INTRODUCTION TO HEALTH

PROMOTION AND DISEASE

PREVENTION
By:- Beimnet DK(MPH/BPHB)
August/2023

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Intro...
Definition and concepts of health
• In the Oxford English Dictionary health is defined as:
‘the state of being free from sickness, injury, disease, bodily
conditions; something indicating good bodily condition’.

❑For a moment think about someone you think is healthy and

someone else who you would consider to be not healthy. Look at
the definition of health again. Is it similar to the things you thought
about when you thought of a healthy and an unhealthy person?

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Intro...
The concept of health is wide and the way we define health
also depends on
• Individual perception, religious beliefs, cultural values, norms,
and social class.
Generally, there are two different perspectives concerning
people’s own definitions of health;
✓a narrow perspective and
✓a broader perspective.

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Intro...
Narrow perspectives of health
• Consider health as the absence of disease or disability or
biological dysfunction
• According to this view (or model), to call someone
unhealthy or sick means there should be evidence of a
particular illness
• This model is narrow and limits the definition of health to
the physical and physiological capabilities that are necessary
to perform routine tasks.

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Intro...
Broader perspectives of health
Defining health 2
The most widely used of the broader definitions of health is
that within the constitution of the World Health Organization
(1948), which defines health as:
• ‘A state of complete physical, mental, and social well-being,
and not merely the absence of disease or infirmity.’

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Intro...
Defining physical health
Could be defined as
• the absence of diseases or disability of
the body parts.
• as the ability to perform routine tasks
without any physical restriction.

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Intro...
Psychological health
• Psychological health is also an important aspect of a health
definition
• How do we recognize a mentally health of a individual?
Mentally healthy person shows growth and maturity in three areas:
cognitive, emotional and social.

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Intro...
Cognitive component Emotional component
• Thinking and being able to work • The ability and skill of expressing
things out emotions in an ‘appropriate’ way
• Ability of an individual to learn, to • Appropriate means that the type
have awareness (consciousness) of response should be able to
and to perceive reality. match the problem.
• It also involves having a memory
and being able to reason rationally
and solve problems, as well as
being able to work creativity and
have a sense of imagination.

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Intro...
Social component of Health
• is the ability to make and maintain
‘acceptable’ and ‘proper’ interactions
and communicate with other people
within the social environment
• Includes being able to maintain
satisfying interpersonal relationships
and being able to fulfill a social role

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Health...
In 1986, the WHO made further clarifications:

“A resource for everyday life, not the objective of living. Health is a

positive concept emphasizing social and personal resources, as well
as physical capacities.”
• This means that health is a resource to support an
individual’s function in wider society, rather than an end in
itself.

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Health maintenance

• Achieving health and remaining healthy is an active process.

• An active process by which an individual progresses towards maximum

potential possible, regardless of current state of health is called Wellness
• Wellness also
described as the attitudes and active decisions made by an individual that
contribute to positive health behaviors and outcomes.

• The Global Wellness Institute defines wellness as the active pursuit of

activities, choices and lifestyles that lead to a state of holistic health

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MOST MODELS OF WELLNESS
INCLUDE AT LEAST SIX
DIMENSIONS

• Physical
• Mental
• Spiritual
• Emotional
• Social
• Enviromental

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Wellness...

Components of Wellness
1. physical,
e.g.:-
• Achieve fitness
• Maintain nutrition and proper body fat
• Avoid abusing drugs, alcohol, or using tobacco products
• Generally, to practice positive life-style habits

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Wellness...

2. Social,
e.g.:-
• Ability to interact successfully with people and within the
environment of which each person is a part
• Develop and maintain intimacy with significant others
• Develop respect and tolerance for those with different opinions
and beliefs

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Wellness...

3. Emotional, e.g.:
• Ability to manage stress and express emotions appropriately
• Ability to recognize, accept, and express feelings
• Ability to accept one’s limitations
4. Intellectual, e.g.:
• Ability to learn and use information effectively for personal,
family, and career development
• Striving for continued growth and learning to deal with new
challenges effectively
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Wellness...

