INTRODUCTION TO HEALTH

PROMOTION AND HEALTH

EDUCATION
BY:
DR. NABIWEMBA ELIZABETH

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HEALTH PROMOTION
Definitions
“any combination of health education
and related organisational, economic,
and environmental supports for
behaviour of individuals, groups, or
communities conducive to health”

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HEALTH PROMOTION
“the science and art of helping people change
their lifestyle toward a state of optimum
health……lifestyle change being facilitated by
a combination of efforts to enhance
awareness, change behaviour, and create
environments that support good health
practices”

American Journal of Health Promotion, 1989

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 HEALTH PROMOTION
“The process of enabling people to increase
control over, and to improve their health”

WHO at the 1st International Conference on Health Promotion.

Ottawa Charter of HP, 1986

“The process of enabling people to increase

control over their health and its determinants,
and thereby improve their health".

Bangkok Charter of HP, 2005

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HEALTH PROMOTION
…….. a commitment to dealing with the challenges
of reducing inequities, extending the scope of
prevention, and helping people to change or cope
with their circumstances…….. creating
environments conducive to health in which people
are better able to take care of themselves”

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Ottawa Charter of Health Promotion
According to this Charter, health promotion:
is not just the responsibility of the health sector, but goes
beyond healthy life-styles to well-being

aims at making... [political, economic, social, cultural,

environmental, behavioural and biological factors]
favourable through advocacy for health

focuses on achieving equity in health

demands coordinated action by all concerned: by

governments, health and other supporting sectors.
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HEALTH PROMOTION
Broad concept
Includes
Educational strategies
Organisational efforts
Policy directives
Economic supports
Environmental interventions
Social/community support
Health promotion vs health education ??
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PRINCIPLES OF HEALTH PROMOTION
Health status can be changed

Disease occurrence theories can be

understood

Appropriate prevention strategies can be

developed for identified health problems

Health is affected by a variety of factors, not

only lifestyle
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PRINCIPLES OF HEALTH PROMOTION
Changes in individual & societal behaviours &
lifestyles will affect their health status

Individuals, families, communities can be

taught to assume responsibility for their health

For health behaviour change to be permanent,

individuals must be motivated & ready to
change

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Models of Health Promotion
1. The BIOMEDICAL model of health

views health as the absence of diseases or

disorders
focuses on individual responsibility

treats people in isolation of their environments

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Models of Health Promotion
2. The SOCIAL model of health
addresses the broader determinants of health

involves inter-sectoral collaboration

acts to reduce social inequities

empowers individuals and communities

acts to enable access to health care

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Models of Health Promotion
The ECOLOGICAL model of health
acknowledges the reciprocal relationship between health-
related behaviours and the environments in which people
live, work and play (behaviour does not occur in a
vacuum)
considers the environment is made up of different
subsystems – (e.g. climate, mosquito, man)
emphasises the relationships and dependencies between
these subsystems
is comprehensive and multi-faceted, using a shared
framework for change at individual and environmental
levels
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Alternative description of HP models
1. The biomedical model views health as the absence
of diseases or disorders.

2. The behavioural model views health as the product

of making healthy lifestyle choices.

3. The socio-environmental model views health as

the product of social, economic and environmental
determinants that provide incentives and barriers to
the health of individuals and communities.

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 Causes of Health Problems
Heart Disease
BIOMEDICAL MODEL BEHAVIOURAL SOCIO-
MODEL ENVIRONMETAL
􀂃cardiovascular 􀂃 smoking 􀂃 poverty
diseases 􀂃 poor eating habits 􀂃 unemployment
􀂃 cancer 􀂃 physical inactivity 􀂃 powerlessness
􀂃 HIV/AIDS 􀂃 substance abuse 􀂃 isolation
􀂃 stroke 􀂃 poor stress coping 􀂃 environmental
􀂃 diabetes 􀂃 lack of life skills pollution
􀂃 obesity 􀂃 stressors
􀂃 hypertension 􀂃 hazardous living and
working

