1. By Hatim Jaber MD MPH JBCM PhD 6- 12- 2017
Faculty of Medicine Introduction to Community Medicine Course ( ) Communication and Health Education By
Hatim Jaber
MD MPH JBCM PhD

2. Ageing and health
Between 2015 and 2050, the proportion of the world's population over 60 years will nearly double from 12% to 22%.
By 2020, the number of people aged 60 years and older will outnumber children younger than 5 years.
In 2050, 80% of older people will be living in low- and middle-income countries.
The pace of population ageing is much faster than in the past.
All countries face major challenges to ensure that their health and social systems are ready to make the most of this demographic shift.

3. Post midterm Causation Week 8 Unit 6: Demography and Data
Week  Midterm assessment (Exams.)
Week Unit Introduction to Epidemiology.
Week Unit 9: Prevention and Control of Diseases
Causation
Week Unit 10: Communication and Health Education
Week Unit 11: Public Health Surveillance and Screening
Week Unit 12: Health Administration and healthcare
management
Week Unit 13: Revision and Health Research
Week Final assessment (Exams.)

4. Presentation outline Health education Principles of Health Education
Time
Health education
08:00 to 08:15
Principles of Health Education
08:15 to 08:30
Heath education methods and materials
08:30 to 08:45
The principle of counseling
08:45 to 09:00
Health education planning models
09:00 to 09:15

5. Health Communication Education Counseling Information Motivation
Persuasion
Counseling
Raising morale
Health development
Organization

6. HEALTH EDUCATION
“Health education is the process by which individuals and group of people learn to “:
Promote
Maintain
Restore health.
HEALTH EDUCATION
A process aimed at encouraging people
to want to be healthy,
to know how to stay healthy,
to do what they can individually and collectively to maintain health, and to seek help when needed.

7. Health education is defined as
“Any combination of learning experiences designed to facilitate voluntary adaptation of behavior conducive to health”.
‐ The word “voluntary ”is significant for ethical reasons
(Educators should not force people to do what they don’t want to do )
i.e. All efforts should be done to help people make decisions and have their own choices.
The word “designed” refers to planned, integral, intended activities rather than casual, incident, trivial experiences.

8. What is health education?
Process which affects changes in the health practices of people and in the knowledge and attitude related to such changes. OR
Teaching process providing basic knowledge and practice of health, so as to be interpreted into proper health behavior.
Health education is a process that informs , motivates and enables people to adopt and maintain healthy practices and lifestyles.
It helps people to achieve health by their own actions and efforts.

9. Health Communication – Its intent, what it can do
The intent of health communications is:
To inform, influence, and motivate individuals and organizations to take action toward health
Health communications can:
increase awareness of a health issue;
demonstrate or illustrate skills;
demonstrate a demand for health services; and
remind of, or reinforce, knowledge, attitudes, or behavior

10. Health Communication – What it can’t do
Health communications can’t:
compensate for lack of health care;
produce behavior change without supportive program components;
be equally effective in addressing all issues or relaying all messages

11. 1-It is not enough to change peoples’ knowledge, but it is more important to change the attitude and practice that is not easy at all.
2-Health education is the responsibility of every person in the community not only the health team.
3-Health education is one of the components of PHC and of its all components (MCH, nutrition, food sanitation and immunization).

12. Aims of Health education
Health promotion and disease prevention.
Early diagnosis and management.
Utilization of available health services.

13. Specific objectives of health education
To make health an assest valued by the community.
To increase knowledge of the factors that affect health.
To encourage behavior which promotes and maintains health.
To enlist support for public health measures, and when necessary, to press for appropriate governmental action.

14. Specific objectives of health education
5. To encourage appropriate use of health services especially preventive services.
6. To inform the public about medical advances, their uses and their limitations.

