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Health education & health education for food & nutrition honours level at semester system., Summaries of Nutrition

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900
COMMUNICATION
FOR
HEALTH
EDUCATION
PRACTICE
OF
HEALTH
EDUCATION
1.
Individual
approach
There
are
plenty
of
opportunities
for
individual
healu
education.
It
may
be
given
in
personal
interviews
in
consultation
room
of
the
doctor
or
in
the
health
centre
o
the
homes
of
the
people.
The
individual
comes
to
the
d0
or
health
centre
because
of
illness.
Opportunity
is
takor
educating
him
on
matters
of
interest-
diet,
causation
an
nature
of
illness
and
its
prevention,
personal
hygieno
environmental
hygiene,
etc.
Topics
for
health
counselli
Educational
material
should
be
designed
to focus
attention
to
provide
new
knowledge,
to
facilitate
interpersonal
and
group
discussion
and
to
reinforce
or
clarify prior knowledge and behaviour.
1.
Audio-visual
aids
No
health
education
can
be
effective
without
audiovisual
aids.
They
help
to
simplify
unfamiliar
concepts;
bring
about
understanding where words
fail;
reinforce learning
by
appealing
to
more
than
one
sense,
and
provide
a
dynamic
way
of
avoiding
monotony.
Modern
science
has
made
available
an
endless
array
of
audiovisual
aids
which
can
be
classified
into
three
groups
(20):
may
be
selected
according
to
the
relevance
of
the
situatio
on.
By
such
individual
health
teaching,
we
will
be
equippingt
the
individual
and
the
family
to
deal
more
effectively
with
tho
health
problems.
physician
in
this
regard,
is
very
great
because
he
has
tha
confidence
of
the
patient.
The
patient
will
listen
more
readilu
to
the
physician's
health
counselling.
A hint
from
the
doctor
may
have
a
more
lasting
effect
than
volumes
of
printed
word.
The
nursing
staff
have
also
ample
oPportunities
for
undertaking
health
education.
Florence
Nightingale
said
that
the
nurse
can
do
more
good
in
the
home
than
in
the
hospital.
Public
health
nurses,
health visitors
and
health
inspectors
are
visiting
hundreds
of
homes, they
have
plenty
of
opportunities
for
individual
health
teaching.
In
working
with
individuals,
the
health
educator
must
first
create
an
atmosphere
of
friendship
and
allow
the
individual
to
talk
as
much
as
possible.
The
biggest
advantage
of
individual
health
teaching
is
that
we
can
discuss,
argue
and
persuade
the
individual
to
change
his
behaviour.
It
provides
opportunities
to
ask
questions
in
terms
of
specific
interests.
The
limitation
of
individual
health
teaching
is
that
the
numbers
we
reach
are
small,
and
health
education
is
given
only
to
those
who
come
in
contact
with
us.
The
responsibility
of
the
attendine
(1)
AUDITORY
AIDSS
Radio, tape-recorder, microphones, amplifiers, earphones.
(2) VISUAL AIDS
(a)
Not
requiring
projection:
Chalk-board,
leaflets,
posters, charts, flannelgraph, exhibits, models,
specimens,
etc.
(b)
Requiring
projection:
Slides,
film
strips.
(3)
COMBINED
A-V
AIDS
Television,
films
(Cinema),
sound
slide-tape
combination.
A
knowledge
of
the
advantages,
disadvantages
and
limitations
of
each
audio-visual
aid
is
necessary
in
order
to
make
proper
use
of
them.
Audio-visual
aids
are
means
to
an
end,
not
an
end
in
themselves.
2.
Methods
in
health
communication
2.
Group
approach
The
methods
in
health
communication
may
be
grouped
as
in
Fig.
3.
Our
society
contains
groups
of
many
kinds
-
school
children,
mothers,
industrial
workers,
patients,
etc.
Group
teaching
is
an
effective
way
of
educating
the
community.
The
choice
of
subject
in
group
health
teaching
is
very
important;
it
must
relate
directly
to
the
interest
of
the
group.
For
example,
we should
not
broach the subjectof
tuberculosis control to a
mother
who
has
come
for delivery
we
should
talk
to
her
about
child-birth
and
baby
care.
A
rundown
of
the
assets
of
mass
media
and
personal
communication
methods
is
as
shown
in
Table
2.
Any
one
or
a
combination
of
these
methods
can
be
used
selectively
at
different
times,
depending
upon
the
objectives
to
be
achieved,
the
behaviour
to
be
influenced
and
available
funds.
Health
Communication
Individual
Group
approach
approach
Mass
approach
1.
Personal
contact
1.
Lectures
1.
Television
2
Home
visits
2.
Demonstrations
2
Radio
3.
Personal
Letters
3.
Discussion methods
3.
News
paper
4 Printed material
Direct mailing
Group discussion
Panel
discussion
5.
Symposium
6.
Posters
Workshop
Conferences
7.
Health
museums
and
exhibitions
Seminars 8
Folk
methods
Role play
9.
Internet
FIG.3
Methods
in
health communication
pf3
pf4
pf5

