4 MDL

Module Title Performing Community Mobilization and
Provide Health Education

TTLM Code HLTHES3 MO4 TTLM 0919v1
This module includes the following Learning Guides
LG12: Conduct health education and communication

LG14:Train model families
LG15:Plan and Undertake advocacy on identified health issues
Instruction Sheet #1
LG12: Conduct health education and
communication
This learning guide is developed to provide you the necessary information regarding the following
content coverage and topics:
 Identifying Community gap assessment
 Describing Resource mobilization /organization
 Identifying Target group
 Promoting Health education
 Designing Methods and approaches of health communication
 Providing Health education
 Monitoring and Evaluation of behavioral change and service Utilization
 Promoting Communication skills and health education
 Identifying Methods and strategies of health communication
 Promoting Human behavior and health
 Identifying Barriers of health education communication
 Describing Ethical principles in Health Education
 Performing Information dissemination
 Maintaining work related network and relationship
This guide will also assist you to attain the learning outcome stated in the cover page. Specifically,
upon completion of this Learning Guide, you will be able to:
 Identify Community gap assessment
 Describe Resource mobilization /organization
 Identify Target group
 Promote Health education
 Design Methods and approaches of health communication
 Provide Health education
 Monitor and Evaluation of behavioral change and service Utilization
 Promote Communication skills and health education
 Identify Methods and strategies of health communication
 Promote Human behavior and health
 Identify Barriers of health education communication
 Describe Ethical principles in Health Education
 Monitor and evaluation of service utilization and behavioral change
 Perform Information dissemination
 Maintain work related network and relationship
Learning Instructions:
1. Read the specific objectives of this Learning Guide.

2. Follow the instructions described below 3 to 6.
3. Read the information written in the information ―Sheet 1, Sheet 2, Sheet 3 and Sheet 4‖.
4. Accomplish the ―Self-check 1, Self-check t 2, Self-check 3 and Self-check 4‖ in page -6, 9, 12 and
14 respectively.
5. If you Learned a satisfactory evaluation from the ―Self-check‖ proceed to ―Operation Sheet 1,
Operation Sheet 2 and Operation Sheet 3 ‖ in page -15.
6. Do the ―LAP test‖ in page – 16 (if you are ready).
Author/Copyright: Federal TVET Page 2 of 100
Health Extension Service L- III HLT HES3 TTLM 0919v1 Version -1
Agency
Sept. 2019
Information Sheet-1 Identifying Community need assessment
1.1. Community need assessment

1.1.1 Concept of need assessment
 A needs assessment is a systematic process for determining and addressing needs, or
"gaps" between current conditions and desired conditions or "wants".
 Before implementing successful health education and promotion activities felt needs/real
need of the community should be assessed and identified.
 The health needs of individual patients coming to take health service may not reflect the
wider health needs of the community. Distinguishing between individual needs and the wider
needs of the community is important in the planning and provision of local health education
program.
 Health needs assessment is the systematic approach to ensuring that the health service
uses its resources to improve the health of the population in the most efficient way. It
involves describing health problems of a population; identify inequalities in health and
access to services; and determine priorities for the most effective use of resources. You
should able to identify, prioritize and select health education and promotion.
 It can be an effective tool to clarify problems and identify appropriate interventions or
solutions. By clearly identifying the problem, finite resources can be directed towards
developing and implementing a feasible and applicable solution.
 Gathering appropriate and sufficient data informs the process of developing an effective
product that will address the groups‗needs and wants.
 Conduct need assessment because it:-
 Provide evidence about a population on which to plan health education program
 Provides an opportunity to engage specific populations and enable them to
contribute in planning and resource mobilization.
 Provides an opportunity for cross-sectoral partnership working with local and
religious leaders and effective interventions
 Helps you in determine priorities for the most effective use of resource.
1.1.2 Steps in community health information need assessment
 To perform community need assessment in your area you need to follow certain steps
to accurately identify the problem. This need assessment encompass a process of data
collection and analysis. (You will learn more about data collection in health service
management module of this curriculum)
 There are some essential steps involved in assessing community health information needs.
1. Getting started
 It is the first step in assessing health information needs of certain community. At this
stage you will be able to identify the population to be assessed, rational of
assessment and community members to be involved.
 At the end of this stage you should be clear about the population you are working
with and clarified aim of assessment and its boundary.
2. Identifying heath priorities
 This phase stage involves serious data collection and analysis. Using the collected
data you will identify major determinants of the gap occurred and develop general
description of the problems. Based on this profile you will be able to prioritize them in
terms of their changeability and importance.

Agency
Sept. 2019
 At the end of this stage you will have short list of factors that hinder access to
health information and their priority in terms of changeability and importance.
3. Assessing a health priority for action

 This stage encompass what changes can you make that will have positive impact
on significant issues affecting the identified factor. At the end of this stage you will
have actions used to reduce the gap and which are acceptable and cost-effective.
4. Planning action
 Now you have worked out what changes you want to make in order to tackle your
choose priority problem. The major task of this stage is developing agreed aims,
objectives, and targets. Health problems of a population; identify inequalities in health
and access to services; and determine priorities for the most effective use of
resources. You should able to identify, prioritize and select health education and
promotion.
 The discrepancy between the current condition and wanted condition must be
measured to appropriately identify the need. The need can be a desire to
improve current performance or to correct a deficiency
5. Program review/monitoring and evaluation
 This is the final stage of health information need assessment. At this stage you
will check your achievement against original aims and objectives.
 You will also assess the opportunities and challenges of your course of action. At
the end you should transfer lesson learned from the program to other programs.
 To successfully assess the need of certain community following the above five stage
is important. To support it program development, team working, community
involvement, data collection and analysis skills are important.
Figure 1.1:- Steps to be followed during need assessment

Agency
Sept. 2019
1.1.3 Need assessment techniques
 Need assessment encompass date collection and analysis.
 The data sources may be from:-
 Primary sources are date which collected by you while need assessment by interview,
discussion and any other ways.
 Secondary data sources are data that is already collected and documented by anybody
else at deferent area.
 Different data-collecting techniques available for carrying out needs assessment.
Various techniques can be used to collect data from the community.
 The techniques are discussed under four categories: individual, group and secondary
source.
1 Individual technique
 Individual techniques involve collecting data from people one at a time. The people from
whom the needs assessment data are collected do not interact with one another in the
course of providing data.
 Individual techniques include:-
A. In-depth interview
 In-depth interview is an individual based interview used to explore individuals‗ beliefs,
practices, experiences and attitudes in greater detail.
 The health extension worker can identify health information needs of the community as
well as their feeling, attitude, and motivation towards health education messages. The
major aim of in-depth interview is to assume enough exploration of the issue at hand.
 During in-depth interview it is preferable to use open ended questions rather than closes
ended questions with yes or no responses.
 While conducting in-depth interview you the following steps should be followed:-
 Select participants -identify an individual with whom you are going to conduct an in-
depth interview, obtain their consent and arrange a time.
 Prepare your interview guide - this is a list of questions you can use to guide you during
the interview.
 Write down the responses truthfully. You can also use a tape recorder to record the
responses.
 Prepare report - after the interview is completed, review your notes or listen to the tape
and prepare a detailed report of what you have learned.

Agency
Sept. 2019
Figure 5.2:- In-depth interviews can help you gather a lot of information that will help you plans
your health education activities. Make sure that you have accurately record individual‗s
response.
B. Key informant interview

 Key informants are people who are considered experts in a given area because of
their professional knowledge or their position of influence in the community or
organization. Examples include teachers, religious leaders, grass-roots workers, and
traditional and political leaders.
 The community members are with their particular knowledge and understanding,
represent the views of an important sector of the community. They can provide you with
detailed information about the community, its health beliefs, cultural practices, and other
relevant information that might help you in your work.
C. Questionnaires
 This needs assessment technique tends to be more structured than interview schedules
and can be administered to each participant. We use questionnaire when we are
dealing with literate communities.
 Questionnaire is a list of question to be asked our participants about the selected
problems. It may include different types of questions; both open ended and close ended
questions.
D. Observation
 Three methods including interviews provide information about people‗s beliefs,

attitudes, values, and reported behavior.
 Observation provides information about actual behavior. To carry out an observation,
you watch and record events as they are happening.
 Observation is important to see people‗s cultures, norms and values in their social
context and hidden peoples behavior. This needs assessment technique is based on
using rating forms, checklists, or observation schedules for collecting information.
2 Group techniques

Agency
Sept. 2019
 Group techniques allow participants to interact with one another during needs assessment
activities.

Agency
Sept. 2019
 Successful needs assessment depends on competent leadership and on having
participants who have both the knowledge and willingness to participate actively in the
interactive group process.
A. Focus group discussion
 Focus group interview is defined as a technique in which a group of people who

possess certain characteristics provide data of a qualitative nature in a focused
discussion.
 Focus group is a group of 6 to 8 individuals who have been selected because they
share certain characteristics which are relevant for the topic to be discussed.
 Steps in arranging focused group discussion:-
 Selection:-Select 6–12 individuals for your focus group discussion. This selection
of participant is based on specific criteria from the total population.
 Focus group discussion guide preparation: - This is a set of questions which are used
to facilitate the discussion.
 Assign facilitator:-There should be one person who facilitates the discussion, and
another person who takes notes during the discussion. If possible, it is also useful to
record the discussion using a tape recorder, so that you can listen and analyze it later.
 Data analysis and reporting:- Data analysis and reporting followed the
interpretative summary format, whereby the data were not only described but also
interpreted.
B. Delphi method
 In this technique, people with exceptional knowledge about a given subject area are
involved in repeated questioning and feedback, using written questionnaires, until a
consensus is reached on the subject.
C. Informal Group Methods
 This category includes gathering information at group meetings and social gatherings. It
is common for participants at meetings to talk about issues and problems in their family,
community, or organization even when they are not part of the agenda.
1.1.4 Secondary Sources review
 Secondary data is defined as "information gathered for other purpose than the immediate
or first application".
 Secondary data sources include census reports, previous studies, and administrative
records and reports. Extension staffs rarely use these data sources in needs
assessment, probably because their application is not clear-cut.
 What community need do you think health extension practitioners should assess?
A. Health need assessment
 It identifies health problems prevalent in your community. In other words, you look into
any local health conditions which are associated with morbidity, mortality and disability.
B. Community resource need
 The local community needs to be equipped with the necessary resource in order to tackle the
identified health problems in your community, as well as to bring about the desired
behavioral change. Therefore, you need to check the availability of resources to the local
community in line with the health need assessment.
C. community resource
Agency
Sept. 2019
 The people or any organizations in the community have some sort of contribution for any
community health activities. Therefore, during a needs assessment, you also need to
identify

Agency
Sept. 2019
the resources available in the community. This includes the help from the community leaders,
religious leaders, and volunteers.
D. Audience segmentation
 Audience segmentation is the process of dividing a broad target audience into more
homogeneous subgroups. The purpose of dividing up an audience into segments is to
make your program more effective and to use your resources wisely.
Self check #1 Written test

Direction: - Choose the correct answer from the given alternatives
1. Data that is already collected and documented by anybody else at deferent area.
A. Primary sources B. Secondary data C. Tertiary source D. None
2. Obtain information about actual behavior you watch and record events as they are happening.
A. Questionnaire B. Interview C. Observation D. Group discussion
3. List of question to be asked our participants about the selected problems.
A. Observation B. Delphi methods C. Questionnaire D. Focus group discussion
4. It identifies health problems prevalent in your community.
A. Health needs assessment B. Audience segmentation C. community resource D. All
Note: Satisfactory rating - 4 points unsatisfactory below-4 points
You can ask you teacher for the copy of the correct answers
Answer Sheet
Score
Rating
Name: Date:
Short Answer Question
1.
2.
3.
4.

Agency
Sept. 2019
Information sheet #2 Describing Resource mobilization /organization
1.2 Resource mobilization /organization

1.2.1 community mobilization
 Community refers to an area or a village with families who are dependent on one another in
their day-to-day, thereby creating mutual advantages.
 To mobilize means to organize or assemble power, force, wealthy and other resources to
increase a full stage of development.
 Community mobilization is defined as a process whereby a group of people have
transcended their differences to meet on equal terms in order to facilitate a participatory
decision-making process.
1.2.2 Basic concept of community mobilization
 Community mobilization is an attempt to bring both human and non-human resources
together to undertake developmental activities in order to achieve sustainable development.
Community mobilization is a process through which action is stimulated by a community itself,
or by others, that is planned, carried out, and evaluated by a community‗s individuals, and
groups. It is an organization on a participatory and sustained basis to improve the health,
hygiene and education levels so as to enhance the overall standard of living in the community.
 Most valuable resource in the community is our own people. They can make decisions about
the development and health care service of the surrounding. Cooperation among community
people is important to develop the community self-sufficiency and self-reliance.
 The community has an important role to identify and use available resources in the kebele,
and to plan and act accordingly. Where there is a mechanism of local self-government,
important decisions are usually made at the local level by the local people themselves.
 Development and health goals cannot be achieved without effective participation of the
community. So community mobilization is concerned about organizing the community and all
the resources available in the community to move them towards achieving this health goal.
 It is an initial and ongoing process central to any community and social change effort that
seeks to build support and participation of individuals, groups, and institutions to work towards
a common goal or vision. It can be viewed as a process which begins a dialogue among
members of the community to determine who, what, and how issues are decided, and also to
provide an opportunity for everyone to participate in decisions that affect their lives.
Figure 2.1:- A community working together will make sure that programme resources will be
complemented by community resources.

