HEALTH EDUCATION in community in nursinghealth

HEALTH EDUCATION
Miss Eliza Koirala

HEALTH EDUCATION
 Health education is a process that help to
increase knowledge and to reinforce desired
behavior patterns .
 It is very essential in achieving individual
and community health.
 There is no single definition of health
education. A variety of definitions exist.

Health education can be defined as a
process which changes knowledge,
attitudes and practice of people .
Knowledge
Practice Attitude

Knowledge
 Information and skills acquired through
education; the theoretical or practical
understanding of a subject.
 What is known in a particular field ; facts and
information.

Attitude
Tendency to respond positively or negatively
towards a certain idea , object, person, or
situation is called attitude . Knowledge alone
cannot lead to behavioural change . A person
may know lot about the ill effects of smoking but
he may continue smoking.

Practice
 The actual application or use of an idea, belief,
or method is called practice .E.g. adopting
healthy habits , maintaining personal hygiene ,
doing exercise regularly , cessation of smoking
etc are good practices.

Definition of Health Education
2. The definition adopted by John M Last is
"The process by which individuals and
groups of people learn to behave in a manner
conducive to the promotion, maintenance or
restoration of health" .

 According to the World Health
organization“ Health education is the process
which enable individual and group of individuals
to realize their need and match them to necessary
healthy behavior for attainment of positive health.
Health education like general education is
concerned with the change in knowledge , attitude
and behavior of the people”.

 Thus from the above mentioned definition , we
can conclude that health education is a process of
helping individual to gain knowledge , develop
attitudes and skills so that they can modify their
health related behavior in order to attain health.

AIMS OF HEALTH EDUCATION(WHO):
 To help people realize that health is the
individual , family and community assets.
 To help people acquire health knowledge
and information , develop positive attitudes
and skills and which will enable them to
protect them from disease and improve their
health.

AIMS OF HEALTH EDUCATION(WHO):
 To help people identify their health
problems and encourage them to solve
those problems by their own action and
efforts and utilizing local resources to
maximum level.
 To encourage people to develop and utilize
the available health services provided for
them.

Specific objectives of health education
 To make health an assets valued by the
community.
 To increase knowledge of the factors that affect
health.
 To encourage behavior which promotes and
maintains health.

 To encourage appropriate use of health services
especially preventive services.
 To inform the public about medical advances,
their uses and their limitations.

Principles of Health Education
 Health education must try to bring change in
people’s health , knowledge , attitudes and
Behaviors whose ultimate goal is to protect
and promote individual , family and
community health.

 Health education is multi – disciplinary
responsibility of parents , teachers , health
educators and health workers . They must
establish their trust before the people
concerned.

 Health education must consider individual’s
socio-economic , cultural as well as
psychological aspects.
 Health education must encourage community
people to develop and utilize community
health services programmes – curative ,
preventive , promotive as well as rehabilitative

Principles of health education:
 Credibility
 Interest
 Participation
 Motivation
 Comprehension
 Repetition

Principles of health education:
 Learning by doing
 known to the unknown
 Setting an example
 Good human relationship
 Feedback
 Leaders

Credibility (believe and trust)
 Good health education is based on facts - that
means it must be consistent and compatible
with scientific knowledge .
 Unless the people have trust and confidence in
the communicator, no desired action will ensue
after receiving the message.

Interest
 It is a psychological principle that people are
unlikely to listen to those things which are not
to their interest. It is very important to
remind ourselves that health teaching should
relate to the interests of the people.

Health educators must find out the real health
needs of the people. Psychologists call them
‘felt-needs’. If a health programme is based
on "felt needs" people will gladly participate
in the programme and only then it will be a
people's programme.

Participation
 Participation is a key word in health
education.
 Health education should aim at encouraging
people to work actively with health workers
and others in identifying their own health
problems and also in developing solutions and
plans to work them out.

Motivation
In every person, there is a fundamental
desire to learn. Awakening this desire is
called motivation. There are two types of
motives –
 primary motives.
 secondary motives.

 Primary motives (e.g. sex, hunger, survival)
are driving forces initiating people into action;
these motives are inborn desires .
 Secondary motives are based on desires
created by outside forces or incentives(e.g.
praise, love, rewards and punishment

 In health education, motivation is an
important factor; that is, the need for incentives
is a first step in learning to change.
 To tell a lady, faced with the problem of
overweight, to reduce her weight because she
might develop cardiovascular disease or it might
reduce her life span, may have little effect; but
to tell her that by reducing her weight she might
look more charming and beautiful , she might
accept health advice.

In health education, we make use of
motivation to change behavior. For example,
men who have already had vasectomies
are among the best advertisements for male
sterilization.

Comprehension
(ability to understand something)
 In health education we must know the level of
understanding, education and literacy of people
to whom the teaching is directed.

In health education , we should always
communicate in the language people
understand, and never use words which are
strange and new to the people.

Repetition
 Few people can learn all that is new in a single
period. Repetition at intervals is necessary.
 If there is no repetition, there is every possibility
of the individual going back to the pre-awareness
stage.
 If the message is repeated in different ways,
people are more likely to remember it.

Learning by doing
The Chinese proverb :
"lf I hear, I forget;
If I see, I remember;
If I do, I know“; illustrates the importance of
learning by doing.

Known to unknown
 In health education work, we must proceed
 "from the particular to the general";
 "from the simple to the more complicated;"
 "from the easy to more difficult"; and
 "from the known to the unknown".
 These are the rules in teaching.
 We start where the people are and with what
they understand and then proceed to new
knowledge.

