PRINCIPLES AND FOUNDATIONS

OF HEALTH PROMOTION AND

EDUCATION
Study guide
What is Health?

o Health is a multidimensional concept that most people

intuitively understand.
o Health has evolved over the centuries from the concept of
o individual concern to a worldwide social goal.
o Many definitions of health have been offered since then.
o An understanding of health is the basis of health education and promotion.

Definition:

o The World Health Organization (WHO) has defined

health as: “The state of complete mental, physical and social well
being not merely the absence of disease or infirmity”
(WHO, 1947)

Limitations (weakness) of The WHO Definition of Health:

1. Health is dynamic, not a state.

2. Diminutions are inadequate (lacking spiritual health,
community orientation, environmental aspect…)
3. Measurement is difficult.
4. The definition is subjective

Facts on Health

o Health can exist in varying degrees ranging from good to poor and
everywhere between.
o Health depends on each person’s individual circumstances “for
example a person who is quadriplegic can be healthy in the sense
that his mental and social well-being is high and physical health is
as good as it can be”
o Health is not perceived the same way by all members of the
community including various professional groups.

Changing Concepts of Health

o Health is evolved over the centuries as a concept from individual concern to

worldwide social goal and encompasses the whole quality of life. Changing the
concept of health till now are:
1. Biomedical concept
2. Ecological concept
3. Psychosocial concept
4. Holistic concept

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 PRINCIPLES AND FOUNDATIONS
OF HEALTH PROMOTION AND
EDUCATION
Study guide

The Determinants of Health

o Many factors combine to affect the health of individuals and communities.

1. Income and social status -higher income and social status are linked to better
health. The greater the gap between the richest and poorest people, the
greater the differences in health.

The poverty cycle

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 PRINCIPLES AND FOUNDATIONS
OF HEALTH PROMOTION AND
EDUCATION
Study guide

2. Education –low
education levels are
linked with poor health,
more stress and lower
self-confidence

3. Environment –safe water

and clean air, healthy
workplaces, safe houses,
communities, and roads all contribute to good health. Employment and
working conditions –people in employment are healthier, particularly those
who have more control over their working conditions.
4. Social support networks greater support from families,
friends and communities are linked to better health. Culture
customs and traditions, and the beliefs of the family and
community all affect health.
5. Genetic inheritance plays a part in determining lifespan,
healthiness and the likelihood of developing certain
illnesses.
6. Personal behavior and coping skills balanced eating,
keeping active, smoking, drinking, and how we deal with
life’s stresses and challenges all affect health.
7. Health services access and use of services that prevent
and treat disease influences health
8. Gender Men and women suffer from different types of
diseases at different ages.

What is health education?

o Health education is defined as “any combination of planned learning experiences using

evidence-based practices and/ or sound theories that provide the opportunity to acquire
knowledge, attitude, and skills needed to adopt and maintain healthy behaviours”
o Health education is the process by which individual and group of people learn and gain the
knowledge to:
1. Promote, maintain, restore health.
2. Address risks prevent disease/ injury.
3. Utilization of available health services.
4. Early diagnose and manage the disease.

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 PRINCIPLES AND FOUNDATIONS
OF HEALTH PROMOTION AND
EDUCATION
Study guide

o Health education is, as the name implies, education about health.

o Health education is a systematic, planned application, which qualifies it as a science.
o The delivery of health education involves a set of techniques rather than just one (video,
brochures, pamphlets, lectures.…)
o Supported by the latest knowledge from research.

o What is the primary purpose of health education? to influence the antecedents of

behavior so that healthy behaviours develop involuntary fashion
o Adapted to what? age, gender, education, and particular health, mental or social
problems of an individual or community
o Respects the environment/culture of an individual
o Health education draws on many disciplines including. psychology, sociology, education,
public health, and epidemiology.

Health education at several levels:

o One-on-one level: “ex. counseling sessions”.

o Group level: “ ex. Group discussion, lectures, workshops..”.
o Organizational level: “ ex. Employee wellness fear”
o Community-level: “ ex. radio, TV, internet, multiple-approach campaign…)

What is the Generalized Model (GM) of Health Education Planning?

o The Generalized Model (GM) represent the foundation of health education and health
promotion program planning.
o Its principles are the building blocks for all other models
o All health education planning models revolves around five
primary tasks incorporated in the Generalized Model (GM) for
Health Education (McKenzie et al.,2013).

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 PRINCIPLES AND FOUNDATIONS
OF HEALTH PROMOTION AND
EDUCATION
Study guide

Principles of Health Education Planning

o It is important that plans are made with the needs and context of the community in mind.
o Consider the basic needs and interests of the community.
o Plan with the people involved in the implementation of an activity
o Identify and use all relevant community resources.
o Planning should be flexible, not rigid.
o The planned activity should be achievable and take
into consideration the financial, personnel, and time
o constraints on the resources you have available.

Health Educator focus on what?

o Health educators focus on helping groups of people, from family units to large urban
communities, by developing educational campaigns and programs to promote healthy
habits and environments.

What is the role of Health Educator?

o Assess community and individual needs for health education

o Plan effective health education programs
o Implement health education programs
o Evaluate effectiveness
o Coordinate health education services
o Serve as a resource person in health education
o Communicate needs, concerns, resources
o Analyse data about key demographics and work to create or improve health programs.