Agency
Sept. 2019
 Sense of immobility arises from a number of factors:
 The misperception that politicians and bureaucrats will alleviate their problems for them,
 A lack of expertise amongst the community to facilitate such organization,
 The unwillingness of the community as a whole to give up individual interests to form
a broader cooperative, and
 An extreme shortage of available resources to facilitate the mobilization process.
 Community mobilization allows you to:
 Identify needs and promote community interests.
 Promote good leadership and democratic decision making.
 Identify specific groups for undertaking specific problems.
 Identify all the available resources in the community.
 Plan the best use of the available resources.
 Enable the community to better govern itself
Figure 2.2:- community is a collection of families who are dependent on each other.
 steps in community mobilization:-

 Create awareness of the health issue
 Motivate the community through community preparation, organizational
development, capacity developments and bringing allies together
 Share information and communication
 Support them, provide incentives and generate resources

Agency
Sept. 2019
1.2.3 Benefits of community mobilization
 The most significant benefit is doing something to help address an issue impacting their
community to save valuable resources. By getting involved, community- and faith-based
organizations, health care professionals, and policy makers will jointly take actions that
answer their community‗s problem.
 Community mobilization can:-
 Infuse new energy into an issue through community buy-in and support.
 Expand the base of community support for an issue or organization.
 Help a community overcome denial of a health issue.
 Promote local ownership and decision-making about a health issue.
 Limit competition and redundancy of services and outreach efforts.
 Create public presence and pressure to change laws, polices, and practices progress
that could not be made by just one individual or organization.
 Bring new community volunteers together (because of increased visibility).
 Increase cross-sector collaboration and shared resources.
 motivating the people and encouraging participation
 Increase access to funding opportunities for organizations and promote long-term,
organizational commitment to social and health-related issues.
Figure 2.3: women‗s army, HEW and health center head on community mobilization. (Photo:
Mohammed Hussein, 2012)

Agency
Sept. 2019
1.2.4 Community mobilization action cycle
 Mobilization process by organizing your plan of work with the community. After that you
can explore all the most important health issues in order to understand what is currently
happening in the community.
 Once the health issues are fully explored, you can set priorities, develop a more detailed
plan of work, and carry out the plan. During implementation of the programme, you
should monitor and finally evaluate your activities.
 The Community Action Cycle is a set of stages and steps that community members
can follow to take action in a participatory and systematic way
Figure 2.4:- Community Action Cycle
 Prepare to mobilize – at this stage you will learn about the communities in which they
will work and the key issues/health problem. They come to understand the importance of
the program.
 Organizing community- establishes relationship with community and invite
for participation. Plan and select a strategy together to solve the problem.
 Explore health issue and set priority- explore and discuss on the issues in order
to identify key actors and stakeholders (village chief, Imam, heads of families, etc.)
 Plan with the community- develop a Community Action Plan that sets out what action the
community will take, who will be responsible and when actions will be taken. Mobilize
these key actors and stakeholders for action (discussions and agreement on what to do).
◻
 Act together- putting their plans into action and monitor the progress. Implement
activities to work towards a solution (capitalize on the sensitization of the people created
by the workshop and intensify this through various follow-up activities).
 Evaluate together- conduct participatory evaluations and thereby measure the impact
Agency
Sept. 2019
of activities carried out to solve the problem.

Agency
Sept. 2019
 Prepare for scale up-Improve activities, based on the findings of the assessment. You
can use findings to begin a new cycle. This is also the time to start sharing success stories.
1.2.5 Techniques to involve a community

 To work with the community you need to identify the right people in the community who can
explain to you their habits, customs, values, taboos and the rules of that community.
 It is also good to know and develop relationships with other influential people within your
localities, such as the religious leaders and kebele leaders, in order to be accepted by the
community..
1 Community relation
 The community members are central to all parts of the Health Extension Programme. If you
are not involving the community the Health Extension Programme will fail. Community
relations are those methods and activities that you undertake to establish and promote a
setting that is conducive to good relationships, and which create a strong bond with the
community.
Figure 2.5:-Typically community mobilization will involve a series of community meetings.
2 Effective networking
 Successful implementation of development activities, you need to involve everyone in a
community network, especially those with power (the decision makers in the community),
as early and as often as possible.
 The community using one or more of the participatory methods, such as small groups,
large meetings, community conversation, local celebrations or exhibitions.
 You should also identify health objectives for your community, and use the right
approaches to engage the whole community. Invite the whole community and
representatives to meetings, and secure their approval for your advocacy objectives. Then
ensure clarification of the roles of all the people involved.
 Advantage of community participation
 Community mobilization it is necessary to employ effective community participation.
 Community has different resources to deal/solve with existing health problem.

Agency
Sept. 2019
 During every program don‗t do everything for community rather helps them to solve
their problem by their own effort and resource.
 Involving local people helps to increase the resources available for the programme,
promotes self-help and self-reliance, and improves trust and partnership between
the community and health workers.
 Level of community participation

 The extent of participation of community members in a program may be minimum or
complete as ownership. It ranges from co-option to collective action.
Figure 2.6:- Community ownership and sustainability
 Community participation increases, community ownership and capacity increases. These

degrees of participations are:-
 Co-option: Local representatives are chosen, but have no real input or power
 Compliance: Tasks are assigned with incentives, but outsiders decide the agenda and
direct the process.
 Consultation: Local opinions are asked for, and outsiders analyze and decide on a
course of action.
 Cooperation: Local people work together with outsiders to determine realities;
responsibility remains with outsiders for directing the process.
 Collective action: Local people set their own agenda and mobilize to carry it out, in the
absence of outside initiators and facilitators
 Co-learning: Local people and outsiders share their knowledge to create a new
understanding, and work together to form action plans, with outsiders facilitating.
 There are two of the commonly used participatory tools:-
A. Community mapping
 During community mapping a map is drawn of selected physical features on a flat surface.
The selected features for a village could be: The natural resource, the poverty patterns
the territory of the village, the housing patterns, the cropping patterns, the space and the
area the village occupies.
 Community mapping is an assessment tool that can help communities and Health
Extension Practitioners identify and understand the real situations in local communities
Agency
Sept. 2019
that positively or negatively impact their health. The process of doing a community map is
really important and can help people understand health problems in their community.
Figure 2.7:- Community mapping help to identify community health
B. Community conversation
 People have the knowledge, capability and resources that can bring about positive health
outcomes individually and collectively, once the community perceives ownership of a health
problem.
 Community Conversations provide a safe space in which people come together for
thoughtful discussion and dialogue about shared values.

Agency
Sept. 2019
Figure 2.8:- the process of community conversation gives community members ownership of their
problems.

Direction: - Choose the correct answer from the given alternatives
1. From level of community participation Local people work together with outsiders
to determine realities; responsibility remains with outsiders for directing the
process.
A. Compliance B. Consultation C. Cooperation D. Collective action
2. Stage you will learn about the communities in which they will work and the key issues
health problem.
A. Prepare to mobilize B. Organizing community C. Plan with the community
3. Steps in community mobilization:-
A. Create awareness B. Motivate the community C. Share information D. All
Note: Satisfactory rating 3 points unsatisfactory below 3 points
Answer Sheet
Score
Rating
Name: Date:
1.
2.
3.

Agency
Sept. 2019
Information sheet #3 Identifying Target group
1.2.Target group identification
 Target is an individual with decision maker power to respond to your advocacy demands.
Nearly always you will have a primary target, policy maker to whom advocacy is targeted
and secondary targets that have some influence over the primary target.
 You should decide which audience to target through advocacy, and you must carefully
determine the advocacy goals and objectives
 Criteria to include in the target group
 Better access of education for the children
 Involvement in agricultural extension package
 Better exposure for the mass-media--good exposure for the international as well as
national information
 Better educational status--at least can read and write
 Credibility in the community--influential or opinion leader
 Better socio-economical status in the community
 Willingness and eagerness to participate in health development activities

Agency
Sept. 2019
Direction: - say ―True‖ or ―False‖
1. Target is an individual with decision maker power to respond to your advocacy demands.
Note: satisfactory rating 1 point unsatisfactory below 1 point
You can ask you teacher for the copy of the correct
answers Answer Sheet
Score
Rating
Name: Date:
1.

Agency
Sept. 2019
Information sheet #4 Promoting Health education
1.4 Health education
1.4.1 Planning for health education
 Planning can be defined as a process of making thoughtful and systematic decisions
about what needs to be done, how it has to be done, by whom, and with what
resources.
 Health Planning refers to process of defining community health problems, Identifying
needs and resources, establishing priority goals, and setting out the administrative
action needed to reach those goals.
 Importance of planning
 Planning enables you to match your resources to the problem you intend to solve.
 Planning helps you to use resources more efficiently so you can ensure the best use
of scarce resources.
 Planning can help avoid duplication of activities.
 Planning helps you prioritize needs and activities.
 Planning enables you to think about how to develop the best methods with which to
solve a problem.
 Steps of health education program planning process
Figure 4.1:- Steps in planning health education activities

Agency
Sept. 2019
1. Assess need
 Conducting a need assessment is the first, and probably the most important, step in any
successful planning process.
 A needs assessment is a systematic process for determining and addressing needs,
or "gaps" between current conditions and desired conditions or "wants". The discrepancy
between the current condition and wanted condition must be measured to appropriately
identify the need. ...
 Community health needs assessment is a process that describes the state of health of
local people; enables the identification of the major risk factors and causes of ill health;
and enables the identification of the actions needed to address these.
 Type of information would you compile/gather at the end of your need assessment?
a) The community and its general socio-economic, demographic and
physical characteristics
 The size of the community (average size of the household) and their sex and age
group, Average number of pregnancies, births and deaths,the economy and its impact
on health, religion and its impact on health, kind of natural resources existing in the
community, the transportation routes and the communication network and public and
private institutions like schools, religious institutions, health facilities.
b) Health beliefs and practices
 Cultural beliefs, attitudes and practices of the community have great influences on
the delivery of the health services.
2. Identifying and prioritizing health problems
 This step is logically done after the need assessment is completed. From the
need assessment result it is possible to identify and list a number of community
health problems and their potential causes
 Identification of the possible causes of disease and other health problem is
another activity and it addresses scientific and cultural perspectives as a cause of
a certain disease.
 After identifying list of problems is prioritization it is a kind of decisions made to put
the identified problem in the order of their urgency, importance and changeability.
 Criteria to prioritize problems
a) Magnitude of the problem: - Are a large number of people affected by the problem?
Is the problem widespread in the community?
b) Severity of the problem: - Does the problem lead to serious illness, death
or disability?
c) Feasibility of the intervention: - Are you able to solve the problem with the
resources you have? Can the problem be tackled with the resources you have?
d) Government concern: - Do the official people want you to tackle this problem?
e) Community concern: - Does the community really want to deal with the problem?
 Listing the criteria does not mean that the problem is already prioritized and ready for
intervention. Rather scoring the points from one to five to each of the problems
makes the prioritization process easier.
 A score of one is the minimum value and the problem is given less concern and a
score of five is the maximum and it means the problem is given more concern.
 Finally the values are added and the total is known, and then ranks the problem with
a largest total value first and so on.
 The second option you have available in prioritizing health problems is to ask a group
of stakeholders, such as community members or other health workers, to prioritize the
problems according to their knowledge and experience
Agency
Sept. 2019
3. Setting Goals and Objectives
 As soon as the problems are prioritized, your next duty will be setting an appropriate
goals and objectives. Both terms imply the target that one's efforts is desired to
accomplish.
 Goals are generically for an achievement or accomplishment for which certain efforts
are put.
 Objectives are time-related to achieve a certain task, and answer the following questions:
 What? Things to be achieved
 Where? Place of action
 Who? The target group
 When? By what time or date?
 Objective should be 'SMART'--it is an abbreviation and stands for the following five criteria
of good objectives S-specific M- measurable A- achievable R- relevant T- time bound.
 Types of objectives in health education
 Health Objectives:-tell you how big the health problem is, and how much it should be
improved.
 Behavioral objectives:-these objectives are related with what the community need to do
or how should they act in order to prevent and control diseases..
 Learning/educational objectives :-these objectives work towards the development of
the knowledge, skill and attitude of the community which helps them to prevent and
control diseases
 Resource objectives:-these objectives are directed to provide the community with the
specific environmental support so that they can be able to participate in the program and
enabled against any community health problems.
4. Developing appropriate Methods/strategies
 Some basic issues to consider before choosing health education methods/strategies.
 How fast do people change? Some people are ready for change and are
economically able to do the advice easily. On the other hand some are ready but
influence from others could hinder.
 How many people are involved? the number of participants can vary from an
individual to family or even to a large number of people
 Is the method appropriate to the local culture? Culture refers to the ways of life of
the community; Therefore, your health education should consider the local knowledge
level, beliefs, attitudes and skills of the community.
 What resources are available? Some methods require the use of: tape recorders,
films or slide projectors, which at the same time require electricity. Other methods
require the use of teaching aids such as posters, flannel graphs, demonstrations,
models, flip charts and the like. What combined methods are needed? Use of a
multiple educational methods makes the audience to easily remember the subject
matter. For example: lecture with discussion, lecture with demonstration...etc
 What methods fit the characteristics (age, sex, religion etc) of the target group?
Health education could be designed for various groups of people: old, young, women
groups, children and so on. Select and adapt your methods to fit the type of people
you meet.

Agency
Sept. 2019
5. Develop your work plan/Action plan
 A plan of work is simply putting together all the components you have worked out to
deliver your health education messages. It is a picture or map‖ of what to do, when to do
it, who will do it, and at what cost each step of activities be accomplished.
 The plan should contain the following elements:
1. Clear objectives 4. Who will help you?

2. Your strategies
3. A list of activities that you will do 5. Resources to be used
6. Timing
6. Implement health education program
 Implementation is a process of bringing the planned activities in to action. Or it is
converting your planning, objectives and strategies in to action according to the plan of
work

Agency
Sept. 2019
Direction: - Choose the correct answer from the given alternative
1. A systematic process for determining gaps between current conditions and desired
conditions or "wants" A. Objective B. Need assessment C. prioritization D. None
2. Action plan contain. A. list of activities B. Resources C. Timing D. All
3. objectives are related with what the community need to do or how should they act in order
to prevent and control diseases A. Health Objectives B. Behavioral objectives C.
Educational objectives D.Resource objectives
Score
Rating
Name: Date:
1.
2.
3.
Information sheet # 5 Designing Methods and approaches of health communication

1.5. Designing Methods and approaches of health communication
Agency
Sept. 2019
1.5.1 .Teaching methods in health education
 There are various formal and informal ways in which health education messages are
transmitted to the target audiences..
I. Individual health education methods
1. Counseling
 Is one of the approaches most frequently used in health education to help individuals and
families?
 It is a person-to-person communication in which one person explicitly and purposefully
gives his time to assist another individual to increase in understanding, ability and
confidence to find solutions to own problems.
 Purposes of counseling
 To help individuals increase knowledge of self
 To encourage individuals or families to think about their problems and understand the
causes.
 Help people commit themselves to take action on their own will to solve the problems
 Help individuals to choose, but not forcing them to do so.
 Principles in counseling
 Counseling requires establishing good relationship between the counselor and the client
 Counselors should assist people identify their own problems.
 Counselors develop empathy (understanding and acceptance) not sympathy for person‗s
feelings.
 Counselors should never try to persuade people to accept their advice.
 Counselors should always respect the privacy of the people they are helping.
 Approaches to counseling
 By using the 'GATHER' approach you can conduct an effective counseling. However, the
word 'gather' is an abbreviation created by taking the first letter from each six steps.
 Greet the individual/client by name: show him respect and trust, and tell him that the
discussion is always confidential.
 Ask about problems as well as how he believes that you can help him.
 Tell him any relevant information that he need to know.
 Help him to make his own decisions and guide him to look at various alternatives.
 Explain any misunderstandings. Ask some questions in order to check his understanding
of important key points and repeat those key points in his own words if necessary.
 Return for follow-up and make arrangements for further visits, or referral to other
institution.