Setting an example
 The health educator should set a good example
in the things he is teaching.
 If he is explaining the hazards of smoking, he
will not be very successful if he himself smokes.
 If he is talking about the "small family norm",
he will not get very far if his own family size is
big.

Good human relations
 Sharing of information, ideas and feelings
happen most easily between people who have
a good relationship.
 Building good relationship develops trust
among the people which can bring desired
change in the people’s behaviour .

Feedback
 Feedback is one of the key concepts of the
health education systems .
 The health educator can modify the elements
of the system (e.g. message, channels) in the
light of feedback from his audience. For
effective communication, feedback is of great
importance.

Leaders
 Psychologists have shown and established
that we learn best from people whom we respect
and regard.
 In the work of health education, we
try to penetrate the community through the
local leaders - the village headman, the school
teacher or the political worker.

 Leaders are agents of change and they can
be made use in health education work.
 If the leaders are convinced first about a
given programme, the rest of the task of
implementing the programme will be easy.

NEW HEALTH PRACTICES
 COMMUNICATION
 MOTIVATION
 DECISION MAKING

COMMUNICATION
 Communication can be regarded as a two-
way process of exchanging or shaping
ideas, feelings and information.
 Broadly it refers "to the countless ways
that humans have of keeping in touch with
one another"

Communication which is the basis of human
interaction is a complex process. It has the
following main components
1. sender
2. receiver
3. message
4. channel(s)
5. feedback

Communication
 Communicator: the person or the team who give
the message (Educator).
 Message: the contents (materials) of health
education
 Channel: method of carrying the message
 Audience: the receivers (users or targets) of the
message
 Feedback

The communication process
Feedback
Sender message channel receiver

The Communication Process
Sender
Feedback
Message
Receiver
The sender is the person who wants to communicate
some thoughts or ideas.

Sender
Feedback
Message
Receiver
The message is the thought or idea to be communicated.
It is transmitted by voice, fax, email, letter, written
proposal, or other form.

Sender
Feedback
Message
Receiver
The receiver is the person who is supposed to receive
the message.

Sender
Feedback
Message
Receiver
When the message has been received , the receiver
may provide verbal and nonverbal feedback.

TYPES OF COMMUNICATION
1. One-way communication :
The flow of communication is "one-way"
from the communicator to the audience. The
familiar example is the lecture method .

The drawbacks of the one way method are :
-knowledge is imposed(force to accept something)
-little audience participation.
-no feedback.
-does not influence human behavior.

2. Two-way communication :
 This method is a two - way method of
communication in which both the communicator
and the audience take part.
 The audience may raise questions, and add their
own information, ideas and opinions to the
subject.
 The process of learning is active and
"democratic".

It is more likely to influence behaviour than
one - way communication . Example of two –
way communication are small group meeting ,
discussion and telephone .

3. Verbal communication
 The traditional way of communication has been
by word of mouth.
 The advent of written and printed matter are of
comparatively recent origin.
 Direct verbal communication by word of mouth
may be loaded with hidden meanings.

4. Non - verbal communication
 Communication can occur even without words.
 It includes a whole range of bodily movements,
postures, gestures, facial expressions (e.g., smile,
raised eye brows, frown, staring etc.).
 Silence is non - verbal communication.
 It can speak louder than words.

5. Formal and informal communication:
Communication has been classified into formal
(follows lines of authority) and informal
( Information shared without any obligation or
restriction ,e.g. talk with friends, family
member or relatives or gossip etc )

6. Visual communication
The visual forms of communication comprise :
charts and graphs, pictograms maps, posters etc.

7. Telecommunication and internet
Telecommunication is the process of
communicating over distance using
electromagnetic instruments. Radio, TV and
internet e.t.c are mass communication media,
while telephone are known as point - to – point
telecommunication systems.

BARRIERS OF COMMUNICATION
Health education may often fail due to
Communication barriers between the educator
and the community-these may be:
1.Physiological – Difficulty in hearing and
expression.
2. Psychological -- Emotional disturbances,
Neurosis, levels of
intelligence, language
difficulties.

3. Environmental -- noise, invisibility.
4. Cultural -- illiteracy, levels of
knowledge and
understanding, customs
beliefs , religion, attitudes,
economic and social class
differences , language
variations, cultural
difficulties .

Good communication technique
 Source credibility.
 Clear message.
 Good channel.
 Receiver: ready, interested, not occupied.
 Feed back.
 Observe non-verbal cues.
 Active listing.
 Establishing good relationship.

MOTIVATION
Motivation refers to the states within a
person or animal that drives behavior toward
some goals.
- MORGAN AND KING

Types of motivation :
INTRINSIC MOTIVATION
 Intrinsic motivation refers to
motivation that is driven by an interest
or enjoyment in the task itself, and
exists within the individual rather than
relying on any external pressure
 Feeling of accomplishment, having
pride in owns work and sense of
recognition.

Types of motivation :
EXTRINSIC MOTIVATION
 Extrinsic motivation comes from outside
of the individual.
 Common extrinsic motivations are
rewards like money , grades , promotion ,
holidays etc

 Decision making is the cognitive process leading
to the selection of a course of action among
alternatives.
 Every decision making process produces a final
choice. It can be an action or an opinion.
 Examples:
Shopping, deciding what to eat, What to wear,
when to sleep, etc..

VARIOUS APROACH TO HEALTH
EDUCATION
 Individual methods
 Group method
 Mass method

Individual method
This method involves person-to-person or face-
to-face communication, which provides
maximum opportunity for two way flow of
ideas , knowledge and information. Example of
Individual method of health education are:
-- Interview
-- Counselling

 It may be given as personal interviews in the
consultation room of the doctor or in the health
centre or in the homes of the people.
 Opportunity is taken in educating him on
matters of interest - diet, illness and its
prevention, personal hygiene, environmental
hygiene etc.