5. Spiritual:
Searching for meaning and higher purpose in human existence.
6. Environmental:
Fostering positive interrelationships between planetary health
and human actions, choices and wellbeing.

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Health...
Prerequisites for health
• The fundamental conditions and resources for health are
peace, shelter, education, food, income, a stable ecosystem,
sustainable resources, social justice and equity.
• Improvement in health requires a secure foundation in these
basic prerequisites.

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 HEALTH
PROMOTION

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HP...
• The concept of health promotion rose to global importance
following a report published in 1974 by Marc Lalonde,
• The report challenged traditional perspectives on health that
directly equate population health with the quality of
healthcare services
• He proposed a wider ‘health field concept’,

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HP...
• proposed a wider ‘health field concept’ which encompasses
four core elements that must be addressed to prevent illness
and maintain population health:
✓individuals’ lifestyles,
✓the environment,
✓healthcare organizations and
✓biology

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HP...
Lalonde (1974) asserted that
• all people who are concerned with health-related decisions -
including healthcare professionals, the scientific community,
governments and the public - should work together with the
aim of preventing ill health, rather than merely responding to
illness.

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HP...
• Following the publication of this milestone report, the
World Health Organization (WHO) (1986) drew up the
Ottawa Charter for Health Promotion.
• WHO formally defined health promotion as
“the process of enabling people to take control over and
improve their health”.

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The 5 HP actions in the Ottawa Charter

1. BUILD HEALTHY PUBLIC POLICY: Putting health on the agenda

of all policies in all sectors and at multi-levels.
2. CREATE SUPPORTIVE ENVIRONMENTS: Creating living and
working conditions that are safe, stimulating, satisfying and enjoyable.
3. STRENGTHEN COMMUNITY ACTION: Working to ensure that
communities set priorities, make decisions, plan strategies and can
implement them to achieve better health.
4. DEVELOP PERSONAL SKILLS: Providing people with information
and education, enhancing life skills and enabling them to cope.
5. REORIENT HEALTH SERVICES: Develop health care services
which focus on the total needs of the whole person and are sensitive to
their cultural needs.

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Health promotion strategies

• Enabling: Acting in partnership with individuals or groups to

empower them, through the mobilization of human and material
resources, to promote and protect their health.
• Mediation: A process through which the different interests
(personal, social, economic) of individuals and communities, and
different sectors (public and private) are reconciled in ways that
promote and protect health.
• Advocacy: A combination of individual and social actions
designed to gain political commitment, policy support, social
acceptance and systems support for a particular health goal or
program

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Interest of HP : the whole Pop

not pop at risk
Scope of HP: multi sectoral
General Principles involvement
of HP
Approaches of HP: Multiple
tools/approaches
public participation
General Principles of HP

• Health promotion involves the population as a whole in the

context of their everyday life, rather than focusing on people at
risk for specific diseases. It enables people to take control over,
and responsibility for, their health as an important component of
everyday life- both as spontaneous and organized action for
health.
• Health promotion is directed towards action on the
determinants or causes of health. It, therefore, requires a close
cooperation of sectors beyond health services, reflecting the
diversity of conditions which influence health.

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Principles… HP
• Health promotion combines diverse, but complementary,
methods or approaches, including communication, education,
legislation, fiscal measures, organizational change, community
development and spontaneous local activities against health
hazards.
• Health promotion aims primarily at effective and concrete
public participation. This focus requires further development
of Problem-defining and decision-making life skills both
individually & collectively.
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DISEASE
PREVENTION

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Is population-based
and individual-based
interventions
Disease
prevention Aiming to minimize the
burden of diseases and
associated risk factors
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 Typical activities for health promotion, disease
prevention, and wellness programs include:
• Communication: Raising awareness about healthy
behaviors for the general public.