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900 COMMUNICATION^ FOR^ HEALTH^ EDUCATION

PRACTICE OF HEALTH EDUCATION 1. Individual approach

There are plenty of^ opportunities^ for^

individual healu

education. It may be^ given^ in^

personal interviews^ in

consultation room^ of^ the^ doctor^

or in^ the health^ centre^ o

the homes^ of^ the^ people.^ The^

individual comes^ to^ the^ d

or health^

centre because^ of^ illness.^

Opportunity is^ takor

educating him^ on^ matters^

of interest-^ diet,^ causation^ an

nature of^ illness^ and^ its^ prevention,^ personal^

hygieno

environmental hygiene, etc.^ Topics^

for health^ counselli

Educational material should be designed to focus attention to provide new knowledge, to facilitate interpersonal and group discussion and to reinforce or

clarify prior knowledge and behaviour.

  1. Audio-visual aids No health education can be effective without audiovisual aids. They help to simplify unfamiliar concepts; bring about

understanding where words fail; reinforce learning by

appealing to more than one sense, and provide a dynamic way of avoiding monotony. Modern science has made available an endless array of audiovisual aids which can be classified into three groups (20):

may be^ selected^ according^

to the^ relevance^ of^ the^ situatioon.

By such^ individual^ health^ teaching,^

we (^) will be equippingtthe

individual and^ the^ family^ to^ deal^

more effectively with tho

health problems.

physician in^ this^ regard,^ is^ very^ great^ because^

he (^) has tha

confidence of^ the^ patient.^ The^ patient^ will^ listen^

more (^) readilu

to the^ physician's health^ counselling.^

A (^) hint from the (^) doctor

may have^ a^ more^ lasting^

effect than^ volumes of^ printed

word. The^ nursing staff^ have^ also^ ample^ oPportunities^ for

undertaking health^ education.^

Florence Nightingale said^ that the nurse^ can^ do^ more^ good^ in^ the^

home than in (^) the

hospital. Public^ health^ nurses,^ health visitors^

and (^) health

inspectors are^ visiting^ hundreds^ of^ homes,^ they^

have plenty

of opportunities for^ individual^ health^ teaching.^

In working

with (^) individuals, the^ health^ educator^ must^ first^ create^ an

atmosphere of^ friendship^ and^ allow^ the^

individual (^) to (^) talk as

much as possible. The^ biggest^ advantage^ of^ individual

health teaching is that we can discuss, argue and persuade the individual to change his behaviour. It provides opportunities to^ ask^ questions in^ terms^ of^ specific^ interests. The limitation of individual health teaching is that the numbers we reach are small, and health education is given only to^ those^ who^ come^ in^ contact^ with^ us.

The responsibility of^ the^ attendine

(1) AUDITORY AIDSS

Radio, tape-recorder, microphones, amplifiers, earphones.

