Introduction PH

Principles of Health Education
and Promotion
for MPHStudents
By
Tsegaye Benti (MPH, Ass’t Professor)
27-Nov-20 Introduction to HEP 1

Introduction to
Health Education and
Promotion

Objectives
At the end of this session, students will be able to:
– Define health education and other major concepts
– State objectives of health education
– List the basic principles of health education

Introduction
What is
– Health ?
– Public health ?
– Health education?
– Health promotion?
– Health information?
– IEC ?
– BCC?
Introduction ….
Health
• There are multiple definitions of health
• “Health is a state of complete physical, mental and

social wellbeing and not merely an absence of
disease or infirmity” (WHO)

Introduction …
• Dimensions of health
Physical Mental Social
Dimensions
of health
Spiritual Emotional Vocational

Introduction …
Physical Health/Wellbeing
– Similar to the negative model definition, physical
health implies the absence of diseases or disability
on the body parts
– Perfect functioning of the body in which each organ

is working in harmony with the maximum capacity

Introduction …
Mental dimension health
– A state of balance between body and mind
– Has two major components: Cognitive and

Emotional/Affective

Introduction …
• Physical & mental health are interrelated as
physical illness can result in mental illness and
vice versa

Introduction …
Social dimension of health
• Harmony and integration with the individual,
between each individual and other members of
society, and between individuals and the world in
which they live
– E.g., to mourn when close family member dies, to
celebrate festivals; to create and maintain friendship
etc.
Introduction …
Emotional dimension of health
• The aspect of health that deals with the ability

to express emotions appropriately; cope with
conflict, stress, and change in a healthy way;
and enjoy life; sometimes referred to as the
psychological dimension of health

Introduction …
Spiritual health
• The aspect of health that deals with values -
beliefs about what is important
Vocational health
• The aspect of health that deals with preparing
for and engaging in work that provides personal
satisfaction and enrichment
Introduction …
Public Health: broadly can be defined as: the
science and art of promoting health, preventing
disease, and prolonging life through the
organized efforts of society
Education: is a process of disseminating

information for the production of desired
change in the behaviour of the people
Introduction …
• Health Education: "comprises of consciously
constructed opportunities for learning involving
some form of communication designed to improve
health literacy, including improving knowledge, and
developing life skills which are conducive to
individual and community health” (WHO)

Introduction …
• Health Education: “Any combination of learning
experiences designed to facilitate voluntary action
conducive to health” (Lawrence Green)

Introduction …
Elaboration of the definition
• Combination: It emphasizes on the importance

of matching multiple determinants of behaviors
with multiple learning experiences or
educational intervention
• Designed: A systematically planned and

organized activity
Introduction …
Elaboration ….
• Facilitate: Creating favorable condition such as
predispose, enable, reinforce
• Voluntary: Without use of coercion or any
manipulative approaches
• Action: Behavioral steps/measures taken by
individuals, groups or community to achieve the
desired health effect.
Introduction …
• Health information: The content of what is
communicated through various channels to be used for
informing various populations about health issues,
products and behaviors; all information related to
health
– MacDonald (1992) stated that HI is a series of messages
transmitted to the public by knowledgeable
professionals
– is just about behavior change and ignores the context
Introduction …
Health Information Health Education
• People are rational & • Baseline information or current
• K/ge alone leads to level of multiple determinants of
action b/r are necessarily required
• Blind to the reasons • Focus on the reason behind b/rs
behind b/r • Required at all stages in
• People blamed for behaviors change Continuum (it
unhealthy b/r is continues, even to prevent

defaulter after adoption)

Introduction …
Information, Education and Communication (IEC)
 IEC is an approach which attempts to change or
reinforce a set of behavior in a target audience
regarding a specific problem in a defined period of time
• It is a process of working with individuals, communities

and societies to develop communication strategies to
promote positive behaviors which are appropriate to
their settings
Introduction …
IEC …
• Information: A collection of useful briefs or
detailed ideas, processes, data and theories that
can be used for a certain period of time
• Education: A series of intervention to bring about
changes in cognitive, psychosocial and other skills
• Communication: A process of exchanging
messages, information etc. using different channels
Introduction …
Behavior Change Communication (BCC)
• An interactive process with communities (as
integrated with an overall program) to develop
tailored messages and approaches using a variety
of communication channels to develop positive
behaviors; promote and sustain individual,
community and societal behavior change; and
maintain appropriate behaviors
Difference between IEC and SBCC
• Experience has shown that providing people with
information and telling them how they should behave
(“teaching” them) is not enough to bring about
behavior change
• While providing information to help people to make a
personal decision is a necessary part of behavior
change, SBCC recognizes that behavior is not only a
matter of having information and making a personal
choice
…IEC & SBCC…
• Behavior change also requires a supportive

environment
• Community and society provide the

supportive environment necessary for
behavior change

Introduction …
Health Promotion
• is a process of enabling people to increase control over
and to improve, their health (by the Ottawa Charter for
Health Promotion,1986)
• is any combination of educational, political, regulatory
and organizational supports for actions and conditions
of living conducive to health of individuals, groups or
communities (Green & Kreuter, 1981)

