ORGANIZATION OF THE SANITARY-EPIDEMIOLOGICAL POPULATION PROVIDING

June 4, 2024
0
0
Зміст

ORGANIZATION OF WORK OF SANITARY-EPIDEMIC SERVICE. CO-OPERATION OF SANITARY-EPIDEMIC SERVICE AND TREATMENT-PROPHYLACTIC ESTABLISHMENTS.

METHODS AND FACILITIES OF HYGIENIC EDUCATION OF POPULATION.

SANITARY EDUCATION.

 

ORGANIZATION OF THE SANITARY-EPIDEMIOLOGIC SERVICE

As it was marked above, among all factors of health the biggest role is played by the social ones – operating conditions and living of people, their way of life. Primary health care (PHC) and, first of all, the family doctor can render the big influence on these factors.

Nevertheless, it is not enough to use efforts of only initial link for rendering these factors, the special sanitary –epidemiological services (SES) is also engaged in them. It is represented by district (in rural areas) and regional (in a structure of cities), city, central regional, linear, port and water-pool sanitary – epidemiological stations, which are subjected to the appropriate leading bodies or so-called state sanitarian doctors: regional, city, central regional. All service is headed by main sanitary-epidemiological department of Ministry of public health services (MPH’s) of Ukraine.

Sanitary -epidemiological services solves such problems:

– The prevention and liquidation of environmental contaminations (land, reservoirs, atmospheric air);

– Improvement of working conditions at the industrial enterprises and in agriculture, the prevention and reduction of general and professional disease;

– Creation of favorable conditions for the normal development and training of children and teenagers;

– Improvement of conditions of nutrition of the population, introduction of balanced diet and the prevention of poisonings and diseases of alimentary type;

– Improvement of operating conditions with radioactive matter and sources of radiations, prophylaxis of professional affection;

– The prevention decrease and liquidation of infectious and parasitic diseases, the prevention and distribution of quarantine infections to the country.

The list of these problems testifies their preventive character. This prophylaxis has received the name ‘primary‘as it is directed on the reasons of diseases and their prevention.

First of all, preventive actions are carried out by medical establishments, but dispensarization is qualified as secondary prophylactic.

From positions of public health services advantage of sanitary – preventive actions before medical-and-prophylactic is not doubtful.

The legal basis of activity of sanitary-epidemiological services is the medico-sanitary legislation, regulations of the state sanitary inspection a set of sanitary-and-hygienic and sanitary -epidemic norms and rules which are issued by organs of local and central authorities and system of the state and departmental standards (GOST and OST).

According to these officials documents the organs and establishments sanitary–epidemiological services have the right:

– To attend objects of supervision and lay claims concerning elimination of sanitary infringements on the side of separate citizens, officials of the ministries, departments, the enterprises, establishments and the organisations;

– To take part in for construction, termination of places of a water-fence and conditions of removal of sewage and emissions in an atmosphere with giving corresponding conclusions;

– To consider projects of planning and building of settlements and long-term plans of the industry ;

– To take part in formal acceptance of apartment distribution houses, buildings of cultural and community purpose, industrial and other objects concerning their conformity the sanitary-hygienic and sanitary – anti-epidemic rules and norms;

– To take tests of foodstuff, products, subjects and materials for the laboratory analysis and hygienic examination.

During carrying out sanitary -anti-epidemic measures experts of SES have the right :

– Suspend of sick persons or bacteria-carrier, that can be a sources of distribution of infectious diseases;

To demand obligatory hospitalization of infectious patients that represents which are dangerous to other people;

– To provide with quarantine persons which had contact to infectious patients;

– To provide obligatory disinfection of the centres of an infectious disease;

 – To solve problems concerning carrying out preventive inoculations.

In case of gross and regular infringement of sanitary-hygienic requirements organs and establishments sanitary -epidemiological services have the right to take measures of compulsion, namely:

– Carrying out of prohibition or suspend sanitary – anti-epidemic actions of working industrial objects if necessary;

– Prohibition of the use of chemical substances and products due to their dangerous influence on health of people;

– Impose fines on officials and citizens;

 – Infringement before states of Public Prosecutor questions concerning institute criminal proceedings against somebody.

Despite of the big list of the rights, practice of their application has shown restrictions of opportunities of sanitary–epidemiological services.

It acts not as the last instance which makes a decision concerning all these above mentioned problems, only as a participator which instructions are quite often ignored.

Regional (in rural areas) sanitary-epidemiological station has the elementary structure. It consists of sanitary-hygienic and epidemiological departments. In structure of sanitary-hygienic department there is a laboratory and in structure of epidemiological – bacteriological laboratory and disinfectant department.

Municipal and regional (in cities) sanitary-epidemiological stations have more powerful structure. The sanitary-hygienic department is based on laboratories of municipal hygiene, hygiene of work, hygiene of nutrition and hygiene of children and teenagers.

The epidemiological department consists of the epidemiological and parasitological department and bacteriological laboratory.

Separate disinfectant department which consists of department of evacuation and seat disinfection, chambers of disinfection and sanitary processing, preventive disinfection, disinfestation and deratization.

Areal SES has sanitary-hygienic, disinfectant, epidemiological, organisational departments and a department of especially dangerous infections. The sanitary-hygienic department consists of departments of the radiological control, municipal hygiene, hygiene of work, hygiene of nutrition, hygiene of children and teenagers and is based on laboratories of municipal hygiene, hygiene of work, hygiene of nutrition, physical and chemical research methods, research of rural chemicals and toxicology.

The epidemiological department has anti-epidemical, parasitological, bacteriological, virological department and bacteriological laboratories.

The organisational department carries out an organisational – methodical management of city and regional SES and takes such measures:

– Studies a state of health of the population;

– Plans improving, sanitary – preventive and anti-epidemic actions;

 – Analyses material and technical base SES, maintenance and level of equipment their staff;

– Improves organisational forms and methods of work, studies the best experience and introduce it in its practice;

– Analyses activity of subordinates SES;

– Control work of public councils (sanitary-epidemiological, laboratory, for the sake of medical assistants and lab assistants).

Sanitary-epidemiological stations carry out the state sanitary inspection which is introduced by two basic forms.

Precautionary sanitary inspection of construction, planning and building of settlements, long term planning of contribution of the industry. The expertise of the documentation on planning, supervision of construction and reconstruction of the enterprises, change of a structure and the “know-how”, and also participation in the commissions putting into operation apartment houses, cultural and community buildings, the industrial enterprises and constructions.

Precautionary supervision provides a sanitary-hygienic estimation of research and serial equipment, polymeric and synthetic materials, industrial products, technologies of devices and tools at stages of design protect and protect development.

The current sanitary inspection is carried out for the objects of municipal services and the industrial enterprises, food objects, children’s school and other educational establishments, sources of radioactive substances and radiations.

Carrying out of the analysis of the general, professional, infectious and parasitic disease in combination with studying sanitary-hygienic and sanitary –epidemiological situations allows to find out the reasons which influence state of health of the population and to develop concrete actions on its improvement.

However, traditional SES mostly is engaged in studying of infectious disease. As for the general morbidity this studying is in the very beginning.

In 1994 in Ukraine the law «About maintenance of sanitary– epidemiological well-being of the population» was accepted.

This law, in particular, adjusts public relations which arise in sphere of maintenance of sanitary –epidemiological well-being, determines corresponding rights and duties of the state organs, enterprises, establishments, organisations and citizens.

Citizens have the right on:

       Safe for health and life food stuffs, drinking water, conditions of work, training, education, life, rest and environment;

       Participation in development, a substantiation and public expertise of projects programs and plans of providing of sanitary-anti– epidemical well-being of the population submit on these questions to corresponding organs ;

       The indemnification, caused to their health due to infringement by the enterprises, establishments, the organisations, citizens of the sanitary legislation;

– The authentic and timely information about state of the health, health of the population and also about existing and probable risk factors for health and their degree.

Citizens are obliged:

– To take care of their health and health and hygienic education of their children, do not harm health of other citizens;

– To take part in carrying out sanitary and anti-epidemic actions;

       To pass obligatory medical examinations to make inoculations in the cases stipulated by the legislation;

– To carry out orders and instructions of officials of the state sanitary-epidemiological services at their realisation of the state sanitary-epidemiological supervision ;

       To execute other duties stipulated by the legislation on providing of sanitary –epidemiological well-being.

The law regulates rights and duties of the organisations and establishments.

The enterprises, establishments and organisations have the right on:

·          Receiving from bodies of the state and executive authority, local and regional self-management, and also corresponding bodies and establishments of public health services of the information on state of health of the population, a sanitary and epidemic situation, Legislative, statutory acts on questions of providing of sanitary –epidemiological well-being of the population and sanitary norms;

    The indemnification, caused by infringements of the sanitary legislation

      by the organisations, establishments and separate citizens.