Agency
Sept. 2019
Figure 5.1:- Counseling helps an individual to choose and make decisions.
 The advantages of home visits

 When people are in their home, they usually feel happier and more secure.
 It also gives an opportunity to see how the environment and the family situation might affect
a person‗s behavior.
 Keeps a good relationship with people and families
 Encourages the prevention of common diseases.
 Enables detecting and improving troublesome situations early, before they become big
problems.
 Enhances checking on the progress of a sick person, or on progress towards solving other
problems.
 Motivate the family on how to help a sick person in which their participation is needed.
2. Group health Education Methods
 A group could be defined as a gathering of two or more people who have a common
interest. For example: A Family, A health committee, A class of school students, A youth
club, A gathering of patients at a clinic, People riding together on a bus...etc
 There are two main kinds of group
a) Formal groups: groups that are well organized with some rules and regulations E.g.
Farmer‗s cooperative, Women‗s Associations
b) Informal groups: groups that are not well organized E.g. People attending market on a
particular day
 Characteristics of formal group
 Has a purpose or goal that everyone strives to achieve together.
 There is a set membership, so people know who is a member and who is not.
 There are recognized leaders who have the responsibility of guiding the group towards
achievement of its goals.
Agency
Sept. 2019
 There are organized activities such as regular meetings and project.
 The group has rules that members agree to follow and works towards the welfare of the
members
 Characteristics of informal gatherings
 May have some features in common, but no special goal that they are trying to achieve
together.
 No special membership or feeling of belonging
 People come and go at will
 No special leader selected, no special rules apply
 Usually no special activity is planned by the people themselves There is usually more
concern for self, and less for the welfare of the other people.
 Common group health education methods
A) Lecture method
 A lecture is usually a spoken, simple, quick and traditional way of presenting your subject
matter, but there are strengths and limitations to this approach.
 The strengths include the efficient introduction of factual material in a direct and logical
manner. However, this method is generally ineffective where the audience is passive and
learning is difficult to gauge. Experts are not always good teachers and communication in a
lecture may be one-way with no feedback from the audience.
B) Lecture with discussion
 This approach is very important because it always involve your audience after the lecture in
asking questions, seeking clarification and challenging and reflecting on the subject matter.
There becomes always active participation from the side of the attendants. i.e., participants
are not passive as in the case of lecture method.
C) Group discussions
 Discussion in a group allows people to say what is in their minds. They can talk about
their problems, share ideas, support and encourage each other to solve problems and
change their behavior.

Agency
Sept. 2019
Figure 7.2 group discussions facilitate the participation of each group members to freely express
his opinions and feelings towards the problem/issue and is appropriate for problem solving
situations.
 Planning a discussion involves:

 Identification of the discussants that do have a common interest
 Getting a group together
 Identification of a comfortable place and time
 Conducting the discussion

 Introduction of group members to each other
 Allow group discussion to begin with general knowledge
 Encourage everyone to participate.
 Have a group act out some activity (drama, role play)
 Limit the duration of discussion to the shortest possible, usually 1-2 hrs.
 Check for satisfaction before concluding the session.
D) Buzz group
 It is a type of group discussion In which a large group will be divided into several small
groups, of not more than 10 or 12 people (buzz groups). You can then give each small
buzz group a certain amount of time to discuss the problem.
 The whole group comes together again and the reporters from the small group report
their findings and recommendations back to the entire audience.
 A buzz group is also something you can do after giving a lecture to a large number
of people, so you get useful feedback.
E) Meetings
 Meetings are good for teaching something of importance to a large group of people.
They are held to gather information, share ideas, take decisions, and make plans to
solve problems.
 Meetings are different from group discussions. A group discussion is free and informal,
while meetings are more organized.
 Meetings are an important part of successful self-help projects.
 When you are planning a meeting, it should be need based, determine the time and
place announce the meeting through village criers or word of mouth and prepare relevant
and limited number of agendas.
F) Clubs
 There are many kinds of organizations to which women, men and young people belong.
Clubs are becoming popular in many areas. They provide an opportunity for a
systematic way of teaching over an extended period of time.
G) Demonstrations
 A demonstration is a step-by step procedure that is performed before a group. They

involve a mixture of theoretical teaching and of practical work, which makes them lively.
 It is used to show how to do something. The main purpose of demonstrations is
helping people learn new skills.
 The size of the group should be small to let members get the chance to practice. It is
particularly useful when combined with a home visit. This allows people to work with
familiar materials available in the locality.
Agency
Sept. 2019
 Demonstration sessions usually focus on practice, they also involve theoretical teaching
as well „showing how is better than telling how‟
 This is because you can remember 20% of what you hear, you remember 50% of what you
hear and see, you remember 90% of what you hear, and see and do with repetition, close
to 100% is remembered.
Figure 5.3:- Demonstrations should be performed to promote skills of the participants.
 Procedures/steps of demonstration
 Introduction: Explain the ideas and skills that you will demonstrate and the need for it
 Do the demonstrations: Do one step at a time, slowly. Make sure everyone can
see what you are doing. Give explanations as you go along
 Questions: Encourage discussion either during or at the end of the demonstration.
Ask them to demonstrate back to you or to explain the steps.
 Summarize: Review
 Qualities of good/effective demonstrations
 Identify the needs of the group to learn
 Collect the necessary materials such as models and real objects or posters
and photographs.
 Make sure that it fits with the local culture.
 Prepare adequate space so that everyone could see and practice the skill.
 Choose the time that is convenient for everyone.
H) Role - playing
 Role-playing consists of the unrehearsed and spontaneous acting out of real-life situations
and problems.

Agency
Sept. 2019
 The player tries to behave in a way that the character might behave when faced with
a given situation or problem.
 Role-playing can be used to start off a discussion, to see what possible consequences of
a certain action are, and to develop a better understanding of why people feel as they do.
Fig 5.4: Role play is one effective health education method especially for illiterate member of our
community.
 Behavior during a role-play, we can discover how our attitudes and values
encourage cooperation and problem solving or, how our attitude and values create
problems.
 During a role-playing participants are selected randomly or blindly and are given a role
or character and have to think and speak immediately without detailed planning, because
there is usually no script.
 Role play is usually undertaken in small groups of 4 to 6 people.
 Role play is a very powerful thing and works best when people know each other, don‗t
ask people to take a role that might embarrass them. Sometimes role play involves some
risk of misunderstanding, because people may interpret things differently.
I) Drama
 Dramas need script, rehearsal and preparation which done on one main learning
objective but can often include 2 or 3 other less important objectives as well.
 Alike stories, dramas make us look at our own behavior, attitudes, beliefs and values in the
light of what we are told or shown. Plays are interesting because you can both see and
hear them.

Agency
Sept. 2019
 It is a suitable teaching method for people who cannot read, because they often
experience things visually. However the preparation and practice for a drama may cost
time and money.
 Let us look at some of the following traditional means of communications which are used
by the community to express their local culture such as their knowledge, feelings,
happiness, sadness or any life situations to others.
J) Songs/dances
 To expression of feelings, songs can also be used to give ideas about health with dances
or some times without dances. For example, the following issues could be entertained:
 The village without safe water, the malnourished child who got well with the proper food
to eat, the village girl who went to school to become a health extension worker.
K) Stories
 Stories often tell about the deeds of famous heroes or of people who lived in the village
long ago. Story telling is highly effective, can be developed in any situation or culture, and
requires no money or equipment.
 It should include some strong emotions like sadness, anger; humor, or happiness as well
as some tension and surprise. An older person, instead of directly criticizing the behavior
of youth, may tell stories to make his/her points. She/he may start by saying.
 I remember some years ago there were young people just about your age and
then continue to describe what these young people did that caused trouble.
l) Proverbs
 They are short common-sense sayings that are handed down from generation to generation.
 For example: Amharic proverb ―Tamo Kememakek Askedimo Metenkek
specify "prevention is better than cure", Dir biyabr anbessa yasir‗
 The above proverbs will specify the importance of working together in other term
community participation.
 "If I hear, I forget, If I see, I remember If I do, I know" Chinese proverb:
 Which state about active learning or learning by doing.
 "One does not go in search of a cure for ringworm while leaving leprosy
unattended." This is to mean that trying to solve the most serious problem must
come first.
5.2 Approaches of health education
 Generally there are two different approaches in health education. These are:-
1. The persuasion approach
 Persuasion approach of health education is the deliberate attempt to influence the other
persons to do what we want them to do. It is sometimes called directive approach or
done forcefully.
 Such approach is used in situation where there is serious treat such as epidemics
and natural disaster and the action needed are clear-cut.
 This approach will be used when the behavior change expected should be urgent and
does not permit time until the community member process the new knowledge and decide.
 During such condition, health extension workers will provide fear arousal types of
messages in order to alert the public easily.

Agency
Sept. 2019
 During persuasion approaches of health education health extension workers should confirm
that the recommended activities are scientifically accepted and can be applies with that
current condition.
 Most of the time persuasion approaches of health education use clear and
easily understandable communication words.
2 .The informed decision making approach
 In infirmed decision making approach health extension workers gives people
information, problem solving and decision making skills to make decisions but
the actual choice will left to the people.

1. step-by step procedure that is performed before a group

A. Lecture B. meeting C. Demonstration D. stories
2. Approach of health education is the deliberate attempt to influence the other persons to do
what we want them to do.
A. persuasions‘ approach B. informed decision making approach C. None
3. Characteristics of formal group A. Has a purpose or goal.
B. A set membership C. Are organized activities D. All
4. Individual health education methods A. counseling B. stories C. Drama D. Proverb
Score
Rating
Name: Date:
1.
2.
3.
4.

Agency
Sept. 2019
Information sheet #6 Providing Health education
1.6. Health education provision

1.6.1 Basic concept of health promotion
 Health promotion is any planned combination of educational, political,

environmental, regulatory, or organizational mechanisms that support actions and
conditions of living conducive to the health of individuals, groups, and communities.
 Combination- refer to that health promotion activity need joint efforts of different
sectors. It also refers the necessity of matching multiple determinants of health
with multiple intervention or sources of supports
 Conducive- refers activities of different sector should create favorable conditions
to the health of the community. E.g. As number of educated females increase in the
community the health status of this household lead by them will be improved. So
education supports health system directly as well as indirectly.
 Health promotion: - the process of enabling people to increase control over, and to
improve, their health‗can be considered as an umbrella term that incorporates
many activities.
 It is also one the most important tools of disease prevention activities. The aim of
health promotion is to reduce the underlying causes of ill-health so that there is a long-
term reduction in many diseases.
 Health promotion is directed towards action on the determinants or causes of
health. Health promotion, therefore, requires a close co-operation of sectors beyond
health services, reflecting the diversity of conditions which influence health.
 Health promotion is the science and art of helping people change their lifestyle to
move toward a balance state of physical, mental, social and psychological health.
4. Strategies of health promotion
 The fundamental conditions and resources for health are peace, shelter, education,
food, income, a stable eco-system, sustainable resources, social justice and
equity. Improvement in health requires a secure foundation in these basic
prerequisites strategies.
5. Advocate
 Good health is a major resource for social, economic and personal development and
important dimension of quality of life. Political, economic, social cultural,
environmental, behavioral and biological factors can all favor health or be harmful to it.
 Advocacy: - refers to communication strategies focusing on policy makers,
community leaders and opinion leaders to gain commitment and support..
6. Enable
 Health promotion focuses on achieving equity in health.
 Health promotion action aims at reducing differences in current health status and
ensuring equal opportunities and resources to enable all people to achieve their
fullest health potential.
7. Mediate
 The prerequisites and prospects for health cannot be ensured by the health
sector alone.
 Health promotion demands coordinated action by all concerned: by governments,
by Health and other social and economic sectors, by non-governmental and
voluntary organizations, by local authorities, by industry and by the media.
 Health promotion strategies and programs should be adapted to the local needs and
possibilities of individual and groups to take into account differing social, cultural
and economic systems.
Agency
Sept. 2019
8. Principles of health promotion
 Health promotion is the process of enabling people to increase control over, and to
improve, their health. This perspective is derived from a conception of health‖ as the extent
to which an individual or group is able to realize aspirations and satisfy needs and change
or cope with the environment.
 Health is a positive concept emphasizing social and personal resources, as well as
physical capacities.
 To promote health the key principles determined by WHO are as follows:
 Health promotion involves the population as a whole
 Health promotion is directed towards action on the determinants or cause of health.
 Health promotion aims particularly at effective and concrete public participation.
 Health promotion combines diverse, but complementary methods or approaches
including communication, education, legislation, fiscal measures, organizational change,
community change, community development and spontaneous local activities against
health hazards.
 Health promotion is primarily a societal and political venture/activity and not medical
service, although health professionals have an important role in advocating and enabling
health promotion.
9. Major actions health promotion
 Health promotion has the following major areas of concern.
A. Formulating healthy public policy
 Health promotion encourages formulation of healthy policies in all sectors. E.g. healthy
workplaces, schools, homes, buildings, villages and communities policies should be
formulated.
 Health aspect should be thought of and included in the policies of the various sectors.
Health Policies should also emphasize the prevention and promotion.
B. Reorienting health services
 Prevention and promotion should decrease the burden on secondary (curative) health
care. Greater emphasis and resources placed on health promotion and primary health
care. Less emphasis can be given for secondary health care or for curative services.
C. Empowering communities to achieve well-being
 Involvement of the community in health decisions in a multi-sectoral and participatory
approach is the exact way to achieve healthy community. To achieve this we should first
provide communities with necessary information and tools to take actions to improve
their health and well-being.
D. Creating supportive environments
 Creating healthy physical, social and economic environment that are conducive to the
wellbeing of the community should be introduced to have a healthier and productive
community.
 All development activities should aim for healthy environment healthy buildings, roads,
workplaces, homes, surroundings and schools.
 Social circumstances; such as education, employment, poverty, environmental
condition; such as toxic agents, environmental pollutants, political structures, public
policy and regulation should put their role in creating conducive environment.
E. Developing /increasing personal health skills
 This major aspect of health promotion concerned about building the capacity of the
community by health information and education at individual, family and community
Agency
Sept. 2019
level. To do so first take in account values, beliefs and customs of the community and
build on existing knowledge.
Figure 6.1:- Important areas to be taken in to consideration in health promotion
10.Major area of concern of health promotion