Introduction …
Health promotion (HP) Vs HE
• Until 1980, HP simply referred to HE
• HP is a term of more recent origin than HE
• Green and Kreuter, 1991 described the two concepts as
follows:
– Health education is aimed at informing people to
influence their future individual or collective decision-
making

Introduction …
• HE Vs HP….
– Health promotion aims at complementary social
and political actions such as advocacy and
community development that facilitate political
changes in people’s social, workplace and
community environment to enhance health

Introduction …
HE Vs HP….
• HE is any combination of learning

experiences designed to facilitate voluntary
actions conducive to health
• HP goes beyond education to seek changes in

total environment

Introduction …
HE Vs HP….
• HP is not just confined to health professionals
and health care services but everyone in
different sectors of society
• HE is part of, but not the sum of HP
• One writer has distilled the relationship
between HE and HP into the formula:
HP = HE × Healthy public policy

Introduction …
HE Vs HP….
• In this course, health education is considered as

an integral part of health promotion;
• Meaning health promotion is wider than health

education in its approaches and scopes as
mentioned above

Introduction …

Introduction …
Goals and objectives of health education
• The ultimate goal is to improve the quality of life
• To help each individual and family exercise the right to

achieve a harmonious development of physical, mental
and social potential
• To promote health, prevent illness, self-adjust to live

with disabilities and decrease morbidity and mortality

Introduction …
Educational objectives of HE
– To provide appropriate knowledge
– To help develop positive attitude
– To help practice health practice/behavior

Introduction …
Principles of health education
• The practice of health education is based on the

assumption “that beneficial health behavior will
result from a combination of planned,
consistent, integrated learning opportunities
and scientific evaluation of programs in
different settings”
Principles of HE…
1) Principle of educational diagnosis
The first task in changing behaviors is to

determine its causes
– If the causes of the behaviors understood health
educator can intervene with the most appropriate
and efficient combination of education,
reinforcement and motivation

Principles of HE…
2) Principle of participation
The prospect for success in any attempt to

change behaviors will be greater if the
individuals, families, community groups, etc.
have been participated in identifying their own
needs for change and have selected the
methods that will enable them to take action
Principles of HE…
3) Principle of multiple methods
This principle follows from the principle of

educational diagnosis
In so far as multiple causes will invariably be

found for any given behaviors

Principles of HE…
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, what and why of health education

Principles of HE…
4) Principles of planning….
It also requires the planning for resources,
methods and materials to be used,
identification of target groups etc.
It is very difficult and often unsuccessful when

carrying out health education program that are
not planned and organized appropriately
Principles of HE…
5) Facts
Health education is given based on scientific

findings/facts and current knowledge
– It is unthinkable to provide health education without
scientific and knowledge related to the topic or
issues to be addressed

Principles of HE…
6) Segmentation
 Health education should be designed for a specific
group of people/ specific target groups
7) Need based
 Health education is primarily educational, and its
purpose is to ensure a desired health related
behavior after real need identification
– if there is no felt need the education will be wasted
Principles of HE…
8) Culture
Health education should not consider as

artificial situation or formal teaching-learning
process
One should get into the culture of the

community and introduce novel ideas with a
natural ease and caution
Principles of HE…
8) Culture …
Health education should respect cultural norms
and take account of the economic and
environmental constraints faced by people
– HE starts from where people are and slowly build up
the talking point to avoid any clash of ideas to allow
for people understanding, appreciation and
internalization of fresh ideas
Principles of health promotion
• Empowering
– Health promotion initiatives should enable
individuals and communities to assume more power
over the personal, socioeconomic and
environmental factors that affect their health
• Participatory
– Health promotion initiatives should involve those
concerned in all stages of planning, implementation
and evaluation
Principles of health promotion…
• Intersectoral
– Health promotion initiatives should involve the
collaboration of agencies from relevant sectors
• Sustainable
– Health promotion initiatives should bring about
changes that individuals and communities can
maintain once initial funding has ended