The enterprises, establishments and organisations are obliged :

       According to offers of officials of the state sanitary-epidemiological services develop and carry out sanitary and anti-epidemic actions;

       To carry out the laboratory control of harmful substances and materials, made due to their activity waste products and emissions, and also finished production ;

       On the demand of officials of the state sanitary-epidemiological services give gratuitously samples of used raw material and materials, and also products which are made or sold, carrying out of the state sanitary-hygienic expertise ;

       To carry out orders and instructions of officials of the state sanitary-epidemiological services on their realisation of the state sanitary-anti-epidemic survey by them;

       To suspend of persons which are carriers of activators of the infectious diseases sick on dangerous for surrounding infectious diseases or persons which were in contact with such patients, on presentation of corresponding officials of the state sanitary-epidemiological services and also persons who avoid obligatory medical examination or inoculations against infections.

       Immediately inform bodies, establishments and establishments of the state sanitary-epidemiological services about extreme events and situations which threaten the health of the population, sanitary and epidemic well-being;

       To compensate workers and citizens the losses to their health due to infringement of the sanitary legislation.

The law also regulates dangerous factors of manufacture and an environment, establishes the order of carrying out of the state sanitary-hygienic expertise and provides other actions directed on providing of sanitary –epidemiological well-being of the country.

Structure of sanitary-epidemiological services in Ukraine:

-State chief sanitary doctor of Ukraine

-State chief sanitary doctor of area

-State chief sanitary doctor of city (municipal station)

-State chief sanitary doctor of region

The basic function of the any state in the health protection of population, there is providing of the complex measures for saving, improvement of health and prevention, of the mass diseases (epidemics, mass sharp and chronic poisonings, professional diseases). Among the principles of the health protection, which are determined by the proper bases of legislation of Ukraine, an important place is occupied by passing-prophylactic character, complete social, ecological and medical approach to the health protection (article 4).

At the same time the international documents in the branch of the health protection, in particular “Bases of policy of achievement of health for all in the European region WHO“: define the tasks, which directly concern saving, improvement of health and prevention of the diseases, namely:

Task 1. Reduction of the prevalence of the infectious diseases.

Considerable reduction of the prevalence of the infectious diseases must happen till 2020 due to the systematic programs of the partial and complete liquidation, and also due to the fight against the infectious diseases, which are a great problem for the community health care.

It foresees:

v in relation to liquidation of the infectious diseases – to liquidate in 2000-2007 poliomyelitis, stupor of babies, measles;

v in relation to the fight against the infectious diseases – to decrease considerably the prevalence of diphtheria, hepatitis, epidemic parotitis, whooping-cough, that  infections of Haemophilus influenzae type of В, inborn Syphilis,  inborn  measles, malaria, AIDS, infections, that are passed in a sexual way, tuberculosis, and also sharp respirator and diarrhoea infections.

Task 10. Healthy and safe environment.

Till to 2015 the population of the Region must live in the conditions of the safe physical environment, not be under the influence of the contaminators, which are dangerous for a health at the levels that exceed the international standards.

It foresees:

v considerable reduction of the influence of physical, microbial and chemical contaminators which make a threat for a health, in a water and air environment, and also in wastes and soil in accordance with the graphic and control numbers, determined in the national plans of actions of the hygiene of environment;

v providing of general access of the population to the sufficient supplies of drinking-water of satisfactory quality.

Task 11. More healthy way of life.

Till to 2015 the people in all the layers of society must adopt more healthy way of life.

It foresees:

v    strengthening of forms of a healthy conduct in such branches as a feed, physical activity and sex appeal;

v    expansion of the access, increase of the financial possibilities and availability of useful to the health and safe food products.

Task 13. Conditions of a healthy environment.

Till to 2015 the population of the Region must have better positions in order to be in a healthy physical and social environment at home, at school, on a workplace and in a local community.

It foresees:

v    rise of safety and quality of the housing conditions;

v    increase of the possibilities for invalids in relation to valuable life;

v    reduction of accidents and professional diseases;

v    creation of the conditions for the so fours stay of children in preschools, oriented to strengthening of health and at schools, which are instrumental in strengthening of health;

v    not less the half of cities and communities must become the active members of  the network of “healthy cities” and “healthy communities”;

v    not less than 10 % of large and middle companies must take the obligation to follow the principles of “healthy” companies (enterprises)

Описание: Описание: Описание: Опис : Unpacking Supplies


In Ukraine the realization of the indicated tasks found the reflection in the “National program of improvement of environment”, “National program of fight against the infectious diseases”, “National program of fight against AIDS“, “National program of saving of health of workers” and other documents and measures on the improvement of health and conditions of its forming.

In the system of the state measures and central organs of the executive power the special function of a health care, the prophylaxis of diseases and state observation after the observance of legislation in the health protection belongs to the State sanitary-epidemiologic service of Ukraine.

The system of conducting of sanitary-antiepidemic measures in Ukraine was created during a rather long period of time. The special sanitary organizations were engaged in this. At first they were created only three (from the nine) provinces: Katerinislav, Kharkov, Kherson. Later the four provinces were attached, to them however, activity of these services was complicated by the insufficient financing.

The difficult sanitary-epidemic situation during the First world war and civil war required conducting of the proper antiepidemic measures. Considerable reserve in this activity was brought by the Odessa disinfection station headed by L.V. Gromashevsciy.

Activity of all organs of health protection was led by the Folk commissariat with a sanitary-epidemiologic department, to which 5 sanitary-bacteriological institutes, 21 sanitary-bacteriological laboratories, 5 stations were submitted.

The basic task of the sanitary organization at that time consisted in conducting the fight against the epidemics of vermin typhuses, cholera, other infectious diseases. Creation of the Extraordinary sanitary commissions (province, circuitous, city) helped very much in the decision of this problem.

In future before the sanitary organization appeared the tasks to reorganize the service, related to the necessity of conducting different sanitary-health measures.

The network of the sanitary-epidemiological stations was gradually created. Sanitary-bacteriological laboratories, disinfection, malarial stations and others like that, entered to the establishments of sanitary epidemic service.

In 1933 a state sanitary inspection was created. Ratification of position about it provided legal bases of state sanitary-epidemiologic observation.

Intensive development of the state sanitary-epidemiologic service in Ukraine lasted during the 30th years of the XX century. Before the Great Patriotic war network of the sanitary-epidemiologic stations was created, which counted in 1941 800 establishments. Specialized research institutes started their activity. In the post-war time for a short period of time the network of the stations was revised.

Notion “Sanitary-epidemiologic business” includes:

  state and public antiepidemiologic, sanitary-hygienic and health measures;

  sanitary legislation;

  practical activity of organs and establishments of the state sanitary-epidemiologic service of Ukraine;

  scientific research works from a hygiene, epidemiology, organizations of  sanitary-epidemiologic business;

  system of preparation, in-plant training of sanitary shots, preparation of workers of medical network on the questions of epidemiology and hygiene;

  hygienical education of population.

Activity of the state sanitary-epidemiologic service is based on the following principles, such as:

Описание: Описание: Описание: Опис : Врачи


State character of sanitary-epidemiologic activity. This principle is defined in legislative documents, due to which sanitary- hygienic and sanitary-antiepidemic norms and rules are obligatory for all departments and services. Any measures related to the defence of health of the population must be carried out with participation of the state sanitary-epidemiologic service.

Scientifically-planned basis of sanitary- hygienic and sanitary-antiepidemic measures, includes research of influence of different factors of external environment on a  human’s health , societies and development of the proper measures, norms and rules directed on providing of the proper conditions of life and labour. All these measures are carried out in the planned order.

Unity of  sanitary- hygienic and  sanitary-antiepidemic  measures, which shows up in the fact, that next to realization in the unplanned or planned order of antiepidemic  measures on liquidation of flashes of separate infections the complex of the sanitary, health and prophylactic measures, directed on the health protection of the population is also conducted. It touches providing with a high quality drinking-water, with food products, improvement of quality of atmospheric air, conditions of labour, rest and others.

Unity of preventive and current sanitary observation as one of the basic functions of establishments and establishments of the state sanitary-epidemiologic service, which are carried out by unique methods on all territory of the state.

Participation of different services and departments, organizations, enterprises, establishments and citizens in conducting sanitary and antiepidemic measures according to the legislative documents.

Participation in international cooperation to provide the sanitary-epidemic prosperity of population.

