declaration
Most utilizes health educationasa primarymeansof prevention of diseasesandpromotion of health
. In viewof this, the nationalhealth policy andHealth Sector Development Programof many communities
haveidentifiedhealth educationasa majorcomponent of programservices.

13. So what is health Education ??
 isa combinationof learningexperiences designedto facilitatevoluntary actionsconducive to health.
Where by
Combination:emphasizesthe importanceof matching the multiple
determinantsof behaviorwith multiple learningexperiencesor
educationalinterventions.
Designed:distinguisheshealth educationfrom incidentallearning
experiences assystematicallyplanned activity.

14. CONT…D
Thisisone of the most cost-effectiveinterventions. Alargenumber of diseasescould be prevented with
little or no medicalinterventionif people wereadequatelyinformed aboutthem andif they were
encouragedto takenecessary precautionsin time.
Thetargetsof educationalefforts may include the generalpublic, patients,prioritygroups, health
providers,community leadersanddecision-makers

15. CONT….D
Facilitatemeanscreate; favorableconditionsfor action.
Voluntary action ;meansbehavioralmeasuresareundertakenby an
individual,groupor community to achieveanintended health effect
without the use of force, i.e., with full understandingandacceptance
of purposes.

16. Aims/objectivesof health education
Motivatingpeople to adopt health-promoting behaviorsby providingappropriateknowledgeandhelping
to develop positive attitude.
Helping people to makedecisionsabouttheir healthandacquirethe necessary confidenceandskills to
put their decisionsinto practice

17. BasicPrinciples
All health educationshould be need based.Thereforebefore involving any individual,group or the
community in health educationwith a particularpurpose or for aprogramthe need should be
ascertained.It has to be also specific andrelevantto the problems andavailablesolutions.
 Health educationaimsatchangeof behavior.Thereforemultidisciplinaryapproachis necessary for
understandingof human behavior aswell asfor effectiveteachingprocess.
 It isnecessary to havea freeflow of communication.The two-waycommunicationis particular
educationto help ingettingproperfeedbackandgetdoubt cleared.

18. CONT…D
Thehealth educatorhasto adjusthis talk andactionto suit the group for whomhe has to givehealth
education.E.g. when the health educatorhas to dealwithilliteratesandpoor people, he hasto getdown
to their level of conversationandhuman relationshipsso asto reduceany socialdistance.
 Health Educationshould providean opportunity for the clients to go throughthe stagesof identification
of problems, planning, implementationandevaluation.This is of special importancein the health
educationof the community where the identificationof problems andplanning, implementing and
evaluatingareto be done withfull involvement of the community to makeit the community’sown
program

19. Cont..d
Health Educationis basedon scientificfindingsandcurrent knowledge.Thereforea health educator
should have recent scientificknowledgeto providehealth education.
 The health educatorshaveto makethemselves acceptable. They should realizethat they areenablers
andnot teachers.They haveto winthe confidenceof clients.
• The health educatorsshould not only havecorrectinformationwith them on all mattersthat they have
to discussbut also should themselves practicewhatthey profess. Otherwise, they will not enjoy
credibility.

20. CONT…D
 It must be rememberedthat people arenot absolutely without anyinformationor ideas.The health
educatorsarenot merely passinginformationbut also givean opportunity forthe clients to analyze
fresh ideaswith old ideas,comparewithpastexperience andtakedecisionsthatarefound favorableand
beneficial.
the process of educationshould be done step-by-stepandwithdue attentionto the differentprinciples
of communication. Thegravedangerwithhealth educationprogramsis the pumping of all bulk of
informationin one exposure or enthusiasmto giveall possible information.Since it isessentially a
learningprocessThehealth educatorshould use terms thatcanbe immediatelyunderstood.Highly
scientificjargonshould be avoided.

21. CONT…D
 Health Educationshould startfrom the existingindigenousknowledgeandefforts should aim atsmall
changesina gradedfashionandnot be too ambitious.People will learn step by step andnot everything
together.For every changeof behavior,a personal trailis requiredandtherefore the health education
should provideopportunitiesfor tryingout changedpractices.

