GANANA INSTITUTE OF MEDICAL SCIENCE AND
TECHNOLOGY
LECTURE NOTES
UNIT: HEALTH PROMOTION
LEARNING OBJECTIVES
MAIN OBJECTIVES
By the end of the module,the learners hould:
Utilize the methods and channels of health promotion in provision of health care.
Share targeted health messages to promote healthful living to patients/clients.
SPECIFIC OBJECTIVES
By the end of the module,the learner should be able to :
1) Define terms used in health promotion/Health education
2) Explain Concepts of health promotion
3) Outline Ottawa charter for health promotion
4) Explain Principles of health promotion, Aims
5) Explain Strategies and approaches of Health Promotion
6) Outline Steps of an organized community dialogue.
7) Describe Aims/objectives of health education
8) State Principles of health education
9) List Theories of learning/health education
10) Explain Steps in carrying out a health programme
11) Explain Methods of health education
12) Define Behaviour change and communication and (IEC).
MODE OF TEACHING: LECTURING, GROUP DISSCUTION, CLASS PRESENTATION
AND ASSIGNMENT, DEMONSTRATION
RESOURCES:
LECTURES NOTES, NEPCHS LIBRARY, NEPCHS SKILLS LAB, E-BOOKS AND
INTERNET
EVALUATION
CAT: 30% MARKS
END MODULE EXAM: 70% MARKS
PASS MARK: 50% MARKS
INTRODUCTION
Health promotion Definition
WHO,1946:‘Health is a state of complete physical, mental & social well-being and not merely
the absence of disease or infirmity’.
HEALTH PROMOTION: Is: The process of enabling people to increase control over their health
and determinants and thereby improve their health(WHO2006)
CONCEPTS OF HEALTH PROMOTION
There are three levels of health promotion:
Primary prevention: focuses of health promotion and protection against specific health
problems. There4, primary preventive measures are directed towards the ‘well’ individuals in the
Pre pathogenesis period to promote their health and to provide specific protection from
diseasese. Eg. Immunization against diseases such as Diphtheria, tetanus, pertussis (DPT) AND
Polio. The purpose of primary prevention is to reduce the risk of exposure of the individual or
community to disease.
Secondary prevention
Focuses on early identification of health problems and prompts intervention to alleviate health
problems.
Its goal is to identify individuals in an early stage of a disease process and to limit future
disability.
Secondary preventive measures are applied to diagnose or treat individuals in the period of
pathogenesis.
Tertiary prevention
Focuses on restoration and rehabilitation with the goals of returning the individual to an optimum
level of functioning.
Therefore, tertiary prevention addresses rehabilitation and the return of people with chronic
illness to a maximal ability to function.
BACKGROUND OF HEALTH PROMOTION
Health promotion received a big boost at the Alma Ata International Conference on Primary
Health Care (PHC) in 1978.
PHC was identified as an approach that would ensure health services are accessible, acceptable,
affordable and available to all people in the world
The Alma Ata declaration identified various key elements for PHC implementation, with health
education being ranked as the most important approach for effective health promotion and
disease prevention.
OTTAWA CHARTER FOR HEALTH PROMOTION
Following Alma Ata declaration, the first international conference on health promotion was held
in 1986 in Ottawa, Canada.
The Ottawa charter for health promotion adopted by 38 countries was primarily a response to
growing expectations for a new public health movement across the world
The charter called for the active role of the community which emphasizes that people cannot
achieve their fullest health potential unless they are able to take control of those things which
determine their health
PRINCIPLES OF HEALTH PROMOTION
Empowering– enabling individuals and communities to ensure more power over the
determinants of health
Participatory– involving all concerned at all stages of the process
Holistic–fostering physical mental and spiritual health
Inter-sectoral– involving the collaboration of agencies from relevant sectors
Equitable–guided by a concern for equity and social justice.
Sustainable- bringing about changes that individuals and communities can maintain once
funding has ended
Multi-strategy–use of a variety of approaches including policy development organizational
change community development, legislation.
STRATEGIES OF HEALTH PROMOTION
There are three main strategies used in the implementation of health promotion:
a)ENABLING
In health promotion, enabling means taking action in partnership with individuals or groups to
empower them, through the mobilization of human and material resources, to promote and
protect their health
Seeks to strengthen people’s knowledge and the skills required to prevent ill health, enhance and
protect healthy behavior. Achieved mainly through education, IEC and social mobilization
interventions among individuals and communities.
b)Creating environments that are supportive of health
In order to create and sustain environments that are supportive of health, health promotion
facilitates mediation in society.
Mediation-process through which the different interests of individuals and communities and
different sectors, both public and private, are reconciled in ways that promote and protect health
Achieved through legal, economic and environmental policies and legislation.
c).Advocacy to create the essential conditions for health
Advocacy for health implies a combination of individual and social actions designed to gain
political commitment, policy support, social acceptance and systems support for a particular
health programme.
Advocacy may be carried out through lobbying, social marketing, IEC and community
organizing.
5 APPROACHES TO HEALTH PROMOTION
1) Medical or preventive
2) Behaviour change
3) Educational
4) Empowerment
5) .Socialchange
6) MedicalorPreventive Approach
1. Medical or preventive approaches
AIM
I. To reduce morbidity and premature mortality.
II. To ensure freedom from disease and disability.
Activity:
I. Uses medical intervention to prevent ill-health or premature death.
II. Based on scientific methods Eg.-Immunization, screening, fluoridation.
2. Behaviour Change Approach
Behavioral risk factors are the leading causes of the occurrence of, and morbidity and mortality
due to, chronic health conditions and Injuries in the world
Behavior Change Approach aims to encourage individuals to adopt “healthy” behaviors that are
regarded as key to improving health.