To the basic directions of the activity of the state sanitary-epidemiologic service belong:

  realization of state sanitary-epidemiologic observation;

  determination of the priority measures in the prophylaxis of diseases, and also in the health protection of the population from the harmful influence of factors of environment on it;

  to study, estimation and prognostication of indices of  population’s health depending on the state of environment of vital functions of human; establishment of factors of environment, that have harmful influence on a population’s health;

  preparation of suggestions in relation to providing of sanitary and epidemic prosperity of the population, prevention of skidding and distribution of especially dangerous (including quarantine) and dangerous infectious diseases;

  the control after the removal of reasons and conditions of origin and distribution of infectious, mass uninfectious diseases, poisonings and radiation defeats of people;

   state consideration of infectious and professional diseases and poisonings;

   delivery of conclusions of the state sanitary-hygienic examination about to the objects of keeping wastes;

   establishment of the sanitary-hygienic requirements to the products, that are produced from wastes, and delivery of hygienical certificate on them;

   methodical providing and realization of control during the determination of the level of danger of wastes.

Dependence of health from various factors, to which except for heredity belong – the state of environment, the way of life (condition of labour, study, rest, feed, way of life and others things like that), level of the system of the health protection, in a country, sets a question about development and realization of the measures directed on warning or reduction of the possible harmful influencing on a health.

Realization of these tasks is possible by realization of complex of national, sanitary-hygienic and antiepidemiologic, health measures with the purpose of creation the most favorable conditions of life.

The important value belongs to the personality also, as without efforts of the population, directed on saving and improvement of their own health, it is impossible to achieve its high level.

In activity of establishments of health protection prophylactic measures are incarnated in different forms such as a primary and second prophylaxis.

In Ukraine the unique sanitary-hygienic requirements to planning and building of settlements are set; buildings and exploitations of industrial and other objects; cleaning and recycling of the industrial and other pollutants, wastes and garbages; maintenance and use of housing, production and official apartments and territories, on which they are located; organizations of feed and water-supply of the population; production, application, saving, transporting and bury of radio-active, poisonous and drastic matters; maintenance and killing of domestic and wild animals, and also to other activities, that can threaten to sanitary-epidemic prosperity of territories and settlements.

The important value has conducting of measures on the prophylaxis of infectious, diseases. According to the article of ZО Bases of legislation it is foreseen to remove from work persons which are the transmitters of exciters of infectious diseases. In relation, especially dangerous infectious diseases obligatory medical reviews, prophylactic inoculations, medical and quarantine measures can be carried out.

Conducting of obligatory medical reviews of the certain contingents of the population is regulated or working. Obligatory medical reviews are organized and are carried out in a set by the legislation order.

Workers of enterprises of food industry, public food consumption and trade, plumbing buildings, medical-prophylactic, preschool and educational establishments, objects of the mode of service, other enterprises, establishments, organizations professional or other activity of which is related to maintenance of population and can entail distribution of infectious diseases, arise the food poisonings, and also workers busy at heavy works and at works with the harmful or dangerous conditions of labour, must pass obligatory previous (before the hire for the job) and periodic medical reviews. Persons under the age of 21 year also pass the obligatory annual medical reviews.

By the legislation of Ukraine, in particular the Law of Ukraine “About defence of the population from infectious diseases” the questions of prevention of the infectious diseases are also regulated. The requirement in relation to the prophylactic inoculations, hospitalizations and treatments of infectious patients and transmitters of exciters of infectious diseases is legislatively defined, sanitary guard of the territory of Ukraine from skidding of infectious diseases.

Prophylactic inoculations with the purpose of prevention of such diseases as tuberculosis, poliomyelitis, diphtheria, whooping-cough, stupor and measles in Ukraine are obligatory.

Groups of the population and categories of workers, which are subjected to the prophylactic inoculations, including obligatory, and also an order and conditions of their conducting are determined by Ministry of health protection of Ukraine.

Persons which are ill especially dangerous and have dangerous infectious diseases or are the transmitters of exciters of these illnesses are kept away from work and other activities, if it can result in distribution of such illnesses. They are subjected to the medical observation and treatment, which is paid by the state with payment of help from facilities of social security in an order that is set by the legislation. Such persons are considered to be temporally or constantly useless on the state of the health to professional or other activity, due to which can appear the promoted danger for surrounding in connection with the features of production or executable work.

Persons patient with especially dangerous infectious diseases in the case of refusal from hospitalization are subjected to the forced stationary medical treatment, and transmitters of exciters of the noted illnesses and person, which had the contact with such sick, – are subjected obligatory medical observation and quarantine in accordance with established procedure.

Entrance to the territory of Ukraine by foreign citizens and citizens of Ukraine, and also transport vehicles from countries (localities), where especially dangerous illnesses are registered, is allowed only at presence of the documents foreseen by the international agreements and sanitary legislation of Ukraine.

In the case of rise or threat of rise or distribution of especially dangerous and dangerous infectious diseases, mass poisonings, radiation defeats of the population executive public authorities, local and regional self-govement after the claim of the proper public servants of the state sanitary-epidemiologic service within the limits of the plenary powers can enter in a set by the legislation order on the proper territories or objects the special conditions and modes of labour, teaching, movements and transportations directed on prevention and liquidation of these diseases and defeats.

In the case of threat there are the origins or distributions of especially dangerous and dangerous infectious diseases, mass poisonings and radiation defeats by the proper public servants of the state sanitary-epidemiologic service the extraordinary prophylactic inoculations, other measures of prophylaxis, can be inculcated.

The second prophylaxis has for an object warning of subsequent development of illness, prevention of appearance of complications and prevention of disability. Mainly medical-prophylactic establishments are engaged in realization of these measures.

The state sanitary-epidemiologic service is organs, offices and establishments of sanitary-epidemiologic type of Ministry of Ukrainian health protection, proper offices, establishments, parts and subsections of the Department of defence, Ministry of the internal affairs, the State Committee of guard of the state boundary and the security Service of Ukraine.

 The specially empowered central organ of the executive public, that carries out the control and observation after the inhibition of the sanitary legislation, the state standards, criteria and requirements directed on providing the sanitary and epidemic prosperity of population authority, is Ministry of health protection of Ukraine.


The function of the specially empowered organs of state sanitary-epidemiologic observation on territories inferior to them, and objects, in parts and subsections, fulfil the offices, the establishments and establishments, establishments and subsections of the state sanitary-epidemiologic service of other ministries and departments are laid to.

Activity of the State sanitary-epidemiologic service of Ukraine is regulated by the Constitution of Ukraine, laws of Ukraine of “Basis of legislation of Ukraine about the health protection”, “About providing of sanitary and epidemic prosperity of population”, “About the guard of natural environment”, “About defence of rights of users”, “About veterinary medicine”, “About a labour protection”, “About advertising”, “About the use of nuclear energy and radiation safety”, “About defence of population from infectious diseases”, “About pesticides and agrohimicati”, “About quality and safety of food products and food raw material” and others, by Code of Ukraine about administrative offences.

FUNCTIONS of the sanitary-epidemiology service:

·                   There is participation in conducting of prophylactic measures

·                   Control  for the observation of  the  sanitary-hygienical and unepidemic norms and rules

·                   Organization, planning and co-ordination of conducting the sanitary-health and unepidemic measures

The important legal underground for providing of the sanitary and epidemic prosperity of population of Ukraine is sanitary legislation to which, except the transferred acts of legislation, the sanitary norms belong (state sanitary norms, rules, hygienical norms).

The basic act which regulates activity of the sanitary-epidemiologic service, is the law of Ukraine “About providing of the sanitary and epidemic prosperity of population”, accepted by the Supreme Soviet in 1994. It contains 7 sections and 50 articles.

In the state standards and other normative documents the list of products taking into account their safety for a health and life of population, which is must be obligatory certificated.

Chief State committee of standardization, metrology and qualities of products determines the order of accreditation and accredits offices, organizations, establishments, which get the right for determination of accordance of products to the requirements of safety for health and life of population.

According to the law of Ukraine “About providing of the sanitary and epidemic prosperity” the notions “sanitary and epidemic prosperity” determine as the “optimum conditions of vital functions, that provide the low level of morbidity, absence of the harmful influence on a health of population the factors of environment, and also the factors for the origin and distribution of infectious diseases”.

Providing by the state of the sanitary and epidemic prosperity depends on the list of pre-conditions, to which belong:

   the developed sanitary legislation, to that number state the sanitary norms, rules, hygienical norms;

   application of the system of state stimulation and regulators directed on his observance;

   organization of the state sanitary-epidemiologic observation.

Offices and establishments of the state sanitary-epidemiologic services carry out the State sanitary-epidemiologic observation that is activity on the control after the observance by physical persons the legal and of sanitary legislation. Prevention, exposure, diminishment or removal of the harmful influence of dangerous factors, on health of people is the purpose of activity. At it is necessity it is possible to application the measures of legal influencing on violators.