 Health promotion best enhances health through integrated action at different levels
on factors influencing health, economic, environmental, social and personal.
 Given these basic principles an almost unlimited list of issues for health promotion
could be generated: food policy, housing, smoking, coping skills, social networks.
 The working group required to frame the general subjects for health promotion in
the following areas:
1. The focus of health promotion is access to health
 Health promotion aims at reducing inequalities in health and to increase opportunities
to improve health. This involves changing public and commercial policies to make them
conducive to health, and involves reorienting health services to the maintenance and
development of health in the population, regardless of current health status.
 HEWs in a kebele will be able to serve all community members equally and
provide service according to their need.
 Health care in need based service that wealthy and poor people should access
according their necessity. E.g. if the community clean their environment and live in
protected environment every member of that community will get its benefit.
2. Health improvement needs development of conducive environment
 The improvement of health depends upon the development of an environment

conducive to health, especially in household and workplace conditions. Since this
Agency
Sept. 2019
environment is

Agency
Sept. 2019
dynamic, health promotion involves assessment and monitoring of these changeable
conditions, cultural and economic state and trends.
 After rainy session malaria outbreak is expected as a result of large stagnant water in
the environment for mosquito bride.
3. Health promotion involves the strengthening of social networks and social support
 This is based on the recognition of the importance of social forces and social
relationships determinants of value sand behavior relevant to health. Social support is
significant resources for coping with health problems and maintaining health.
4. Health promotion foster healthy lifestyle
 Individuals are the major determiners their health status, even if the
environmental condition influences them dramatically.
 Lifestyle, the predominant way of life in society is central to health promotion, since
it fosters personal behavior patterns that are either beneficial or harmful to health.
 The promotion of lifestyles conducive to health involves taking balanced diet,
working regular exercise, quitting cigarette smoking, safe sexual practice and the
likes.
 Promoting positive health behavior and appropriate coping strategies is a key aim in
health promotion. As a HEW you have large responsibility in fostering healthy
lifestyle.
5. Health promotion is based on strong health education
 Providing health education increases peoples informed decision making skills. It is

necessary and core components of health promotion, which aims at increasing
knowledge and disseminating information related to health.
 This should include: the public‗s perceptions and experiences of health and how it
might be sought; knowledge from epidemiology, social and other sciences on the
patterns of health and disease and factors affecting them; and descriptions of the total‖
environment in which health and health choices are shaped.
 The mass media and new information technologies are particularly important in
disseminating health message. HEWs should use any available recourse to send
health message to their community.

Agency
Sept. 2019
1. Health promotion activities are concerned about disease and disability cases management
of the patients.
2. Health promotion activities can be achieved without health education.
3. Health promotion aimed at social and political action that will facilitate supports for
the conversion of individual action into health enhancement.
Score
Rating
Name: Date:
1.
2.
3.

Agency
Sept. 2019
Information sheet #7 Monitoring and Evaluation of behavioral change and service Utilization
1.7 Monitoring and Evaluation of behavioral change and service Utilization
1.7.1 Monitor behavioral change and service Utilization
 Monitoring:-is an ongoing process of collecting and analyzing data on actual
implementation of the program so that any deviations from the planned operations are
detected, diagnosis for causes of deviation is carried out and suitable corrective
actions are taken.
 Monitoring can take place at any time during the implementation process, on a regular or
periodic basis. For instance, you will be able to monitor your activities daily, fortnightly or
monthly, or as the need arises. You need to monitor the progress of your health education
activities by making periodic visits to the house-holds or any other health education
activity settings.
11.Types of monitoring
Figure 7.1:- Types of monitoring in health education
1. Input monitoring
 Measures the quantity, quality, and timeliness of resources human, financial and
material or equipments like posters, leaflets, flipcharts, computers, LCD and other
technological and information — provided for a health education activity/program
2. Output monitoring
 Measures the quantity, quality, and timeliness of the products or services that are the
immediate result/effect of a health education activity/program. In output monitoring you
need to assess whether the desired product or the output is obtained due to the
effective and efficient utilization of the resources.
3. Process monitoring
 Measures the progress of health education activities in a program and the way these
are carried out (for example, referring to the degree of participation).
1.7.2 Evaluate behavioral change and service Utilization
 It is the systematic collection, analysis and reporting of information about health
education activities. It is a systematic way of learning from experience and using
the lessons learnt to improve current activities and promote better planning by
careful selection of alternatives for future action.
 Evaluating is making judgments about the current status of health education objectives.
Agency
Sept. 2019
12.While you are evaluating health education activities you need to rise the following
questions:
 How well did we do?
 Did the plans work?
 What do we do next?
 Why did we succeed? Or fail?
 Did we learn from our mistakes or successes?
13.What is the purpose of evaluation of Health education programs?

 To check program effectiveness and efficiency.
 Effectiveness: - refers to the extent to which you have achieved your goals and
objectives (health objectives, learning objectives, behavioral objectives or
resource objectives).
 Efficiency: - means the extent to which you have achieved your objectives with
the available amount of resources. In other words, it refers to the proper utilization
of resources when achieving your health education objectives.
14.Types of evaluation
Figure 7.3:- Types of evaluation in health education
1. Process evaluation
 What health education methods were used during learning activities?
 How acceptable were the methods?
 What health learning materials were used during learning activities?
 How effective were the materials?
 What health issues were taught? How were they selected? Were they appropriate
topics for health education?
 What resources were used in health education sessions? Think about Personnel,
resources, material and financial and so on.
Agency
Sept. 2019
2. Impact evaluation
 This form of evaluation assesses the immediate effect of the program or change in
behavior (knowledge, attitude and skills) at the end of each health education programs.
3. Outcome evaluation
 Outcome evaluation assesses the long-term effect of the health education program and
you need to assess the decrease in morbidity, mortality and also disability among the
target audiences as a result of the health education program.
 Outcome evaluation assess the effectiveness as well as the efficiency of the
goal/objective at the end of the program
15.Steps to evaluate health education program
 Follow the following six steps to evaluate your health education activities:
Step-1 involve the local people in the process of evaluation
Step-2 describe the type of health education activity you want to evaluate
Step-3 selects the evaluation methods
Step-4 collects the important data on the selected activity by using data collection
techniques you learnt in your need assessment phase
Step-5 analyzes and interprets the data in a meaningful ways
Step-6 learns from the evaluation--objective achieved or failed? What do you want to do in
the future?

Agency
Sept. 2019
1. Measures the progress of health education activities in a program and the way these
are carried out
A. Input monitoring B. Output monitoring C. Process monitoring D. All
2. Assesses the long-term effect of the health education program
A. Process evaluation B. outcome evaluation C. process evaluation D. None
3. Making judgments about the current status of health education objectives.
A. Monitoring B. Evaluation C. None
Score
Rating
Name: Date:
1.
2.
3.

Agency
Sept. 2019
Information sheet # 8 Promoting Communication skills and health education
1.8 Communication skills and health education
 It is important to remember that people respond to messages differently and that what
might persuade one person may not appeal to another.
 Generally there are four approaches to health communication.
A. Informative communication
 Provides information about a new idea and makes it familiar to people. Mass media of
this type is mostly used for wide coverage and reaching a large audience.
 Print materials and interpersonal communication are used to reinforce mass media
messages and inform people in more detail and in ways that are more tailored to
them as individuals.
B. Educative communication
 Is where a new idea on health behavior is explained, including its strengths and
weaknesses?
 This approach is used when people are already aware of an issue, but need more
information or clarification.
 Interpersonal communication with individuals or small groups is probably the most
appropriate way to provide more detailed information and can be reinforced by print
materials such as books, pamphlets and other multimedia approaches.
C. Persuasive communication
 is usually in the form of a message that promotes a positive change in behavior and
attitudes, and which encourages that audience to accept the new idea.
 This approach to message development involves finding out what most appeals to a
particular audience. Persuasive approaches are more effective than coercive
approaches in achieving behavior change.
D. Prompting/entertaining communication
 Messages are designed so that they are not easily ignored or forgotten they can be
used to remind the audience about something that reinforces earlier messages.
 Using the entertaining method draws the attention of the audience by using
messages which entertain, for example, posters, songs, puppets or film.
 Main characteristics of effective communication
 Promotes actions that are realistic within the constraints faced by the community
 Builds on people‘s existing beliefs and practices
 Is repeated and reinforced over time using different methods
 Is adaptable and uses established channels of communication
 Is entertaining and attracts the community‘s attention
 Uses simple, clear and straightforward language
 Emphasizes the short-term benefits of taking action
 Uses demonstrations to show the practical benefits of adopting beneficial practices
 Develops a natural style: each person has his or her own natural way of presenting
ideas
 Provides opportunities for dialogue and discussion.

Agency
Sept. 2019
Self check # 8 Written test
Direction: - Matching
―A‖ ―B‖
1. Informative communication A. draws the attention of the audience

2. Persuasive communication B. New idea makes it familiar to people
3. Prompting communication C. strengths & weaknesses of new idea explained
4. Educative communication D. promotes a positive change in behavior & attitudes
Score
Rating
Name: Date:
1.
2.
3.
4.

Agency
Sept. 2019
Information #9 Identifying Methods and strategies of health communication
1.9. Methods and strategies of health communication
1.9.1 Methods of communication
1. Intrapersonal communication
 Intrapersonal communication takes place within a single person. It is usually considered

that there are three aspects of intrapersonal communication, self awareness,
perception and expectation.
 Self-awareness is the part of intrapersonal communication that determines how a
person sees him or herself and how they are oriented toward others. Self-awareness
involves three factors: beliefs, values and attitudes.
 Perception is about creating an understanding of both oneself and one‘s world and being
aware that one‘s perceptions of the outside world are also rooted in beliefs, values and
attitudes
 Expectations are future-oriented messages dealing with long-term roles, sometimes called
‗life scripts‘. Intrapersonal communication is used for clarifying ideas or analyzing
a situation and also reflecting on or appreciating something.
 Self-awareness is a life skill that is practiced and then applied to overcome the day-to-day
challenges of life in a more positive and effective way.
 Self awareness also affects one‘s view of oneself in the context of either being HIV-
infected or not being HIV-infected.
2 Interpersonal communication
 Interpersonal communication is the interaction between two or more people or groups.
You will be using this form of communication all the time during your health work.
 This form of communication can be face-to-face, two-way, verbal or non-verbal
interaction, and includes the sharing of information and feelings between individuals or
groups.
 The most important parts of personal communication are characterized by a
strong feedback component, and it is always a two-way process.
 Interpersonal communication involves not only the words used, but also various
elements of non-verbal communication.
 The purposes of interpersonal communication are to influence, help and discover as well
as to share and perhaps even play together.
 The main benefits of interpersonal communication include the transfer of knowledge and
assisting changes in attitudes and behaviour.
 It may also be used to teach new skills such as problem solving. The communication
takes place in both directions from the source to the receiver and vice versa.
 There is a chance to raise questions and start a discussion so that the idea is
understood by both parties. Since the communication is interactive there is a high
chance of utilising more than two senses such as seeing, hearing and touching.
 Adoption of a behaviour passes through several stages and interpersonal communication
has importance at all of these stages. So if you want to help someone change their
health behaviour you will certainly have to use interpersonal communication effectively.
This is especially important when the topic is taboo or sensitive.

Agency
Sept. 2019
Figure 9.1:- Health workers get lots of opportunities to develop strong relationships using their
interpersonal communication skills.
3 Mass communications
 Mass communication is a means of transmitting messages to a large segment of
a population. Electronic and print media are commonly used for this.
 The word ‗media‘ is currently used to refer not only to broadcast media such as radio, the
internet and television but also to print media such as papers, magazines, leaflets and
wall posters. Remember also the importance of local folk media such as local art, songs,
plays, puppet shows and dance
 The powerful advantage of mass media over face-to-face contact is the rapid spread
of simple facts to a large population at a low cost.
 The main effects of mass communication are the increased knowledge or awareness of
an issue, the potential influence on behaviours at the early stages and the possibility to
communicate new ideas to early adopters (opinion leaders).
 The other benefits of mass communication are accuracy and plausibility. Think of the
influence of a newspaper article, giving the opinion of a highly respected person. However
it also has limitations. These include the lack of feedback because the broadcaster
transmits this message without knowing what is going on in the receiver‘s mind.
 There is also the danger of selective perception because the audience may only grasp part
of the message, or selectively pick up the points that they agree with and ignore others.
Mass communication does not differentiate between targets and so some people may
think.
‗This does not concern me‘.
 It only provides non-specific information because it is broadcast to the whole
population, and it is difficult to make the message fit the local needs of your community,
whose problems and needs may be different from the rest of the country.
 For an effective mass media communication, the message or advice should be realistic
and pre-tested so that it is transmitted accurately without distortion.
 The message should be useful in creating awareness, and has to be followed by
individual or group approaches to achieve positive behavior change.

Agency
Sept. 2019
Figure 9.2:- Sometimes getting children to make songs about a health message can help you get
information to a wider audience.

Agency
Sept. 2019
Self check # 8 Written test
Direction: - Say ―True‖ or ―False‖
1. Mass communication is a means of transmitting messages to a large segment of a

population.
2. Intrapersonal l communication is the interaction between two or more people or groups.
3. Interpersonal communication takes place within a single person.
Score
Rating
Name: Date:
1.
2.
3.

Agency
Sept. 2019
Information #10 Promoting Human behavior and health
1.10 Human behavior and health
 Behavior is an action that has a specific frequency, duration and purpose

whether conscious or unconscious. It is what we do and how we act.
 Many health education programs have failed because they put too much emphasis
on individual behavior and neglected to understand the cultural, social, economic and
political factors that influence his/her behaviors or actions.
 For example: Learning is a behavior of the students which has a specific frequency,
purpose and duration. People stay healthy or become ill, often as a result of their
own action or behavior.
 To say a person has smoking behavior
 Action – he/she must smoke cigarette
 Duration –is it for a week/month?
 Frequency- how many times a day?
 Purpose –is he/she doing consciously or not
 Health behaviors are those personal behaviors or, actions and habits that an
individual performs in order to stay healthy, in order to restore his health when he gets
sick and in order to improve their health status.
 Examples of behaviors promoting health and preventing diseases
(health behaviors).
 Preventive behaviors: - actions that healthy people undertake to keep
themselves or others healthy and prevent disease.
 Good nutrition, breast feeding, reduction of health damaging behaviors like
smoking are examples of preventive behaviors
 Utilization behavior: - utilization of health services such as antenatal care,
child health, immunization, family planning…etc
 Illness behavior: - recognition of early symptoms and prompt self referral
for treatment.
 Compliance behaviors: - following a course of prescribed drugs such as
for tuberculosis.
 Rehabilitation behaviors: - what people need to do after a serious illness
to prevent further disability.
 For example: Practicing walking after injuring your leg or talking after a stroke.
 Community action: - actions by individuals and groups to change and
improve their surroundings to meet special needs.
1.10.1 Determinants of human health
 The people‗s lives determines their health, and so sometimes blaming

individuals for having poor health or crediting them for good health is
inappropriate.
 Individuals are unlikely to be able to directly control many of the determinants of
health. For example polluted water, unsafe environment and the likes influence
the health status of the community.
 There are four general determinants of health:-
1. Human biology
 All those aspects of health, both physical and mental, which are developed within the
human body as a consequence of the basic biology of human beings and the
Agency
Sept. 2019
organic make-up of an individual.