Group approach
 Our society contains groups of many kinds –
school children, mothers, industrial workers,
patients, etc.
 Group teaching is an effective way of
educating the community.
 The choice of subject in group health teaching
is very important; it must relate directly to the
interest of the group.

 For example, we should not broach the subject
of tuberculosis control to a mother who has
come for delivery; we should talk to her about
child-birth and baby care.
 Similarly, school children may be taught about
oral hygiene; tuberculosis patients about
tuberculosis; and industrial workers about
accidents.

 We have to select the suitable method of
health education including audio-visual aids
for successful group health education.
 Teaching in a group can also be effective
because it also provide ample opportunity for
question answer and discussion.

 Example of group method are :
 Chalk and board(lecture)
 Demonstration
 Group discussion
 Role play
 Panel discussion
 Study trip
 Symposium
 Workshop

Mass method
 Mass media are a "one-way" communication.
 They are useful in transmitting messages to
people even in the remotest places.
 The number of people who are reached usually
count in millions.
 Until the early 1920s, mass communication
depended largely on what was printed -
posters, pamphlets, books, and newspapers.

 Then came the radio with it a new
dimension of experience.
 TV step further and has become a very
powerful weapon.

Individual method of health
education
INTERVIEW :
 Interview means to meet and talk with each
other and collect information and ideas and
provide suggestion tactfully.
 In this process there occur some exchange of
ideas between the interviewer and
interviewee.
 It is a process of providing health education
through question and answer between the
health educator and learner.

Kind of interview
Structured interview:
 It is taken with the help of written
questionnaire or interview tool. It contain a set
of predetermined questions which are
structured in a written form to collect
information on the knowledge, attitude and
practice of the individual concerned.

 Unstructured interview:
 In such interview no pre-determined questions
are set or asked.
 The interviewer collects information by free
discussion on existing health problem.
 In the process of question and answer ,some
teaching is done. Interview with the mother of
child in a clinic or with a patient in the hospital
by a physician are examples of unstructured
interview.

 Type of question
 Open ended question :
Open ended question leads to free response
by the interviewee out of his knowledge and
feelings ,which should be in brief. E.g.
suggest some of the ways of preventing
hypertension.

 Closed ended question:
It is answered by choosing from few fixed
alternative responses , such as yes or know,
agree or disagree etc.
E.g. Do u smoke ? Yes no
Smoking is good for health.
Agree Disagree

Stages or process of interview:
 Preparing of interview:
 In order to take interview health educator
should first of all , make some preparation.
 Health educator should have adequate
knowledge and information on topic of
interview.

 Develop the questionnaire .
 Decide the time and place for interview.
 Interviewee should be informed about the
interview.

 Beginning the interview:
After the preparation has been completed,
health educator must be ready to conduct
interview session. While beginning the
interview following points are to be considered
 Establish proper rapport with the interviewee.
Greet and give self introduction . Ask name
and profession of the interviewee.

 State the purpose and importance of interview.
 Ask interview question politely in a natural
way.
 You should listen carefully and attentively .
Maintain eye contact.
 Make sure the interviewee understand the
question.

 Don’t pass any embarrassing comment in
between the interview process.
 Allow enough time to think and answer.
 Avoid disturbing factor like talking with other
person during the interview.

 Conclusion ,suggestion and report:
 Discuss with the interviewee and make
conclusion clear to him regarding to the
problem and treatment plan.
 Close the interview in a friendly manner by
thanks .
 Make written report of interview result.

 Advantages
 Helpful to know individual knowledge , attitude
and behaviour.
 Helpful for systematic teaching with exchange of
ideas and feeling.
 Help to know better solution for a problem.
 Cost-effective .

 Even illiterate people can be interviewed and
taught.
 Follow up can be made with each interviewee
to know the impact of teaching.

 Disadvantages
 Time consuming
 Difficult to cover wide range of target group
with limited manpower.

 Counselling:
Counselling is a process of encouraging and
helping an individual in identifying his or her
health problem, the cause of the problem , the
ways for its solution and also encourages taking
necessary action to solve it. The decision is
made on his own choice.

 Counselling is an effective and frequently
used health education approach for
individual.
 There is adequate exchange of ideas , feeling
and experience between the counselor and his
client.

For example mental patient , diabetes patient ,
cancer patient , AIDS patient , family planning
couselling etc.
The important setting for counselling are
hospital , school , home.

 Steps of counselling
 Building rapport
 The counselor should always show positive
attitude and concern towards his client.
 Give self introduction and take introduction
from the client.
 Good rapport will help to gain confidence ,
trust and mutual understanding as well as
keep the client at ease.

 Identifying client problem or need:
 A counselor must try to understand the
problem of the client .
 A counselor must speak clearly.
 A counselor should listen attentively to
exchange of ideas and help in identifying the
problem the client is facing.

 Finding way to solve the problem:
 He must discuss and encourage the client to
develop problem solving strategies based on
his own situation.
 He should provide advices on such matter.
 Counselor can provide appropriate
information and helps identify resources.
 Encourage implementing what is planned.

 Maintaining patience:
 Both the client as well as counselor should be
patience throughout the counseling session.
 Avoid rushing and exercise responsibility
seriously.

 Keeping secret:
 Maintain confidence on sensible personal
matters. Inability on the part of counselor to
maintain confidentiality will result in non
cooperation and failure in counselling.

 Follow up:
 Plan with the client a follow up schedule.
 It help to assess the progress and help to
know further effort to be taken to solve the
problem.