Basic tasks of the state sanitary-epidemiologic observation:

  observation after organization and conducting by the organs of executive power and organs of local self-the state, unepidemic, enterprises, establishments, organizations and citizens the sanitary and measures;

  observation after realization of the state policy on the questions of prophylaxis of diseases of population, participation in development and control after implementation of the programs from prevention of the harmful influence of dangerous factors of environment and production environment on a health man;

  observation after the observance of sanitary legislation;

  observation after implementation of orders and requirements of public persons of the state sanitary-epidemiologic service;

  conducting of the state sanitary-hygienical examination, giving to the grant of conclusions and permissions on conducting of types of activity, according to the law of UkraineAbout providing of sanitary and epidemic prosperity of population”;

  conducting of hygienical regulation of some dangerous factor of physical, chemical, biological nature, which is in the environment of vital functions of man, with a purpose establishments and claims of criteria of their possible influence on a health of man.

The state sanitary-epidemiologic observation is carried out by:

a) offices and establishments of the state sanitary-epidemiologic service of the system of MOZ:

  main sanitary-epidemiologic administration of MOZ;

  management on the medical problems of failure on Chornobilsciy AES of MOZ;

  central sanitary-epidemiologic station of MOZ;

   Crimean republican sanitary-epidemiologic station;

   regional, city, district and district in towns sanitary-epidemiologic stations, stations;

   central sanitary-epidemiologic station on a railway transport, sanitary-epidemiologic stations on the railway, linear sanitary-epidemiologic stations on the  railway roads;

   central sanitary-epidemiologic station on an air transport;

   central sanitary-epidemiologic station on a water-transport, sanitary-epidemiologic stations of pools and ports;

   sanitary subsections;

   special offices and establishments of  MOZ for the fight against very dangerous infections;

• sanitary-epidemiologic stations of objects which have the special office hours.

Verification of observance of the sanitary legislation is the basic form of realization of the state sanitary-epidemiologic observation. Verifications are conducted after the plans of offices and establishments of the state sanitary-epidemiologic service, and also not provided for by the plan depending on a sanitary, epidemic situation, on the requests of citizens.

Sanitary-epidemiology services of other ministries and departments is financed due to the budgets.

Financing of The state sanitary-epidemiologic service of Ukraine is carried out in accordance with the Laws of Ukraine “About providing of sanitary and epidemic prosperity of population” and “About the sources of financing of public authorities”.

The state sanitary-epidemiologic service of Ukraine is headed by the main state health-officer of Ukraine is the first Deputy minister of health protection of Ukraine on the questions of the state sanitary-epidemiologic observation which is assigned for position and get is rid of the position in accordance with the legislation and directly accountable to Cabinet of Ministers of Ukraine.

All levels of management of SES include the sanitary-hygienical and epidemiology departments. With the increase of level of management structure of SES becomes more difficult.

In regional SES increases laboratory service, the structure of epidemiology department is complicated (fig. 1).

Sanitary-epidemiologic station

Sanitary-hygienic department                      Epidemiology department

                                                             

Self-supporting department

                                                                 of prophylactic disinfection

 

Bacteriological                       Disinfects                             fumigations and

laboratory                              separation                                    deratization

 

Establishments of desinfection service belong to sanitary-epidemiologic, among them there is the city station, its categories are determined by the quantity of urban population.

/ category is quantity of population from a 500 thousand to 1 million;

// category is quantity of population from a 200 thousand to 500 thousand;

The III category is the quantity of population of a to 200 thousand.

Chief state health-officer of Ukraine:

    provides the observance of equal requirements in realization on the  territory of Ukraine of state sanitary-epidemiologic observation;

    determines a list, structure, functions of offices and establishments of the state sanitary-epidemiologic service of the system of MOZ, and also co-ordinates lists, structure, functions of  offices and establishments of the state sanitary-epidemiologic service of ministry of Defence, MJA, SSU and decides the questions related to organization of their activity;

    gives out the orders about the activity of the state sanitary-epidemiologic service, other prescriptive documents, and also gives in suggestions (presentation) on questions are organizations and realizations of state sanitary-epidemiologic observation in Ukraine;

   it is of interests of the state sanitary-epidemiologic service on enterprises, in establishments and organizations of all patterns of own, court, arbitration court;

   organizes the study and generalization of international experience, takes in accordance with established procedure part in preparation and realization of international projects, programs, agreements with the proper state and unstate organizations of other countries and co-operates with WHO, the Code Commission and other international organizations on questions which belong to its jurisdiction;

   takes part in forming of the state policy in the branch of health protection, prepares the projects of legislative and other normatively-legal acts in relation to sanitary-epidemiologic prosperity of population;

   gives for consideration of Cabinet of Ministers of Ukraine of suggestion on the questions of providing of sanitary and epidemic prosperity of population;

   Описание: Описание: Описание: Опис : Санитарные врачи предупреждают об опасности биотерроризмаdirectly informs the Cabinet of Ministers of Ukraine about the sanitary and epidemic situation in Ukraine and on separate its territories, cases of very dangerous and mass infectious diseases, poisonings, radiation defeats, professional diseases and other questions which belong to its jurisdiction;

   organizes the implementation of commissions of the President of Ukraine, the Supreme Soviet of Ukraine and the Cabinet of Ministers of Ukraine on the questions of the state sanitary-epidemiologic observation in Ukraine.

Heads a college and the chief state health-officer of Ukraine heads a college and asserts position and its composition.

Guidance by the state sanitary-epidemiologic service on a water, railway, air transport is carried out accordingly the main state health-officer of water, railway and air transport which is assigned for position and get rid of position by the main state health-officer of Ukraine.

The state sanitary-epidemiologic service of objects which have the special office hours is headed by the chief state health-officers of these objects which are assigned for position and get rid of position by the chief state health-officer of Ukraine.

The managers of departments, separations and laboratories, deputy of the chief doctor on economic questions are in the managerial staff of the SES different levels.

In the management of regional SES entered position of deputy of main doctor.

The states, regardless of level of management, include: doctors, assistants of the doctors, laboratory assistants, younger medical sisters, and medical statisticians.

The states and shots of the SES of the first level of management are determined by their type and category. Some of the SES rural districts have the norms of city SES of the third category, as a quantity of population in some districts exceeds a 100 thousand.

Positions of doctors-bacteriological are set according to the volume of work of the bacteriological laboratory shown in the laboratory units.

A doctor-bacteriological manages the work of the control laboratory. The assistants of epidemiologist, medical sisters, work in all subsections (in quality controllers and evacuates).

Task and directions of activity of state the sanitary-epidemiology service are it is possible to point such their sections.

Control work is it is realization of state preventive and current sanitary-epidemiology.

Consultation work is consulting of consultations of different departments on the questions of the protection of the environment, prophylaxis of infectious diseases, organization of the proper conditions of life, labour, study, rest, in the giving to the legal and physical persons the information about a sanitary-epidemic situation.

Carrying out the organizationally-methodical work, the establishments of sanitary-epidemiology services are co-ordinate, activity of enterprises, establishments, organizations on implementation of sanitary-hygienical, unepidemic norms and rules.

The scientific-practical work consists in conducting the deep study of influence of factors of environment and way of life on a health of population with the purpose of development of measures for its improvement.

Normative work is development and claim (concordance) of the sanitary rules, hygienical norms, conducting of sanitary-hygienically examination.

A volume and orientation of the concrete measures during realization of the transferred sections of work depend above all on the level of management of the establishment.

The main place in the work of SES activity of the first and second levels (that the SES of rural districts and city SES) occupies the control work.

Doctors-hygienists and epidemiologists of the district and city SES of the first level of and management conduct the considerable part of working hours on objects, in the cells of infectious diseases. They carry out preventive and current sanitary-epidemic control,  take part in organization of periodic prophylactic reviews, helped a sanitary asset, consult  the workers of accident prevention of enterprises carried out or controlled taking the tests (materials) for laboratory researches, conduct separate instrumental researches.

Organizationally-methodical work is carried out in a few directions

SES work assignments

Study of the state of population’s health on its separate groups

Estimation of the activity of the district and city

SES, and also own activity of the

regional SES

Planning of measures with

in-plant training of the

employees of SES and participation in

their conducting

Study and distribution

front-rank experience of different subsections

of SES

There is participation in preparing of different having a special purpose program   

There is participation in drafting plans of work of the SES and different complex plans

There is participation in preparation of different data, references and so on

Fig. 2. Organizational-methodical work assignments of sanitary-epidemic station.

 

A basic place in work of sanitary-epidemic service occupies the preventive and current state sanitary-epidemiologic observation.

Preventive sanitary epidemic observation, depending on the level of establishment (establishment) of sanitary epidemic service is:

  hygienical and epidemiology setting of norms potentially of factors dangerous for the health of man , that finds the reflection in hygienical and epidemiology norms, regulation of application of these factors, and also technologies, production and so on in the sanitary rules and norms,  the state and branch standards;

  the state sanitary-hygienical (sanitary-epidemiologic) examination, directed on determination of accordance of a new activity, technology, products, raw material, normative document, project, technical, instructional-methodical document and so on, that can directly or mediated influence on a health’s man, to the sanitary legislation,  sanitary norms, the state standards, technical conditions and regulations and so on, and in the case of their absence with establishment of criteria of safety (indexes and air maximum possible levels, maintenance, concentration and others);

  control after the observance of sanitary-hygienical norms and rules at planning, building, reconstruction of housing, communal, industrial and other objects, at the change of the technology of production or introduction of the new production processes. The control after planning, building and equipment modern with amenities of the inhabited places is carried out also, after conducting of measures from the sanitary guard of atmospheric air, sources of water-supply, soil from some contamination.