Agency
Sept. 2019
 For example, age is one of the biological determinants of health because older
people are more at risk of developing non-communicable diseases such as cancer.
2. Environment
 All those matters related to health which are external to the human body and
over which the individual has little or no control. Some examples include
geography, climate, industrial development and the economy.
 For example, people living in the lowland areas (geographic factors) are more
exposed to malaria than people living in the highlands. If the economic environment
gets worse than more people will have to live in poverty and this is very bad for their
health.
3. Lifestyle
 Is made up of the habits and usual practices of human beings which affect
their health and over which they more or less have control.
 For example people who are not sleeping under insecticide treated bed nets are
at more risk of acquiring malaria.
 A person's lifestyle or behavior can be a risk factor or a reason for the
development of health problem.
4. Health care organization
 Consists of the arrangement and resources that are used in the provision of healthcare
often referred to as the healthcare system.
 For example if someone is sick from malaria and there are no health facilities nearby to
treat the patient, the patient is more likely to develop a severe complication and may
even die.
 The question of availability, accessibility and affordability of the health care
organizations as well as services should be raised and answered here.
 Risk factors can be divided into two categories:
A. Modifiable (changeable or controllable) risk factors.
 These are things that individuals can change and control such as their sedentary
 lifestyle refers to the collection of behaviors that make up a person‗s way of life
including smoking, drinking alcohol, or poor dietary habits.
B. Non-modifiable (non-changeable or non-controllable) risk factors.
 These are factors such as age, sex and inherited genes and are things that individuals
cannot change or do not have control over.
 These two categories of risk factors may be interrelated and in fact the combined
potential for harm from a number of risk factors is greater than the sum of their
individual parts.
 For example: If an old person (old age – as a non-modifiable factor) smokes and drinks
(smoking and drinking are modifiable risk factors) to excess as well they are especially
likely to become ill with problems related to smoking and drinking.
 Developing countries like Ethiopia, more than 80% of the disease burden and its
related morbidity and mortality is due to communicable diseases and the root cause of
these diseases are usually the changeable /modifiable risk factors.
1.10.2 level of disease prevention
 Prevention is defined as the planning for and the measures taken to prevent the
onset of a disease or other health problem before the occurrence of undesirable
health events.
 There are three distinct levels of prevention:
a. Primary level of prevention
 Primary prevention is comprised of those preventive activities carried out by a
Agency
Sept. 2019
healthy individual to keep himself and other people from getting disease.

Agency
Sept. 2019
 Examples of important behaviors for primary prevention includes using rubber
gloves when there is a potential for the spread of disease, immunizing against
specific diseases, exercise, and brushing teeth.
 The role of health education here is aimed at the prevention of the onset of illness
or health problems.
b. Secondary level of prevention
 Secondary prevention includes preventive measures that lead to an early
diagnosis and prompt treatment of a problem/disease before it becomes serious.
 It is important to ensure that the community can recognize early signs of disease
and go for treatment before the disease become serious.
 The actions people take before consulting a health worker, including recognition of
symptoms, taking home remedies (self-medication‗), consulting family and healers
are called illness behaviors.
 Illness behaviors are important examples of behaviors for secondary prevention.
For example: screening for high blood pressure and breast self-examination.
c. Tertiary level of disease prevention
 Tertiary prevention seeks to limit disability/death or complications arising from an
irreversible condition. The use of disability aids and rehabilitation services help
people from further deterioration and loss of function.
 For example, a diabetic patient should take strictly his/her daily insulin injection
to prevent complications, HIV/AIDs patient should use ART drugs to prolong his
life.
 Health Education can be applied at all three levels of disease prevention and can
be of great help in maximizing the gains from preventive behavior.
 For example at the primary prevention level you could educate people to practice
some of the preventive behaviors, such as having a balanced diet so that they
can protect themselves from developing diseases in the future.
 At the secondary level, you could educate people to visit their local health
centre when they experience symptoms of illness, such as fever, so they can
get early treatment for their health problems.
 At the tertiary level, you could educate people to take their medication
appropriately and find ways of working towards rehabilitation from significant illness
or disability.
1.10.3 Behavior change in health education
 The ultimate goal of health education and promotion program is to bring
voluntary behavior modification among the community members.
 Certain behaviors changes may be natural while others are planned changes.
1. Natural changes
 When changes occur because of natural events in the community around us,
we often change without thinking much about it.
 Some changes take place because of natural events or processes such as age-
sex related behaviors. E.g. Eating clay during pregnancy
2. Planned changes
 We make plans to improve our lives or to survive for that matter and we act
accordingly. Example: plan to stop smoking or drinking, plan to become a health
professional.
 When changes occur deliberately and/or planned.
 Planned change in behavior can be faster or slower depending on the
response of the acceptor and adapter of the behavior.
1.10.4 Models of disease causation and spread.

Agency
Sept. 2019
 There are three models of disease causation:-
A) Chain of infection model

Agency
Sept. 2019
 This model explains the spread of a communicable disease from one host (or person) to
another. The basic idea represented in the chain of infection is that individuals can break
the chain (reduce the risk) at any point, thus the spread of the disease can be stopped.
Figure 10.1:- Link of the infection model
1. Disease:-malfunctioning or abnormality of body parts caused by the infectious

agents
2. Human reservoir :-a person who is harboring the infectious agent
3. Portal of exit :-The body part through which the infectious agent is exiting from
the reservoir, for example the mouth or the anus
4. Transmission :-The spread of the infectious agent from the reservoir to the
new host
5. Portal of entry:-The body part through which the infectious agent will enter
the new host, for example the skin after a mosquito bite, the mouth
6. Disease in the new host:-The development of the signs and symptoms of the
communicable disease in the new host
 The portal of entry and exit both involve preventive measures such as hand
washing, condoms, hair nets and insect repellents, while the human
reservoir and transmission measures both involve isolation.
 The application of such information, health education can help to create
programs that are aimed at breaking the chain and reducing the risks of
infection in other people.
B) Communicable disease model
 This model includes the three minimal requirements for the presence and
spread of a communicable disease in a population
Figure 10.2:- the communicable disease model

Agency
Sept. 2019
1) The infectious agent
 The element that must be present for the disease to occur and spread.
For example: Bacteria, viruses and parasites
2) ) The host
 Any susceptible organism. For example: Plants, animals or humans can
be invaded by the infectious agent and become the host.
3) The environment
 Includes all other factors that either promote or prohibit disease
transmission. Communicable disease transmission occurs when a
susceptible host and an infectious agent exist in an environment
that allows disease transmission.
 The Health Extension practitioner need to design and give health
education to avoid or reduce susceptibility of the host, and to reduce
some favorable environmental conditions which may be good for the
development and spread of the agents.
 For example: Health education should be given on good dietary practices
to develop the host immunity and to reduce susceptibility.
C. Multi-causation disease model
 A model that explains the onset of disease caused by more than one
factor. Both the chain of infection and communicable disease models are
helpful in trying to prevent disease caused by an infectious agent.
 However, these models are not applicable to non-communicable
diseases, which include many of the chronic diseases such as
heart disease and cancers.
 Therefore, the possible causes for such and other chronic non-
communicable diseases include a combination of factors such as
infectious agents, environment, genetic factors, personal behaviors,
economics...etc

Agency
Sept. 2019
Figure 10.3:- Multi-causal disease model

1. Activities carried out by a healthy individual to keep himself & other people from
getting disease. A. primary prevention B .Secondary prevention
C. Tertiary prevention
2. Recognition of early symptoms and prompt self referral for treatment.
A. Compliance behaviors B. Illness behavior C. Utilization behavior D. None
3. a person who is harboring the infectious agent
A. Portal of exit B. Human reservoir C. Mode of transmission D. None
4. Modifiable Risk factors. A. age B. sex C. Smoking D. Inherited genes
Score
Rating
Name: Date:

Agency
Sept. 2019
Information #11 Identifying Barriers of health education communication
1.11 Barriers of health education communication
 Generally communication barriers can be categorized as follows:
 Physical barriers include difficulties in hearing and seeing.
 Intellectual barriers may occur because of the natural ability, home background
or schooling that affects the perception and understanding of the receiver.
 Emotional barriers include the readiness, willingness or eagerness of the receiver and the
emotional status of the educator.
 Environmental barriers might occur if there is too much noise or if the room is
too congested.
 Cultural barriers include those customs, beliefs or religious attitudes that may cause
problems. Economic and social class differences and language variation, as well as
age differences, may also be difficult to overcome.
 Either too high or too low status of the educator (sender) compared to the
audience may affect communication.
 Principles of communication
 Shared perception: for communication to be effective the perception of the sender
should be as close as possible to the perception of the receiver. The extent of
understanding depends on the extent to which the two minds come together.
 Sensory involvement: the more senses involved in communication, the more effective
it will be.
 Face- to- face communications: when communication takes place face-to-face it is
more effective.
 Two-way communications (feedback): any communication without a two-way process
is less effective because of lack of opportunity for concurrent, timely and appropriate
feedback.
 Clarity of the message: ideas, facts and opinions should be clear to the sender
before communication happens. Communication should always use direct, simple and
easily understandable language.
 Correct information: the sender should have at hand correct, current and
scientific information before communicating it.
 Completeness of the idea: subject matter must be adequate and full. This enables the
receiver to understand the central theme or idea of a message. Incomplete messages
may result in misunderstandings.
 Main characteristics of effective communication
 Promotes actions that are realistic within the constraints faced by the community.
 Builds on people‗s existing beliefs and practices
 Is repeated and reinforced over time using different methods
 Is adaptable and uses established channels of communication
 Is entertaining and attracts the community‗s attention
 Uses simple, clear and straightforward language
 Emphasizes the short-term benefits of taking action
 Uses demonstrations to show the practical benefits of adopting beneficial practices
 Develops a natural style: each person has his or her own natural way of presenting ideas
 Provides opportunities for dialogue and discussion.

Agency
Sept. 2019
1. Communication to be effective the perception of the sender should be as close as possible

to the perception of the receiver
2. Intellectual barriers include difficulties in hearing and seeing
Score
Rating
Name: Date:
1.
2.
3.
4.

Agency
Sept. 2019
Information sheet #12 Describing Ethical principles in Health Education
1.12. Ethical principles in Health Education
 Everybody has ethical issues in their lives and ethical theory can help us all to understand
these issues – and work out ways of dealing with them.
 Ethics is the branch of philosophy, which takes a systematic approach to define social and
individual morality – the fundamental standards of right and wrong that a whole society, as
well as individuals, learn from their culture and peers.
 Philosophy is the study of general and fundamental problems, such as existence,
knowledge, values, reason, mind, and language. It is distinguished from other ways of
addressing such problems by its critical, generally systematic approach and its reliance on
rational argument.
 Two important ethical theories
 Two of the most relevant ethical theories for your professional practice:-
 Utilitarianism:-considers an action as morally right if its outcomes or consequences are
good for the greatest number of the population.
 It focuses on ‗the greatest good for the greatest number‘.
 This theory disregards individual rights and considers the welfare of the greatest
majority to be the most important factor.
 Deontology:- on the other hand, considers the way that things are done rather than
focusing just on the consequences.
 This type of ethics holds at its core the respect for fundamental rights, such as the
right to truth, privacy and the fulfilling of promises.
 Deontology considers the rightness or wrongness of an action.
 For instance, someone who believes that lying is always wrong, even if a lie might
accomplish some good for individuals and society, is following the principles of
deontology – although they may never have heard of the theory.
 The five main principles of ethics are usually considered to be:
 Truthfulness and confidentiality
 Autonomy and informed consent
 Beneficence
 Non-maleficence
 Justice.
 Some of these are difficult words, but in this study session you will be able to consider
each of them in turn, using examples that will be familiar to you.
 This will help you to see how ethical principles are present in almost every aspect of
your health work and daily life.
1. Truthfulness and confidentiality
 Two concepts that you may commonly face in your day-to-day practice are truthfulness
and confidentiality.
 Truthfulness is about telling the truth to someone who has the right to know the truth.
For example, if you have been informed about the result of an HIV test taken by
someone in your community who then asks to know his/her result.
 On the other hand, the concept of confidentiality urges you to keep a secret – by which
we mean knowledge or information that a person has the right or obligation to conceal.
 For example, if the family of a person who has had an HIV test demands that you give
them the result, you must not tell them..

Agency
Sept. 2019
 There are three types of secrets:
 Natural secret: information which if revealed is harmful by its nature.
 Promised secret: information that we have promised to conceal which, if broken, leads
to public mistrust.
 Professional secret: knowledge which, if revealed, will harm the client, the profession
and the society that obtain services from the profession. A professional secret is the most
serious of all secrets, because its violation can cause the greatest harm.
2. Autonomy
 The term refers to every individual‘s right of self determination, independence and
freedom to make their own choices.
 In the context of healthcare, the concept of autonomy is most concerned with the
ethical obligation of the practitioner to respect their clients‘ right to make
decisions about their own health.
 Autonomy must be respected even if you, as the healthcare provider, do not

agree with the client‘s decision.
 However, there are conditions in which that personal choice or autonomy may
be restricted because of concern for the wellbeing of the community.
 For instance, if a communicable disease, such as tuberculosis, is diagnosed, clients

can be required to take prescribed medication and may have to be isolated to
prevent the spread of the infectious agent to others.
3. Informed consent
 Informed consent means that each person who has any sort of procedure done to them in
a healthcare context should give their approval for that procedure to be done to them.
 In order to be fully informed, it is the duty of the health care worker to tell the
person exactly what the procedure will involve as well as the things that might
happen if the procedure is not carried out.
 In quite a lot of the work that Health Extension Practitioners do on a routine

basis informed consent is implied.
 In other words if a mother brings her child to the Health Post to be

immunized, informed consent is necessary because the Health Extension
Practitioner is performing a procedure that has benefits, but may also have
side effects.
 However, the act of bringing the child for the procedure implies consent as does
attending for a contraceptive injection. But Health Extension Practitioners should
always explain what they are doing and how it impacts on individuals, their
families and the wider community.
4. Beneficence and non-maleficence
 The term beneficence tells you about ‗doing good‘ for your client, for instance
by providing immunization.
Agency
Sept. 2019
 On the other hand, the concept of non maleficence tells you to ‗do no harm‘
either intentionally or unintentionally to your clients.
 However, there are circumstances in which it is impossible to ‗do good‘ and ‗avoid
doing harm‘ all at the same time. For instance, you may plan to provide birth control
to all the women in your locality who are in need of it, but resource availability, cultural
beliefs of the community, clients‘ reaction to the service and other factors can limit
you from doing good to the greatest number.
 Moreover, you cannot always avoid doing harm to a client; for instance, in times
when a communicable disease arises in your vicinity, you may have to suggest
isolating individuals with the infection against their will to contain the spread of
the disease and for the good of the majority.
5. Justice
 In this final section, you will be able to learn about the concept of justice, which is an
important concept that will help you during your interaction with individuals, families
and communities at large.
 Justice is a complex ethical principle and it entails fairness, equality and impartiality; in
other words, it is the obligation to be fair to all people. Most Health Extension
Practitioners will understand about justice without necessarily having come across the
word itself.
 The concept of justice will become clearer if you understand the meaning of
two categories of justice: distributive justice and social justice.
 Distributive justice means that individuals have the right to be treated equally
regardless of ethnic group, gender, culture, age, marital status, medical diagnosis, social
standing, economic level, political or religious beliefs, or any other individual
characteristics.
 Social justice is based on the application of equitable rights to access and participation
in all aspects of goods and services provided in a society, regardless of their individual
characteristics.
 Everyone should have access to the same things that might improve their health. You as
a Health Extension Practitioner will be able to carry out distributive and social justice by
enabling the inclusion and empowerment of all people living within your area to exercise
their rights.