Such approaches seek to educate the individual so that they change their lifestyle or a particular
behavior to help improve their health. This may be to stop partaking in risk behaviour or to start
enjoying some protective behaviors. Either way, the aim is to change the person’s lifestyle or
behaviour.
3. Educational Approach
Strongly linked to health education, information, and to Seeks to provide knowledge and develop
the necessary skills so that people can make informed decisions about their behavior.
Assumption
Increasing knowledge may change in attitudes that may result in changed behavior.
4. Empowerment or Client Centered Approach
Aim:
Helps people to identify their own needs and concerns, and gain the necessary skills and
confidence to act upon them.
So-called bottom up approach-idea is premised on Helping people or communities to identify
their own health concerns, gain the skills and make changes to their lives accordingly.
Professional acts as a facilitator rather than expert.
5. Social Change Approach
Targets groups and populations, top down method of working
Sometimes known as radical health promotion and is underlined by a belief that socio-economic
circumstances determine health status.
Its focus is at the policy or environmental level.
Aims is to bring about physical, social, economic, Legislative and environmental changes.
HEALTH EDUCATION
DEFINATION
Health Education is defined as: “Any combination of learning experiences designed to
facilitate voluntary action conducive to health”
Is educating people about their health
IMPORTANCE OF HEALTH EDUCATION
1) HE improves the health status of individuals, families, and communities in general.
2) HE enhances the quality of life for all people
3) HE reduces premature deaths
4) HE is concerned with helping people to help themselves.
5) A way of empowering people to understand their own problems, identifying its solution
and take appropriate action.
PRINCIPLES OF HEALTH EDUCATION
1) Principle of educational diagnosis
2) Principle of Participation
3) Principle of multiple methods
4) Principle of planning and organizing
5) Facts
6) Segmentation
7) Need based
8) Culture
THEORIES OF LEARNING
1) Classical Conditioning by Ivan Pavlov
2) Operant Conditioning by [Link]
3) Cognitive Learning by Jean Piaget
4) Social Learning by Albert Bandura
STEPS OF INITIATING A HEALTH EDUCATION PROGRAMME IN THE
COMMUNITY
1) Assessing individual and community health education needs
2) Meeting the health facility staff to lay the strategies
3) Interaction with community leaders
4) Plan for collection of baseline data i.e. baseline survey
5) Involve the SCHMT(Sub-County Health Management Team), as your supervisors to
assist you with technical knowledge and material support e.g. medical supplies, logistics
etc
6) Meeting with community members to decide the plan of action e.g. venue, dates & time.
7) Identify the available community resources.
8) Discuss the evaluation mechanisms.
9) Preparation of teaching / learning resources
10) Implementation of the programme
11) Evaluation of the programme i.e. to assess the effectiveness of the programme
12) Discuss with the community leaders any follow-up action required
HEALTH TALK
LESSONPLAN
Systemic planned summary of teaching/learning process which consist of the topic to be taught,
objectives, content and teaching/learning resources
SIMPLE LESSON PLAN
Components of a lesson plan
1) Date and time of the day
2) Topic or subtopic
3) Venue
4) Audience
5) Language used
6) Method of teaching
7) Objectives or aims of the teaching
8) Content (body)
9) Evaluation –assess behavior change based on the set objectives
10) summary-highlighting the main points
11) Teaching/learning resources
APPROACHES/STRATEGIES OF HEALTH EDUCATION
1. Individual teaching(one-to-one)
At the personal level, teaching must be practical, realistic and appropriate to the actual problem
that concerns the individual e.g. malnourished child.
2. Group teaching
This involves sharing health messages with a group of people with similar problems e.g. diabetic
patients, family planning clients etc.
3. Mass media
Use of radio, TV sets to reach many people eg message on an important disease like cholera,
HIV/AIDS etc.
Learning experiences/Teaching methods
1) Different ways of presenting the information to enhance learning include:
2) Lecture Method.
3) Discussion
4) Demonstration
5) Dramatization or role play
6) Field trip
7) Exhibitions
8) Group work
9) Assignments
10) Story telling,
11) Experiments
PROCEDURE OF GIVING HEALTH TALK
1) Greet your audience and introduce yourself
2) Ensure the environment is conducive for learning
3) Tell the group what your subject for discussion is and why it is important
4) Find out what they know about the subject by asking them questions related to the
topic.
5) Give your presentation in simple and clear language-Present your message in more
than one way i.e. use different methods of teaching and use of visual aids.
6) Include all members of the group in the discussion. Commenton their answers in a
positive way and avoid ridicule if wrong answer is given
7) Give time for asking questions
8) Evaluate by asking the audience questions or are turn demonstration
9) Give specific suggestions as to the expected behavior
10) Summarize the topic by highlighting the main ideas
11) Thank the audience for their co-operation
ADVOCACY, BEHAVIOUR CHANGE AND COMMUCATION(BCC)
AND INFORMATION, EDUCATION AND COMMUNICATION
Dfn: Health advocacy is speaking, acting, or writing with minimal conflict of interst to support
a health consumer or group’s wellbeing, and to promote, protect and defend their right to
accessible, safe, quality health care
BCC—Refers to the process of any intervention with individuals, communities and/or societies
to develop communication strategies to promote positive behaviors which are appropriate to their
settings.
INFORMATION, EDUCATION AND COMMUNICATION
Dfn: It is a public health approach aiming at changing/reinforcing health related behaviours in
target audience concerning a specific problem and within a predefined period of time through
communication methods and principles OR the process of working with individuals,
communities and societies to develop communication strategies.
THE END
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