Community Medicine

Communication for
Health Education
Chapter 21

Atul K Shankar
31
ESSAY
Define Health Education. Explain the principles & methods of Health Education.
Health Education is the translation of what is known about health, into desirable individual and
community behaviour patterns by means of an educational process. The definition by John M Last
is the “process by which individuals and groups of people learn to behave in a manner conducive
to the promotion, maintenance or restoration of health”.

PRINCIPLES OF HEALTH EDUCATION:

- To encourage people to adopt and sustain health promoting lifestyle and practices
- To promote the proper use of health services available to them
- To arouse interest, provide new knowledge, improve skills and change attitudes in making
rational decisions to solve their own problems
- To stimulate individuals and community self-reliance and participation to achieve health
development through individual and community involvement at every step from
identifying problems to solving them.

METHODS OF HEALTH EDUCATION

- Regulatory Approach (Managed prevention)

o This approach seeks change in health behaviour and improvement in health through
a variety of external control or laws placed on people
o The legislative approach may seem to be simplest and quickest way to improve
health or bring about desired changes in society, but there are also important
failures of laws, e.g., prohibition of alcohol.
- Service Approach
o This approach was tried by the Basic Health Services in 1960s
o It aimed at providing all the health services needed by the people at their door
steps on the assumption that people would use them to improve their own health
o This approach proved a failure because it was not based on the felt-needs of the
people.
o For example, when water seal latrines were provided by the government, free of
cost, many people in the rural areas did not make use of them because it was not
their habit to use latrine
- Health Education Approach
o There are many problems which can be solved only through health education
o It is a general belief in western democracies that people will be better off if they
have autonomy over their own lives, including health affairs on which an informed
person should be able to make decisions to protect his own health
o This approach is consistent with democratic philosophy which does not order the
individual
- Primary Health Care Approach
o this is radically new approach starting from the people with their full participation
and active involvement in the planning and delivery of health services based on
principals of primary health care
o the objective is to help individuals to become self-reliant in matters of health
o this can be done if the people receive the necessary guidance from health care
providers in identifying their health problems and finding workable solutions
o this approach is a fundamental shift from the earlier approaches
SHORT NOTES
Barriers of Effective Communication
- Health education may often fail due to communication barriers between the educator and
the community – these may be:

- PHYSIOLOGICAL
o Difficulties in hearing
o Expression
- PSYCHOLOGICAL
o Emotional disturbances
o Neurosis
o Levels of intelligence
o Language
o Comprehension difficulties
- ENVIRONMENTAL
o Noise
o Invisibility
o Congestion
- CULTURAL
o Illiteracy
o Levels of knowledge and understanding
o Customs, beliefs, religion, attitudes, economic and social class differences
o Language variations, cultural difficulties between foreigners and nationals
o Cultural difficulties b/w urban education and the rural population

Key Elements in Communication Process

The main components in the communication process are:

- Sender
o The sender is the originator of the message
o to be an effective communicator, he must know
 his objectives, audience, message, channels of communication,
professional abilities and limitations
o the impact of the message will depend on his own social status, knowledge and
prestige
- Receiver
o All communicators must have an audience
o It is the element of audience and their frame of mind which lends meaning to all the
different types of communication
- Message
o The information which the communicator transmits to his audience to receive,
understand, accept and act upon.
- Channels of Communication
o The physical bridges or the medica of communication between the sender and
receiver
- Feedback
o It is the flow of information from the audience to the sender
o It is the reaction of the audience to the message.
 Audio-Visual Aids
- Audio visual aids help to simplify unfamiliar concepts and bring about understanding where
words fail
- They reinforce learning by appealing to more than one sense and provides a dynamic way
of avoiding monotony
- Audio-visual aids are classified into 3 groups:
o Auditory Aids
 Radio
 Tape recorder
 Microphones
 Amplifiers
 Earphones
o Visual Aids
 Not requiring projection
 Chalkboard, leaflets, posters, charts, flannelgraph, exhibits,
models, specimens
 Requiring projection
 Slides, film strips
o Combined A-V Aids
 Television,
 sound films,
 slide-tape combination

Group Discussion
- Considered a very effective method of health communication
- It permits the individuals to learn by freely exchanging their knowledge, ideas and opinions
- It provides wider interaction among members than is possible with other methods
- For effective group discussion, the group should comprise not less than 6 and not more
than 12 members
- A well conducted group discussion with adequate resources is very effective in reaching
decisions, based on the ideas of all people. The decision taken by the group tends to be
adopted more readily than in situations where the decision is a solitary one
- The group acceptance has a binding effect on the individual member to translate their
acceptance into action
- a well conducted group discussion is effective for changing attitudes and the health
behaviour of people.

