Dambidollo University

Institute of Health
Department of Public Health

Health Promotion and disease prevention for Nursing students

By ChimdesaJ. (MSc HN)

Dec. 2023

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 PRESENTATION OUTLINE
•History,
•Basic concepts,
•Aims
•Principles of health education and
•Contributions of Social science in HPDP

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Historical developments of HP & HE
• The history of health education as an emerging profession is only a little
over one hundred years old, the concept of educating about health has
been around since the dawn of humans.
• It does not stretch the imagination too far to begin to see how health
education first took place during pre-historic era.
• Someone may have eaten a particular plant or herb and become ill. That
person would then warn(educate) others against eating the same substance.
• Conversely, someone may have ingested a plant or herb that produced a
desired effect.
• That person would then encourage (educate) others to use this substance.

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• Development of HE is related to the initiation of health promoting
activities for school children and their environment including nutrition
education.
• In 1779, a German physician, Johan Peter Frank, raised and
propagated the importance of supervising health of school children
as part and parcel of school education program.
• At the beginning of 20th century, official formulation of education
policies has been started in Europe and USA.

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• Growth and development of HE have been accelerated with the
inception of Primary Health care.
• At the time of Alma Ata declaration of Primary Health Care in 1978,
health education was put as one of the components of PHC and it was
recognized as a fundamental tool to the attainment of all health
(health for all), social and economic goals.

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History of HP & HE in ETHIOPIA
• It may be hard to show clearly how health education is developed in
Ethiopia.
• The propagation of health education can be associated with the
introduction of the concept of primary health care approach.
• Adopting this declaration, Ethiopia utilizes health education as a
primary means of prevention of diseases and promotion of health.
• Its contribution to health promotion and strengthening of community
involvement is not well exploited/poor service due to a number of
reasons.

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• The beginning of health education in Ethiopia may be seen in the light of
the introduction of modern medicine into the country.
• During the period of the pre Italo-Ethiopian war, health education had
been limited to the few hospitals which were mainly established for
curative services.
• During this period most of these health institutions were staffed by
expatriates.
• The primary focus was to increase the awareness of people to modern
medicine and encourage them to utilize the service.

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• After the Italo-Ethiopian war; this was the time when the Gondar
Public Health College and Training Center (1954), Mettu Health
Science college (1958) were opened with the assistance of the WHO,
UNICEF, Mension fur mension and USAID .
• During this period, the medical services and training had expanded
rapidly.
• Health education was also given by Mobile Child Health Centers on
child nutrition, personal hygiene and other.
• Preventive, promotive and curative activities were given at this time.

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• In 1965, the first Health Education Workshop was conducted in Addis
Ababa .
• In this workshop the issue of family planning was openly discussed
and high religious leaders have shared their views.
• In fact they were against the practice.

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• Although there is little evidence concerning the impact of health
education, concepts and practices of health education have increased
in dimension during the last 20 years.
• Today, as clearly indicated in the National Health Policy,
strengthening of the health education program is believed to be
essential in the effort to improve the health status of the population
through Primary Health Care.

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• Health Education included almost in all health professional
trainings.
• Health Education is part of practice by all health professionals.
• The national health policy and Health Sector Development Program
of Ethiopia have identified health education as a major component of
program services.

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Definition of Health Education

• Health education has been defined in many ways by different authors

and experts.
• In a WHO Technical Report Series of 1954 it was defined as follows:
• "Health education, like general education is concerned with changes
in knowledge, feelings and behavior of people. In its most usual
forms it concentrates on developing such health practices which are
believed to bring about the best possible of well beings."

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Health Promotion

• To reach a state of complete physical, mental and social well being it

is beyond the activity of health education and even health sectors.
• In other words health is not just the responsibility of health sector
alone. But the responsibility of every sectors working for development
.
• Thus, the concern for health outside to the healthcare sector is the call
for health promotion.
• Most people use the term health education and health promotion
interchangeably.

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• However, health promotion is defined as a combination of
educational and environmental supports for actions and conditions
of living conducive to health(Green and Kreuter, 1991).

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• World Health Organization defines health promotion as the process of
enabling people to increase control over, and to improve their health
• This is derived from the conception of ‘health’ to the extent that an
individual or group is able, on the one hand to realize aspiration and
satisfy needs; and on the other hand to change or cope with the
environment.
• Health is therefore seen as a resource for everyday life and not the
objective of living: it is rather a positive concept emphasizing social
and personal resources, as well as physical capacities.

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Elements/component of health promotion
• Health education
• Political environment
• Social environment
• Economic environment
• Organizational environment

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Other Terminologies
• 1. Health Campaign
• Campaign can be planned to promote knowledge, skills, attitude and
values relating to particular health issue. Example: ‘know your lemons.’
• 2. Information, Education and Communication (IEC) is a term
originally from family planning and more recently HIV/AIDS control
program in developing countries

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• 3. Behavior Change Communication (BCC)
• Behavior change communication (BCC) is an
interactive process with communities (as integrated
with an overall program) to develop tailored messages
and approaches using a variety of communication
channels to develop positive behaviors; promote and
sustain individual, community and societal behavior
change; and maintain appropriate behaviors.

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• Behaviour Change Communication (BCC): Is an interactive process
aimed at changing individual and social behaviour, using targeted,
specific messages and different communication approaches, which are
linked to services for effective outcomes.

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• 4. Social mobilization is a term used to describe a campaign
approach combining mass media and working with community
groups and organizations.
• 5. Patient education is a term for education in hospital and clinic
settings linked to following of treatment procedures, medication, and
home care and rehabilitation procedures.