 

Observations for radioactive pollution

Описание: Описание: Описание: Опис : http://file.menr.gov.ua/publ/specrep/sistmon/gamma.gif

Radiometric observations are carried out by the State Committee of Ukraine for Hydrometeorology according to the following program:

  • daily measurements of the gamma doze rate (182 stations);

  • daily sampling of radioactive deposits (68 stations);

  • daily sampling of radioactive aerosols from atmospheric air (9 stations);

  • sampling of water in prescribed terms for the determination of tritium and Sr-90 in fresh and sea water (5 stations);

  • monthly sampling of precipitation for determination of tritium (36 stations).

By field works, observations are carried out for the radioactive pollution of small rivers within Dnieper and Pripyat’ basins, for the radioactive pollution of water objects and soil in locations of NPPs, for the radioactive pollution of soil over territory of Ukraine.

Sanitary-Epidemiological Service (SES) of Ministry of Health Protection conducts radiological studies in urban and agricultural populated areas within radioactive polluted zones, urban and agricultural populated areas within 30-km zones of NPPs, industrial facilities, municipal objects, children’s and educational institutions. SES as well supervises radiological objects at industrial facilities, medical institutions, research institutes.

Описание: Описание: Описание: Опис : http://file.menr.gov.ua/publ/specrep/sistmon/sesgisf.gif

 

Sanitary education, forms, methods and facilities of sanitary and educational work.

The main aim of sanitary and educational work, carried out by the doctor, is to teach the populations how to follow a healthy way of life.

The way of life includes such concepts:

а) Standard of living, that is the structure, the level of material well-being of the population;

b) Lifestyle is the individual psychological features of the human behaviour;

c) Way of life is a public, social order and mode of life, culture.

Among the leading factors of the life mode, that negatively influence people’s health are: smoking, bad nourishment, an alcohol abuse, occupational hazards, stress, hypodynamia, bad conditions of life, the use of drugs, incomplete or large family, excessive urbanisation and others.

Basic methods of sanitary and educational work are:

І. Verbal;

ІІ. Printing;

ІІІ. Visual;

ІV. Combined.

Characteristics and basic means of verbal method

A verbal method is one of the leading and most effective methods of sanitary education. It is the most popular and economic from the point of view of expenses, simple and available. Its using allows to specify material, taking into account specific character and personal interests of the audience.

The basic advantages of verbal method are simplicity and availability, individual approach and economy. The main disadvantages are small number listeners, absence of visual aids, fixed time, and quick forgetting of the information.

Basic means of the verbal method:

1. Lecture is theoretically oriented, deals with any theme or question and is delivered in the form of monologue.

2. Report is practically oriented, deals with any theme or question and is realised in the form of monologue.

 3. Conversation is the discussion of some theme with a small number of listeners (to 25-30 persons). In this case bringing into the discussion large number of listeners becomes the purpose of the doctor. Conversation, unlike the lecture and report has individual, flexible character, availability, and bilateral communication.

4. Evening party of questions and answers. An audience asks questions covering the theme, and the doctor answers them. It is a bilateral communication. If the audience is prepared to the conversation in a proper way there observed active discussion of the problem.

5. School of maternity is organised at female dispensary. Its basic feature is a systematic purposeful sanitary and hygenic education of pregnant women for a certain period of time concerning the observance of the rules of personal hygiene, specifics of labour, rest and nutrition. School of maternity teaches a woman in the first half of her pregnancy how to look after the baby, in the second one – carries out psychoprophylactic work on the women preparation to the labour.

6. Course preparation – is carried out on the basis of the special program of teaching the basis of pre-medical aid (arresting of bleeding, application of the splint, direct and indirect massage of the heart and others) for the firemen, militiamen and others. Course preparation, unlike the other means, has obligatory character; after completing the course the student is to pass the credit test in theory and practice.

Описание: Описание: Описание: Опис : Картинка к новости 'Американские врачи завершают клинические испытания электронных стимуляторов мозга'


Characteristics and basic means of printing method

Basic advantages of printing method are large edition, mass character, and possibility of mastering the material at any time. The basic disadvantages of printing method are lack of individual approach and mutual conversation, material expenses, sometimes misunderstanding of the material.

A printing method is divided into 2 groups:

а) Material is prepared by himself (wall newspaper, bulletin);

b) Official sources include material prepared by typographical method (approved by the Ministry of Public Health of Ukraine).

Basic means of printing method:

1. A slogan is the appeal to follow of this or that advice. A text is direct, laconic, expressive (for example, “Be careful, flu!”, “Attention: cholera!”).

2. A leaflet is a short explanation of a certain sanitary and hygenic problem. It consists of advises and rules which are necessary to observe, for example in case of intestinal infection.

3. Booklet is the list of advises and rules which are necessary to observe. It may contain some practical recommendations and it is more comprehensive than a leaflet. For example, “Booklet about hygiene and health of schoolchildren”, “How to prevent tetanus”.

4. A brochure is the list of advises and rules which are necessary to observe. It contains theoretical recommendations and is more comprehensive than a leaflet. For example, “Diet of the patients with ulcers”, “Advises concerning regimen and nourishment in tuberculosis”.

5. Sanitary-elucidative wall newspaper. The articles must be short, interesting and brightly illustrated. For example, wall newspaper, which is devoted to the hygiene of the mouth cavity or tuberculosis prophylactics.

Description and basic means of visual method.

Basic advantages of visual method are large striking influence on an audience as a result of authenticity, possibility of demonstration, individual approach and mutual communication with an audience. The basic disadvantages of visual method are relatively small number of listeners and fixed time.

Basic facilities of evident method:

1. Natural objects, for example, microscopic preparations (smears), sets for the first medical aid (splints and plaits).

2. Artificial objects:

а) Moulage is an artificial object in a natural size, for example, moulage of the nasal cavity or internal ear;

b) Model is the magnified or diminished recreation of the natural object;

c) Pattern is the magnified or diminished recreation of the natural object with the possibility of its functioning, for example, illustration of blood circulation;

d) Poster contains information in a condensed form; it is brightly illustrated.

 

Description and basic means of the combined method

It is the method of mass information. Mass character, popularity, high perception of the material and the vividness are the basic advantages of this method. The fixed time is its main disadvantage.

Basic means of the combined method:

1. Broadcasting on medical topics is the most mass mean.

2.  Transmission of the medical programs over television differs from other means in its picturesqueness and obviousness.

3. The Internet is an actuality and novelty of information.

 

FORMATION OF HEALTHY WAY OF LIFE

Educative activities concern the major directions of preventive activity of medical workers. It’s object is, on the one hand, raising sanitary culture of the population, and on the other one – preparing a sanitary active which does not only distribute sanitary knowledge among people, but also aids medical attendants in carrying out of medical and preventive work.

Forms of health education are various: oral propagation (conversations, lectures, reports, public speeches on radio and TV), written or printed propagation (distribution of the literature, release of sanitary bulletins, wall newspapers), evident propagation (creation of the corners and rooms of health, the organization of thematic exhibitions).

Giving Educative activities, it is necessary to adhere to several basic methodical requirements.

First, the subjects and the maintenance of health education actions should be closely connected to the performance of general economy problems.

Second, sanitary agitation and spreading of health education should be based on a district material. It is necessary to take into account features the group of people or separate persons with whom the following work is going to be spent.

Thirdly, it is necessary the content of any health education action is to be clear.

District Councils and public organizations have the big help to the medical attendants in carry out of the educative activities.

Therefore, medical workers periodically involve to this work the managerial personnel, experts from different areas and intelligence and with their help sanitary posts and sanitary divisions are organized, training of sanitary active is being held.

Besides educative activities spend in houses of culture (clubs) and libraries, it needs to be held in children’s preschool establishments and schools, at home.

So, during outpatient reception hours it is expedient to organize an individual and group conversations, paying the basic attention to hygiene and preventive maintenance of diseases. In reception medical institutions it is necessary to arrange small thematic exhibitions. It is possible to hang out posters, tables, illustrated slogans and brochures on walls and rotating stands. Beside it is expedient to place wall newspapers and the sanitary – educational bulletins, which are prepared by the medical attendants.

On prominent place there can be wall a board of questions and correspond to. But it is necessary to avoid rather detailed medical advice, it is necessary to make the basic accent on preventive maintenance of diseases, observance of a mode by patients.

Efficiency of the educative activities directly depends on a sanitary and aesthetic condition of the medical establishments and from quality of health services in them.