Ontario Health Promotion Resource System

Approaches to reducing heart disease
Health model Cause of problem Strategies to address
problem
Biomedical - hypertension - treatment
- family history - drugs
- hyper-cholestrolemia - low salt/low cholestrol
dietary regimen
Behavioural - lifestyle - health education
- smoking - health communication
- high fat diet - self-help/mutual aid
- low level of physical - advocacy for health
activity public policies supporting
- high stress levels lifestyle choices (e.g.,
workplace smoking bans)
Socio environmental - living conditions - policy change
- working conditions - advocacy
- social isolation - community mobilization
- self-help/mutual aid

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 Causes of Health Problems
Maternal death
BIOMEDICAL MODEL BEHAVIOURAL SOCIO-
MODEL ENVIRONMETAL

Ontario Health Promotion Resource System

Approaches to reducing maternal deaths
Health model Cause of problem Strategies to address
problem
Biomedical

Behavioural

Socio environmental

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ETHICS AND HEALTH PROMOTION
Respect values of target audience
Be aware of degrees of autonomy
related to health behaviour
 Facilitation
 Persuasion

 Manipulation
 coercion

Provide informed consent

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ETHICS AND HEALTH PROMOTION
Fairness and justice

Confidentiality and privacy

Non-maleficence (do no harm)

Beneficence

Omission and commission

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HEALTH EDUCATION
Definitions
“any combination of learning experiences designed
to facilitate voluntary adaptations of behaviour
conducive to health”

“the process of assisting individuals, acting

separately or collectively, to make informed
decisions about matters affecting their personal
health and that of others”

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HEALTH EDUCATION
Aim
 Close the gap between what is known about
optimum health practice and what is actually
practised

 Bring about behavioural changes in individuals,

groups and larger populations from behaviours
presumed to be detrimental to health, to
behaviours that are conducive to present and
future health.
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FOCUS OF HEALTH EDUCATION
Behaviours & conditions that promote
health or put health at risk
Knowledge, attitudes, beliefs & values
related to those behaviours/ conditions
Skills needed to practice those behaviours
or address the conditions personally or
collectively
Providing learning experiences to model &
practice skills
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PRINCIPLES OF HEALTH EDUCATION
View health as more than the absence of disease
Utilise all educational opportunities
Harmonise all health messages
Empower learners to act for healthy living &
promote conditions supportive of health
Establish a basis for lifelong learning & health
promotion
Foster interaction between community & local
services

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PEDAGOGY OF HEALTH EDUCATION
Needs assessment
Learning environment – comfortable,
supportive
Community involvement
Build on prior knowledge/ past experiences
Facilitate learning thru a variety of
modalities
Include social aspects of health alongside
physical, mental
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SETTINGS FOR HEALTH EDUCATION
Provide channels for delivering health programs and
access to specific populations
Homes

Schools

Communities

Workplaces

Health care centers

The consumer market place

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AUDIENCES FOR HEALTH EDUCATION
Who needs health education?
Dimensions of potential audiences
1. Socio-demographic characteristics –
2. Ethnicity - health risks
3. Life cycle stage – unborn, children,
adolescents, adults, elderly
4. Disease or at risk status – stage of illness,
perceived severity,

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AUDIENCES FOR HEALTH EDUCATION
HE designed with an understanding of the target
audience
Health characteristics
Social characteristics
Beliefs
Attitudes
Values
Skills
Past behaviours
Health risk
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HEALTH PROMOTION AND HEALTH
EDUCATION DELIVERY METHODS

Variation of methods aids learning

Individuals are different
Context varies
Tasks may involve sub-tasks that require different
teaching methods
Variation in stimulus esp NB for sustaining
attention and interest

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Health Education Methods
Different methods to affect knowledge, skills and
attitudes

Vary according to availability of resources

NB. Most HE is to adults

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Methods for delivery of HE & HP
One to one
Consultations
Counseling
Demonstrations

One to small groups

Talks
Lecture
Discussions
Role plays
Demonstrations
Peer education
Community drama

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Methods for delivery of HE & HP

To masses (large populations, communities)

Radio/Television talks
Rallies
Print media – newsletter, pamphlets, posters, newspaper
articles, billboards
Electronic media – internet, sms
Music

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Principles of adult learning
Need to know why they should learn something

Need to be self directing

Have much but different experience

Have a wealth of information

Relate new knowledge to previously learned

information & experiences

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Principles of adult learning
Have established values, beliefs, opinions

Ready to learn when they experience a

life situation where they need to know

Learning process has

task-centered/problem based orientation

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