1.

1 - MEANING OF HEALTH / ITS DIMENSIONS

Health – comes from the English word, “Heal”, which represents the whole person and his integrity, soundness or wellbeing. It is holistic and includes the following dimensions:

*

* The broader dimensions of health in the outer circle are referring to the environmental and social dimensions;

* While the Individual dimensions of Health include: a. Physical Health – refers to the well-being and fitness of one’s body; b. Mental Health – the positive sense of purpose & belief of the person in his own worth or self-esteem. c. Emotional Health - ability to express one’s feelings and to develop & sustain relationships;

d. e. f.

Social Health - Involves the support system that is available from family & friends; Sexual Health - Refers to the acceptance and the expression of one’s sexuality; Spiritual Health - Refers to the recognition of a supreme being and the ability to put into practice one’s moral principles and beliefs;

g.

Societal Health - the link between health and the way a society is structured; refers to the basic infrastructure necessary for health e.g. shelter, peace, food and income and the degree of integration or division, and Environmental Health – refers to the physical environment where people live; it involves housing, transport, sanitation, pollution & pure water facilities.

h.

MODERN CONCEPT OF HEALTH This refers to the optimum level of functioning (OLOF) of individuals, families and communities which is affected by factors in the ecosystem such as: 1. Political Factors - involves power and authority to regulate the environment or social climate. Examples include: safety, oppression, and people empowerment.

2.

Behavioral Factors – refers to a person’s level of functioning and is affected by certain habits, their lifestyles, healthcare, and child-rearing practices which are determined by one’s culture and ethnic heritage e.g. culture, habits, mores ethnic customs etc. Hereditary Factors - refers to understanding of genetically influenced disease and genetic risks which can be familial, ethnic and racial.

3.

4. Healthcare Delivery System – Primary healthcare is a partnership approach to the effective provision of essential health services that are community-based, accessible, acceptable, sustainable and affordable. Focus is on the following: a. b. c. d. Promotion of health Preventive aspects Curative aspects Rehabilitative aspects of care

What are Environmental Influences? - these refer to the adverse effects of pollution, e.g., air, water, noise & radiation; communicable diseases due to poor sanitation, poor garbage collection, smoking, use of pesticides, lack or absence of proper and adequate waste and sewerage system & its management, which exert tremendous negative effects on the environment.

What are Socio-Economic Influences?

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these refer to factors such as employment, education, and housing which affect mostly, the lower income groups.

BASES OF HEALTH AS A BASIC HUMAN RIGHT 1. Universal Declaration of human rights

Art. 25, Section 1: “States that everyone has the right to a standard of living adequate for health and well-being of himself and of his family, including, food, clothing, housing, medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or lack of livelihood in circumstances beyond his control”.

2. 1987 Philippine Constitution

Art. XIII, Section 11: States that: “The State shall adopt an integrated and comprehensive approach to health development which shall endeavor to make essential goods, health and other social services available to all the people at affordable cost. There shall be priority for the needs of the underprivileged sick, elderly, disabled, women and children. The State shall endeavor to provide free medical services to paupers.

3. World Health Organization (WHO), 1995: Believes that:

“Governments have the responsibility for the health of their people which can be fulfilled only by the provision of adequate health and social measures. It emphasizes three basic positive concepts of health which are: a) Reflecting concern for the individual as a total person; b) Placing health in the context of the environment; and c) Equating health with productive & creative living.

HISTORY OF HEALTH EDUCATION

2.1 - MEANING OF HEALTH EDUCATION

* Health Education is a process concerned with designing, implementing and evaluating educational programs that enable families, groups, organizations and communities to play active roles in achieving, protecting and sustaining health.

* Also defined as any combination of learning experiences designed to facilitate voluntary adaptations of behavior conducive to health ( Green et al, 1980). Its purpose: To contribute to health & well-being by promoting lifestyles, community actions, and conditions that make it possible to live healthful lives.

PRINCIPLES OF HEALTH EDUCATION Health education according to Hubley (1983), is an essential component of any program to improve the health of community and has the major role in promoting: 1) Good health practices such as sanitation, clean drinking water, good hygiene, breast feeding, infant weaning, and oral rehydration; 2) The use of preventive services like immunization, screening, antenatal a nd child health clinics

3) The correct use of medications and the pursuit of rehabilitation regimens, e.g., for T.B. & leprosy, respectively; 4) The recognition of early symptoms of disease and promoting early referrals; and 5) Community support for primary health care and government control measures.

In developing countries, health education planning should consider the following decisions:
1. 2. 3. 4. “What is the desired change” “Where should health education take place” “ Who should carry it out?” “ How should it be done.”

WHAT TO CHANGE:

1.