- LIMITATIONS:
o Group discussion is not without limitations
o Those who are shy may not take part in the discussions
o Some may dominate the discussion
o There may be unequal participations of members in group discussion, unless
properly guided
o Some members may deviate from the subject and make the discussion irrelevant or
unprofitable
 Principles of Health Education
1) Credibility
o It is the degree to which the message to be communicated is perceived as
trustworthy by the receiver
o Good health education is based on facts – that means it must be consistent and
compatible with scientific knowledge and also with the local culture, educational
system and social goals
2) Interest
o It is a psychological principle that people are unlikely to listen to those things which
are not to their interest
o It is salutary to remind ourselves that health teaching should relate to the interests
of the people.
3) Participation
o It is a key word in health education
o It is based on the psychological principle of active learning
o Health education should aim at encouraging people to work actively with heath
workers and others in identifying their own health problems and also in developing
solutions and plans to work out
4) Motivation
o In everyone, there is a fundamental desire to learn
o Primary – driving forces initiating people in action
o Secondary – based on desires created by outside forces or incentives
5) Comprehension
o In health education, we must know the level of understanding, education and literacy
of people to whom the teaching is directed.
o One barrier to communication is using words which cannot be understood
6) Reinforcement
o Few people can learn all that is new in a single period
o Repetition at intervals is necessary
o There is no reinforcement, there is every possibility of the individual going back to
the pre-awareness stage
o If the message is repeated in different ways, people are more likely to remember it.
7) Learning by Doing
o Learning is an action-process; not a memorizing one in a narrow sense
8) Known to Unknown
o Start where the people are and with what they understand and then proceed to new
knowledge
o It is a long process full of obstacles and resistance, and we must not expect quick
results.
9) Setting an example
o The health educator should set a good example in the things he is teaching
10) Good human relations
o Ideas and feeling happen most easily between people who have a good relationship
11) Feedback
o The health educator can modify the elements of the system in light of the feedback
12) Leaders
o Leaders are agents of chance and they can be made use of in health education.
o We learn best from people who we respect and hold in a high regard.
 Health Education in Schools
The method of health education used in schools is the “GROUP APPROACH”.

- It is an effective way of educating the community

- The choice of subject must be important and must relate to the interest of the group
- The different types of group education are:
o Chalk and Talk (Lecture)
 Carefully prepared oral presentation of facts, organised thoughts and ideas
by a qualified person
 The chalk lends the visual component
o Demonstrations
 Carefully prepared presentation to show how to perform a skill or
procedure
 The procedure is carried out step by step before an audience or target group
 The demonstrator involves the audience in the discussion
 Advantages:
 Dramatizes by arousing interest
 Persuades the onlookers to adopt recommended practices
 Follows the principles of “seeing is believing” & “learning by doing”
 Brings desirable changes in the behaviour pertaining to the use of
new practice
 As a means of communication has been found to have a high educational
value in programmes such as sanitation, MCH and control of diseases
o Discussion Methods
 A very effective method of health communication
 It permits the individuals to learn by freely exchanging their knowledge,
ideas and opinions
 Provides a wider interaction among members than is possible with other
methods
 Types of discussion methods include:
 Group and Panel Discussions
 Symposium
 Workshops and Conferences
 Seminars
 Roleplay

Roleplay as a Health Education Method

- Based on the 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
- The group members enact their roles as they have observed or experienced them and the
audience is not passive but actively concerned with the drama.
- They are supposed to pay sympathetic attention to what is going on, suggest alternative
solutions and come up and take an active role in demonstrating how they feel a role
should be handle
- Roleplay is a useful technique to use in providing discussion of problems of human
relationship
- It is a particularly useful educational device for school children
- It is usually followed by discussion of the problem
 Internet as a Health Education Medium
- The internet is a tool belonging to the Mass Approach to Health Education with the aim of
providing education to the general public
- Internet has opened vast capability of knowledge transfer and has made it possible to get
into direct and instant communication across the world by means of email and online chat
- It is a fast-growing communication media and holds very large potential to become a
major health education tool
- Vast amounts of health-related literature from WHO and other heath agencies are available
online
- The health-related Information from the Ministry of Health and Family Welfare is also
available on their website.