(2) VISUAL AIDS

(a) Not requiring projection: Chalk-board, leaflets,

posters, charts, flannelgraph, exhibits, models,

specimens, etc.

(b) Requiring projection: Slides, film strips.

(3) COMBINED A-V AIDS Television, sound films (^) (Cinema), slide-tape combination. A knowledge of the advantages, disadvantages and limitations of each audio-visual aid is necessary in order to make proper use of them. Audio-visual aids are means to an end, not an end in themselves.

2. Methods in health communication

2. Group approach

The methods in health communication may be grouped as in Fig. 3.

Our society contains groups of many kinds - school children, mothers, industrial workers, patients, etc. Group teaching is an effective way of educating the community. The choice of subject in group health teaching is very important; it must relate directly to the interest of the group. For example, we should not broach the subjectof

tuberculosis control to a mother who has come for delivery

we should talk to her about child-birth and baby care.

A rundown of the assets of mass media and personal communication methods is as shown in Table 2. Any one or a combination of these methods can be used selectively at different times, depending upon the objectives to be achieved, the behaviour to be influenced and available funds.

Health Communication

Individual Group

approach approach^ Mass approach

  1. Personal contact 1.^ Lectures^ 1. Television (^2) Home visits 2.^ Demonstrations^2 Radio
  2. Personal Letters 3.^ Discussion methods^ 3. (^) News paper

4 Printed material

Direct mailing

Group discussion Panel discussion (^) 5.

Symposium 6. Posters

Workshop

Conferences 7.^ Health^ museums and exhibitions Seminars Role play 8 Folk^ methods

  1. Internet

FIG. Methods in health communication

PRACTICE OF HEALTH EDUCATION (^901)

ArundOwn TABLE^2

of (^) assets (^) of (^) mass media and Mass Media^ personal^ communicatou (TV, radio, newspaper) (^) Personal communication

  1. (^) Reaches the (^) widest

population

(Interpersonal and group methods) Capitalizes on warmth and understanding and knowledge of communication

  1. Provides the opportunity for involvement, for asking questions, expressing tears, and learning more
  2. Gets public^ attention

Gives (^) greater (^) support for programmes such as thoseconcentrated for a week or month

Can get people to make changes in personal habits more readily, when discussion presents reasonable explanations for these changes.

  1. More influential with average and below average educational level.

More effective among t

educational level

  1. (^) ose with above average

Similarly, school^ children may be (^) taught about oral tuberculosis hygiene; patients about^ tuberculosis; and (^) industrial uOrkers about^ accidents.^ We (^) have (^) to (^) select also (^) the method of^ health^ suitable education including (^) audio-visual (^) aids for SuCcessful group^ health^ education. A (^) brief (^) account of (^) the methods of group teaching is given below

thinking or^ problem-solving^ capacity;^ the^ comprehension^

of

a lecture^ varies^ with^ the^ student;^ and^ the^ health^ behaviour

of the listeners is not necessarily affected.

(2) Demonstrations

A demonstration^ is^ a^ carefully prepared^ presentation^ to

show how to perform a skill or procedure. Here a procedure

(e.g. lumber^ puncture,^ disinfection^ of^ a^ well)^ is^

carried out

step by step before^ an^ audience^ or^ the^ target^ group,^

the demonstrato

(1) Chalk and talk (Lecture)

A lecture may be defined as carefully prepared oral

presentation of facts, organized thoughts and ideas by a qualified person. The "chalk" lends the visual component. The chalk and talk communication has still a very important place in small group education. Its effectiveness depends to a large extent on the speaker's ability to write legibly and to

draw with chalk on a black board. The talk should be based

on a topic of current interest or health needs of the group. The (^) group should^ not^ be^ more^ than^30 and^ the^ talk^ shoulo not exceed 15 to 20 minutes. If the talk is too long people may become^ bored^ and^ restless.

ascertaining that^ the^ audience^ understands how to^ perform it.^ The^ demonstrator^ involves^ the^ audience in discussion.