 Qualities of good counselor
 A counselor must be friendly , sincere ,
cooperative and social so that he can work with
the client well.
 He must have capacity of judging things closely
and in detail.
 He must have patience to listen and deal with
problem.

 He must have skills of communication and
monitoring the progress of counselling.
 He must have the ability to convince his client
to take necessary action to solve his health
problem.

 Advantages
 Helpful in dealing with client and motivating
him for taking appropriate action.
 Provide maximum opportunity for feedback
and maintain good two way communication.
 Enable to solve even serious and complicated
problems.

 Disadvantages
 Takes long period of time
 Difficult to cover larger population
 Sometimes , loss of patience might make
counselling a failure.

Group method of health education
CHALK & BOARD(lecture):
 Lecture is an oral presentation of information
and ideas by a person to a large group of
people and generally in a face –face situation
at a particular place.
 Inexpensive, easily available
 Needs advance preparation

Write key words, simple line diagrams, solve
problems
Step by step build up concepts & organization
of structure
Good hand writing is a must.

Advantages
 One person can provide health education to
many people at a time.
 Not expensive.
 Can be used in different settings e.g. school ,
community etc

Disadvantage
 One way communication method with no
exchange of ideas and view.
 Message will be retained for short period of
time.
 Difficult to draw attention for longer period
of time.

Demonstrations
A demonstration is a carefully prepared
presentation to show how to perform a
procedure. E.g. preparing ORS, water
filtration etc is carried out step by step before
an audience or the target group.

Demonstration
 dramatizes by arousing interest.
 persuades the onlookers to adopt recommended
practices.
 upholds the principles of "seeing is believing" and
"learning by doing“.
 Involves verbal and visual explanation of facts and
processes . It is mixture of theoretical and practical
teaching.

Demonstration as a means of communication
has been found to have a high educational
value in programmes like environmental
sanitation (e.g. waste disposal , water
filtration); mother and child health (e.g.
demonstration of oral rehydration
technique) etc.

The no of learner in the group may be about
fifteen . The learner are given opportunity to
see and manipulate the device or material
used in demonstration . They are given the
opportunity to practice the process.

Advantages
 Effective teaching method which uses
various learning experiences like seeing ,
hearing etc.
 Interesting and draws attention of the
learner.
 Develop skill required for performance.
 Cheap , practicable , accessible and useful
for different categories of learner.
 Client performance can be evaluated
immediately.

Disadvantage
 Sometimes difficult to get adequate
materials for demonstration.
 May not be appropriate for every topic.

Group discussion
A "group" is an "aggregation of people
interacting in a face -to - face situation". Group
discussion is considered a very effective method of
health communication. It permits the individuals
to learn by freely exchanging their knowledge,
ideas and opinions.

Group discussion provides a wider interaction
among members than is possible with Other
methods. E.g. cessation of smoking, obesity
Reduction etc. Any discussion should take only
an hour or less to avoid boredom . Any ideal
group may consist of 6 to 12 members
depending upon the situation.

Advantage
 Helps learner to come to a group decision and
solve common problem.
 Helps member to develop positive attitude
towards working together.
 Provides adequate communication among all
workers.
 Effective method
 Costeffcetive

Disadvantage
 Some discussion will be prolonged without
any fruitful result.
 Sometimes the discussion may go out of tract.
 May take longer time.

Panel discussion
 In a panel discussion, 3 to 4 persons who are
qualified about the topic sit and discuss a
given problem in front of a large group or
audience.
 The panel comprises of a chairman or
moderator and 3 to 4 speakers.
 The chairman opens the meeting, welcomes
the group and introduces the panel speakers.

 He introduces the topic briefly and invites the
panel speakers to present their points of view.
 There is no specific agenda, no order of speaking
and no set speeches .
 After the main aspects of the subject are
explored by the panel speakers, the audience is
invited to take part.

Advantage
 Provides varied knowledge , ideas and
experiences about the subject.
 Interesting and can draw attention of people.
 Learner get opportunity to ask question and
pass comments , which helps in teaching
learning process.

Disadvantage
 Sometimes it is difficult to get the appropriate
experts.
 Difficult to set time for each experts.

Symposium
 A symposium is a series of speeches on a
selected subject/topic.
 Each person or expert presents an aspect of the
topic briefly.
 There is no discussion among the symposium
members like in panel discussion.
 In the end, the audience may raise questions.
The chairman makes a comprehensive
summary at the end of the entire session.

Advantages
 Interesting and draws attention.
 New speaker can develop the technique of
presentation.
 Does not require special kind of materials and
equipment.

Disadvantage
 Difficult to get appropriate export
 My be time consuming
 Difficult to adjust time for each experts.

Role playing
 Role playing or socio-drama is based on the
assumption that many values in a situation
cannot be expressed in words.
 The communication can be more effective if
the situation is dramatized by the group.
 The group members can conduct role
playing by taking different roles e.g.
teacher’s role , doctor’s role , mother’ roles ,
patient’s role etc.

 Someone may pretend to be sick person , other
may play the role of mother of a child , health
worker etc.
 In role playing there will be about 5 to 6
characters.
 The size of the group is thought to be best at
about 15 to 20 .

 Role playing last particularly for short period
of time say about 30 min including few min of
discussion with audience to know their
reaction.

Advantages
 Can learn from real life situation.
 Enable learner to see things through the eye of
others. They can apply those knowledge in real
life situation.
 Is interesting and provide active learning
opportunity.
 Not expensive
 Easily conducted

Disadvantage
 May act as recreational activity so may not
achieve educational objectives
 Participant may not be collected sometimes.
 Participant may not act accordingly so that
message can’t be delivered properly.