In houses of culture (clubs) it is necessary to organize lecture halls and sanitary – educational circles, thematic evenings, exhibitions, to create sanitary stand, to make wall newspapers, to show sanitary – educational films. In libraries it is expedient to spend debates and exhibitions of the literature. In industrial premises the best form of educative activities are conversations and employment on sanitary education, creation of sanitary stand, release of corresponding bulletins and wall newspapers. Conversations on sanitary-and-hygienic themes can be spent during visiting patients at home.

Medical workers of more and more attention give propagation of a healthy way of life. The state of health of a person is mostly determined by the social and economic conditions in which he lives, closely connected with influence of an environment, air, water, solar radiation, space radiation, electromagnetic fluctuations, etc.

The task of the health educators is to acquaint people with how natural factors influence an organism of a person. It is necessary to emphasize that environmental contamination has an adverse effect on a state of health of a person that everyone should participate actively in an accomplishment and gardening of cities and villages, in struggle against noise, air pollution, waters, ground.

Very important factor for health of a person – correctly organized work with regular breaks for rest. Covering in conversation or lecture these questions, medical attendants should take into account professional features of students. It is necessary to aid to graduates of schools to choose their profession correctly.

Balanced diet also means a lot for the health of a person. It is necessary to warn people of typical mistakes iutrition – non-observance of a mode, hyper alimentation, consumption of monotonous foods, fast meal, abusing fats and sweet, sharp seasonings, hard liquor.

It is impossible not to pay attention at personal and public hygiene. It is necessary to propagandize bases of mental hygiene. In fact, it is proved, that emotional stresses – are principal cause of the occurrence of hyper tonic disease, heart attacks of a myocardium, heavy defeats of nervous system, etc. So, during lectures and conversations it is necessary to emphasize, how important it is to avoid stressful situations in daily life. The big harm to health renders smoking, abusing alcohol, self-treatment.

The child since the childhood needs to be brought up benevolent, cheerful; with a life optimism, make impacts on a good sense of humor, to bring up respect for others and, on the contrary, it is necessary to struggle with displays of egoism, vanity, to aid to get rid of bad character traits.

It is possible to offer the following themes for lectures and conversations on a healthy way of life:

1.  The nature and health of a person.

2.  Christian morals and health.

3.  Prophylactic medical examination – a basis of health.

4.  Work – the source of health and longevity.

5.  Profession and health.

6.  Be able to have a rest.

7.  Personal bases and public hygiene.

8.  How to eat correctly.

9.  Physical culture and health.

10.                   Quenching, self-massage, self-checking.

11.                   Emotions and health.

12.                   Habits and actions which are injurious to health (smoking, abusing alcohol, etc.).

13.                   Be able to submit first care.

14.                   Your health – in your hands.

15.                   Hygiene and sexual life.

16.                   About harm of self-treatment.

Extremely big number has sanitary-and-hygienic work at schools. Themes that need to be covered are identical to schoolboys of any age. They differ only in volume and character of a teaching material.

The theme I – « Improving number of physical training » will consist of 4 sections: morning hygienic gymnastics, quenching, formation of a correct bearing, an implant mode.

The theme II – « Hygiene of brainwork of schoolboys » covers a mode of day, hygiene of work at school, hygiene of training, rational rest, hygiene of dream.

The theme III – « Hygiene of polytechnic training » is devoted to the rational organization of work and to the prevention of industrial traumas.

The theme IV – « Public and personal hygiene. Preventive maintenance of infectious diseases » for pupils of 1-3 classes will consist of 4 sections, for pupils of 4-7 classes – from 3, for pupils of 8-10 classes – from 5 sections.

Themes « Personal hygiene », « Hygiene of an environment », ” Infectious diseases ” study pupils of all age groups, a theme « the Nature and health of a person » – children of 7-9 and 15-17 years, and a theme « Some questions of social hygiene » – only senior pupils.

These subjects should be guided, holding an appropriate work at school.

As it was already marked, without the aid of groups of sanitary active and medical attendant it will be hard to perform these tasks. Prepare some profile groups of a sanitary active which are responsible for protection of work, performance of anti-epidemic actions, care of patients, struggle against a tuberculosis, health protection of children, propagation of a healthy way of life, etc.

They are expedient for creating on the basis of industrial institutions, schools, clubs and libraries.

With groups of a sanitary active regular and purposeful methodologies work should be done. The best form of work – thematic rates. Carrying out of them should be united with other mass actions, which are spent in the city or in the village.

The centres of health are engaged in a management of sanitary – educational work. Doctors and average medical workers – methodologies from sanitary – educational work should be a part of their structure.

 

Communication for Health Education

Communication can be regarded as a two- way process of exchanging or shaping ideas, feelings and information. Broadly it refers “to the countless ways that humans have of keeping in touch with one another”.

Communication is more than mere exchange of information. It is a process necessary to pave way for desired changes in human behavior, and informed individual and community participation to achieve predetermined goals. Communication has, in recent years, developed into an interdisciplinary science drawing richly from social sciences. With the development of newer methods of communication and information explosion, the mental development of the humans has expanded considerably for clearer thinking, better social inter- sectoral coordination.

Communication and education are interwoven. Communication strategies can enhance learning. The ultimate goal of all communication is to bring about a change in the desired direction of the person who receives the communication. This may be at the cognitive level in terms of increase in knowledge; it may be affective in terms of changing existing patterns of behaviour and attitudes; and it may be psychomotor in terms of acquiring new skills. These are referred to as learning objectives.

Communication is part of our normal relationship with other people. Our ability to influence others depends on our communication skills, e.g.; speaking, writing, listening, reading and reasoning. These skills are much needed in health education. The developing countries are now beginning to exploit the current “communication revolution” to put today’s health information at the disposal of families, to help people to achieve health by their own actions and efforts. It is said that without communication an individual could never become a human being, without mass communication, he could never become a port of modern society.

THE COMMUNICATION PROCESS

Communication which is the basis of human interaction is a complex process. It has the following main components (Fig. 1);

1.              sender          (source)

2.              receiver        (audience)

3.              message        (content)

4.              channel(s)     (medium)

5.              feedback       (effect)

1. Sender

The sender (communicator) is the originator of the message. To be an effective communicator, he must know:

v his objectives, clearly defined

v his audience: it’s interests and needs

v his message

v channels of communication

v his professional abilities and limitations

The impact of the message will depend on his own social status (authority), knowledge and prestige in the community.

2. Receiver

All communications must have an audience; this may be a single person or a group of people. Without the audience, communication is nothing more than mere noise. It is this element of audience and their frame of mind (e.g., opinions, attitudes, prejudices) which lends meaning to all the different types of communication.

The audience may be of two types: the controlled and the uncontrolled. A controlled audience is one which is held together by a common interest. It is a homogeneous group. An uncontrolled or “free” audience is one which has gathered together from motives of curiosity. This type of audience poses a challenge to the ability of the educator. The more homogeneous the audience is, the greater are the chances of an effective communication.

 


FIG. 1 Communication Process

3. Message

A message is the information (or “technical know – how”) which the communicator transmits to his audience to receive, understand, accept and act upon. It may be in the form of words, pictures-or signs. Health communication may fail in any cases, if its message is not adequate.

A good message must be:

v in line with the objective (s)

v meaningful

v based on felt needs

v clear and understandable

v specific and accurate

v timely and adequate

v fitting the audience

v interesting

v culturally and socially appropriate,

Transmitting the right message to the right people at the right time is a crucial factor in successful communication.

4. Channels of Communication

By channel is implied the “physical bridges” or the media of communication between the sender and the receiver.

Media systems

The total communication effort is based on three media stems:

a.     Interpersonal communication

b.     Mass media

c.     Traditional or folk media

a. Interpersonal communication

The most common channel of communication is the interpersonal or face – to – face communication. Being personal and direct it is more persuasive and effective than any other form of communication. Interpersonal communication is particularly important in influencing the decisions of the undecided persons. The superiority of interpersonal communication over mass media for creation of motivational effect has been well documented.

When the message relayed via mass media gets diffused in the community, it is picked up by the interpersonal and informal networks. The message is then subject to debate and discussion by interpersonal communications. On the basis of this scrutiny a consensus is gradually built up in the community whether to accept or reject the message.

b. Mass media

In mass communication, the channel is one or more of the following “mass media”, viz TV, radio, printed media, etc. Mass media have the advantage of reaching a relatively larger population in a shorter time than is possible with other means. Being one – way channels of communication, mass media carry messages only from the centre to the periphery; feedback mechanisms are poorly organized. Being impersonal media, they are usually not effective in changing established modes of behaviour.

c. Folk media

Every community has its owetwork of traditional or folk media such as folk dances, singing, dramas, Nautankt in Uttar Pradesh, Burrakatha in Andhra Pradesh and Harikatha in Western India besides informal group gatherings, caste or religious meetings. These are important channels of communication close to   the cultural values of the rural population. They have been the principal instruments of preserving the cultural heritage. Health messages may be communicated through these traditional media.