Activities
Examples of communication strategies include public service
announcements, health fairs, mass media campaigns, and
newsletters.

for
• Education: Empowering behavior change and actions
through increased knowledge.
Examples of health education strategies include courses,

HP,DP...
trainings, and support groups.
• Policy, Systems, and Environment: Making
systematic changes – through improved laws, rules,
and regulations (policy), functional organizational
components (systems), and economic, social, or
physical environment – to encourage, make available,
and enable healthy choices.
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 34

HEALTH
EDUCATION
Objectives

At the end of this class, You will be able to:

• Define Health Education
• Describe objectives of Health Education
• State Rationales of Health Education
• State basic principles of Health Education
• Identify the role of Health Education in Primary Health Care

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Introduction to HE…

Definition:
Health Education, according to Green, is defined as any combination of learning
opportunities and teaching activities designed to facilitate Voluntary
adaptation of behavior that is conducive to health.
[ Health Educators/HE Professionals]

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Introduction...
• HE comprises consciously constructed opportunities for
learning involving some form of communication designed
to improve health literacy, including improving knowledge,
and developing life skills which are conducive to individual
and community health.
• HE is not only concerned with the communication
of information, but also with fostering the motivation, skills
and confidence (self-efficacy) necessary to take action to
improve health.
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HE...
• HE includes the communication of information
concerning the underlying social, economic and
environmental conditions impacting on health, as well as individual
risk factors and risk behaviors, and use of the health care system.

• Thus, health education may involve the communication

of information, and development of skills which
demonstrates the political feasibility and organizational possibilities
of various forms of action to address social, economic
and environmental determinants of health.
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Health Education and its
Relationships with Health Promotion
• Health Education is one of the strategies of Health
Promotion; whereas,
✓Health Promotion is one of the central Public Health Disciplines.
✓While Public Health is the science & art of preventing
disease, prolonging life & promoting health through the
organized efforts of society,
• Health Promotion is specifically concerned with the socio-
behavioral processes for improving personal health
behaviors and factors influencing those behaviors

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Rationale for health education

• The continued existence and spread of

communicable diseases. such as malaria, TB, HIV/AIDS,
• About 75% of childhood illnesses are preventable need the
involvement of the community members and environmental
interventions.
• For some diseases health education is the only
practical choice: to prevent the spread of the disease or
to lead a normal life. E.g. HIV/AIDS.

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Rationale...
• Increasing the tendency of chronic conditions.
E.g., Hypertension.
Human behaviors are almost the single causes for
the development of such currently emerging health
problems and the main solution.
• Many people do not seek treatment until it is too
late. Ignorant, access, afraid of seeking treatment

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Rationale...
• Prevention is better than cure. is a statement which
is generally true especially for non-communicable diseases

• Increasing threats to the young from new and

harmful behaviors. Eg. tobacco use, teen-age pregnancy,
substance use etc.

• Increasing tendency of chronic health problems and

the need-to-know preventive actions.
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Objectives of HE
• Goal of health education is to promote, maintain and
improve individuals and community health.
Educational objectives of health education
• To provide appropriate knowledge: provision of
correct knowledge, facts and information.
For example, facts about CVD, HIV/AIDS.
• To help develop positive attitude has a lot to do
with changing opinions, feelings and beliefs of people.

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HE objectives...
• To help exercise health practice/behavior: concerned
with helping people in decision-making and actually
performing.
For example, helping people choosing alternatives (weather to
abstain, be faithful, or use condom)
Decision-making: means choosing between and/or among
alternatives in the future about health.

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Settings of health education :
• Health education occurs in a variety of places, these
include:
✓Health facilities
✓Schools
✓Worksite
✓Health departments
✓Voluntary health agencies
✓Communities

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Settings of Health Education
Setting Primary Mission Who is served
Hospitals Treat illness Patients

Community primary care Prevent, detect and treat illness Patents, clients and local
settings and trauma community
Schools Education Children, adolescents …
Worksite Produce goods and services Consumer of products and
services
Health department Disease prevention and control Public

Voluntary health agencies Disease prevention and control Public

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Principles of health education
1. Principle of educational diagnosis
• The first task in changing behaviors is to determine its causes.