22. Approaches to health education / strategies
Thepersuasionapproach–deliberateattemptto influence the other persons to do whatwe wantthem to
do(DIRECTIVEAPPROACH)
 Theinformed decisionmakingapproach-givingpeople information,problem solving anddecision
makingskills to makedecisionsbut leavingthe actualchoice to the people. E.g. familyplanning methods

23. Factors to Consider for Conducting Effective Health Education
Knowyour targetgroup(values, customs andhabits)
Knowtheir strengthsandweaknessesi.e. what they can door can’t.Will they only participateor be
involved?
Establish thatresourcesareattheir disposale.g CORPs (Community Own ResourcePersons), funds,
local materials,availabilityof time, skilled labor etc.

24. Targets for health education
Individualssuch asclients of services,patients,healthy individuals
 Groups E.g. groupsof studentsin a class, youth club
Community E.g. people livingin a village

25. Health education settings
When considering the range of health education interventions, they are usually described in relation to different
settings. Settings are used because interventions need to be planned in the light of the resources and
organizational structures peculiar to each. Thus, health education and promotion takes place, amongst other
locations
in:
 Communities
 Health care facilities
 Work sites
 Schools
 Prisons
 Refugee camps …etc

26. Role of health educator
 Talkingto the people andlistening of their problems
 Thinkingof the behaviororactionthat could cause,cure andprevent theseproblems.
 Findingreasonsfor people’s behaviors
 Helping people to seethe reasonsfor their actionsandhealth problems.
Askingpeople to givetheir own ideasfor solving theproblems.
 Helping people to look astheir ideasso that they could see which werethe most useful andthe simplest
to put into practice.
 Encouragingpeople to choose the ideabest suitedto their circumstances.

27. Note
Healtheducationis thedutyof everyoneengagedinhealthandcommunity developmentactivities.Health
Extension Workers are primarily responsible in working with the families and community at a
grass root level to promote health and prevent disease through provision of health education. If
health and other workers are not practicing health education in their daily work, they are not
doing their job correctly. When treating someone with skin infection or malaria, a health worker
should also educate the patient about the cause of the illness and teach preventive skills. Drugs
alone will not solve the problems. Without Health Education, the patient may fall sick again from
the same disease. Health workers must also realize that their own personal example serves to
educate others.

28. Health promotion
isdefined asa combinationof educationalandenvironmental supports for actionsandconditionsof
living conduciveto health.
Or
isthe processof enabling people to increasecontrol over andto improve health.” It isnot directed
againstanyparticulardisease,but isintendedto strengthen the host through a varietyof approaches
(interventions).
GOALS OF HEALTH PROMOTION
To createenvironmentsthat allow all the ability to accessall needed services.
 To equipwiththe skills to determinetheir own health needs.

29. Strategies of health education and promotion

31. ENVIRONMENTALMODIFICATION
Thehistory of medicinehasshown thatmany infectiousdiseaseshavebeen successfully controlled in
manycountries throughenvironmental modifications.

32. ENVIRONMENTALMODIFICATION
• A comprehensiveapproachto health promotion requiresenvironmental modifications,such asprovision
of safewater;installationof sanitarylatrines;control of insects androdents;improvement of housing
etc.

33. NUTRITIONAL INTERVENTIONS
These comprisefood distributionand nutritionalimprovementof vulnerable groups: child feeding
programmes,foodfortification;nutritional education,etc

35. LEGISLATION MEASURES
 Lawrelatedto prevention of motor vehicle accidents
 Lawsrelatedto control of environmental pollution
 Lawsrelatedto maintainfood hygiene
 Lawsrelatedto alcohol use/ tobaccouse/ drugabuse
 Lawsrelatedto crime

36. LIFE STYLE AND BEHAVIOURAL CHANGES
The conventional public health measuresor interventionshave not been successful in makingin roadsinto
lifestyle reforms.The actionof prevention in thiscase, isone of individualandcommunity responsibility for
health The effortsaredirectedtowardsdiscouragingfromadoptingharmful lifestyles eg.Smoking,
eatingpatterns,lack of exercise, alcoholism etc

37. PRINCIPLES
 Health promotion involves population asa whole in the context of their everydaylife.
 Health promotion isdirectedtowardsactionon the determinantsof health.
 It includescommunication,education,legislation,fiscal measures,organizationalchangeandlocal
activitiesagainsthealth hazards.
 It aimspublic participation.
 It isbasicallyan activityinhealth andsocial field andnot a medicalservice

39. CONT…D
• Preventive, protectiveandpromotivemeasuresarerequiredto achievehealth. These measureshaveto
be adoptedcontinuously to remainhealthy

40. DO NOT DO TOMORROW WHAT YOU THINK YOU CAN DO
TODAY
Thanks for your great attention
TOGETHER WE CAN