15. Contents of Health Education
1. Human biology Understanding health demands an understanding of human biology. Child spacing, breast feeding, safe motherhood, immunization, weaning and child growth, diarrheal disease, respiratory infections, house hygiene
2. Nutrition To guide people to choose optimum and balanced diets. Remove prejudices and promote good dietary habits.
3. Hygiene Personal Hygiene.
Environmental Hygiene. Domestic
Community.
4. Family Health Health promotion, Disease prevention, Early diagnosis, and Care of the sick.
5. Disease prevention and control: Education of the people about locally endemic diseases. Drugs alone can not solve the problem.
6. Mental Health: To help people to keep mentally healthy and to prevent a mental breakdown. Special situations: mother after child birth, decision about a future career, starting a new family etc.
7. Prevention of accidents: Three main areas: the home, road and the workplace.
Safety education.
8. Uses of health services: Availability of health services When to seek medical services.

16. Contents of Health Education
1. Human biology
Understanding health demands an understanding of human biology.
– Child spacing, breast feeding, safe motherhood, immunization, weaning and child growth, diarrheal disease, respiratory infections, house hygiene
2. Nutrition
To guide people to
choose optimum and
balanced diets.
Remove prejudices
and promote good
dietary habits.

17. 3. Hygiene Personal Hygiene. Environmental Hygiene. Domestic
Community.

18. 4. Family Health
Health promotion, Disease prevention, Early diagnosis, and Care of the sick.
5. Disease prevention and control:
Education of the people about locally diseases.
Drugs alone can not solve the problem.
endemic

19. 6. Mental Health:
To help people to keep mentally healthy and to prevent a mental breakdown.
Special situations: mother after child birth, decision about a future career, starting a new family etc.

20. 7. Prevention of accidents:
Three main areas: the home, road and the workplace.
Safety education.

21. 8. Uses of health services: Availability of health services When to seek medical services.

22. Principles of Health Education
1. Credibility: Consistent and compatible with scientific knowledge, local culture, educational system. 2. Interest: Felt‐needs 3. Participation: Based on the psychological principle of active learning. Create a sense of involvement, personal acceptance and decision making; provides maximum feedback. 4. Motivation: The need for incentives is a first step in learning to change. Carrot & Stick approach and Motivation is contagious.

23. Principles of Health Education
5. Comprehension: Always communicate in the language people understand. 6. Reinforcement. 7. Feedback. 8. Learning by doing. 9. Known to unknown: Start where the people are and with what they understand and then proceed to new knowledge. 10. Good human relations. 11. Setting an example. 12. Leaders: Agents of change. Try to penetrate the community through the local leaders.

24. Components of Health Education Process
Health Education has three broad components ●● Levels of Health Education ●● Methods of Health Education ●● Activities undertaken in individual methods

25. Practice of Health Education
Audiovisual Aids
Auditory aids
Radio, tape‐recorder, microphone, amplifiers, earphones.
Visual aids
Not requiring projection: Chalk‐board, leaflets, posters, charts, models etc.
Requiring projection: Slides, film strips.
Combined A‐V aids
Television, slide‐tape combination.

26. Models of Health Education
Medical Model
Motivational Model
Social Intervention Model

27. Approach to Health Education
Regulatory Approach (Managed Prevention)
Service Approach
Health Education Approach
Primary Health Care Approach.
Individual approach
Group approach
Mass approach

28. Mass approach
Television
Radio
Newspapers
Internet
Printed material
Direct mailing
Posters, billboards and signs
Health museums and exhibitions
Folk media

29. Group Approach 1. Chalk and talk (Lecture) Flipcharts Flannel graph
Exhibits
Films & charts

30. 2. Demonstration 3. Role play
4. Group Discussion
5. Panel discussion
6. Symposium
7. Workshop
8. Conferences and Seminars

31. 1-Lectures: one way method 2-Group Discussions: double way method.
Approach of groups:
In the form of talks, lectures, meetings and seminars. They are attended by group of people who can share in discussion, give suggestion and ask questions.
Disadvantage of group approach:
Few points only can be retained by the general audience
It is difficult to fix the attention for long time
The effectiveness of lecture depends on the personality of the lecturer
Forms of group approach:
1-Lectures: one way method
2-Group Discussions: double way method.
3-Demonstrations: is a mixture of theoretical teaching & practical training.

