DR.

S MAHMUD MISHU BDS MPH

LECTURER
DEPARTMENT OF PUBLIC HEALTH
SCHOOL OF HEALTH AND LIFE SCIENCE
NORTH SOUTH UNIVERSITY

HEALTH PROMOTION
HEALTH EDUCATION
HEALTH BEHAVIOR
 CONTENTS

 Concepts of Health Promotion & Health Education.

 History of health promotion & Ottawa charter
 Objectives and impact of health promotion and health education.
 Principles and approaches in health promotion and health education
 relationship between health concepts.
 Stakeholders of health promotion.
 commencing towards concepts of health behavior and behavior
changing communication
 HEALTH PROMOTION

Health promotion is the process of enabling people to increase control over, and to
improve, their health

Health promotion is any combination of health, education, economic, political, spiritual or

organizational initiative to initiative to bring about positive attitude-related, behavioral,
social or environmental changes conducive to improving health of a population

Health Promotion is directed towards action on the determinants of health and thus
requires close cooperation of sectors beyond health services, such as education,
agriculture etc.
HEALTH EDUCATION
Health education means a set of
consciously constructed
opportunities for learning to
improve health literacy, including
improving knowledge, and
developing life skills which are
beneficial for individual and
community health

Health education informs

individuals of healthy practices and
lifestyles and motivates or helps
them to adopt to these practices

Health education also advocates

environmental changes as required
to facilitate the goal of improving
health
HISTORY AND EVOLUTION OF HEALTH PROMOTION

1986 1991 2000 2009 2016

Ottawa Charter of Sundsvall Statement Mexico Ministerial Nairobi, Global Shanghai, Global
Health Promotion Statement Conference on HP Conference on HP

Adelaide
Recommendation on Helsinki, Global
Health Public Policy Jakarta Declaration Bangkok Charter Conference on HP

1988 1997 2005 2013

 In 1986, the first international conference on Health Promotion
was held in Ottawa, Canada. The charter outlined 5 areas in which
Health Promotion action should be directed:
1. Building healthy public policy – concern for health, equity
and accountability for health impact. Policy makers
should be informed on health consequences of the
OTTAWA CHARTER formulated policies
(INTERNATIONAL CONFERENCE 2. Creating supportive environments – all development
ON HEALTH PROMOTION) activities should aim for a healthy environment, enabling
reciprocal maintenance (take care of community and
environment)
3. Strengthening community action
4. Developing personal skills
5. Re-orienting health services
 3. Strengthening community action – persuasion of need
identification by group sharing a common need and
establish a mechanism to meet the needs. Equal
OTTAWA CHARTER partnership and access to information is important
(INTERNATIONAL 4. Developing personal skills – to enable individuals to
CONFERENCE ON HEALTH identify, select, and apply healthy options in daily life
PROMOTION) through information, education and communication
5. Re-orienting health services - from clinical or curative to
health promotion and disease prevention
OTTAWA CHARTER
(INTERNATIONAL CONFERENCE
ON HEALTH PROMOTION)

The charter also identified nine (9)

prerequisites:
1. Peace
2. Shelter
3. Education
4. Food
5. Income
6. Stable eco-system
7. Sustainable resources
8. Social justice
9. Equity
PRINCIPLES OF
HEALTH PROMOTION
The five (5) key principles of
health promotion determined by
WHO are:
1. Encompasses population as a
whole
2. Action directed towards the
determinants or causes of
health
3. Ensuring effective and
concrete public participation
4. Applies combination of diverse
but complementary methods
such as education, legislation,
fiscal measure, community
change
5. Used as a social and political
venture and not as a medical
service
STAKEHOLDERS OF HEALTH
PROMOTION
Outside Health Sector Within Health Sector
Education • Environmental Health
Agriculture
• Nutrition
Community services
• Community Nursing
Sports
Media • Mental Health

Community groups • Oral Health

Legal and public works • Hospital (secondary) care
Housing authority
• Occupational therapy
Religious services
 Enable Advocate
Mediate

Enabling people from all walks Coordinated action between Taking a position on an issue to
of life to reduce the inequality all concerned. Professional and influence private and public
by securing a supportive social groups have a major policy choices
environment, access to
role to mediate between Health advocacy promotes
information, life skills and
differing interests in society health or healthcare access in
opportunities
or the pursuit of health individual or community

STRATEGIES FOR HEALTH PROMOTION

Importance of Health Promotion

Focus Strategies Impact Outcome

Education

Counseling
Behavioral or Better Health
Educational
Economic
Individuals change
change
Groups
Legislative
Social,
change
Population economic,
environmental Improved
Policy or
change Quality of Life
Organization
change
HEALTH EDUCATION
“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.” –WHO

The WHO health promotion glossary describes health education as

not limited to the dissemination of health -related information but
also “fostering the motivation, skills and confidence (self -efficacy)
necessary to take action to improve health”,

who.int/iris/handle/10665/119953
So, if we simplify these definitions,
Health education is a systematic, planned application which
qualifies it as a science.

