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HEALTH EDUCATION
Definition
The definition adopted by National Conference on Preventive
Medicine in U.S.A is as follows. "Health education is a process that
informs, motivates and helps people to adopt and maintain healthy
practices and life styles, advocates environmental changes as
needed to facilitate the goal and conducts professional training and
research to the same end''2
Changing concepts
Following the Alma-Ata declaration in 1978 emphasis has shifted
from.
Prevention of disease to promotion of healthy life styles. Modification of individual behaviour to modification of social
environment in which the individual lives.
Community participation to community involvement.
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OBJECTIVES
1.Informing the peopleThe first directive of health education is to inform the people
or disseminate scientific knowledge about prevention of
disease and promotion of health. Exposure to knowledge will
melt away the barriers of ignorance. Prejudices, and
misconceptions, people may have about health and disease.2
This creates an awareness of health needs and problems and
also of responsibilities on the part of the people.
2.Motivating peopleTelling the people about health is not enough. They must he
motivated to change their habits and the ways of liv big. since
many present day problems of community health require
alteration of human behaviour or changes in health practices
which are detrimental to health, like poll ta ion or water,
cigarette sinokink4 physical activity etc. The accent should be
on motivating the "consumer- to make his own decision and
choices about health matters, that is what kind or health
actions to be taken, and when and under what conditions totake them.
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3.Guiding into actionPeople need help to adopt and maintain healthy practices and
life styles, which may be totally new to them. Governments
have a major responsibility to provide the necessary infra
structure of health services. People need to be encouraged "to
use judiciously and wisely the health services available to
them"2 Governments are now beginning to realise that the
services and facilities they provide to improve the socio-
economic and health status of the people will not be fully
effective unless the people not only make use of the services
but also undertake various practical self help measures to
improve their own health status and the communities in which
they live in.
Contents
The following contents health education.
1.Human biology.2.Nutrition.3.Hygiene. (personal and environmental hygiene)4.Family health care.5.Control of communicable and non-communicable diseases.6.Mental health.7.Prevention of accidents.
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PRINCIPLES
1.Interest:It is a psychological principle that people are unlikely to listen
to those things, which are not of their interest. Health teaching
should relate to the interest of the people. 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.
2.Participation:It is a key word in health education. Participation is based on
psychological principle of active learning: it is better than
passive learning. Group discussion, panel discussion, workshop
all provide opportunities for active learning.
3.Known to unknown:In health education work, we proceed from the known to
unknown. i.e. start where the people are and with what they
understand and then proceed to new knowledge. New
knowledge will bring about a new, enlarged understanding,
which can give rise to an insight into the problem.4.Comprehension:
In health education we must know the level of understanding.
education and literacy of people to whom the teachings are
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directed. One barrier to communication is using words, which
cannot be understood .We should always communicate in the
language people understand, and never use words, which are
strange and new to them. Teaching should be within the
menial capacity of the audience.
5.ReinforcementFew people can learn all that is new in a single period.
Repetition at intervals is extremely useful. Every health
campaign needs reinforcement, we may call it a "booster (lose.
6.Motivation:In every person there is desire to learn. Awakening this desire
is called motivation. There are two types of motives-primary
and secondary motives. Primary motives are driving forces
initiating people into actions, these motives are inborn desires.
Secondary motives are based on desires created by outside
forces or incentives.
7.Learning by doing:Learning is an action-process; not a memorizing one in a
narrow sense. The Chinese proverb: "if I hear. l forget: if I see. I
remember: if I do: I know." illustrates the importance of
learning by doing.
8.Soil, Seed and Sower:
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The people are the soil, the health facts are the seeds and the
transmitting media the sower. The seeds or health facts BUN
be truthful and based on scientific knowledge. The trans-
mitting media should be attractive, palatable and acceptable.
9.Good human relations: Good human relations are of utmostimportance in learning. The health educator must be kind and
sympathetic.
10.Leaders:We learn best from people whom we respect and regard. In the
work a health education, we try to penetrate the community
through the local leaders the village headman, the
schoolteacher or the political worker. If the leaders are
convinced first about the programme the task of implementing
the programme will be easy.