32. Teaching methods Lecture Lecture discussion Seminar Symposium
Panel discussion
Group discussion
Tutorials
Role play
Integrated teaching (horizontal and vertical)
Talking point sessions
Workshops
Conferences

33. Demonstrations • Group discussion • Panel discussion • Symposium
• Workshop
• Role playing
• Conferences and Seminars

34. A Symposium is a formal gathering in an academic setting where participants are experts in their fields. small scale conference
A Conference refers to a formal meeting where participants exchange their views on various topics.
A Seminar is a form of academic instruction, either at a university or offered by a commercial or professional organization.
A Workshop includes all the elements of the Seminar, but with the largest portion being emphasized on “hand-on-practice” or laboratory work. 
A Congress - would typically be held once a year per discipline, highlighting the achievements, notable results in that field. These are typically attended by leaders in that field, and feature a series of invited talks

35. Research shows . . .
People get health information from: TV
Doctor or other health professional
Newspaper
Family or friends
Magazines
Medical or health books
Health plan or health insurance company
Health newsletters
Radio
Internet
39%
37%
28%
24%
23%
21%
15%
14%
13%
NOTE:
35% spoke with a doctor about a medical condition as a result of a media report.
And 54% said they changed a health-related behavior as a result of a media report!!

36. Adoption of new ideas or practice
Five steps
Awareness (know)
Interests (details)
Evaluation (Advantages Vs Disadvantages)
Trial (practices)
Adoption (habit)

37. Counseling
Counseling is the process used to help people to take decision
Counselors never try to persuade people to accept their advice they encourage them to choose the best solution
Setting of counseling: - Medical center - Outpatient clinics- Schools- hospitals

38. Rules for counseling (GATHER)
G: Greet, respect, &trust
A: Ask about the problem
T: Tell them relevant information
H: Help them to make decisions
E: Explain any understand
R: Return to follow-visit

39. good relationship
To establish a good relationship between physician and patient, rapport and communication are prerequisite
Rapport is the emotional elements contributing to good relationship between physician and patient like:
the atmosphere of the waiting area ,the doctor greeting to the patient, degree of confidence the physician gain, continuing relationship of the doctor with his patient

40. Comparison of Personal approach versus mass media of health education:
Only reach small number of people
More effective and impressive as the educator faces the recipients
Recipients are enrolled and share in discussion
Valuable to discuss confidential matters or problems, e.g. family planning(home visits are the most suitable approach)
Can influence knowledge attitude and practice (KAP )of the exposed
Can reach large number of people ion no time
One way method and can’t distinguish the effect of the message
Recipients can’t share in the
discussion .
The media may not be effective due to illiteracy or time of conducting the message or non available media
Give knowledge and instructions only that not necessarily influence attitude, practice and behavior of recipients

41. Factors considered in Health Education
Predisposing factors: including traditional targets of education including KAP which often change in response to one way educational and mass communication methods or any antecedent to behavior.
Enabling factors: including time, money and material resources, special skills, appropriate and accessible health services
Reinforcing factors: including social support from the family, colleagues, teachers and providers of health services. They are becoming more prevalent in health education where the assumed causes of the behavior are largely social such as peer influence.

42. Advocacy Advocacy (Dick de Jong)
Advocacy is an approach to gain support of decision-makers for interventions.
"Advocacy is the action of delivering an argument to gain commitment from political and social leaders and to prepare a society for a particular issue. It involves the selection and organization of information to create a convincing argument, and its delivery through various interpersonal and media channels. Advocacy includes organizing and building alliances across various stakeholders."