Study trip
A study trip is a planned visit to a place outside
the classroom to provide practical knowledge
in real situation. It is also called as a field trip
or an educational tour . A study trip may be
taken within the walking distance or even a long
distance. A study trip may also be taken within
the school complex to see and study the waste
disposal , water supply system , hygiene of
canteen etc.

Study trip can also be taken to distance
places for several days.
Advantages:
 Better learning
 Creates interest and curiosity
 Enable student to relate to real world what
they have learned in classroom

Disadvantage
 Expensive and difficult to conduct
 Difficult to handle large group of student

MASS APPROACH
 Health camps
 Advertisement

Media of health education
Audiovisual aids
Audiovisual aids are those sensory
objects or images which initiate or
stimulate learning.
BURTON
No health education can be effective
without audiovisual aids.

Media of health education
Audiovisual aids
PURPOSE
 simplify unfamiliar concepts;
 draw attention and interest
 bring understanding an interaction
 reinforce learning by appealing to more than one
sense
 provide a dynamic way of avoiding monotony.
 Provide information to large no of people

Audiovisual aids which can be classified into
three groups :
(1) AUDITORY AIDS
Radio, tape-recorder .
(2) VISUAL AIDS
(a) Not requiring projection : Chalk-board,
leaflets/pamphlets , posters, charts, flannel
graph, models etc.

(b) Requiring projection: Slides, film strips,OHP.
(3) COMBINED A-VAIDS
Television sound films (Cinema),
slide – tape combination.
Video
Computer and LCD

AUDITORY AIDS
Radio
 Radio: - Radio is the audio aids through which messages
are relayed to a heterogeneous and large number of people
at one time, who are not physically present before the
communicator.
 It is a mass media, which provides one-way
communication.

AUDITORY AIDS
Radio
Advantages
1. It is very much helpful for illiterate people; the
message should be simple to understand.
2. It leaps the barriers of distance and space.
3. attend the radio health programme anywhere the
individual goes.
4. information to large number of people in a very
short t period of time.

Radio
Disadvantages
1. one-way communication system.
2. cannot be sure if people are sure listening to and
understanding his message.
3. There may be electricity and batteries problems
4. difficult to evaluate the impact of radio teaching.
5. language barrier to certain group of people.
6. Message received only through verbal teaching so it
is easy to forget.
7. Difficult in timing to fit the convenience of the
specific target people.

AUDITORY AIDS
Tape Recorder
 Tape recorder is small portable machine or
equipment which is operated with the help of
electricity or batteries.
 It can be used for the purpose of providing
health education to group of audience.

 Tape recorder can be used in direct group
teaching followed by discussion.
 In the beginning introduction should be
given by health educator about the subject
of teaching.
 During the health education session, tape
recorder can be paused in between and
explanation can be made when ever
required.

Teaching programme should not exceed
more than thirty minutes including the
discussion.
AVANTAGE
 Message can be recorded and played at
various places.
 Message can be used for future use.
 It can be played with the help of batteries
where there is no electricity supply

 It is portable and easy to carry.
 It is safe to use.
DISADVANTAGE
 Tape recorder may be costly.
 Problem of repairing.
 Lack of electricity or lack of batteries might
cause problem.
 Cant be used by everyone.

VISUAL AIDS
POSTER
 A poster is a picture or drawing designed
for public display to convey message on
certain subject .
 Usually a relevant caption is also included
to explain the meaning of the picture.

Healthy diet poster
Balanced diet Healthy diet

In fact poster must contain:
 Caption
 Picture
 Course of action suggested
 Symbols/logo--official
 A good poster should be of app size, normally of about
60cm x 60cm .
 Colored poster is more natural, attractive and clean.
 Poster to be displayed at eye level and place where visible
 The picture and letters should be big enough to be seen
clearly
 Message should be based on the need of target of people

ADVANTAGES
 Pictorial and colored poster are attractive and
effective.
 Can be carried easily.
 Many people can learn from limited poster.
 Poster can also be written on walls of busy street,
on walls of houses, building where people can see
easily.

 Can be prepared locally without less technology.
 Even illiterate people can learn something from
picture.
 Creates learning atmosphere.
 Develops creativity.
 Communicate ideas quickly.
 Can be saved for future use.

DISADVANTAGES
 One way communication –Not effective
 Many create misunderstanding and confusion.
 Take time to print in large scale.
 Expensive to print.
 Difficult to evaluate.
 Cannot be sure if intended group have seen the
poster.

PAMPHLET
 Pamphlets are visual media, which are
considered as mass media of health education.
 A pamphlet give short description of different
aspects of a specific topic.
 Message can also be written in a form of poem
or song.
 It can also be formed in the form of dialogue.

 A pamphlet should be as brief as possible.
 It should not exceeds more than four pages.
 Pamphlet can also be distributed to family
members, school students, In FP/MCH clinic,
occupational workers etc.

ADVANTAGES
 Transfer message rapidly in large scale.
 People can carry it home and read at free
time and understand it.
 Can be kept safe to read it again.
 Easier to prepare and produce in large scale
at low cost.
 Can be even written by hand.

DISADVANTAGES
 One way communication.
 Not useful for illiterate.
 Printing service may not be available in rural
area.
 Cannot be sure if target group read it.
 Difficult to evaluate.

FLASH CARD
 Flash card is a set of visual aid.
 It consists of simple message in series or steps
by consecutive pictures which convey certain
message about the specific topic .
 For e.g. the breast feeding positioning , steps of
bathing baby , water purification process etc.

 Flash card are usually used in group teaching
especially for illiterate , reviewing session etc.
 They are used with verbal explanation
 Good size of flash card is 25 cm x 30 cm.
 The size may vary according to the group of the
learner.