Demonstration (a) dramatizes^ by arousing^ interest

(b)persuades the onlookers to adopt recommended

practices (c) upholds^ the^ principles^ of^ "seeing^ is^ believing"

and "learning by doing", and^ (d) can^ bring^ desirable

changes in^ the^ behaviour^ pertaining^ to^ the^

use of neww practice. Demonstration as^ a^ means^ of^ communication^ has^ been

found to have a^ high educational^ value^ in^ programmes^ like

environmental sanitation (e.g., installation of a hand-pump,

construction of a sanitary latrine); mother^ and^ child^ health

(e.g. demonstration^ of^ oral^ rehydration^ technique)^ and

control of diseases^ (e.g., scabies).^ The^ clinical^ teaching^ in

hospitals is^ based^ on^ demonstrations.^ This^ method^ has^ a

high motivational value.

The lecture^ method^ can^ be^ made^ more^ effective by combining^ with^

suitable audio-visual^ aids^ such^ as a) Flipcharts^ : They^ consist^ of^ a^

series of charts^ (or posters),

about 25 by 30 cms^ or^ more,^ each^ with^ an^

illustration

pertaining to^ the^ talk^ to^ be^ given.^ They^

are meant^ to^ be

shown one after^ another.^ Each^

chart is "flashed"^ or

displayed before^ a^ group^ as^

the talk^ is^ being^ given.^ The

message on^ the^ charts^

must be^ brief^ and^ to^ the^ point.^

These

Charts are (^) primarily designed^ to^ hold^

attention of^ the^ group

ànd help^ the^ lecture^

to proceed. (b)^ Flannelgraph:^ A^ piece

of rough flannel^ or^ khadi^ fixed^

over a wooden^ board

provides an^ excellent^

background for^ displaying^

cut-out

plctures, graphs,^ drawings^

and other^ illustrations.^

The cut-

Out pictures^ and^

other illustrations^ are^ provided^

with a^ rough

Surface at^ the^ back^ by^

pasting pieces^ of^

sand paper, felt^ or

ough cloth^ and^ they^

adhere at^ once^ when^ put^

on (^) the

iannel. Flannelgraph offers^ the^

advantage that^ pre-arranged

Euence of^ pictures^

displayed one^

after another^ helps

ain continuity^

and adds^ much^ to^

the presentation.^

The

oner advantages^

are that^ the^ flannelgraph^

is (^) a very cheap

m, easy^ to^

transport and^

promotes thought^

and

CIsm (c)^ Exhibits^

Objects, models,^

specimens, etc.

ey a^ specific^

message to^ the^

viewer. They^ are^ essentially

Cr nedia^

of communication,

which can^ also^ be^

used in

eaching. (d)^ Films^ and^

charts

These are^ mass^

media

ommunication. If^ used^

with discrimination,^

they can^ be

OTvalue in educating small^ groups.

(3) Group discussion

A "group" is^ an^ "aggregation^ of^ people^ interacting^ in^ a

face-to-face situation".^ This^ contrasts^ sharply^ to^ the^ group^ of

students in^ a^ class^ room^ situation.^ Group^ discussion^ is

considered a very effective^ methood^ of^ health communication. It permits the individuals to learn by freely

exchanging their^ knowledge,^ ideas^ and^ opinions.^ Group

discussion provides a^ wider^ interaction^ among^ members

than is^ possible^ with^ other^ methods.^

Where long term

compliance is^ involved^ (e.g.,^ cessation^ of^ smoking, obesity

reduction) group^ discussion^ is^ considered^

valuable.