Communication in Health Education
Education is primarily a matter of communication. The purpose of
education is to transmit information from one person or group of
persons to other persons or groups; with a view to bring about
behavioural changes. The key, element in communication press are
the COMMUNICATOR (he is the originator of the message and must
know the interests and the needs of the audience). MESSAGE (it is
the information a communicator wishes his audience to receive,
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understand. accept. and act upon.), AUDIUNCE (they are the
consumers or the message and maybe the total population or
specific group). CHANNELS OF COMMUNI-CATION (it is the medium
of communication and an attempt should be made to provide variety
in selecting the channels so as to keep the teaching process
interesting and entertaining.)3
Barriers of Communication
These can be
I. Physiological-difficulties in hearing expression.II. Psychological-emotional disturbances and neurosis.
III. Environmental-noise. Invisibility. conges-tion.IV. Cultural-levels of knowledge and under-standing, CUSIOMS,
beliefs, attitudes.
The barriers should be identified and removed for achieving
effective communication.
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PRACTICE OF HEALTH EDUCATION
The practice of health education involves a number or health
education materials.3 They are;
1.Audiovisual aidsThese help to simplify unfamiliar concepts and bring about
understanding where words fail. They can be classified into
A.Auditory aids: Radio, tape recorder. microphones.Amplifiers, and earphones.
B.Visual aids:1.Not requiring projection: Chalk board, leaflets, posters,
charts, flannel graphs, exhibits, models, specimens. etc.
2.Requiring projection: Slides, filmstrips.3.Combined audio visual aids: Television, sound films,
slides tape combination.
2.Methods in health communicationThe methods in health communication may be grouped as:
a.Individual approachHealth education may be given in personal interviews in the
consultation room or in the health centre or in the homes of
the people. Public health nurses. health visitors and health
inspectors have plenty of opportunities for individual health
teaching.
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Advantages:
Can discuss, argue and persuade the individual to change his
behaviour.
Provides opportunities to ask questions in terms of specific
interests.
Disadvantages:
Numbers vie reach are small
b.Group approachGroup teaching is an effective way of educating the
community. The subject must relate directly to the interest
of the people. A brief account of the methods of group
teaching is given below.
1.Chalk and talk (Lecture): A lecture may be defined ascarefully prepared oral presentation of facts, organized
thoughts and ideas by a qualified person. The group
should not be more than 30 and the talk should not
exceed 15 to 20 minutes. The lecture method can be made
more effective by combining with suitable audiovisual
aids such as clipcharts, flannel graphs, exhibits, films,
charts. etc.
Disadvantage:
Learning is passive and it does not stimulate thinking and
problem solving capacity.
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2.Demonstrations: A demonstration is a carefullyprepared presentation to show how to perform a skill or
procedure. It is carried out step by step before an
audience or target group. The demonstrator involves the
audience in discussion.
3.Group discussion: Group discussion permits theindividual to learn by freely exchanging their knowledge,
ideas and opinions. Where long-term compliance is
involved (eg. Cessation of smoking) group discussion is
considered valuable. For effective group discussion, the
group should comprise not less than 6 and not more than
12 members. The participants should be visible to each
other. There should be a group leader who initiates the
subject, helps the discussion in die proper manner,
prevents side conversations, encourages everyone to
participate and sums up the discussion in the end. If the
discussion goes well, the group may arrive at decisions.
which no individual member would have been able to
make alone. In a group discussion, the members should
observe the following rules:
4.(a) express ideas clearly and concisely (b) listen to whatothers say (c) do not interrupt when others are speaking
(d) make only relevant remarks e) accept criticism
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gracefully and n help to reach conclusions. The decision
taken by the group tends to be adopted more readily than
in situations where the decision is a solitary one.
Limitations: Those who are shy may not take part in the
discussions. Sonic may dominate the discussion. Sonic
members may deviate from the subject and make the
discussion irrelevant or unprofitable.
5. Panel discussion: In a panel discussion persons who arequalified to talk about the topic sit and discuss a given
problem, or the topic. in front of a large group or
audience. The panel comprisesof a chairman and about 4
to 8 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 point:, of view. The chairman
has to keep the discussion going and develop the train of
thought. After the main aspects of the subject are
explored by the panel speakers. the audience is invited to
lake part. Panel discussion can be an extremely effective
method of education, provided it is properly planned and
guidet
6.Symposium: A symposium is a series of speeches on aselected subject. Each person or expert presents an
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aspect of the subject briefly.. There is no discussion
among the symposium members in the panel discussion.
In the end the audience may raise questions. A chairman
makes a comprehensive summary at the end or the entire
section.
7.Workshop: It consist of series of meetings usually 4 ormore with emphasis on individual work, within the
group. with help of consultants and resource personnel.