Identify what the key problems are, and

2. What advice should be given.

Proposals for change of health practices and beliefs are guided by principles . Proposals that seek change should :
1. 2. 3. 4. 5. Simple to put into practice with existing knowledge & skills in the community; Fit in with existing lifestyle and culture and not in conflict with beliefs; Not require resources or money , materials and time that ae not available locally; Meet a felt need of the community; Be seen by the people to convey real benefits in the short term, not in the distant future.

Health education programs should be flexible, and should fit in with people’s beliefs, culture, needs and circumstances. Actual identification of their own needs, active participation in identifying possible solutions, and proactive formulation of action plans and implementation of the plan of action will ensure success and continuance of the health programs. Once the benefits are seen and felt, this will pave the way for trust and goodwill that will make future undertakings achievable and workable.

WHERE TO CONDUCT HEALTH EDUCATION

* Can be done in the privacy of the patient’s room which my involve the patient and his family ,or in the outpatient departments of hospitals, clinics, health centers and other healthcare settings.

* It can also be done in the community barangay hall involving different organized groups or members of a health education class or during the conduct of home/follow-up visits.

* Can also be done where people come together like in market places, church, community centers or the town plaza can be good places for discussing health-related matters whether done in either formal or informal strategies of teaching. * Schools are now academic partners and venues for service delivery of health education. Efforts are now directed to strengthen the school health and nutrition programs which are actually the springboards for more advanced health education programs since the school teacher is the first contact in formal health education.

* Schools have the mandate to provide comprehensive health education so that the students will understand the importance of practicing healthful behavior for active, productive and rewarding lives as individuals, family members, and citizens leading to the development of healthy communities and the adoption of healthy lifestyles.

WHO SHOULD DO HEALTH EDUCATION * All health workers: Nurses, since they belong to the biggest professional organization in the country, they are the primary agents for conducting health education to patients, his family; to community health workers, members of the community; to student nurses, staff nurses, members of organized groups of persons of influence, schoolchildren and anybody who is in need of health information and instruction.

HOW SHOULD HEALTH EDUCATION BE CONDUCTED?

1. 2. 3. 4.

Demonstration Word of Mouth Use of Multisensory Aids Film-Viewing

CHARACTERISTICS OF EFFECTIVE HEALTH EDUCATION 1. It is directed at people who have influence in the community, and who are also the opinion makers; Lessons are repeated and reinforced over time using different methods; Lesson are adaptable and use existing channels of communication like songs, drama and story-telling; It is entertaining and attracts the community’s attention;

2. 3.

4.

5. 6. 7. 8.

It uses clear, simple language with local expressions; It emphasizes short term benefits of action; It provides opportunities for dialogue, discussion, and learner participation and feedback. It uses demonstration s to show the benefits of adopting the practices.

HEALTH EDUCATION TODAY / AND FUTURE TRENDS

Due to the emergence of global consciousness brought about by the heightened technological advances, the health educator is faced with enormous challenges as well as opportunities to improve health education and preventive care.

Currently, the trend is towards populationbased health promotion & maintenance vs. Preference for hospital –based healthcare. Its emphasis is on the health of the community and the adaptation of healthy behaviors and lifestyle through health empowerment of the people. Thus, today’s health educator is considered as a community health worker whose main concern is to improve the health of the people by using different methods and strategies.

There is a call for developing global health strategies with the integration of health education and action…. Which health educators can not ignore. Globalization, war, terrorism, social instability, disease, poverty and environmental degradation are among the key challenges facing the world today! The pandemic HIV/AIDS and severe acute respiratory syndrome ( SARS) , as well as, bioterrorism preparedness receive utmost priority and attention from governments of different nations!

Thus, there is a need to develop clear strategies for global health capacity-building at the national level ; and the adequate training for public health professionals where concerted action is undertaken to build their capacity. In development, testing and validation of global health training and action are therefore necessary in integrating theory , practice and policy domains. The outcomes of such initiatives have the potential for facilitating learning and teaching on critical health challenges in the 21st century.

In the U.S.A, for instance, patients are being discharged “ quicker & earlier” due to: 1) their new “ healthcare economics” & 2) Advances in medical technology ; patientsand their families are challenged with the responsibility of continuing the medical treatment at home , oftentimes, under the supervision or care of the nurse ( Rankin & Stallings,2001; Redman,2001; Boyd, et al,1998).

This reform in the healthcare system which has been sweeping the country is known as “ managed care” which is aimed at “ bridging the gap between in-patient services and community-based services” . Today, nurses are required to have greater involvement in: 1 Client-teaching for self-management; ) 2) Discharge planning, and 3) Providing for continuing care.

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