For effective^ group^ discussion,^ the^ group^

should (^) comprise

not less^ than^6 and^ not^ more^

than 12 members.^ The

participants are^ all^ seated^ in^

a circle, so^ that^ each^ is^ fully

visible to^ all^ the^ others^ (Fig. 4).^

There should^ be^ a^ group leader who^ initiates^ the^ subject,^ helps^

the discussion^ in^ the

proper manner,^ prevents^

side-conversations, encourages everyone to^ participate^

and sums^ up the^ discussion^ in^ the end. If^ the^ discussion^ goes^ well,^

the (^) grouP may arrive^ at decisions which^ no^ individual^

member would^ have^ been

able to^ make^ alone.^

It is also desirable^ to^ have^ a^ person^ to Lectures can^ be^

faulted on^ a^

number of^ grounds.^ Their

antages include^

the following:^

students are^ involved

nmum extent;^ learning^

is passive;^ do^ not^

stimulate

a (^) Mass approach - Education

of the

general

PRACTICE OF HEALTH EDUCATION 903 public No (^) health worker (^) or health (^) team (^) can alth (^) education (^) programme mount (^) an (^) effective for (^) the whole (^) community,

and other health agencies is available on line. The Health

related information from the ministry of health and family health welfare Govt. of India, is also available on their website.

except (^) through mas (^) media

of

the (^) media (^) has (^) been communication.. (^) The rapid. (^) Uptill the (^) early

olution of 4.^ Newspapers

1920s, mass^ communication depended (^) largely on (^) what orinted (^) posters, (^) pamphlets, was

newspapers. (^) hen came (^) the books,^ periodicals and radio (^) and (^) with (^) it dimension or^ experlence. (^) TV (^) went a^ new a (^) gigantic nd (^) has (^) become a (^) very (^) powertul step further

nrimarily to^ the^ eye, weapon.^ The^ press caters the radio^ appeals to (^) the hath (^) eye and ear. (^) A (^) final (^) word ear, and (^) TV to

about radio and TV -

eome close to (^) the (^) warmth (^) and they

nerson-to-person motivational^ effect^ of^ a communication. (^) They have of the tabric^ of^ modern (^) civilization. become (^) part

Mass media are a

"one-way" (^) communication. useful in^ transmitting They^ are meSsages to^ people even (^) in (^) the remotest (^) places. The (^) number (^) of usually count^ in^ people^ who^ are^ reached

millions. Their effectiveness

returns for^ the^ time^ and can^ give^ high

money involved.

Mass media alone (^) are generally (^) inadequate in (^) changing human behaviour. For (^) etfective health should be^ used^ in^ communication,^ they combination (^) with (^) other (^) methods. (^) The

power of^ mass^ media^ in^ creating a political will in favour of

health, raising the health consciousness of the

norms, people,^ setting

delivering technical^ messages, popularising health

knowledge and^ tostering community involvement are well

recognized (6). Public health methodologies should be

culturally appropriate; they should be carefully thought-out

before use. A brief account of the mass media is given below

Newspapers are the most widely disseminated of all forms

of literature. News must be newsworthy before it is printed. Whereas many people turn to radio or TV for entertainment,

newspaper readers are

Newspapers should, therefore provide more factual, detailed

and even statistical material (7). Unfortunately, health

problems have little of value to newspapers. Newspapers

have limitation^ of^ having^ low^ readership^ in^ rural^ areas because of^ illiteracy. They^ reach^ only^ a^ limited^ group,^ i.e. the literates in the community.

often seeking newspapers.

  1. Printed material

Magazines, pamphlets, booklets and hand-outs have long

been in use for health communication. They are aimed at

those who can read. Their usefulness lies in the fact that they

can convey detailed information. They can be produced in

bulk for very little cost, and can be shared by others in the

family and community.

6. Direct mailing

This is a new innovation in health communication in India. The intention is to reach the remote areas of the country with printed word (e.g., folders and newsletters and booklets on family planning, immunization and nutrition etc.). These are sent directly to village leaders, literate persons, panchayats and local bodies and others who are considered as opinion

leaders. Direct mailing has been a successful mass media in

  1. Television creating^ public^ awareness.^ It is^ possibly^ the^ most^ personal^ of mass communication.

Television has become the most popular of all media. It is

effective in not only creating awareness, but also to an

extent influencing public opinion and introducing new ways of (^) life. It (^) is (^) raising levels of (^) understanding and (^) helping

people familiarise with things they have not seen before,

including crime^ and^ violence^ which^ are^ shown^ as^ part^ of feature programmes. TV is a one-way channel. It can only be an aid to teaching. It cannot cover all areas of learning. lt has much potential for health communication.