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 PRINCIPLES AND FOUNDATIONS
OF HEALTH PROMOTION AND
EDUCATION
Study guide
What is health promotion?

o “Any planned combination of educational, political, environmental, regulatory, or

organizational mechanisms that support actions and conditions of living conducive to the
health of individuals, groups, and communities”
o Is the science that aims to reach optimal health.
o Health promotion includes activities that aim to
increase the wellbeing, prevention of disease and
health hazards and control of the disease.
o Health promotion is to add “life into the years” and not
just add “years into life”

why Health Promotion is Essential to Public Health Because:

o It improves the health status of individuals, families, communities, and populations.

o It enhances the quality of life for populations.
o It reduces premature deaths.
o It reduces costs incurred by individuals, employers, families, insurance companies, medical
facilities, communities, state, and the nation.

Health Promotion Means Changing Behavior at Multiple Level

1. Intrapersonal (individual) level: knowledge, attitudes, values, and skills.

2. Interpersonal level: Social relationships including family, friends, and
peers.
3. Organizational level: organizational influences and factors (rules,
regulations, policies) that requires or constrain recommended behavior.
4. Community-level: (community characteristics) social networks and norms
or standards, which exist as formal or informal among individuals, groups,
and organization.
5. Public policy level: local, state and federal policies
and laws that regulate or support healthy actions and
practices for disease prevention, early detection
control, and management.
6. Physical environment: natural and build environment.
7. Cultural level: Shared beliefs, values, behaviours, and
practices of population.

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 PRINCIPLES AND FOUNDATIONS
OF HEALTH PROMOTION AND
EDUCATION
Study guide

Approaches in Health Promotion

o Medical or Preventive
o Behavior Change
o Educational
o Empowerment
o Social Change

1. The Medical Approach

o The aim is freedom from medically defined disease and disability such as infectious
diseases.
o Involves medical intervention to prevent diseases.
o Values preventive medical procedures and the medical profession’s responsibility
to ensure that patients comply with recommended procedures.
2. The Behavior Change Approach
o The aim is to change people’s individual attitudes and
o behavior so that they adopt a healthy lifestyle
o Examples include teaching people how to stop
smoking, encouraging people to take exercise, eat the
right food, look after their teeth, etc.
3. The Educational Approach
o The Aim is to give information and ensure knowledge and
understanding of health issues and to enable well informed
decisions to be made.
o Information about health is presented and people are helped
to explore their values and attitudes and make their own
decisions.
o Help in carrying out those decisions and adopting new health
o practices may also be offered.
4. The Client Cantered Approach (Empowerment)
o The aim is to work with clients in order to help them to identify
what they want to know about and act on and make
their own decisions and choices according to their own
interest and values.
o Health promoter’s role is to act as a facilitator in helping
people to identify their own concerns and gain the knowledge
and skills they require to make things happen.
o Clients are valued as equal who have knowledge, skills and
abilities to contribute, and who have an absolute right to
control their own health destinies.

5. The Societal Change Approach

o The aim is to effect changes in, in order to make it more conducive to good health.
o Focus is on changing society not on changing the behavior of individuals.

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 PRINCIPLES AND FOUNDATIONS
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Study guide
o The proponent of this approach will value their democratic right to change society
and will be committed to putting health on the political agenda.

Example of the five approaches of health promotion addressing

smoking behavior

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 PRINCIPLES AND FOUNDATIONS
OF HEALTH PROMOTION AND
EDUCATION
Study guide
Health Promotion and Disease Prevention

What is Disease Prevention?

o “The process of reducing risks and alleviating disease to promote, preserve, and restore
health and minimize suffering and distress”
o Both health promotion and disease prevention focus on keeping people healthy
o Disease prevention differs from health promotion
because it focuses on specific efforts aimed at
reducing or preventing the development and severity of
chronic diseases and other comorbidities

what are the Levels of Prevention?

There are three distinct levels of preventive measures

1. Primary prevention
2. Secondary prevention
3. Tertiary prevention

1. Primary prevention:
o “includes the preventive measures that lead to an early diagnosis and prompt treatment
of a disease or any injury to limit disability and prevent more serious pathogenesis”.
Examples of Secondary prevention measures:
o Personal and clinical screening and examination such as
blood pressure, blood cholesterol, mammograms, and
pap smears

2. Secondary Prevention:
o The goal of the secondary preventive measures is not
to prevent the onset of the disease but rather to detect
its presence during early pathogenesis, thus permitting
early treatment and limiting disability
o Secondary prevention involves screening interventions that detect asymptomatic disease
and improve outcomes.
3. Tertiary Prevention:
o The tertiary preventive measures aimed at retraining, re-educate, and rehabilitation the
individual who has already incurred disability, impairment, or dependency
o Examples of tertiary prevention measures:
o Educating a patient after lung cancer surgery or working with an individual who has
diabetes to ensure that daily insulin injection is taken, or ophthalmology examinations in
diabetic patients.

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 PRINCIPLES AND FOUNDATIONS
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EDUCATION
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Why is disease prevention and health promotion a better way to go?

o Prevention is the entail step to be taken to avoid getting a disease.

o Prevention saves lives.
o Prevention improves quality of life.
o Prevention is cost-effective.

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