Study Session 1 Starting your Health Education Work: Basic Principles 5
Learning Outcomes for Study Session 1 5
1.1 Definition and concepts of health 5
Box 1.1 Defining health 1 5
1.1.1 Narrow perspectives of health 6
1.1.2 Broader perspectives of health 7
Box 1.2 Defining health 2 7
1.2 Physical health 8
Box 1.3 Defining physical health 10
1.3 Psychological health 10
1.3.1 Cognitive component 11
1.3.2 Emotional component 11
1.3.3 Social component 12
1.4 Health education 13
Box 1.4 Promoting healthy behaviours 14
1.4.1 Rationale for health education 14
1.5 Health promotion 16
1.6 Finding out what’s going on in your community 18
1.6.1 Participation 18
1.6.2 Using multiple methods and materials in health education 19
Case Study 1.1 Meron 19
1.6.3 Organising and planning 19
1.6.4 Audience segmentation 21
1.6.5 Needs-based assessment 22
1.7 Motivation 24
Summary of Study Session 1 25
Self-Assessment Questions (SAQs) for Study Session 1 25
SAQ 1.1 (tests Learning Outcome 1.1) 25
SAQ 1.2 (tests Learning Outcome 1.2) 26
SAQ 1.3 (tests Learning Outcome 1.3) 26
Study Session 1 Starting your Health Education Work: Basic Principles
In this first study session you will learn about the nature of health, health education, health promotion and some related concepts. This will help you as a Health Extension Practitioner to understand the social, psychological and physical components of health. You will also learn about the principles of health education and have the opportunity to consider these basic ideas while planning and carrying out your health education sessions.
Learning Outcomes for Study Session 1
When you have studied this session, you should be able to:
1.1 Define and use correctly all of the key words printed in bold.(SAQ 1.1)
1.2 Discuss the concepts of health, health education, health promotion and some related terms. (SAQ 1.2)
1.3 Describe and discuss the basic health education principles you are expected to apply. (SAQ 1.3)
Your job as a Health Extension Practitioner will be to prevent health problems in your community. Malaria, diarrhoeal disease, measles, tuberculosis, pneumonia, HIV/AIDS, substance abuse and harmful traditional practices are among the health problems you will become familiar with in your community setting. Let’s begin with a definition of health (Box 1.1).
Box 1.1 Defining health 1
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’.
Now stop for a moment and 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?
This definition of health is a widely publicised one. But you may have thought of someone who has a disability or wondered about someone who looks OK but who you know does no exercise. Clearly health is not quite as simple as the definition implies.
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 that you as a Health Extension Practitioner will be expected to understand; a narrow perspective and a broader perspective.
1.1.1 Narrow perspectives of health
People with a narrow perspective 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 (Figure 1.1). Social, emotional and psychological factors are not believed to cause unhealthy conditions. This model is narrow and limits the definition of health to the physical and physiological capabilities that are necessary to perform routine tasks.
According to this definition, the individual is healthy if all the body parts, cells, tissues and organ systems are functioning well and there is no apparent dysfunction of the body.
Figure 1.1 Concentrating only on cells and tissues can lead to a narrow definition of health. (Photo: I-TECH/Julia Sherburne)
Using this model people view the human body in the same terms as a computer, or mechanical device — when something is wrong you take it to experts who maintain it. Physicians, unlike behavioural experts, often focus on treatment and clinical interventions with medication rather than educational interventions to bring about behaviour change.
About two months ago Serena lost her six month old twins. She is grief stricken. She was always slender but now she looks very thin. She cannot sleep, she cannot eat and she doesn’t want to talk to anyone. Do you think the view of health you have just read about applies to Serena?
This view of health ignores many of the social and psychological causes of ill health. Serena’s grief is not an illness but it is certainly affecting her health.
End of answer
In the next section we will discuss the broader perspective of health which includes other factors in addition to physical ones. In your work as a Health Extension Practitioner you will be expected to diagnose the overall social, psychological and physical factors which affect the health of your community and you will have to think about effective interventions accordingly.
1.1.2 Broader perspectives of health
In the previous section you read about a narrow definition of health. This section will help you understand the concept of health in a broader and more holistic way, as defined in Box 1.2.
Box 1.2 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.’
This classic definition is important, as it identifies the vital components of health. To more fully understand the meaning of health, it is important to understand each of its individual components. The broader concept of health can help you as a Health Extension Practitioner when you are planning and implementing your health education activities at community level.
Think back to Serena. Describe her state of health.
Serena is mentally distressed. She does not by any means have ‘mental and social well-being’.