Principles of health promotion…
• Holistic
– Health promotion initiatives should foster physical,
mental, social and spiritual health
• Multi-strategies
– Health promotion initiatives should use a variety of
approaches, including policy development,
organizational change, community development,
legislation, advocacy, education and communication,
in combination with one another
27/11/2020 46
Five principles of Health Promotion: Ottawa
Charter
Building Healthy Creating Supportive

Public Policy Environments
Health
Promotion
Action
Developing Strengthening
Personal Skills Community
Action
Reorienting Health
Services

Introduction…
• There are 5 different approaches to health
education
Medical
Behaviour change
Educational
Empowerment
Social change

Approaches to HE…
• Medical
– Relies on a medical view of health and professional
interventions based on medical science e.g.,
immunisation
– Includes primary, secondary and tertiary prevention

Approaches to HE…
• Behaviour change
– The aim is to encourage individuals to adopt healthy
behaviours
– There are many different models of how to achieve
behavioural change, including factors such as media coverage,
the example of role models, information, and supportive
environments
– This is a popular approach because it is focussed on
individuals and retains a role for the professional who gives
information and advice
Approaches to HE…
• Education
– The aim is to provide information to enable people
to make informed choices for their health
• Learning involves 3 aspects:

Cognitive (information and understanding)
Affective (attitudes and feelings)
Behavioural (skills)
Approaches to HE…
• Empowerment
– Enables people to gain control over their lives
– Seen as ethically sound because it supports

autonomy and free choice
– Can be individual or community focussed

Approaches to HE…
• Social change
– The focus is to change the socio-economic
environment to enable people to make healthier
choices and adopt healthier behaviours – to make
the healthy choice the easier choice
– This is a top-down approach including policy

change, media advocacy and legislation

Challenges to the process of HE
 People are not concerned
 Changing behavior is conditioned by many factors
 People are preoccupied by many daily activities
 Lack of prestige/status
 Lack of special training
 The need for change of attitudes and actions not

simple transfer of information

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Principles of Health Education

27-Nov-20 Introduction to HEP 1

27-Nov-20 Introduction to HEP 2

– State objectives of health education

– List the basic principles of health education

27-Nov-20 Introduction to HEP 3

• “Health is a state of complete physical, mental and

27-Nov-20 Introduction to HEP 5

Physical Mental Social

Spiritual Emotional Vocational

27-Nov-20 Introduction to HEP 6

– Perfect functioning of the body in which each organ

27-Nov-20 Introduction to HEP 7

– A state of balance between body and mind

– Has two major components: Cognitive and

27-Nov-20 Introduction to HEP 8

27-Nov-20 Introduction to HEP 9

• The aspect of health that deals with the ability

27-Nov-20 Introduction to HEP 11

Education: is a process of disseminating

27-Nov-20 Introduction to HEP 14

27-Nov-20 Introduction to HEP 15

• Combination: It emphasizes on the importance

• Designed: A systematically planned and

• K/ge alone leads to level of multiple determinants of

action b/r are necessarily required

• Blind to the reasons • Focus on the reason behind b/rs

behind b/r • Required at all stages in

• People blamed for behaviors change Continuum (it

unhealthy b/r is continues, even to prevent

27-Nov-20 Introduction to HEP 19

• It is a process of working with individuals, communities

• Behavior change also requires a supportive

• Community and society provide the

27-Nov-20 Introduction to HEP 24

27-Nov-20 Introduction to HEP 25

27-Nov-20 Introduction to HEP 26

27-Nov-20 Introduction to HEP 27

• HE is any combination of learning

• HP goes beyond education to seek changes in

27-Nov-20 Introduction to HEP 28

HP = HE × Healthy public policy

• In this course, health education is considered as

• Meaning health promotion is wider than health

27-Nov-20 Introduction to HEP 30

27-Nov-20 Introduction to HEP 31

• To help each individual and family exercise the right to

• To promote health, prevent illness, self-adjust to live

27-Nov-20 Introduction to HEP 32

– To help develop positive attitude

– To help practice health practice/behavior

27-Nov-20 Introduction to HEP 33

• The practice of health education is based on the

The first task in changing behaviors is to

27-Nov-20 Introduction to HEP 35

The prospect for success in any attempt to

This principle follows from the principle of

In so far as multiple causes will invariably be

27-Nov-20 Introduction to HEP 37

Planning and organizing are fundamentals for

It involves deciding in advance the when, who,

27-Nov-20 Introduction to HEP 38