Agency
Sept. 2019
Direction: - Match the following questions from column ―B‖ to ―A‖
“A” “B”
1. Autonomy A. Do no harm
2. Informed consent B. Fairness
3. Beneficence C. Doing good
4. Non-maleficence D. Each person approval for the procedure to be done to them.
5. Justice E. Freedom to make their own choices
Score
Rating
Name: Date:
1.
2.
3.
4.
5.

Agency
Sept. 2019
Information sheet #13 Performing Information dissemination
1.13. Information dissemination
 When do we disseminate?
 In the course of preparing for the start of your project, you will have been required to draw
up a project plan that identifies your milestones. The planning and development of your
dissemination strategy must have equal importance placed on it as the other preparatory
work you will be doing, or have already done.
 Having identified exactly what it is your project will be disseminating, you need to give some
thought to the timing of particular dissemination activities and the setting of targets. You will
need to consider each of your target audiences/groups and the level of dissemination
required and begins to plan the timing.
 Developing a dissemination plan
 Following is a list of some of the key elements that should be included in a
dissemination plan. While this is not a detailed guide to developing a dissemination plan,
it provides a good overview of some of the most critical things that should be
considered.
1. Project overview
 Describe the current environment or context that provides what being undertaken what is
your aiming to clarify or change? Who is or should be interested in the results?
 Briefly sketch out its objectives. How will it address the context or challenges you
have identified?
2. Dissemination goals
 What are you hoping to achieve by dissemination of message? You may have a single
long-term goal, such as a change in a policy, practice, or even culture, but make sure
to also include any supporting or shorter-term goals.
3. Target audiences
 These are the groups you want to reach with your message results and who you will
target in your dissemination activities.
 Be as specific as you can who are the people who can use this message?
 You may want to divide your list into primary audiences (more important) and
secondary audiences (less important) and allocate dissemination efforts according to
audience importance.
4. Key messages

Agency
Sept. 2019
 In your first stab at a dissemination plan, you won‘t be able to develop specific key
messages because you won‘t know the results of your message. However, you can
plan broadly around what you anticipate the content will be.
 Effective messages explain what your results is, why they are important, and what action
should be taken as a result. They are not simply a summary of the results.
 Make messages clear, simple, and action-oriented. The style and content should be
tailored for each audience. Messages should be based on what that audience wants
to know, rather than on what you think it should hear.
5. Sources/messengers
 Since using influential spokespersons to spread your messages can help ensure uptake
of your message results, identify the people or organizations that are viewed as credible
with each of your target audiences.
 Then think about how you can get those people and organizations ―on board‖ —
maybe you can partner with them in a workshop, or ask them to include message in
their talk.
6. Dissemination activities, tools, timing, and responsibilities
 This is the meat of your dissemination plan. Here you describe the activities (such as
briefings or presentations) you will undertake to reach each target audience, and the
tools (such as printed materials or web sites) that will support these activities. You also
set out timing (what you will do first and when you will do it) and assign responsibilities to
team members.
 Look for activities that promote a two-way dialogue, not a one-way flow of
information. Face-to-face meetings or briefings are a very effective way to reach
decision makers.
 A good dissemination plan will have activities that reach each of your target
audiences, taking into account their attitudes, habits, and preferences.
7. Budget
 Time and budget requirements for dissemination are frequently underestimated. Effective
dissemination involves resources and planning think about travel, layout and printing,
translation, equipment, and space rental costs when allocating a budget for dissemination
activities. Don‘t forget to include resources the individual(s) will need to do the future
planning and co-ordination of the activities you have identified!
8. Evaluation
 Evaluation is most effective when it is built in from the start. Decide how you will

Agency
Sept. 2019
evaluate the success of your team‘s dissemination efforts, selecting measurable criteria
for each

Agency
Sept. 2019
dissemination activity. Focus less on efforts (how much you did) and more on outcomes
(what was the result).
 Starting early usually increases the impact of dissemination. Using vehicles such as
seminars and conferences can be an effective way of disseminating findings. It is
important not to feel that you have to have a completed product or process before
starting to disseminate. The greater the involvement of your target audiences/groups, the
greater impact you will achieve and the stronger the routes of communication be
developed.
 Target audiences/groups need to know and have some idea of what it is about and
trying to achieve.
 You have to use the opportunity to present in a clear and easily recognizable way to
consider some of the following:
 Previous records of accomplishment –have a proven track record in the work you are
undertaking and, if so, how might you best exploit this?
 Alliances with other programs – are there other programs within your subject area that you
could form links with which would give you a better presence and image?
 Links with professional bodies/subject associations – are there any professional bodies
within your subject area that you could build links with and who would be able to promote
your work and boost your profile?
 What are the most effective ways of disseminating?
 Begin to match vehicles for dissemination to your objectives. The major mediums for
information dissemination utilized included posters, local newspapers, local radio and
the before mentioned public meetings.
 Once the dissemination objective and the audience are identified, there are a variety
of ways to share the developed content.
 Common methods of dissemination include:
 Publishing program or policy briefs
 Publishing project findings in national journals and statewide publications
 Presenting at national conferences and meetings of professional associations
 Presenting program results to local community groups and other local stakeholders
 Creating and distributing program materials, such as flyers, guides, pamphlets and DVDs
 Creating toolkits of training materials and curricula for other communities
 Sharing information through social media or on an organization's website
 Summarizing findings in progress reports for funders
 Disseminating information on an organization's website
 Discussing project activities on the local radio

Agency
Sept. 2019
 publishing information in the local newspaper
 Issuing a press release

Agency
Sept. 2019
 Hosting health promotion events at health fairs and school functions
Information #13 Written test

1. The major mediums for information dissemination
A. Posters B. Local newspapers C. Public meetings D. All
2. The groups you want to reach with your message
A. Project overview B. Dissemination goals C. Target audience‘s D. Key messages
answers
Answer Sheet
Score
Rating
Name: Date:
1.
2.

Agency
Sept. 2019
Information #14 Maintain work related network and relationship
1.14. Maintain work related network and relationship
 What is a network?
 A network includes a group of people who cooperate with each other. This implies
people working closely together and with some crossover or connection in their purpose.
 Networking is about recognizing and taking advantage of valuable relationships to get

things done and to achieve a goal. It also involves working closely with other workers to
be aware of potential and future needs or problems and devising strategies to address
them.
 Networking is also related to participation. Through the process of participation in issues

in the workplace (people in the workplace joining to discuss concerns and have a say in
developing solutions), relationships and networks are established between people and
workers in the organization (or even in the community if your organization provides
services to the community).
 Networks potentially build a sense of common destiny and support. Thus, they help
to empower individuals and strengthen the work team and the organization itself.
 The importance of networking
 No matter your education, your experience, your personality, or your title, if you can't play
well with others, you will never accomplish your work mission. Effective interpersonal
work relationships form the cornerstone for success and satisfaction with your job and
your career.
 They form the basis for promotional opportunities, pay increases, goal
accomplishment, and job satisfaction.
 Workers network to:
 Achieve outcomes
 Establish credibility with relevant service providers
 Advocate about issues
 Maintain contact with other professionals
 Debrief about issues
 Have access to information about what other organizations are doing, especially
those providing similar services
 Provide information about your own service and organization
 Work collaboratively to better meet the needs of clients

Agency
Sept. 2019
 Establish new contacts who you may work with in the future

Agency
Sept. 2019
 Learn about the role, services and resources of other organizations
 support joint programs or activities
 Provide information for policy development.
 Networking can occur on a formal or informal basis.
 Formal networks
 Formal networks involve structured meetings or processes. Your network, in this
work situation, would include your supervisor (or team leader) and your colleagues.
 Think of some of the formal networks you will encounter in your work. An example of
a formal network is:-
 If you work in the sterilization unit, your work team would be responsible for ensuring
that the surgical instruments that come out of an operating theatre are logged, washed,
disinfected, sterilized, packaged, logged again and stored.
 Here is another example of a formal network:
 A small hospital has been having temporary problems implementing best practice
standards in cleaning, disinfection and sterilization due to a break-down in
equipment.
 The head of the sterilizing services unit attend a meeting with the manager of a
larger unit in a regional hospital to discuss out-sourcing of work (to the larger unit).
 Informal networks
 These networks may be internal or external networks.
 They are the relationships you develop and build up over time with and colleagues.
These networks carry lots of information in the form of facts, gossip and rumor about
issues affecting your work such as government policy initiatives, local developments
or changes in services.
 Skills and attitudes for participating in networks
1. Professionalism
 When you are participating in a network, whether it is formal or informal, external or
internal, you need to be mindful that you are a professional worker representing your
organization. You are ‗the face‘ of the organization and your conduct, the impression
you make, the information you provide and the message you communicate needs to be
clear and appropriate.
2. problem solving
a. Identify the problem
 First, find out what precisely is the problem. For instance, could it be that staff are

Agency
Sept. 2019
not familiar with work practices? Or do staff know what to do but have been taking
‗short-

Agency
Sept. 2019
cuts‘ as they under a lot of pressure to complete daily work targets? Does individual staff
feel overworked? Do they feel unsupported?
 Problem solving skills are essential to the networking process, as we need to be able
to accurately identify problems so that we can assist our colleagues or work team.
b. Identify and assess potential solutions
 One you have gathered relevant information and analyzed the needs and concerns of
the people involved, the next step is working out the possible solutions and which
solution is the most appropriate one.
 This step will utilize your knowledge of what services are available in the community
and also requires research skills.
 How to Develop Effective Work Relationships
 These are seven ways you can play well with others at work. They form the basis for
building effective interpersonal work relationships. These are the actions you want to
take to create a positive, empowering, motivational work environment for people:
1. Bring Suggested Solutions to Problems to the Meeting Table - Thoughtful solutions
are the challenge that will earn respect and admiration from your coworkers and
bosses.
2. Do not Ever Play the Blame Game- it is not my fault and identifying and blaming others
for failures will earn you enemies. Throwing other employees under the bus, either
privately or publicly, will also create enemies. These enemies will, in turn, help you to
fail.
3. Your Verbal and Nonverbal Communication Matters- If you talk down to another
employee, use sarcasm, or sound nasty, the other employee hears you. Humans are
all radar machines that constantly scope out the environment. When you talk to another
employee with a lack of respect, the message comes through loudly and clearly.
4. Never Blind Side a Coworker, Boss, or Reporting Staff Person-If the first time a
coworker hears about a problem is in a staff meeting, you have blindsided the
coworker. Always discuss problems first, with the people directly involved who own the
work system. You will never build effective work alliances unless your coworkers trust
you. And without alliances, you will never accomplish the most important goals for your
job and career.
5. Keep Your Commitments- In an organization, work is interconnected. If you fail to
meet deadlines and commitments, you affect the work of other employees. Always keep
commitments, and if you can't, make sure all affected employees know what happened.

Agency
Sept. 2019
Provide a new due date and make every possible effort to honor the new deadline.

Agency
Sept. 2019
6. Share Credit for Accomplishments, Ideas, and Contributions- Take the time,
and expend the energy, to thank, reward, recognize and specify the contributions of
the people who help you succeed. It is a no-fail approach to building effective work
relationships. Share credit; deflect blame and failure.
7. Help Other Employees Find Their Greatness- Every employee in your organization
has talents, skills, and experience. If you can help fellow employees harness their best
abilities, you benefit the organization immeasurably. The growth of individual
employees benefits the whole.
Information #14 Written test
1. A network includes a group of people who cooperate with each other.

2. Effective Work Relationships is the actions you want to take to create a positive
work environment for people
answers
Answer Sheet
Score
Rating
Name: Date:
1.
2.

Agency
Sept. 2019
Instruction Sheet
LG14: Train model families
 Training of model families
 Planning and Undertake advocacy on identified health issues
 Train model families
 Plan and Undertake advocacy on identified health issues
9. Read the information written in the information ―Sheet 1, Sheet 2.and,Sheet 3‘‘
4. Accomplish the ―Self-check 1, Self-check and self check 3 on page 4, 5 & 14.

Agency
Sept. 2019
Information Sheet-1 Applying Training Model Family
1.1 Concepts and principles of Women Health Development Army

(WHDA) Concepts and principles of Women Development Army
Health Extension Program (HEP) brings community participation through awareness creation,
behavioral change communication, and planned and systematic community mobilization. Community
engagement for improved lifestyle was initially based on innovation of diffusion theory, which
focuses on model household graduation. Model households go through an intensive vetting for
graduation and are publicly recognized by local leaders after completing key health extension
practices at the household level. Model households also provide mentorship and act as role models
for their neighbors. This has brought about impressive results concerning health outcomes resulting
in significant reduction of harmful traditional practices, improved lifestyles and use of health
services. However, there was a gap in quality and comprehensiveness. Hence, health development
army was initiated in 2012 for engaging everyone in the community through an organized and
inclusive manner, particularly the under-served and disadvantaged groups.
The Health Development Army as part of universal coverage for basic health services, a
complimentary initiative undertaken by the Ethiopian Government is the establishment of the Health
Development Army (HDA), and now renamed as Women Development Army (WDA). WDA is a
systematic, organized, inclusive and collaborative movement of the neighboring Households through
active participatory learning and actions to practice key health activities. WDA is designed to bring
about transformational change in health outcomes and ensuring every household is reached. The
WDA provides an effective platform to engage the community in the planning, implementation,
monitoring, and evaluation of health and other programs. Women are organized into one to five
household networks and groups of 25 to 30 families and are encouraged and engaged in learning,
practicing and collaborating with each other to bring significant practical and attitudinal change. In
one to five networks, six households are organized based on social and geographic proximity.
Among five or six households one will be lead to advise/inform and counsel her team members. And
recently, the new initiative called competency based training (CBT) with level I &II has been
launched so as to enhance health extension program intervention by improving the skills of WDA
one to five members through providing training on basic community health packages.