Every channel of communication has its advantages and limitations. For instance, knowledge of surgery cannot be effectively transmitted by verbal communication, demonstrations are needed. The proper selection and use of channels results in successful communication. Since effective communication is seldom achieved through the use of one method atone, an attempt should be made to combine a variety of methods to accomplish the educational purpose. Health education uses a variety of methods to help people understand their own situations and choose actions that will improve their health.

5. Feedback

It is the flow of information from the audience to the sender. It is the reaction of the audience to the message. If the message is not clear or otherwise not acceptable the audience may reject it outright. The feedback thus provides an opportunity to the sender to modify his message and render it acceptable. In interpersonal communication the feedback is immediate, in mass communication it takes some time to get feedback. Feedback is generally obtained through opinion polls, attitude surveys and interviews. It can rectify transmission errors.

TYPES OF COMMUNICATION

1. One – way communication (Didactic Method)

The flow of communication is “one-way” from the communicator to the audience. The familiar example is the lecture method in class rooms. The drawbacks of the didactic method are:

        knowledge is imposed

        learning is authoritative

        little audience participation

        no feedback

        does not influence human behaviour

2. Two – way communication (Socratic Method)

The Socratic method is a two – way method of communication in which both the communicator and the audience take part. The audience may raise questions, and add their own information, ideas and opinions to the subject. The process of learning is active and “democratic”.. It is more likely to influence behaviour than one – way communication.

3. Verbal communication

The traditional way of communication has been by word of mouth. The advents of written and printed matter are of comparatively recent origin. Direct verbal communication by word of mouth may be loaded with hidden meanings. It is persuasive. Non – direct or written communication may not be as persuasive as the spoken word.

4. Non – verbal communication

Communication can occur even without words. It includes a whole range of bodily movements, postures, gestures, facial expressions (e.g., smile, raised eye brows, frown, staring, gazing etc.). Silence is non – verbal communication. It can speak louder than words.

5. Formal and informal communication

Communication has been classified into formal (follows lines of authority)   and informal (grape-vine) communication. Informal network (e.g. gossip circles) exists in alt organizations. The Informal channels may be more active, if the formal channels do not cater to the informatioeeds.

6. Visual communication

The visual forms of communication comprise: charts and graphs, pictograms, tables, maps, posters etc.

7. Telecommunication and Internet

Telecommunication is the process of communicating over distance using electromagnetic Instruments designed for the purpose. Radio, TV and internet etc. are mass communication media, while telephone, telex (or teletype) and telegraph are known as point – to – point telecommunication systems. The point – to – point systems are closer to interpersonal communication. With the launching of satellites, a big explosion of electronic communication has taken place all over the world.

BARRIERS OF COMMUNICATION

Health education may often fail due to communication barriers between the educator and the community-these may be:

 

Even when health services are readily available, the social and cultural barriers can present serious problems to the achievement of health behaviour change. These barriers should be identified and removed.

HEALTH COMMUNICATION

Health is the concern of everyone for everyone. Health communication is therefore an important area of communication. The term “health communication” is often used synonymously with health education, which itself suggests “outward and downward” communication of knowledge. Health education is the foundation of a preventive health care system.

Functions of health communication

Health communication has to cater to the following needs:

1.    Information                     5.   Counselling

2.    Education                        6.   Raising morals

3.    Motivation                      7.   Health development

4.    Persuasion                       8.   Organization

 

1. Information

The primary function of health communication is to provide scientific knowledge or information to people about health problems and how to maintain and promote health. People rarely seek such information although they have a right to know the facts about health and disease.

Information should be easily accessible to the people. Exposure to the right kind of health information can

          eliminate social and psychological barriers of ignorance, prejudice and misconceptions people may have about health matters;

   increase awareness of the people to the point that they are able to perceive their health needs; and

    influence people to the extent that unfelt needs become felt needs, and felt needs become demands.

The government, the media and health providers have an important social responsibility to provide factual and balanced health and health related information to the people and awaken their interest on the basis of which they can make informed decisions. But, the assumption that the acquisition of information will mean a change in an individual’s behaviour and attitudes is fallacious. Most people make important decisions regarding their health only after much thought – perhaps over a period of time and after serval educational contacts. The cultural values, beliefs and norms of the people influence theft acceptance of health information. Correct information is a bask part of health education.

2. Education

Education of ‘the general- public is an integral part of a prevention – oriented approach to health and disease problem; and, the basis of all education is communication. Education can help to increase knowledge. It is often assumed that knowledge determines attitudes and attitudes determine behaviour.

Health education-can bring about changes in life styles and risk factors of disease. Most of the world’s major health problems and premature deaths are preventable through changes in human behaviour at low cost. But education alone is insufficient to achieve optimum health. The target population must have access to proven preventive measures or procedures.

3. Motivation

It is the power that drives a person from within to act. One of the goals of health communication is to motivate individuals to translate health information into personal behaviour and life – style for their own health. Motivation includes the stages of interest, evaluation and decision making. Health communication assists the individual in passing from the state of awareness and interest to the final stage of decision making and adoption of the new idea or programme. Motivation may not be long – lasting; it may diminish with lapse of time. The best channels of success involve programmes directed at individuals who already have some strong motivation, in patients with chronic illness or a disability, those facing acute crisis such as surgery or childbirth. This suggests that probably the quickest pay off will come in the area of patient education.

4. Persuation

Persuasion is the art of winning friends and influencing people. It is an art that does not employ force or deliberate manipulation. The sole purpose of communication is to influence. Persuasion is “a conscious attempt by one individual to change or influence the general beliefs, understanding, values and behaviour of another individual or group of individuals in some desired way”. Persuasive communication is more effective than coercion or authoritative communication. Persuasion can change life style and modify the risk factors of disease.

When persuasive communication is deliberately employed to manipulate feelings, attitudes and beliefs, it becomes “propaganda” or “brain washing”.

5. Counseling

Counseling is a process that can help people understand better and deal with their problems and communicate better with those with whom they are emotionally involved. It can improve and reinforce motivation to change behaviour. It can provide support at times of crisis. It helps them face up to their problems and to reduce or solve them.

Counseling is different from advising. It implies choice, not force. Advising amounts to directing people and cautioning them to some do’s and dont’s.

In different circumstances different people can undertake counseling. A counselor should be able:

                                to communicate information

                                to gain the trust of the people

                                to listen sympathetically to people who are anxious, distressed and possibly hostile.

                                to understand other person’s feelings and to respond to them in such a way that the other person can feel free to express his feelings

                                to help people reduce or resolve their problems.

Thus counseling relies heavily on communication and relationship skills. Counseling is an important part of treatment, disease prevention and health promotion. It helps people to avoid illness and to improve their lives through their own efforts. Counselling develops positive attitudes. It is an integral part of all health care programmes.

6. Raising morale

Morale is “the capacity of a group of people (or team) to pull together persistently or consistently. Communication – vertical and horizontal, internal and external is the first step in any attempt to raise morale of the health team or a group of people.

7. Health development

Communication can play a powerful role in health development by helping to diffuse knowledge in respect of the goals of development and preparing the people for the roles expected of them. But its own role is essentially, supportive. Judicial use of communication media can contribute to health development.

8. Health organization

Communication is the life and blood of an organization. There are two major directions in which communications within an organization flow. These are vertical and horizontal communications. Vertical communication can be downward or upward. Horizontal or cross communication takes place usually between equals at any level. The downward communication extends from top administrator down through the hierarchy of professionals and non- professionals to the beneficiaries or employees. The direction in which communication flows in an organization suggests the degree of freedom in the internal communicatioetwork.

Communication is an important dimension of health organization. It is an important means of intra- and inter- sectoral coordination.

HEALTH EDUCATION

Health education is a term commonly used and referred to by health professionals.

Definitions

Health education is indispensable in achieving individual and community health. It can help to increase knowledge and to reinforce desired behaviour patterns. But there is no single acceptable definition of health education. A variety of definitions exist. Concepts of health education as a process or an activity for inducing behavioural changes are emphasized in the following definitions:

1. Health education is the translation of what is known about health into desirable individual and community behaviour patterns by means of an educational process.

2. The definition adopted by John M Last is “The process by which individuals and groups of people learn to behave in a manner conducive to the promotion, maintenance or restoration of health”.

3.  Any combination of learning opportunities and teaching activities designed to facilitate voluntary adaptations of behaviour that are conducive to health.

4.  The definition adopted by the National Conference on Preventive Medicine in USA is “Health education Is a process that informs, motivates and helps people to adopt and maintain healthy practices and lifestyles, advocates environmental changes as needed to facilitate this goal and conducts professional training and research to the same end”.