Health education delivery involves a set of techniques rather

than one, such as informational brochures, pamphlets, and videos;
delivering lectures; facilitating role plays or stimulations; group
discussion and different training programs or workshops.

The primary purpose of health education is to influence

antecedents of behavior so that healthy behaviors develop in a
voluntary fashion.

Finally, health education is performed at several levels such as-

One to one Counseling session
group of people focal group discussions
Organizational level Employee wellness fair
Community level Multi approach campaign.
OBJECTIVES OF HEALTH EDUCATION

▪ To increase knowledge of the factors that affect health.

▪ To encourage behavior which promotes and maintain
health.
▪ To enlist support for public health measures.
▪ To encourage appropriate use of health services
especially preventive services.
▪ To inform the people about medical care advancements,
their uses and limitation
APPROACHES IN HEALTH EDUCATION
APPROACHES IN HEALTH PROMOTION & HEALTH EDUCATION

01 02 03 04 05
Medical or Behavioral Educational Empowerment Social
preventive changes/ approaches changes
approaches modifications
MEDICAL OR
PREVENTIVE
 Aims to reduce morbidity and
premature mortality and ensure
freedom from diseases and
disability
 Uses medical intervention
(based on scientific method) to
prevent ill-health or premature
death
 Led by experts or
professionals, requires
compliance. Ignores social and
environmental dimensions
 Examples are Immunization,
screening etc.
BEHAVIOR CHANGE
APPROACH

 Aims to address the

behavioral risk factors and
encourages individuals to
adopt healthy behaviors

 This can be done by educating

the individuals of health
benefits of certain practices
 EDUCATIONAL

Seeks to provide knowledge

and information and to
Strongly linked with health
develop the necessary skills
education
so that people can make
informed decisions about
their behavior

Based on the assumption that

Ignores the social, economic
increasing knowledge may
and environmental
change in attitudes and that
constraints.
may change behavior
EMPOWERMENT
(CLIENT CENTERED APPROACH)

 Helps people to identify their own needs and concerns and gain
the necessary skills and confidence to act upon them (bottom-up
approach)

 Professionals acts as a facilitator rather than an expert

 There are two types of empowerment: Self-empowerment

(based on counseling) and community empowerment (related to
community development to create active participatory
community)
 SOCIAL CHANGE

 Targets groups and populations (top-

down method)
 Sometimes knowns as “radical health
promotion” and underlined by the
belief that socioeconomic
circumstances determine health status
 Focuses on the policy or environmental
level aiming to bring about physical,
social, economic, legislative, and
environmental change
EXAMPLE WITH SMOKING

Behavioral
Medical change Education Empowerment Social change
Encourage people to Prevent nonsmoker Giving information about Clients identify if No smoking policy at
seek early detection form starting effects of smoking they want to know public places
and treatment of smoking anything about it
smoking related Helping them to explore Cigarette sales less
disorders Persuade smokers values and attitudes accessible
to stop
Helping them to learn how Promotion of not
to stop smoking smoking as a social
norm
RELATIONSHIP
BETWEEN
HEALTH
CONCEPTS
 Inter-
relationship
between health
promotion and
health education
HEALTH BEHAVIOR
WHO defined health behavior as
“any activity undertaken by an
individual regardless of actual or
perceived health status, for the
purpose of promoting, protecting
or maintaining health, whether or
not such behavior is objectively
effective toward that end”

Three key foci of this definition

are-
maintenance of health,
restoration of health,
improvement of health
ROLE OF THEORY IN HEALTH EDUCATION & HEALTH PROMOTION

Health education and health promotion have multiple influence from

several disciplines. But the primary influence derived from behavioral
science and social science. In social science, the core concepts are
organized in the form of theories and these theories are developed as
result of researches.

In health education and health promotion, we are primarily interested

in predicting or explaining changes in behaviors or environments. A
theoretical foundation is becoming almost mandatory for practitioner of
health education and health promotion.

We will explore different theories and behavioral changing

communications with the advancement of our course.
BENEFITS OF THEORY IN HEALTH
EDUCATION AND HEALTH PROMOTION

 Helps to distinguish measurable program outcome.

 Specific method for behavior change.

 Identifies the timing for interventions.

 Helps to chose the right mix of strategies.

 Enhance communication between professionals.

 Improve replication.

 Improve program efficiency and effectiveness.

GROUP EXERCISE
& SKILL BUILDING
ACTIVITY

• Pick a health behavior as a health

determinants.
• Chose a target population for
whom this behavior would be most
relevant.
• Now brief/suggest/design health
promotion or health education
interventions to bring positive
changes in this behavior in your
target population
THANK YOU