7. Posters, billboards and signs

These are intended to catch the eye and create awareness.

Therefore, the message to be communicated must be simple,

and artistic.^ Posters are^ not^ expensive^ when^ one^ considers they are seen by a large number of people. Motives such as humour and fear are introduced into posters in order to hold the attention of the^ public. In^ places^ where the^ exposure^ time is short (e.g., streets), the message of the poster should be

short, simple, direct and one that can be taken at a glance

and easy to understand immediately. In places where people

have some time to spend (e.g., bus stops, railway stations,

hospitals, health centres) the poster can present more

information. The right amount of matter should be put up in

the right place and at the right time. That is, when there is an

epidemic of viral hepatitis, there should be posters displayed

on viral jaundice, but not on cholera. The life of a poster is usually short; posters should be changed frequently, otherwise they will lose their effect. As a media of health

education, posters have much less effect in changing

behaviour than its enthusiastic users

  1. Radio

Radio is found nearly in every home. In many developing

countries the^ radio^ has^ a^

broader audience^ than^ TV.^ Both

radio and^ TV^ can^ reach^ illiterate^ population^

not accessible

through printed^ word.^ It is^

a (^) purely didactic^ medium.^ It^ can

De valuable^ aid^ in^ putting^

across" useful^ health

information, in^ the^ form^ of^ straight talks, plays,

questions

ana answers^ and^ quiz^ programmes.^

Radio is^ much^ cheaper

tnan TV. Doctors and health^ workers^ may^ speak^

out on

radio. Local^ health^ issues^ may^

be identified^ and^ discussed

eading to^ increased^ general^ awareness.^

would hope. Indiscriminate use ot posters by pasting them on walls serves no other useful purpose than covering the wall.

  1. Internet

his new^ means^ of^

computer based^

communication

ylem has^ opened^ vast^

capability of^ transter^

of knowledge,

has made^ it^ possible^

to get into^ direct^

and instant

Inmunication across^ the^ world^ by^

means of^ e-mail^ and^ even

-ine chat.^ This^ is^ a^

fast growing

communication (^) media

holds very^ large potential^

to become^ a^ major^

health

Cation tool.^ Already^

a fairly large^

number of persons^ in

a are^ using^ this^

media, and^ the^

numbers are^ growing

yday. Vast^ amount^ of^

health related^ literature^ from^

WHO

8. Health museums and exhibitions

If properly organized, health museums and exhibitions

can attract large numbers of people. By presenting a variety of ideas, they do increase knowledge and awareness Photographic panels attract more persons than graphic panels. This is because photos give a humanized touch to the communication. The three dimensional models with lighted visuals are even more effective than photos.

COMMUNICATION FOR HEALTH EDUCATION

In exhibitions, there is a big element of personal

communication through workers who explain each item on

the exhibit. Printed literature explaining the exhibits is often

freely distributed. Health exhibitions and museums thus

offer a package of both personal and impersonal methods of

Communication.

9. Folk media

TheThe^ term^ "mass^ communication"^ ought^ to^ refer^ to^ the

totality of communication which takes within its compass not

only the electronic media, but also folk (or indigenous)

media such as keerthan, katha, folk Songs, dances and

dramas and puppet shows which have roots in our culture.

The muslims have their own traditional folk forum like the

ghazals, the kawali.

the

The mass media are only "instruments". As such they are

neither good nor bad; what matters is the message

they

carry and the way the message is delivered (6). There is no

single way to do public education. Health education is still

rather than a science. Each community and country

should develop techniques that meet its own needs.

art