• Just as physicians must diagnose an illness before it can be

properly treated, so in health education there must a behavior
be assessed/diagnosed before it can be properly changed.

• If the causes of the behaviors understood health educator can

intervene with the most appropriate and efficient combination of
education, reinforcement and motivation
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Principles HE...
2. Principle of Participation
• The prospect for success in any attempt to change behaviors will
be greater if the individuals, families, community groups,,
etc…have been participated in identifying their own needs for
change and have selected the methods that will enable them
to take action.

3. Principle of multiple methods

• This principle follows from the principle of educational diagnosis.
In so far as multiple causes will consistently be found for any
given behaviors.

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Principles HE...
4. Principle of planning and organizing
• Planning and organizing are fundamentals for health education
which distinguishes it from other incidental learning
experiences.

• It involves deciding in advance the when, who, what, how and

why of health education.

• It also requires the planning for resources, methods

and materials to be used, identification of target groups etc.

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Principles HE...
5. Facts
• Health education is given based on scientific findings/facts and
current knowledge.
6. Segmentation
• Health education should be designed for a specific group
of people/specific target groups
7. Need based
• Health education is primarily educational, and its purpose is to
ensure a desired health related behavior after real
need identification.

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Principles HE...
8. Culture
• Health education should not consider as artificial situation or
formal teaching –learning process.
• One has to get into the culture of the community to introduce
new ideas easily
• Rigid statements particularly contrary to existing belief, culture,
practices will not be liked.
• Therefore, HE starts from where people are and slowly build up
the talking point to avoid any clash of ideas through the
communication process
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HE…
Targets of health education
Individuals
• include all health service users...
Groups
• Groups are gatherings of two or more people with a common interest;
they are a good target for your health education sessions
Community
• A community can be described as a collection of people who have a feeling
of belonging and share a common culture, beliefs, values and norms.
• In this context a community will also have a common interest regarding
the possible health problems within your area
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The role of HE in primary health care
What is PHC?

• Primary health care is essential health care made accessible at a cost a

country and community can afford, with methods that are practical,
scientifically sound and socially acceptable.

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PHC...
HE is:
• A component of PHC
• Core principles of primary health care is “community participation”.
Thus:
• Health education is central to primary health care
• All components of primary health care have health education
• Informing the community is the first important step towards
community participation
• Facilitating inter-sectoral action
• Primary health care cannot successfully be implemented without health
education.
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Methods and Materials of Health Education

Formal methods Informal methods

1. Health talk
1. Conference 2. Lecture
2. workshop 3. Brainstorming
3. Seminar 4. Group discussion
4. Panel discussion 5. Buzz group discussion
5. Symposium 6. Demonstration
7. Role play
8. Drama
9. Case studies
10. Traditional media

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Materials HE...

There are four types of health learning materials:

1. Printed HLMs
2. Visual HLMs
3. Audio HLMs
4. Audio-visual HLMs

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Assg...
Example of print IEC materials
1. Poster
2. flipcharts
3. leaflets
4. booklets
5. cards
6. Newspaper etc

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References
v TheodoreH, Tulchinsky, Elena A. Varavikova(2000) The new public health
v John Hubley 1993. Communicating health. An action guide to health education and
health promotion.
v Lawrence W. Green et al. 1980. Health education planning a diagnostic approach
v Getnet Mitike 2003 health education for health science students. Lecture note series. Addis
Ababa University, Ethiopia.
v Randall R. Cottrell, James T. Girvan, James F. McKenzie 2006. Principles& foundations of
health promotion and education. Third ed. USA.
v John Hubley 1993. Communicating health. An action guide to health education and
health promotion.
v Health policy of the transitional government, 1993

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Assignment
Assignment
• G-I = Role of health education in primary health care
➢What is PHC?
➢Components of PHC
➢Principles of PHC
➢Ethiopian PHC strictures

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Assig...
Assignment
• G-II= Teaching Method and Materials in health education
➢What is health education method?

➢Common health education methods

➢Information Education Communication (IEC) materials/Health Learning

Materials (HLMs)

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THANK YOU!!

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