Advantages:
 Is interesting and attractive.
 Is easy to carry.
 Easy to prepare with low cost.
 Pictorial and systematic presentation of
diagram is useful.
 Can be used to reviewing the session

Disadvantages:
 Not good for mass teaching.
 Expensive and difficult to produce in large
numbers.
 Sometimes there may be problem of
drawing.
 Appropriate pictures may not be available.

Flip chart
 A flip chart is a kind of visual teaching aid.
 It is also called a flip book or turnover chart.
 It is series of sequential chart which are fastened
together at the top so that as one chart is viewed it
can be flipped back to revel the next one.
 Each chart carries inter-related message in the
form of picture or diagram.

 The picture is usually accompanied by relevant
caption.
 A set of flip chart normally consist of six to eight
charts , the number may slightly vary depending
upon the message to be conveyed .
 The size of individual chart should be
approximately 50cm x 70 cm .
 The size of the picture and letter should be big
enough to see clearly from distance by group of
people.

Advantages:
 Helpful for making systematic presentation .
 Pictorial explanation is better and more
effective.
 Portable and easy to carry out.
 Can be stored for future use.

Disadvantage:
 Expensive to produce in large scale.
 There may be problem of drawing.
 May not be visible to larger group.

Flannel board:
 A flannel board consist of a series of cut
pieces or cut-outs.
 The use of flannel graph helps the health
educator to illustrate the points of teaching
and reinforce the message presented.

 A flannel board is made
by wrapping a piece of
flannel cloth over one
face of board.
 A flannel board size
should be approximately
40cm x 30 cm.

Advantages:
 The pictorial information is interesting and
attractive.
 Teaching can be impressive and effective.
 Can be used in different teaching situation –
classroom , FP/MCH clinics etc
 Easy to carry
 Durable and can be used for future use.
 Not expensive.

Disadvantages:
 Sometimes the cut piece may not be
properly fixed.

Graph
 Graph is a visual teaching aid for presenting
statistical information and contrasting the
trend or changes of certain attributes.

Types of graphs:
Bar graph:
 It consists of bars arrange horizontally or
vertically from an origin base.
 It is useful in comparing and contrasting two
variables or two groups.
 Use 50 x 72 cm size chart paper to draw bar
graph.

Line graph:
 The free hand smooth line to various points can
be drawn indicating variables.
 The line may be straight or a curved line.
 Indicate relationship b/n two variables.

Pie graph: it is usually shown on a disk (pie)
or a circle divided into sectors of different
fractions or percentage of the division of a
distributive nature.

Advantages:
 Effective teaching aid
 Can explain various facts and process.
 Easy to prepare
 Easily transportable and storable

Disadvantages:
 Ordinary people may get confused
 Not useful for illiterate people
 Chart alone cannot provide detail
explanation ,,teacher need to describe it.

Models
 Model is the representative of original reality.
 It is the three dimensional teaching aids.
 It helps to provide health education effectively
and so is commonly used by health educator.
 We make model of different objects like model
of sanitary pit latrine , the model of human
anatomy etc.

Advantages
 It is representative of real object so provide
correct and concrete knowledge of the things.
 It is interesting and attractive. It helps to draw
attention of the learner.
 There can be better retention of learning
through the use of model

Disadvantages
 Sometimes it is difficult to make or collect
the appropriate model
 Sometimes model may be expensive

Bulletin Board: -
 Bulletin board is a non-projected visual aid
 health education message and any other information are
displayed with view to informing people.
 The board is made of sheet of light plywood, card -board
sheet or similar rigid material usually set within a frame.
 different education material like cuttings , picture, graphs,
leaflets and other appropriate teaching aids are displayed with
the help of thumb pin.

Bulletin Board: -
 We can keep the bulletin board in library section, waiting hall,
offices, hospitals, health post, nursing home etc.
 The normal size of the bulletin board is 60cm×40cm in size.

Advantages
1. it is attractive , simple and economical way of
providing information and message
2. Stimulate learners' thoughts when they are involved in the
preparation of display.
3. People get opportunity to learn while waiting in the hall,
passing through corridors, etc.
5. Helps to provide up -to date information

CHALK BOARD
 It is the most commonly used av aid.
 It is also known as black board.
 It gives motivation and gives instruction which are understandable.
TYPES OF CHALK BOARD: Fixed Portable
CHARACTERISTICS OF BLACKBOARD:
Size- 5m x 6m Surface- rough
Dull- to eliminate glare
The writing should be easily eliminated with duster
The chalkboard should be mounted on an appropriate height within
the reach of teacher and visibility of students

Advantages:
 It is convenient for group teaching
 It is economical and it can be used over and again
 It captures attention
 It can be used for revision
 It can be used for drawings and illustrations from the
textbooks.
Limitations
 It makes students dependent on the teachers
 It does not care for the individual needs of the students
 It makes the lesson a dull routine
 It makes the chalk board to spread and inhaled by the teachers
and students

 Magnetic board
 Comic strip
 Comic
 Cartoon
 Picture
 Diagrams

Filmstrip
 Filmstrip is a continuous strip of film consisting
of series of individual pictures or messages
arranged in sequence to convey certain message .
 The pictures usually carry their titles or caption .
 Each strips may contain about twenty pictures
or message are projected on the screen with the
help of projector.

 The picture and message are commonly
explained orally .
 There will be gradual change or picture goes
along with explanation of each.

