Health education

Oliver Mweemba
 Health Education

“The only thing that interferes with my learning

is my education.”

Einstein
 Procedures to promote learning

• Education Indoctrination Advising

• Teaching Propaganda Social Marketing
• Instruction Conditioning Lobbying
• Training Facilitating Brainwashing
• Persuasion Counseling Advocating
To propagandize is to spread particular
systemized doctrines; to advertise is proclaim
desirable qualities in order to arouse a desire to
purchase or invest; to campaign is to conduct a
series of operations to bring about a desired
result; to work at public relations is to seek to
win public goodwill for an organization; to inform
is to give news or factual data: to publicize is to
spread information designed or slanted, to
advance special interest; to interpret is to bring
out the real meaning; to teach or to educate is to
cause, or facilitate, learning; and to learn is to find
out about, and gain knowledge and understanding
 Types of health education
• Health education as persuasion – Associated
with ‘coercing’ people into adopting health,
illness and sick role behaviours in order to
prevent disease at primary, secondary and
tertiary levels (associated with disease
prevention model)

• Health education as empowerment – concerned

to strengthen individual capacity and achieve
social and political change – associated with
empowerment model ( a preferred model for
promoting health)
 Objectives of health education
• I hear and I forget
• I see and I remember
• I do and I understand
OR
• You tell me and I forget
• You teach me and I remember
• You involve me and I learn
 Health education
• Health education provides the
consciousness-raising, concern
arousing, action-stimulating impetus for
public involvement and commitment to
social reform essential in a democracy.

• Without health education, health

promotion would be a manipulative
social engineering enterprise

Green and Kreuter, 1999. 3rd ed

 Health Education
• Is to make people think about health and related
problems with a view that they see the need to
modify their behaviour and life styles to contain
(and reduce) existing health problems and
prevent new ones (behaviour change is one of
the important outcomes of health education)

• Health education provides conditions necessary

to generate varieties of health or illness –related
learning, understanding and motivation

• The communication process is a prerequisite

to all kinds to learning
 Levels of Health education
• Individual – One to one
• Group or family – A directed discussion of new
ideas provides reinforcements of certain actions
• Mass – Radio/TV/Newspapers/Films
• The person-to-person method appears to be the
most effective
• Unless people in a group all have the same
problem, difficulties, way of life, it is not possible
as a group to take the same steps to solve their
problems
 Health education
To succeed in health education, it is suggested that you
need to:
• Know the people you need to advise
• Know their thinking
• Know their beliefs
• Know their customs and daily habits
• Know the way they live
• Know what they can and what they cannot do
• Start with something people know –work towards new
ideas
• Work from thinks we can see and hear to less obvious
things
• Start with the particular and move to the general
• Start with simple ideas and move to those more complex
• Start with easy skills and move to those more difficult
 Health Education
• Understanding behavours and
environments that influence people’s
health in important to implement
successful health education programs

• Models have been developed to health

design health education/promotion
programs at various levels
Critical health education

The empowerment model for

health education
 Critical health education
• Primarily focused on empowerment
strategies that influence the physical,
socio-economic and cultural environments

• This means building environments that

facilitate healthy choices and remove
barriers that militate against these
 Critical health education
Approaches
• Activism and social action
• Critical consciousness raising
• Providing life skills and action
competencies
• Community organisation
• Media advocacy
 Critical consciousness raising

• Refers to “learning to perceive social,

political, and economic contradictions, and
to take action against the oppressive
elements of reality”
 Critical consciousness raising
In this kind of approach
• People
– Reflect on aspects of their reality
– Looking behind immediate problems to their
root cause
– Examining the implications and
consequences of these issues
– Develop a plan of action to deal with problems
collectively.
 Health education
Possible steps
• Define the problem - Describe
behavioural/environmental problem. What do people do
or not do which is considered detrimental to their health?

• Analyse the problem –diagnosis. Why is it done in a

specific way? Is it important? Is it widespread or local?

• What needs to be done? Plan the program with health

workers and representatives from the community?

• Organise the program

• Assess program success. What measurements to be

used? One measure of success of HE is behaviour
change
 Health Education
Keep in mind
• Most people are not interested in health except when
sick

• People have knowledge but do not act on it. Why?

• Change of behaviour means change of something,

which one has lived with for a very long time.

• Provide information and motivation at crucial times

The communication process
 The communication process
• Communication is a necessary prerequisite for
learning/health education

• Clear communication between health promotion

practitioners and those you are trying to influence
is essential

• Several models on the best ways to communicate

have emerged (we will consider two)
 Communication strategies for
change to promote health
• Communication-behaviour change
model

• Social marketing
Communication-behaviour
change model
• Developed by McGuire, W.J
• Model based on communication inputs
and outputs which are designed to
influence attitudes and behaviour
• Five communication inputs include
– Source: the person, group or organisation
from whom a message is perceived to
have come. The source can influence the
credibility, clarity and relevance of a
message
 Communication-behaviour
change model
• Five communication inputs cont’d
– Message: what is said and how is said.
The content and form of message can
influence an audience response
– Channel: the medium through which a
message is delivered
– Receiver: the intended target audience
– Destination: the desired outcome to the
communication.may include change in
attitudes, beliefs or even behaviour
 Communication-behaviour
change model
• The model also provides a twelve step sequence of
events, representing outputs from communication,
which link initial exposure to a communication to long-
term change in behaviour

• These include: exposure, attention, interest,

understanding, skill acquisition, attitude change,
memorisation, recall, decision making, behaviour
change, reinforcement, maintenance.

• The model shows that developing public

communication is complex especially if it is to lead to a
sustainable behavioural change
 Communication strategies for
change to promote health
• Communication-behaviour change model

• Social marketing
 Social marketing
• “is a process that attempts to create voluntary
exchange between the marketing organisation
and the members of a target market based on
mutual fulfilment of mutual interest” (Maibach
et al, (2002)
• A marketing organisation uses its resources to;
– Understand the perceived interests of target market
members
– Enhance and deliver the package of benefits
associated with a product service or idea
– Reduce barriers that interfere with the adoption or
maintenance of that product, service or idea
 Social marketing
• On the other hand, target market
members expend their resources (such
as money, time or effort) in exchange
for the offer when it provides clear
advantage over alternative behaviours

• Social marketing differs from

commercial marketing in its intent to
benefit the target population and/or
society in general, rather than to benefit
the marketer
 Social marketing
Social marketing cycle
• Market analysis
– Understanding the priority population through
market research into understanding the knowledge
and attitudes to the issue or service and the
potential channels of communication
– Market research intended to lead to clearly defined
marketing objectives and strategies for achieving
them, and to allow for the segmentation of
different priority population with different needs
and interests
– Market research is followed by development and
testing of the marketing plan elements and
subsequent implementation
 Social marketing
Social marketing cycle cont’d
• Selecting channels and materials: the marketing mix
– Marketing strategies are multi-factorial and generally
based on achieving a balanced mix of four major inputs;
1. Product –Identifying what is on ‘offer’ and presenting the
appropriate image for the priority population
2. Price –the relation between the cost and benefits of the
product
3. Promotion –selecting the most appropriate channel,
message delivery and source essential to success
4. Placement – finding high access points
 Social marketing
Social marketing cycle cont’d
• Implementation, assessment and feedback
– Monitoring the implementation of the program
according to a planned schedule and monitoring
its impacts and effects according to
predetermined objectives
Commentary
• SM is less theory than a planning model
• Since ‘products’ in health promotion are not
tangible, marketing techniques to achieve
sustained mass behaviour change are a
great deal more complex than promoting a
tangible product based on financial
exchange in the commercial place