The total workshop may be divided into small groups and
each group will choose a chairman and a recorder. The
individuals work, solve c a part of the problem through
their personnel effort with the help of consultants,
contribute to group work and group discussion and leave
the workshop with the plan of action on the problem. The
workshop provides each participant opportunity to
improve his effectiveness as a professional worker.
8.Role playing: Role-playing or socio-drama is based onthe assumption that many values in a situation cannot be
expressed in words and the communication can be more
effective if the situation is dramatized by the group. 'f he
audience are not passive but actively concerned with
drama. It is particularly a useful educational device for
school children.
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9.Conferences and Seminars: This category contains alarge component of commercialized continu1n2
education. The programmes are usually held on a
regional, state or national level.
Mass approach - Education of the general public
No health worker can mount an effective health education
programme for the whole community, except through mass media of
communication.
Mass media are "one way- communication. They are useful in
transmitting messages to people even in remote places.'lhe number
of people reached usually count in millions. Their effectiveness can
give high returns for the time and money involved. The mass medias
includes.
1.Television.2.Radio.3.Health magazine.4.News papers.5.Printed materials.6.Direct mailing.7.Posters. bill boards and signs.8.Health museums and exhibitions.
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9.Films.The Site of Oral Health Education
1.In the Office or ClinicThe process of education for oral health applies in the one-to-
one selling with a patient. First, of course, is the advantage of
working with one person at a time. Second, the dental
professional often sees these same persons periodically over
longer periods of time, perhaps for many years permiiting thedevelopment of high levels of trust and allowing reinforcement
and gradually refinement of desirable skills, knowledge and
attitudes is not necessary to teach everything at once, a
reasonable long- range educational plan can he developed and
implemented for each patient.
2.In the SchoolAn atmosphere in which the pursuit of knowledge prevails
would seem the ideal location to bring about extensive changes
in oral health behaviours, attitudes and knowledge. Recent
teaching has focused on developing the knowledge and skills
needed to brush and floss the teeth. Attention also has been
directed to establishing desired habits by including supervised
plaque removal in the class. Should a classroom session be
planned, several factors must be remembered. First, the visit
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should be cleared with all persons who have responsibility for
monitoring instructions by non-school personnel. Prior to (he
visit the process of planning, including a careful identification
of needs for instruction should be conducted and appropriate
objectives established-preferably jointly with the teacher and
the student,. Finally after instruction has been given, it should
be evaluated against the objective)
3.In the CommunityEducation for oral health in the community often seems limited
to activities such as puppet shows, smile contests or public
service announcements on television, radio, or newspaper. The
dental health professional should pursue the planning process
particularly when the objective is to improve oral health
status.' The content should emphasis the known effective
preventive measures, eg., fluorides and sealants, and
educational methods should encompass activities such as
community organization and community development.
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PLANNING A DENTAL HEALTH EDUCATION
PROGRAMME
1.Collect background informationThe first stage is to collect relevant information on the
problem. It is necessary in establish the correct scientific facts
which are to be communicated.
2.Define the target populationThe target population will ensure efficient utilization of
resources by preventing the inclusion of irrelevant group.
3.Assessment of baseline knowledgeToo often health educators tell people what they already know
and fail to give information that the target group wants.
4.Anchorage attitudesThese are basic to a person's way of life and are a form of
personal identity. People strongly resist the attempt to change
them Health educators should try to utilize These believes and
opinions in a positive way.
5.Level of literacyBefore using visual or written presentation it is essential to
assess population levels of literacy so that the appropriate
educational techniques are utilized.
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6.Define objectivesIt is necessary to precise objectives stated in terms of the
knowledge or behaviour that are expected from the target
group. .
7.Assess resourcesIt is important to ensure. that the necessary facilities and
personnel are available to carry out the programme. It is
necessary to consider the possible effects of programme on
other professional groups. .
8.Pilot studyIdeas are put into practice on a small scale so that problems
can be discovered and necessary modifications made before
the main programme is initiated. .
9.Timing of a programmeIt is important to gie careful consideration in the tuning of a
health education. This will reduce the possibility of the target
population not being available and receptive. .
10.EvaluationThis should occur during the amdtici of the programme and at
the end.
a. Midterm evaluation; It is important to monitor theprogramme as if is being conducted 10 ensure that it is
proceeding as designed and planned.
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b.End term evaluation. The evaluation of the health educationprogramme can be done at the end of the programme.
provided the objectives of the programme are clearly
defined. It is possible to measure the change in knowledge
and attitudes by well-designed questionnaire.
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