Advantages:
 Interesting and can draw attention
 Repetition can also be done
 Pictorial presentation so aid in better
learning
 Provide ample opportunity for question and
answer
 Simple to operate projector

Disadvantage:
 There may be problem of getting appropriate
filmstrip
 No sound only picture so may not be so
attractive
 Cannot be operated by illiterate people

Slide presentation
 A PowerPoint presentation is a presentation
created using Microsoft PowerPoint software.
 The presentation is a collection of individual
slides that contain information on a topic.
 PowerPoint presentations are commonly used in
meetings , training and educational purposes

Tips to be Covered while
preparing slides
 Outline
 Slide Structure
 Fonts
 Colour
 Background
 Spelling and Grammar
 Conclusions
 Questions

Outline
 Only place main points on the outline slide
 E.g.: topic
 Use appropriate front and front size

Slide Structure – Good
 Use 1-2 slides per minute of your
presentation
 Write in point form.
 Include 4-5 points per slide
 Avoid wordiness: use key words and
phrases only

Slide Structure – Good
 Show one point at a time:
 Do not use distracting animation
 Be consistent with the animation that you
use

Fonts - Good
 Use at least an 18-point font
 Use different size fonts for main points and
secondary points
 this font is 24-point, the main point font is
28-point, and the title font is 36-point
 Use a standard font like Times New Roman or
Arial

Fonts - Bad
 If you use a small font, your audience won’t be able to read what you have written
 CAPITALIZE ONLY WHEN NECESSARY. IT IS
DIFFICULT TO READ
 Don’t use a complicated font

Colour - Good
 Use a colour of font that contrasts sharply
with the background
 Ex: blue font on white background
 Use colour to reinforce the logic of your
structure
 Ex: light blue title and dark blue text
 Use colour to emphasize a point
 But only use this occasionally

Background - Good
 Use backgrounds such as this one that are
attractive but simple
 Use backgrounds which are light
 Use the same background consistently
throughout your presentation

Background – Bad
 Avoid backgrounds that are distracting
or difficult to read from
 Always be consistent with the
background that you use

Spelling and Grammar
 Proof your slides for:
 spelling mistakes
 the use of of repeated words
 grammatical errors you might have
make

Conclusion
 Use an effective and strong closing
 Use a conclusion slide to:
 Summarize the main points of your
presentation

Questions??
 End your presentation with a simple
question slide to:
 Invite your audience to ask questions
 Provide a visual aid during question period
 Avoid ending a presentation abruptly

COMBINED AUDIO – VISUAL AID
 Films
 Television
 Video
 Computer and LCD

Steps of carrying out
Health education
Programme

1. Planning of health
education programme

 Health education programme should not be
started all of sudden.
 It need some careful planning and
systematic approach.
 Planning of health education programme
should be done at local or national level

 Planning at local level should seek
community involvement and utilize local
resources.
 A series of sequential steps have to be
followed in order to develop a realistic and
effective health education programme.

 Certain factors needs to considering while
planning health education programme.
These factor are:
-- Peoples need
-- culture
-- socio-economic factors
-- Environment condition

Steps of planning
1) Collecting baseline data and information
 Baseline data and information are very
important for planning an appropriate and
effective health education programme.
 Baseline data and information indicate the stage
of situation which are essential for planning
process

 Through , baseline data and information
community diagnosis can be made.
 The information is collected on following
areas:
>vital statistic ( birth and death rates,
maternal mortality rate , infant mortality
rate etc)
> Status of knowledge ,attitude and practice.

 Socio-economic and cultural life (religion ,
beliefs , habits , family pattern , occupation
etc)
 Sanitary condition and facilities ( waste
disposal and garbage system ,drinking water
supply system etc)
 Available health services in the community
( hospital , health post and health programme)

 Literacy rate and education level
 Language
 Demographic pattern of population structure
( total population , family size , age , sex ,
ethnic group etc)
 Local organization and institution r/t health
and health education

These baseline information can be grouped
into two categories:
 measurable facts :
e.g. – age , sex , population etc
 Unmeasurable information:
e.g. – beliefs , values , feelings , attitudes etc

Both types of data should be collected
carefully . It should be collected through
different means like interview, discussion ,
meeting with community people and study
of health records etc.

2) Identifying health and health education need on
priority basis
 We can determine health and health education
need on priority basis by analyzing the data
collected . But we cannot solve all problems at a
time.

 We must priorities them and deal with most
important one.
 Criteria to be considered for prioritizing
problems:
-- widespread problem and severity
in term of morbidity and mortality
-- Felt need of the people
-- Feasible to meet the need ( in term
of man , money and materials)

3) Establishing goals and objectives
According to WHO , a goal is described in
term of
I. What is to be attained and to what extent

Example of goal :
 To provide health education to the families
of Dhankuta VDC on the need and
importance of safe disposal of human excreta
and to motivate families for construction of
pit latrines in their houses within one year of
time.

 Objectives leads to direction and are developed to
fulfill the goal of the programme
 The objective should meet the SMART characteristic
S -- Specific
M -- Measurable
A -- Achievable
R -- Reasonable
T – Time bound

.
 Based on above goals certain objectives can be
made:
 Increase awareness and knowledge of the
people on importance of safe disposal of
excreta;

 Increase knowledge regarding faecal-oral
transmission of disease and technique of
breaking transmission route.
 Increase knowledge regarding
construction of pit latrines including its
proper location
 Increase no of construction and use their
pit latrine properly.
 Promote environment health and hygiene

4) Deciding content to be taught
 The content of health education to be taught
will be based on the objectives set. In above
case , the content will be the need and
importance of safe disposal of human excreta ,
fecal-oral transmission of disease, teaching of
constructing a pit – latrine and proper use of
latrines.

