Introduction to Health Education and

Promotion
By:- FITSUM NIGATU(BSc, MPH)
Address:-fitsumnigatu3@gmail.com

1
 Learning Objectives

At the end of this class; you will be able to:

1. Define health and related concepts
2. Define Health Education (HE),Health Information (HI)
and Health Promotion (HP)
3. Describe principles of HE

2
What is Health ???

3
What is Health …

Health is a very abstract concept to

 conceptualize
 measure
 it is too difficult to put in words

It differs among social classes, Cultures, religion

and ethnic groups

4
What is Health…

Generally, there are two opposing models

concerning the
definition of health:
1. Negative (narrow) model
2. Positive (broad) model

5
What is Health …

I. Negative model
This model views health as:
 Absence of diseases or disability or infirmity
 Biological integrity of the individual
 Physical and physiological capabilities to perform routine tasks

 According to this definition individual is healthy if all the body parts;

cells, tissues,
organs, organ systems are functioning well 6
What is Health…

 The human body is often thought of in the same terms as a car or

other mechanical devices when something wrong you take it into
experts who put it right

 Despite its narrowness, it is a widely held view among lay people

by equating health with the absence of diseases
Disease “A” + Medical treatment= health

7
 What is Health…

2 The positive model

 It is broader and more holistic concept.

 Probably the most widely known of such models is that of the

constitution of World Health Organization (1948), which defines

health, as:

 “A state of complete physical, mental, and social well-being

not merely the absence of disease or infirmity.”

World Health Organization (1948)8

What is Health…

Physical health
 It is the absence of diseases or disability on the body parts
(negative definition)

 It is the ability to perform routine tasks without any physical

restriction

Mental health
 Termed as psychological health and it is subjective sense of
well being
9
 What is Health…

Social health
 Is the ability to make and maintain “acceptable” and
“proper” interaction and communication with other people and
the social environment;
 satisfying interpersonal relationship and role fulfillment.

For example, to mourn when close family member dies, to

celebrate festivals, to create and maintain friendship etc
10
What is Health…

 Hanlon (1974) defined health as “a functional state which

makes possible the achievement of other goals and activities.”
 The WHO (1986, Ottawa charter) has restated that “health is a
resource for every day life, not the objective of living.”
In other words, good health should not be the goal of life, but rather
a vehicle to reach one’s goal in life

11
 What is Health…

Despite it is said a broader paradigm as to what health; different scholars

criticize this (WHO) definition.

 It is an over attractive, overambitious, ideal and unattainable definition.

 Health is a process rather than a state

 State indicates static however, health is dynamic, it flows, and it is a

process

N.B It is the process of adaptation to a social environment including man

made and natural factors
12
What is Health…

 Generally, the different aspects of health are interrelated

and interdependent

 Physical problems could lead to mental consequences and

vice versa

13
What is Health Education ?

14
Health Education

 Different scholars defined HE in different ways but fundamentally it is the

same

 Griffiths (1972),
 “HE attempts to close the gap between what is known about
optimum health practice and that which is actually practiced.”
 Simonds (1976)

 “ HE as aimed at bringing about behavioral changes in individuals,

groups, and larger populations from behaviors that are presumed to
be detrimental to health, to behaviors that are conducive to present
and future health.”
15
Health Education…

However; the widely accepted definition emphasized voluntary, informed

behavior changes.
“Any combination of learning experiences designed to facilitate voluntary
action conducive to health”
 Green et al(1980)

 Combination: matching multiple determinants of behaviors with multiple

learning experiences or educational intervention

 Designed: HE is not incidental learning experiences. It is systematically

planned and organized activity.

 Facilitate: creating favorable condition such as predispose, enable, reinforce

16
Health Education…

 Voluntary: with full understanding and acceptance of the purpose of

the action. Without use of coercion or any manipulative approaches

N.B In health education we do not force the people to do what we want

them to do, instead our effort is to help people to make decisions and
choices by themselves

 Action: behavioral steps/measures taken by individuals, groups or

community to achieve the desired health effect

17
 Health Education…

 To reach a state of complete physical, mental and social well being it is

beyond the activity of health education. (This so b/c behavior is not just
a personal choice)
 Thus, with rising criticism that H.E. was too narrow (focused on individual’s

lifestyle) and could become “victim blaming”

 More work was done about wider issues eg. social policy, environmental

measure

Emergence of Health promotion

18
 Health information
Health Information

 It is health message disseminated to the target audience focusing on the basic

facts related to the health issue under consideration, which primarily aimed

at increasing of knowledge on that particular health problems

Characteristics of HI

 base line information or data is not necessarily required.

 The assumption is unhealthy behaviors is due to Knowledge gap and
knowledge alone leads to action
 Appropriate for newly emerging health problems and during epidemics, may
not bring behavioral change
19
Comparison of HE and HI

20
 Health promotion

 HP: “A combination of educational and environmental supports for

actions and condition of living conducive to health.”
 Green and Kruetr (1991)
 Combination: Matching multiple determinants of health with multiple
intervention or sources of supports.
 Educational: the communication part of HP; that is HE.

 Environmental: refers to the social, political, and economic, organizational,

policy and regulatory circumstances influence behavior or more directly
health
21
 Create environments that support good health practices, behaviors
 Relationship between HP and HE

 Health education is one of the most important component of health

promotion
 He provides consciousness-raising, concern-arousing, motivation for
public involvement and commitment to social reform essential to its
success.
 Health education is primarily focused at voluntary action people can
undertake on
their own to improve their own health, their families’ health and the
community as 22
 Relationship between HP and HE

 With out the policy support for social change, Health education is
often powerless to help people to reach their health goals, even
with successful
individual change efforts
N.B Health promotion is a structural (laws, regulation,
organizational...) support for health education to develop its full
potential

 Health promotion aimed at social and political action that will 23

Example: HIV/AIDS prevention intervention

24
Rationale for health education (HE)

Why Do you think health education is important ?