Agency
Sept. 2019
Self-Check -1 Written Test
Directions: Choose the best answers from the given alternative.
1. Concepts and principles of Women Development Army
A. behavioral change communication B. planned and systematic community mobilization. C.

Community engagement D.ALL
2. a systematic, organized, inclusive and collaborative movement of the neighboring Households

through active participatory learning and actions to practice key health activities.
A. WDA B.SMART C. Advocacy D.ALL
3. The WDA provides an effective platform to engage?
A. the community in the planning implementation B. monitoring,
C. evaluation of health and other programs. D.ALL
answers
Answer Sheet
Score
Rating
Name: Date:
1.
2.
3.

Agency
Sept. 2019
Information Sheet-2 Identifying Better performing households (Recruitment)
2.1 Level 1 trainees will be selected from the 1 to 5 network leaders who are willing to attend the
training given at the kebele level. And for recruiting level 2 trainees, a committee is led by woreda
health office. The members of the committee include: women, youth and child affairs, community
representatives, health extension workers, primary Health Care Unit Director, Kebele
administrator/ manager. While recruiting the level 2 trainees, the committee has the following main
criteria:-
 The most recent score of the WDA leader (―A‖ and ―B‖ grade)
 Performance of WDA at level 1 may be measured using the WDA score card which
includes various criteria– proper written plan, facilitating regular discussion with members,
more number of graduated model households, regular participation and involvement in
preventive and promotion during health campaigns and environmental hygiene, creating
strong relationship among members, proper support and follow up of members.
 Willingness to attend the training and work as WDA
 Minimum educational qualification – basic education. Moreover, given the fact that, level 2
trainees need to pass through the level 1 examination, the eligible trainee for level 2 needs
to pass the level 1 competence examination
 Directions: SAY TRUE OR FALSE
1. Trainees will be selected from the 1 to 5 network leaders who are willing to attend the
training given at the kebele level.
2. To identify better performing House Hold The members of the committee include,
Women, youth and child affairs, community representatives, health extension
workers.
Score
Rating
Name: Date:
1.
2.

Agency
Sept. 2019
Information Sheet-3 Planning, Implementing and evaluating WHDA training
31-Space, time and modality for WDA training

Level-1 Level-2
Venue The training will be provided at the The health centers at the woreda
venue selected and prepared by the town will be prepared for the level-2
kebele administration and health trainings.
extension worker. The venue can be
farmers training centers, primary
schools, Kebele meeting hall, or
health posts depending on the
convenience to provide the training.
Cohort of trainee For easy management, training would The trainees would be pulled from
be organized by batch. Each cohort various kebles under each PHCU.
needs to reside in one zone/cluster of
Gotes/Kushets. The trainers would
complete one after the other.
Training modality
Initial training: The class room Initial training: The class room
sessions can be given for two to three sessions can be given for two days
days per week for four hours each. In per week for four hours each. In
addition, every week one day will be addition, every week two days will
dedicated for cooperative training – an be dedicated for cooperative
assignment would be given to a training – an assignment would be
trainee to practice the competence in given to a trainee to practice the
her 1 to 5 network. At the end of the competence at household and
class room training, 3 weeks (3 community levels. At the end of the
days/week) will be assigned for class room training, 2 weeks (3
cooperative trainings. The trainees days/week) will be assigned for
exit from the training program once cooperative trainings. The trainees
they have completed the chart of will exit from the training program
competence. once they have completed the chart
of competence.
Community Each attachment will be led by the Health Extension workers and health
Attachment center staff assigned to each kebele. In addition, the trainees would practice
by their own to complete specific assignments provided to them in the class
room sessions. Any issues requiring clarification would be presented to the
supervisors when they come to re-enforce the skills acquired at site level.

Agency
Sept. 2019
Quality assurance The quality assurance will be made at multiple stages. The curriculum will
be piloted in the demonstration sites and assessed using standard
measurement indicators. The feedbacks will be considered to finalize the
implementation manual and training plan. Then, the content and modality of
the training will be reviewed based on their relevance and lessons from field
for the scale-up. In addition, the capacity of the trainers will be meticulously
assessed after completion of the TOT and during the training and necessary
action will be taken on the spot and the shortfalls and actions will be
documented for future use. Using the checklist (-----Annex-1), the training
Quality assurance will also be made by a core team comprising of MOH,
RHB, TVET colleges and partners staff and Woreda Health Office.
Identify necessary resources

Depending on the responsibilities of each qualified WDA assumes, the supplies and materials
required to carry out those responsibilities may vary. The following table provides the list, which
may expand during implementation though.
Table--: list of supplies and materials required by Level-1 and Level-2 WDA
Level-1 Level-2
 Family health guide  Family health card

 Village map and d/t stickers– target  Field register book
identification
 Maternal, neonatal, & Child
health recording book
 Record note book  Demonstration sets (e. g., Nutrition, breast
feeding)
  Referral Slip
 Contraceptives – Condoms and Pills,  Contraceptives – Condoms and Pills,
Injectable, implants, IUCD, Injectable, implants, IUCD,
  Kit for simple First aid services
 IEC/SBBC materials
 Digital scale, salter scale  MUAC, Digital scale, salter scale
 Aqua tab  Penile model
The list of materials required for the program are identified and included in the PHCU annual plan
and procurement plan. The management would then follow the existing supplies chain
management – Integrated Pharmaceutical Logistics System (IPLS) to manage supplies required
for the Level I and Level 2 WDAs.
Competence assessment

Agency
Sept. 2019
The competence assessment guide and questions are prepared by the TVET agency in collaboration with Federal
Ministry of Health and Partners. While preparing the assessment tools, necessary ―material lists‖ were also identified.
As Health extension workers will do the assessment, training on basic skills on assessment would be given to them
and the Agency of Competence (AOC)/ Regional Center of Competence (COC) will certify them as an assessor.
After completion of all the competencies for each level, the trainees would be assessed by certified HEWs from other
kebeles. While preparing for an assessment, it is the duty of the training facility/Woreda Health Office to prepare the
required logistics/materials and expenses before the assessment.
Certification
When the trainee completes each unit of competence, the training institution/woreda health office will provide
certificate for completion. But when the trainee completes chart of competences for each level, they are expected to
take the qualification examination provided by Agency of Competence (AOC)/ Regional Center of Competence (COC).
A copy of the certificate would be presented to the health extension workers and Keble Administration.
Deployment
Initial placement: Before the actual deployment, the kebele council members and HEWs will do a
community sensitization and introduce the role level-1 and level-2 play in the community. Then,
after completion of the training, the level-1 and Level-2 WDA will be deployed at their permanent
residence. In the first week of their deployment, there will be an introduction session organized for
their catchment population and the will be linked to the Health Extension workers and other
development team and 1:5 leaders.
Key responsibilities/Service package:
The 18 health extension packages are going to be provided by both the Level-1 and Level-2
WDAs. The Key responsibilities of those trained are derived from the national qualification
framework prepared.
Table--------Description of key responsibilities of Level 1 WDA interims of the Health Extension

Package
Health Extension package Unit of Competence for Level-1

Health Education Facilitate Community Mobilization and Communication
1. Conduct communication
Facilitate Community Mobilization
Environmental Hygiene and Sanitation Promote Basic Hygiene and Environmental Health
Services
1. Promote and implement hygiene and environmental health
services
2. Promote basic hygiene and environmental health services
Family Health Promote Family Planning Services

1. dentify Family Planning Targets
2. Promote Family Planning Methods

Agency
Sept. 2019
Promote maternal, infant and young child nutrition

(MIYCN)
1. Preparation for message dissemination
2. Provide information on MIYCN for mothers
Promote key messages on child survival and growth
1. dentify target groups for the child survival interventions
2. Promote child survival and growth activities
Promote birth preparedness and complication readiness

1. identify a skilled birth attendant and health facility
2. Prepare resources required for birth preparation and
complication readiness
Promote Post-natal Care
Provide information for women on post partum period.
Pay a follow up home visits
Promote Immunization Services
1. Identify target groups and prepare plan
2. Facilitate the promotion
Communicable and non- disease Prevent Common Communicable Diseases
1. Promote key massages to the community on
prevention of communicable and non-
communicable diseases
2. Identify suspected Cases
Table------Description of key responsibilities of Level-2 WDA interims of the Health Extension

Package
Health Education Perform Community Mobilization and Communication
Environmental Hygiene and Sanitation Facilitate and Implement Basic Hygiene and Environmental Health
Services
Family Health Promote Family Planning and Provide selected Family Planning
Services
Promote community based nutrition
Identify and refer sick child
Promote ANC services and referral of cases
Promote Institutional Delivery services

Agency
Sept. 2019
Promote PNC and Provide selected PNC services
Facilitate Immunization Services
Communicable disease Facilitate common communicable diseases prevention and control
Follow up and monitoring
The monitoring and evaluation plan would utilize the existing arrangements and the supervisions
made by the health extension workers and staff member of the health centers. However, this new
inclusion might require revising the existing reporting tools and supervision checklist to
accommodate the data needs of this program.
Table-----Indictor matrix
S.No Indicator Definition of Method of Calculation Data Source of Frequency
Indicator collection information
responsibil
Numerator Denominator
ity
1 Number of Number of WDA who Absolute Woreda Attendance / Every six
WDA have completed all number Health List of months
trained by the unit of Office graduates
level competencies
2 Proportion Percentage of WDA Number of Number of Woreda Registers / Every six

of WDA who took COC and graduates who graduates Health Qualification months
who Passed passed the exam out passed COC Office Certificate
COC by of those who
level completed trainings
by level
3 Number of Number of kebles Absolute WOreda Woreda Every
Kebeles for who have started number Health Health Office Quarter
the with the providing trainings Office reports
program
4 Proportion Proportion of WDA Number of Number of Supervisor Field visit Monthly
of WDA who complete set of WDA with Visited WDA at s checklist/repor
who have supplies at the day complete set the same day by t
all the of visit out of those of supplies supervisors
necessary who have visited by and materials
materials at supervisors at the day of
the day of visit
visit

Agency
Sept. 2019
responsibil
ity
5 Frequency Frequency of Absolute Health Report/ Monthly
of meetings meetings with HEWs number Extension Minutes
with HEWs at each kebele by Workers
within a level
month
6 Frequency Frequency of Absolute Level 2 Report/ Monthly

of meetings with Level number WDAs Registers
developmen 2 WDA at each
t team kebele
meetings
within a
month
7 Proportion Health related issues Number of Total number of Level 2 Reports/ Monthly
of health raised during meetings on meetings within a WDAs Registers
issues development team health related month
raised meetings issues
during
developmen
t team
meetings
with in a
month
8 Updated Number of Number of HEWs Supervision Monthly
Family household households report
Health Card with updated supervised
at each family health
household care
9 Proportion Households in a Total number Total number of HEWs Monthly Monthly

of model kebele which has of graduated households in Report
households done the following - household each kebele
graduated 4th ANC, Facility
in a kebele delivery, modern FP,
EPI as per the
schedule, Exclusive
breast feeding, GMP
under two, Latrine
construction and
Utilization, solid and
liquid waste
management, proper
housing)
10 Proportion Mothers/ Number of Number of HEWs Supervision Monthly

of mothers Family members households households checklists/
or family with a knowledge who listed and visited in a Monthly
members and prepared all the showed the month supervision
with items required as prepared summary
appropriate part of birth items sheet
birth preparation which
preparation are included in the
in a month family health card

Agency
Sept. 2019
responsibil
ity

who name with a knowledge all who listed all visited in a Monthly
all the the danger signs of the danger month supervision
danger pregnancy signs of summary
signs pregnancy sheet
pregnancy

danger labor signs of labor summary
signs labor sheet

danger newborn signs of summary
signs newborn sheet
newborn
14 Households Proportion of Number of Number of Level 2 Supervision Monthly

visited with newborns visited households expected births WDA checklists/
48 hours by within 48 hours in a who was in a month Monthly
the WDA month visited by supervision
members WDA with 48 summary
after birth in hours sheet
a month

Agency
Sept. 2019
Directions: Choose the best answers from the given alternative.
1. When the trainee completes each unit of competence, the training institution/woreda
health office will provide for completion
A. Competence assessment Certification C. Deployment D.ALL

2. The kebele council members and HEWs will do a community sensitization and introduce
the role level-1 and level-2 play in the community.
A. Competence assessment Certification C. Deployment D.NONE
3. Guide and questions are prepared by the TVET agency in collaboration with Federal Ministry
of Health and Partners
A. Competence assessment Certification C. Deployment D.NONE
Answer Sheet
Score
Rating
Name: Date:
1.
2.
3.
 Ramachandran L. and Dharmalingam. T. 1995. Health education‘s new approach.

 Randall R. Cottrell, James T. Girvan, James F. McKenzie 2006. Principles& foundations
of health promotion and education. Third ed. USA

Agency
Sept. 2019
LG15: Plan and Undertake advocacy on
Instruction Sheet
identified health issues
 Introducing advocacy
 Introduction to advocacy
12. Read the information written in the information ―Sheet 1‘‘
13. Accomplish the ―Self-check 1, on page 7.

Agency
Sept. 2019
Information Sheet-1 Introducing advocacy
1.1 Basic concept of advocacy in health

The word advocacy is difficult to understand. As a Health Extension Practitioner, you will be able to
use some of the skills of advocacy during your routine work with people in your locality.
Advocacy is the pursuit of influencing outcomes, including public policy and resource allocation
decisions within political, economic, and social systems and institutions - that directly affect people‘s
health status. Health status of community is directly or indirectly influenced by policy decision of
different sectors. As an advocacy coordinator, you will need support and technical assistance, and
possibly extra personnel to carry out your advocacy activities.
Health advocacy encompasses direct service to the individual or family as well as activities that
promote health and access to health care in communities and the larger public. Advocates support and
promote the rights of the patient in the health care arena, help build capacity to improve community
health and enhance health policy initiatives focused on available, safe and quality care. Health
Advocates are suited best to address challenge of patient-centered care in our complex healthcare
system.
Health advocates work for positive change in the health care system, improved access to quality care,
protection and enhancement of patient's rights. Competing health needs of diverse and ever shrinking
resources available to support these needs often serve as the impetus for the initiation of advocacy
efforts to improve community health. Most simply, community health advocacy entails advocacy by a
community around issues related to health.
Fig-1.1- In every community there are issues that are larger than the individual that will require
detailed advocacy work.
Health advocacy is integral to achieving better health outcomes for individuals and communities and to
improving health services and systems. It empowers community and their advocates to actively
participate in decision-making around their healthcare and the broader health system.
Effective health advocacy ensure people‘s needs to be addressed, increases the confidence of
peoples on health system and increases accountability and responsibility.
Advocacy: refers to communication strategies focusing on policy makers, community leaders and
opinion leaders to gain commitment and support. It is an appeal for a higher-level commitment,
involvement and participation in fulfilling a set program agenda.