5) Deciding target group
 To make the health education programme
activities economical , effective and fruitful ,
target group should be decided.
 Instead of dealing with the all people in the
community , it is better to deal with only the
more concerned and influential people.

 In r/t construction of family pit latrine the
target group may be selected to be
guardians or parents of the family.

5) Deciding for appropriate methods and medias
 The method and medias for providing health
education depend upon the nature of objective ,
content and target people.
 The important method that could be applied
could be interview , discussion , counselling ,
demonstration ,and role playing.

 The important media may be the wall chart ,
flip chart , flash card , models , posters ,
pamphlets and fannel graph etc
 Use of variety of method and media cause
better learning of knowledge and skill for
adopting expected behaviour

6) Identifying necessary and available resources
 A health educator needs different kinds of
resources that he could utilize in the process
of giving health education.
 The resources could be in terms of man ,
money and materials.

 Several resource may be available locally
and some may be brought from outside.
 These resources may be used to prepare
health education method and media.

7) Developing a detailed plan of action
 This is an important steps which provide
guideline for programme implementation .

 Specific objectives to be dealt with
 Content to be taught
 Target group to be dealt with
 Methods and media to be used
 Kind of manpower to be involved such as
ANM , AHW , HA , Health education assistant
etc

 Date and time of teaching with duration
 Location where health education is given
such as health post , home ,school etc

8) Determining time and technique for evaluation:
 Evaluation should be done at three different
stage of the programme , which have their own
specific area for evaluation .
 Evaluation of planning process is done
> in the beginning(planning phase)
> progress evaluation in the middle of the
programme
> achievement evaluation is done at the end of
the programme

Implementation of
health education
Programme

Implementation of health education Programme
Implementation is the process of putting the
plan of action into operation which need some
technique to be applied.
These special techniques are known as strategies
of implementation .
These strategies are described below:

Building commitment
 Before starting a health education programme
the local political leaders as well as the staff to
be involved should be committed.
 The community leaders should appreciate the
importance and need of the programme and
should be ready to cooperate.

 They should be well convinced that the
changes is designed to solve their health
problems.

Training of manpower
 The health education worker who are to be
involved in the health education programme
should be appropriately and adequately
trained .
 Training can be given in two different ways:
> Basic training – Pre service
> Refresher training –In service training

 Training is provided to health education
worker for up-to-date knowledge and
development of skills as well as to develop
attitude so that they can carry their job
responsibility successfully. The training may
range from one week to few months.

Mobilizing and utilizing resources:
 The health educator should mobilize available
community resources for the purpose of
providing health education.
 Resources is considered in term of man ,money
and material.
 The health educator should be aware of
utilizing appropriate and adequate workers .
He should orient them about their
responsibility.

 Through necessary meeting and discussion
the health education workers should be
encouraged to work sincerely.
 The workers can be motivated to work well
by giving proper reward like appreciation ,
prize , training opportunities , promotion etc

 Proper allocation of budget , receiving the
budget in time and proper utilization of
available budget plays vital role in
implementation of health education
programme

Organizing community
 Organizing community is the process of
bringing people together .
 Community mobilization is quite necessary to
make people understand the cause of their
health problem and encourage them for their
voluntary participation in removing the
problem.

 Health cannot be given to people , it must be
acquired by themselves through their full
participation .
 J.M de Miguel , the professor of Medical
sociology says” It is not so much a question of
what physician , sociologist or a technicians can
do to solve health problems, it is a question of
what people can do by themselves.

Supervision and monitoring
 Supervision is a process of enabling the worker
to learn better skills and perform their
responsibilities well .
 After supervision the worker should have
developed greater capacity and confidence in
performing their duties.

Objectives of supervision
 Improve knowledge , attitude and skills
 Perform responsibility successfully
 Improve overall working situation
 To identify difficulties and drawbacks

Ways of supervision
 Interview
 Observation of actual work performance
 Review of office records and reports
 Checking of worker’s personal diary

Recording and Reporting
 Recording is the system of documentation of
the information regarding the programme
activities including progress and problems .
The information are kept in register , form ,
reports , tapes , computer etc

 Recording is made regarding
• activities performed
• Supplies and equipment
• Report of monitoring and supervision
• Changes brought in the programme
activities
The record should be accurate , valid and
up- to –date.

EVALUATION
 “Evaluation is the process of determining
the amount of success in achieving the
predetermined objectives” American
Public Health Association

 The meaning of evaluation in Health
education can be generally described as
> the process of assessing the degree
of success of a particular health
education programme.
> identifying the limitation and problems
which need timely treatment for further
operation of programme.

Stages of evaluation
Diagnostic Evaluation:
 Evaluation done at the beginning of the
programme.
 It is the evaluation of planning phase.
 Here evaluation is done to know if proper steps
are followed in planning ,if objectives are set
appropriately t, if methods and resources are
properly determined , if plan of action is
appropriately developed.

Formative Evaluation
 Evaluation done in the middle of the
programme.
 It is the mid-term activities during the
implementation phase.
 It is also called as progress evaluation.
 It measure s the progress in changing the
knowledge , attitude and behaviour of target
group

E.G of formative evaluation , increasing
the no of latrine built and tube well
installed , increasing no of clinical
attendance of sick people, increasing in no
of family planning users etc.

Summative Evaluation:
 Evaluation done at the end of the
programme.
 It is the terminal evaluation done at end
of the whole programme.
 It determines the success or
achievement of the programme as a
whole.
 Also called as achievement evaluation.

 E.g. ,Change in morbidity and mortality
rate , decrease in no of diarrheal cases
etc

 Evaluation can be done through different
methods like interview , observation ,
study of office records and reports ,
meeting and discussion.

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