25
Rationale for HE…

 The continued existence and spread of communicable diseases

 About 75% of childhood illnesses are preventable

• e.g. measles by immunization, malnutrition and diarrhea by teaching

mothers about proper food handling and promoting breast feeding up until
age of two.

 For some diseases health education is the only practical choice in order
to prevent the spread of the disease or to lead a normal life e.g. HIV AIDS
 The tendency of increasing magnitude of chronic conditions and other
emerging agendas
26
Rationale for HE…

 Human behaviors are almost the single causes for the

development of such currently emerging health problems and
also the main solution
• prevention of emerging health problems life style
modification and behavioral changes Health
Education(profession)

 Many people are ignorant of the causes of their illnesses and may
be afraid of seeking treatment and hide their illness not to be
considered, as an “outcast” from society

• health education is a frontline to promote the use of

preventive and curative health services 27
Rationale for HE…

 Prevention is better than cure, is a statement which is generally

true especially for non communicable diseases

 Increasing threats to the young from new and harmful behaviors.

E.g. tobacco use, teenage pregnancy, substance use, etc.

28
Ultimate goals and educational objectives of HE
 The ultimate goal of all service professionals including health
educators is to improve the quality of life.
 The highest goal in life is to die young, at as old an age is

possible
 In simple words the ultimate goals of health education are:

 To help each individual and family exercise the right to achieve a

harmonious development of the physical, mental and social
potential.

 To promote health, prevent illness, self-adjust to live with

disabilities and decrease morbidity and mortality. 29
Educational objectives of health education

Educational objectives of health education are;

 To provide appropriate Knowledge

 To help develop positive Attitude
 To help exercise health Practice/behavior
 To equip people with necessary skill

30
 Dimensions of health Education
 Health education is life long process. It is not one time affair

 Health Education is concerned with people at all points of health and

illness continuum
 Health education is not an end by itself. Rather a way of empowering people
to understand their own problems, identifying its solution and take appropriate
action
 Health education is not limited to patients in clinical setups. It includes
those who are apparently healthy and who want to minimize the risk of having a
problem

31
Principles of health education

1 Principle of educational diagnosis

 The first task in changing behaviors is to determine its causes.
 There must be a behavior be assessed before it can be properly
changed.
 If the causes of the behaviors understood; then it can be easily
intervened with the most appropriate and efficient combination of
education, reinforcement and motivation

32
Principles…
2. Principle of Participation
 The prospect for success in any attempt to change behaviors will be greater if
the individuals, families, community, etc.…have been participated in identifying
their own needs and have selected the methods that will enable them to take
action
3 Principle of multiple methods
 This principle follows from the principle of educational diagnosis. In so far as
multiple causes will consistently be found for any given behaviors.
 For each of the multiple predisposing, enabling, and reinforcing factor identified
a different methods or components of comprehensive behavioral change must
be provided
33
Principles…

4 Principle of planning and organizing

 Planning and organizing are fundamentals for health

education which distinguishes it from other incidental learning
experiences.

 It involves deciding in advance the when, who, what, how and

why of health education.

 It also requires the planning for resources, methods and

materials to be used, identification of target groups etc.

34
 Principles…

5. Facts
 Health education is given based on scientific findings/facts and current
knowledge.
 E.g. which type of HIV is found in our country? What type is so common here?
What's the difference between them? [so funny questions that professionals
may not be aware of it]

6. Segmentation
 Health education should be designed for a specific group of people/specific
target groups
 Segmentation? 35
Principles…

7 Need based
 Health education is primarily educational and its purpose is to
ensure a desired
health related behavior after real need identification.
• Felt need
• Expressed need
• Agency determined needs

36
 Principles…

8. Culture

 HE should not considered artificial situation or formal teaching-learning process.

 One has to get into the culture of the community to introduce new ideas easily

 Rigid statements particularly contrary to existing belief, culture, practices will

not be liked.
 Therefore HE starts from where people are and slowly build up the talking point
to avoid any clash of ideas through the communication process
Do you think this principles are bieng followed during HE given for the covid-19
epidemic in your local area ???

37
 Health education in the levels of disease prevention

Health education is practiced at all levels of disease prevention

1.Primary health education
 Is encompass of those health education activities that aimed specifically at prevent
the onset of illness or injury before the disease process begins
Examples
Wearing safety belt
Immunization ,Physical exercise
Brushing one’s teeth , Breast feeding
38
Health education in the levels…

2 Secondary health education

 Once the disease occurred health education is important to slow
down the disease progression to prevent the onset of disability.
Example
 Providing HE on adherence
 educating ill person to seek treatment

39
Health education in the levels…

Tertiary health education

 Health education programs that specifically aimed at patients
with irreversible, incurable, and chronic condition for social and
psychological adjustment

 it meant to avoid major disability, premature death.

Example
• educating after lung cancer surgery
• Working with the diabetes patients to ensure the daily Injections are
taking

40
 Targets and settings of health education
Targets
 Individuals:- this includes clients who come to use services (FP
or VCT users) and healthy individuals
E.g. diabetic or hypertensive patients
 Groups: includes gatherings of two or more people
E.g. ANC attendants about dangers signs of pregnancy
 Community:- E.g. health education on protection of spring water
to a village community

settings
 Communities schools
 Health care institutions Prisons
 Work sites refugee camps
41
Who is a health educator?

 Health education is the duty of everyone engaged in health and community

development activities
• All health professionals
• Community health workers
• Other trained members, leaders, teachers

42
thank you

43