Agency
Sept. 2019
In simple term other define advocacy as ‗advocacy is speaking, acting and writing with minimal conflict
of interest on behalf of the interests of a person or group in order to promote, protect and defend the
welfare and justice for either the person or group‘.
Fig 1.2- Health advocacy diagram
1.2-Purpose of advocacy
Promotion and protection of a community‘s wellbeing and rights‘ focuses on a core function of health
advocacy. Advocacy is not just one thing or one way of doing things; it can be delivered through a
variety of interpersonal and media channels. Advocacy also includes organizing and building alliances
across a wide variety of stakeholders, are person, group or organization that has interest or concern in
an organization. Stakeholders can affect or be affected by the organization's actions, objectives and
policies. When we see the benefit of Health advocacy contributes to:
 Positive changes to legislation, policies, practices, service delivery and developments
and community behavior and attitudes.
 Promotion of wellness and resilience in individuals, families and communities in conjunction
with health literacy and patient activation strategies.
 Raised awareness of the significant impact on an individual‘s health and wellbeing of
broader social and environmental factors (such as housing, education, employment, and
cultural identity, gender and sexuality identities), thereby enabling health advocacy to
facilitate individual and systemic change in these areas.
 Empowering health consumers to become more involved in their healthcare decision-making
and broader health policy and initiatives.
 Resolution of consumers‘ issues as they arise, mitigating escalation and lengthy
complaints processes.
 Consumer focused, affordable and responsive health services that are cost-effective
Advocacy builds support for a course of action, influences others to support it, and influences or
reforms regulation that affects it. The outcomes of advocacy should influence policy, decision
making,
educate leaders and policy makers to reform existing policies/laws and budgets, assist in developing
new programs, and create more democratic, open, accountable decision making structures and
procedures
The advocacy approaches

Agency
Sept. 2019
Sometimes advocates find themselves working with peoples who are unable to work on advocacy
because they cannot communicate in a meaningful way. The advocacy approach uses many different
methods of reaching people. Inter-personal meetings or face-to-face approaches with the decision
makers are the most effective advocacy approaches for those people.
The other approach is involving leader; leaders, refer to those who are extremely influential in
facilitating changes in national or local issues of population and health. As a result of leaders are
acceptable by many community members involving them will help you to get large support. Draw
attention of the leaders to key population and health issues and to encourage them to take action. You
can also use other channels for reaching the public, for example newsletters, flyers, booklets, fact
sheets, posters video, dramas and folk media.
 Make a list from your initial thinking of organizations that may be able to help you with
your advocacy work in the future
 You can get support for your advocacy activities by identifying the governmental and non-
governmental agencies responsible for your locality, and building a good relationship with
their officials
 You can get resources for your locality include the woreda Health Office, the nearby health
centre, local NGOs and other governmental sectors such as the Departments of Agriculture
and Education, as well as local women‘s associations and kebele leaders.
Principles of effective advocacy
 You might already be involved in advocacy to improve the lives of your own community. For
example, some cultures impose on their communities the practice of female circumcision or
female genital mutilation. Principles of advocacy are designed to assess the current
effectiveness of health advocacy approaches, in particular whether they are working well and
whether they can be improved; and strengthen current and future health advocacy
approaches to promote safe, quality healthcare and health systems. Six core principles for
effective health advocacy are identified.
Table 1 below Show

Agency
Sept. 2019
To be effective in advocacy remember to consider the above principles which can help you to get
support for your advocacy activities. To get good support for advocacy campaigns you need to form a
cooperative team for your advocacy activities, and you need to know the stages to go through in order
to achieve the best results.
Goals and objectives of advocacy
It is vital to know what you are trying to do before you start your advocacy work. This involves
developing a goal and objectives that applies to the situation that needs to change. The goals and
objectives of advocacy are to facilitate change and the development of new areas of policy, in order to
tackle unmet health needs or deal with emerging health needs in a given community.
An advocacy goal is the long-term result three to five years of your advocacy effort; it is your vision
for change. The goal statement of an advocacy communicates the benefit that will be felt by those
affected by an issue. A goal gives direction which helps you know where you are going. It needs an
accompanying route map or strategy to show you how to get there. You can probably recognize them
as the overall purpose of the sort of health education work that community health workers involved.
An advocacy objective is the short-term target one to two years that contributes toward your goal.
They are specific activities derived from the major goal of advocacy. It refers to the desired changes in
policy and practice that will be necessary to help you and your communities meet that goal. It should
be achievable using available resource in a defined time bound. While seeing your objectives it should
be ―SMART‖. This stands for
 S- Specific — by this we mean that you need to set a specific objective for each of your
health programmes.
 M- Measurable — your objective should be measurable.
 A- Achievable — the objective should be attainable or practicable.
 R- Reliable — which also means credible.
 T -Time-bound — and should be accomplished and achieved within a certain amount of
time. For example, let see this objective according to SMART principle. You plan is to:-
Increase the number of pregnant women taking antenatal care by 15% in one year. It is:-
 Specific - you plan to increase by 15%
 Measurable – number of pregnant women who follow antenatal care are known
 Achievable – if in previous time 10 pregnant are following antenatal care now it is to
change from 10 to 12mothers.
 Reliable – because current utilization is very low.
 Timely bounded – it is accomplished in one year period of time.
Advocacy objective should be SMART may and include the following
elements
Elements of advocacy objective

 Policy actor or decision maker is the individual with the power to convert the advocacy
objective into action (i.e., Minister of Health, local health office, local administration
etc.).
 Policy action or decision is the action required to achieve the objective (i.e., adopt a certain
policy; allocate funds to support a specific program or initiative, etc.).
 Timeline describes when the objective will be achieved. Advocacy objectives should be
Agency
Sept. 2019
achievable within one to two years. Some advocacy objectives also indicate the degree of
change—or a quantitative measure of change—desired in the policy action. For example,

Agency
Sept. 2019
degree of change could be expressed as redirecting 25% of the health office family planning
budget to target adolescent services.
Advocacy tools
In the previous section you have learned about developing SMART advocacy objectives. Now you will
learn about tools that help to advocate health issues. Which are called advocacy tools. These are
media advocacy, lobbing, meeting, project visit, and community organizing.
Media advocates design media campaigns around delivering messages to those (secondary targets)
who can influence these people with the power (primary targets). Advocates want these

Agency
Sept. 2019
Influencers to act and communicate their messages to the authorities. It is not necessarily concerned
about using national media.
◻ For example, think about campaign about traffic accidents around schools. You may identify
the school‘s administration as having the power to ask traffic slowing around the school.
◻ you can focus on student‘s parents, teachers, and students ‗find their voice‘ and deliver messages
to school administration.
Lobbying is concerned primarily to directly influencing individuals who have the power to make the
policy changes for which advocates are campaigning. It is influencing the policy process by
working closely with key individuals in political and governmental decision making.
Another tool is the use of meetings, usually as part of a lobbying strategy or negotiation, to reach a
common position. Project visits are another useful tool of advocacy to demonstrate good practice and
information, education and communication as various means of sensitizing the decision makers
1.3Planning, implementing, monitoring and evaluating advocacy
You need well-planned activities to achieve your advocacy goals and objectives. Advocacy needs
resource; you also need to identify and attract resources (money, equipment, volunteers, supplies and
space) to implement your advocacy campaigns.
Planning advocacy is important because it gives sequence of steps to follow, use limited resources
effectively, it easier to monitor and evaluate our plans and it helps to ensure public and stakeholders
participation. The process of planning an advocacy initiative entails four crucial stages.
Identifying a problem
This is the first stage of advocacy which is about what you aim to do. You need to identify the problem
that requires a policy action. You should discuss with the beneficiaries of the advocacy, the
disadvantaged people like persons with disabilities, stakeholders and members of your group. You
need to consult the people you represent to find out what is the most important problem or issue for
them.
You need to make sure that this process is as participatory as possible. This means you should
involve the persons with disabilities you represent in planning identifying what problems are most
important for them, through discussions at a group meeting. But make sure everyone has the chance
to participate. You can also do a ranking exercise where members vote on the problem which affects
them most. You can also go out to talk to people with disabilities in their homes, at the market or at
their place of work or you could send out a questionnaire to find out their concerns.
Identify targets
Target is an individual with decision maker power to respond to your advocacy demands. Nearly
always you will have a primary target, policy maker to whom advocacy is targeted and secondary
targets that have some influence over the primary target. This means you should decide which
audience to target through advocacy, and you must carefully determine the advocacy goals and
objectives
Build support
At this time you should also identify your allies, people and organizations that support your advocacy
campaign and opponent; these are influential people and institutions who oppose your advocacy
campaign. An advocacy will be effective when individuals and organizations join together in order to
increase the strength of your advocacy efforts and when there are no or only small opponents.
Developing your message
An advocacy message is a central statement that is be communicated to different audiences. These
messages define the issue, state solutions, and describe the actions that need to be taken. The types
of message we develop also assist you in selection of appropriate communication channels. The
message should clearly communicate the issue you want to advocate and suite to the channel.
Identifying the channels of communication

Communication channels are physical means by which a message s transferred to targets audiences.
Identify the channels and the messages to be delivered to the various target audiences through radio,
television, flyers, press conferences, or during meetings. The channels should be appropriate to the
message and it should be familiar to the target audiences.
Agency
Sept. 2019
Resource mobilization
Advocacy needs resource. This means you need to identify and attract resources such as money,
equipment, volunteers, supplies and space in order to carry out your advocacy campaign. You need to
analyze your supporters who give helps resources to your advocacy campaign.
Advocacy activity
Once you have mobilized all necessary resources develop an action plan of your advocacy campaign
activities in light of available recourse. Based on action plan developed you will be able to implement a
set of planned activities to achieve your advocacy objectives.
1.4 Monitoring and evaluating the activities
After you have already implement your advocacy campaign you need to monitor the process of an
activity and gather information about how it is going, in order to measure progress towards your
advocacy goal. Then evaluate the data gathered about the advocacy activities and analyze them to
support each step of your advocacy campaign

Directions: Choose the best answers from the given alternative
1. Refers to communication strategies focusing on policy makers, community leaders and

opinion leaders to gain commitment and support
A. Advocacy B. Health Advocacy C .Community Mobilization D.ALL
2. Encompasses direct service to the individual or family as well as activities that promote health
and access to health care in communities and the larger public.
A. Advocacy B. Health Advocacy C .Community Mobilization D.ALL
3. Purpose of Advocacy?
A. Promotion and protection. B. undermining Women C. Done only for Relatives D.None
4 Sometimes advocates find themselves working with peoples who are unable to work on advocacy
because they cannot communicate in a meaningful way
A. Promotion and protection. B. undermining Women C. Advocacy approach D. None
5. Individual with decision maker power to respond to your advocacy demands

A. primary target B. secondary targets C. Target D .None
answers

Agency
Sept. 2019
Reference
 Bruce G, Simons M, Walter H, Nell H. Introduction to health education and health
promotion. Second edition, 1984
 Ramachandran L. and Dharmalingam. T. 1995. Health education‘s new approach.

Agency
Sept. 2019

4 MDL

Uploaded by

Copyright:

Available Formats

4 MDL

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

4 MDL

Uploaded by

Copyright:

Available Formats

Module Title Performing Community Mobilization and

Provide Health Education

This module includes the following Learning Guides

LG12: Conduct health education and communication

1. Read the specific objectives of this Learning Guide.

1.1. Community need assessment

Author/Copyright: Federal TVET Page 3 of 100

3. Assessing a health priority for action

Figure 1.1:- Steps to be followed during need assessment

Author/Copyright: Federal TVET Page 5 of 100

B. Key informant interview

 Three methods including interviews provide information about people‗s beliefs,

Author/Copyright: Federal TVET Page 6 of 100

Author/Copyright: Federal TVET Page 7 of 100

 Focus group interview is defined as a technique in which a group of people who

Author/Copyright: Federal TVET Page 9 of 100

Self check #1 Written test

Note: Satisfactory rating - 4 points unsatisfactory below-4 points

Short Answer Question

Author/Copyright: Federal TVET Page 10 of 100

1.2 Resource mobilization /organization

Author/Copyright: Federal TVET Page 11 of 100

 steps in community mobilization:-

Author/Copyright: Federal TVET Page 12 of 100

Author/Copyright: Federal TVET Page 13 of 100

Figure 2.4:- Community Action Cycle

Author/Copyright: Federal TVET Page 15 of 100

1.2.5 Techniques to involve a community

Figure 2.5:-Typically community mobilization will involve a series of community meetings.

Author/Copyright: Federal TVET Page 16 of 100

 Level of community participation

Figure 2.6:- Community ownership and sustainability

 Community participation increases, community ownership and capacity increases. These

Figure 2.7:- Community mapping help to identify community health

Author/Copyright: Federal TVET Page 18 of 100

Self check #1 Written test

Note: Satisfactory rating 3 points unsatisfactory below 3 points

Short Answer Question

Author/Copyright: Federal TVET Page 19 of 100

Author/Copyright: Federal TVET Page 20 of 100

Note: satisfactory rating 1 point unsatisfactory below 1 point

answers Answer Sheet

Short Answer Question

Author/Copyright: Federal TVET Page 21 of 100

Figure 4.1:- Steps in planning health education activities

Author/Copyright: Federal TVET Page 22 of 100

Author/Copyright: Federal TVET Page 24 of 100

1. Clear objectives 4. Who will help you?

Author/Copyright: Federal TVET Page 25 of 100

Note: satisfactory rating 3 point unsatisfactory below 3 point

answers Answer Sheet

Short Answer Question

Information sheet # 5 Designing Methods and approaches of health communication

Author/Copyright: Federal TVET Page 27 of 100

 The advantages of home visits

Author/Copyright: Federal TVET Page 29 of 100

 Planning a discussion involves:

 Conducting the discussion

 A demonstration is a step-by step procedure that is performed before a group. They