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• 6. Advocacy: refers to communication strategies focusing on policy
makers, community leaders and opinion leaders to gain
commitment and support.
• Is the act or process of persuading and influencing decision makers
at various levels to get them support an issues or concern through
changes in policies, programs, formulating new regulation etc.
• Is also speaking up, drawing a community’s attention to an important
issue, and directing decision makers toward a solution.

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• 7. Impairment - this is any loss or abnormality of mental, anatomical
structure, physiological function.
• 8. Disability - is any restriction or lack, resulting from an
impairment, of the ability to perform an activity in a manner or range
considered normal for a human being.
• Thus, the loss of a finger may be an impairment but not a disability
because it is unlikely to restrict normal activity.

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• 9. Handicap - is a long-term disadvantage which adversely affects an
individual's capacity to achieve the personal and economic independence that is
normal for one's peers.
• Thus, for example, female circumcision would be considered an impairment,
but in some cultures not being circumcised would be considered handicap
because it reduces a girl's chances of getting married and achieving
independence from her parents.
• 10. Illness; specific condition that prevents your body or mind from working
normally
• 11. Sickness: the feeling or fact of being affected with disorder
• 12. Disease: a disorder of structure or function in body; distinctive group of
S&S.

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• The criteria for a disability, and especially a handicap, are more
culturally determined in that they depend on the activities performed
in that culture and the qualities required for independence.

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Aims (fundamental objectives) of Health
Education
1.Motivating people to adopt health promoting behaviours by
providing appropriate awareness, knowledge, necessary environmental
support and helping to develop positive attitude (possible behavioural
change)
2. Promote health, prevent illnesses and minimize avoidable deaths.
Prevent premature deaths that are related to lifestyles and behaviour.

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• 3. Helping people to make decisions about their health problems
and acquire the necessary confidence and skills to put their decisions
into practice.
• To help each individual, each family to exercise their right to achieve
the harmonious development of their physical, mental and social
potential.

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Principles of Health Education

• 1. All health education should be need based: Therefore before

involving any individual, group or the community in health education
with a particular purpose or for a program the need should be
ascertained.
• It has to be also specific and relevant to the problems and available
solutions.
• 2. Health education aims at change of behaviour: Therefore
multidisciplinary approach is necessary for understanding of human
behavior as well as for effective teaching process.

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• 3. It is necessary to have a free flow of communication: The two
way communication is particularly of importance in health education
to help in getting proper feedback and get doubt cleared.

• 4. The health educator has to adjust his talk and action to suit the
group for whom he has to give health education.
• E.g. when the health educator has to deal with illiterates and poor
people, he has to get down to their level of conversation and human
relationships so as to reduce any social distance.

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• 5. Health Education should provide an opportunity for the clients to
go through the stages of identification of problems, planning,
implementation and evaluation.
• This is of special importance in the health education of the community
where the identification of problems and planning, implementing and
evaluating are to be done with full involvement of the community to
make it the community’s own program.

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• 6. Health Education is based on scientific findings and current
knowledge.
• Therefore a health educator should have recent scientific knowledge to
provide health education.
• A health educator has to employ all possible methods of education

• 7.The health educators have to make themselves acceptable.

• They should realize that they are enablers and not teachers. They have
to win the confidence of clients.

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• 8. The health educators should not only have correct information with
them on all matters that they have to discuss but also should themselves
practice what they profess. Otherwise, they will not enjoy credibility.
• 9. It must be remembered that people are not absolutely without any
information or ideas.
• The health educators are not merely passing information but also give an
opportunity for the clients to analyze fresh ideas with old ideas, compare
with past experience and take decisions that are found favorable and
beneficial.

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• 10. The grave danger with health education programs is the pumping
of all bulk of information in one exposure or enthusiasm to give all
possible information.
• Since it is essentially a learning process, the process of education
should be done step-by-step and with due attention to the different
principles of communication.
• 11. The health educator should use terms that can be immediately
understood: Highly scientific jargon should be avoided.

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• 12. Health Education should start from the existing indigenous knowledge
and efforts should aim at small changes in a graded fashion and not be too
ambitious.
• People will learn step by step and not everything together.
• For every change of behavior, a personal trail is required and therefore the
health education should provide opportunities for trying out changed
practices.
• Introduce new ideas with natural ease and caution not to affect the culture

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• 13. HE is important for people from all walks of life as
applicable to changing conditions: pervasive

• 14. Can be institutional or a self learning process.

Health education is an educational and learning process

• 15. Health educator should be aware of the predictors of

health behaviour and have knowledge and skills of
behavioural sciences.

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Contribution of social sciences to health
promotion
• The social sciences can contribute to preventing and treating illness by
pinpointing
✓the environmental settings,
✓social relationships (Drawing upon social and behavioral science
communication, diffusion, and behavior change, mass media
campaigns,)
✓interpersonal processes, and
✓cultural factors that lead people to engage in healthy and unhealthy
behaviors,
✓seek health services before disease symptoms worsen, and
✓participate with medical professionals in treating illness.

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• Moreover, social science approaches emphasize social structural and
organizational factors that influence the kinds of care available, access to
that care and quality of care.
• In recent years, a variety of prevention programs have taken their
inspiration from basic research on social processes.
• For example, friendship groups by enrolling entire groups into an HIV
prevention intervention,Home-visiting programs have recently emerged
as a strategy for delivering services to individuals and families.
• This strategy recognizes social, economic, and other barriers to seeking
services and draws at least in part on concepts of social support.

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.

THANK YOU

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