5.   Health education is the part of health care that is concerned with promoting healthy behaviour.

Alma Ata Declaration

The Declaration of Alma – Ata (1978) by emphasizing the need for “individual and community participation” gave a new meaning and direction to the practice of health education. The dynamic definition of health education Is now as follows :

“a process aimed at encouraging people to want to be healthy, to know how to stay healthy, to do what they can individually and collectively to maintain health, and to seek help wheeeded”.

The Alma – Ata Declaration has revolutionized the concepts and aims of health education:

The modern concept of health education emphasizes on health behaviour and related actions of people.

Health education and behaviour

The behaviours to be adopted or modified may be that of individuals, groups (such as families, health professionals, organizations or institutions) or entire community.

Strategies designed to influence the behaviour of individuals or groups will vary greatly depending upon the specific disease (or health problem) concerned and its distribution in the population as well as upon the characteristics and acceptability of available methods preventing or controlling that disease (or health problem).

Health education can help to increase knowledge and to reinforce desired behaviour patterns.

It is clear that education is necessary, but education alone is insufficient to achieve optimum health. The target population must have access to proven preventive measures or procedures.

Changing concepts

Historically health education has been committed to disseminating information and changing human behaviour Following the Alma – Ata Declaration adopted in 1978, the emphasis has shifted from:

                                Prevention of disease to promotion of healthy lifestyles;

                                the modification of individual, behaviour to modification of “social environment” in which the individual lives;

                                community participation to community involvement; and

                                promotion of individual and community “self reliance”.

Aims and objectives

The definition adopted by WHO in 1969 and the Alma Ata Declaration adopted in 1978 provide a useful basis for formulating the aims and objectives of health education, which may be stated as below:

1.   to encourage people to adopt and sustain health promoting lifestyle and practices;

2.   to promote the proper use of health services available to them;

3.   to arouse interest, provide new knowledge, improve skills and change attitudes in making rational decisions to solve their own problems; and

4.   to stimulate individual and community self – reliance and participation to achieve health development through individual and community involvement at every step from identifying problems to solving them.

The educational objectives are aimed al the group to be taught in the educational programme. The objectives flow from the health needs which have” been discovered. They should be carefully unambiguously defined in terms of knowledge to be acquired, behaviour to be acquired or actions to be mastered. They must be pertinent if the programme is to be appropriate and successful.

The focus of health education is on people and on action. Its goal is to make realistic improvements in the basic quality of life. Many health education programmes hope, in some way, to influence behaviour or attitudes. The implication of these new concepts is that health education is an integral part of the national health goals. The fact remains that effective health education has the potential for saving many more lives than has any one research discovery in the foreseeable future.

Role of health care providers

It is clear that education is necessary, but education alone is not sufficient to achieve optimum health. The role of health care providers in this regard comprise to:

a. provide opportunities for people to learn how to identify and analyze health and health related problems, and how to set their own targets and priorities ;

b. make health and health – related information easily accessible to the community;

c. indicate to the people alternative solutions for solving the health arid health-related problems they have identified; and

d.   people must have access to proven preventive measures.

APPROACH TO HEALTH EDUCATION

There are 4 well-known approaches to health education:

1. Regulatory approach (Managed prevention)

Regulation in the context of health education may be defined as any governmental intervention, direct or indirect, designed to alter human behaviour. Regulations may be promulgated by the State by a variety of administrative agencies. Regulations may take many forms ranging from prohibition to imprisonment.

The coercive or regulatory approach seeks change in health behaviour and improvement in health ^through a variety of external control or laws placed on people as for example. The Child Marriage Restraint Act in India and the use of compulsory seat belts in the western countries. The legislative approach may seem to be simplest and quickest way to improve health or bring about desired changes in society, but there are also important failures of laws, e.g., prohibition of alcohol.

The reasons for the failure of the coercive approach are not far to seek; in the first place, the cause of disease (medical or social) cannot be eradicated by legislation, at the most the government can make laws to prevent a person spreading disease in his community, as for example vaccination in an emergency. Secondly in areas involving personal choice (e.g., diet, exercise, and smoking) no government can pass legislation to force people to eat a balanced diet or not to smoke. It amount to taking away some of the rights of the individual. The disastrous sterilization campaign of 1976 in India which led to the Congress defeat in the 1977 elections is a case in point. The lesson learnt is that it is difficult to enforce a law unless the majority of people are in favour of it and if ii does not interfere with the rights of the individual.

However, laws may be useful in times of emergency or in limited situations such as control of an epidemic disease or management of fairs and festivals. Even in cases where it is the duty of the government to make laws to prevent the spread of disease (e.g., AIDS) it is difficult lo enforce laws without a vast administrative infrastructure and considerable expenditure. To a degree, the people must be ready to accept a law. In short, the coercive approach runs counter to the basic tenet of health education, that is, in health education, we do not force people to change. In specific situations, legislation can be used to reinforce the pressure to change collective behaviour.

2. Service approach

This approach was tried by the Basic Health Services in 1960’s. It aimed at providing all the health services needed by the people at their door steps on the assumption that people would use them to improve their own health. This approach proved a failure because it was not based on the felt – needs of the people. For example, when water-seal latrines were provided by the government, free of cost, many people in the rural areas did not make use of them because it was not their habit to use latrines. The lesson is simple – the people will not accept a programme or service, even if it is offered free of cost, unless it ii based on their felt – needs.

3. Health education approach

There are many problems (e.g., cessation of smoking, me of safe water supply, fertility control) which can be solved only through health education. It is a general belief in western democracies that people will be better off if they have autonomy over their own lives, including health affairs on which an informed person should be able to make decisions to protect his own health. These are the higher goals of health education. However, if the necessary behaviour changes are to take place, people must be educated through planned learning experiences what to do, and be informed, educated and encouraged to make their own choice for a healthy life. This approach is consistent with democratic philosophy which does not “order” the individual. The results are slow, but enduring. The mass media and social organizations must be mobilized to help introduce new attitudes and new habits without conflicting with the masses and the collective reaction to particular change.

Since attitudes and behavioural patterns are formed early in life. We must move back in time and start health education with young population. The assumption is that behaviour is more easily controlled or developed in young population than adults.

4. Primary health care approach

This is a radically new approach starting from the people with their full participation and active involvement in the planning and delivery of health services based on principals of primary health care, viz community involvement and intersectoral coordination. The underlying objective Is to help Individuals lo become self – reliant in matters of health, This, in turn, can be done if the people receive the necessary guidance from health care providers in identifying their health problems and finding workable solutions. This approach is a fundamental shift from the earlier approaches.

Health education versus propaganda

Health education is not health propaganda; it is more than mere information or propaganda. To educate means to cause or facilitate learning; propaganda means to spread particular systemized doctrine. The differences between health education and propaganda drawn up by the Central Health Education Bureau, Govt. of India are given in Table 1.

Table 1

Health education and propaganda

 

Education

Propaganda or publicity

1

Knowledge and skills actively acquired

Knowledge instilled in the minds of people

2

Makes people think for themselves

Prevents or discourages thinking by readymade slogans

3

Disciplines primitive desires

Arouses and stimulates primitive desires

4

Develops reflective behaviour. Trains people to use judgment before acting

Develops reflexive behaviour; aims at impulsive actions

5

Appeals to reason

Appeals to emotion

6

Develops individuality, personality and self-expression

Develops a standard pattern of attitudes and behaviours according to the mould used

7

Knowledge acquired through self-reliant activity

Knowledge is spoon-fad and passively received

8

The process is behaviour centred – aims at developing favorable attitudes, habits and skills

The process is information centred – no change of attitude or behaviour designed.

 

MODELS OF HEALTH EDUCATION

During the past few decades, a number of health education models have been developed. They include the following:

1. Medical Model

Most health education in the past has relied on knowledge transfer to achieve behaviour changes. The medical model is primarily interested in the recognition and treatment of disease curing) and technological advances to facilitate the process. It is concerned with disease (as defined by the doctor) or opposed to illness (as defined by the client).

Originally health education developed along the lines of the bio-medical views of health and disease. The emphasis was on dissemination of health information based on scientific facts. The assumption was that people would act on the information supplied by health professionals to improve their health. In this model social, cultural and psychological factors were thought to be of little or no importance. The medical model did not bridge (he gap between knowledge and behaviour.

2. Motivation Model

When people did not act upon the information they received, health education started emphasizing “motivation” as the main force to translate health information into the desired health action. But the adoption of a new behaviour or idea is not a simple act, it is a process consisting of several stages through which an individual is likely to pass before adoption. In this regard, sociologists have described 3 stages in the process of change in behaviour (Fig. 2).

 

 

FIG. 2 Adoption Model

 

The individual first goes through AWARENESS or getting general information about the subject. In health education, we must first create awareness of health needs and problems through a programme of public information. Mere awareness is not of much value unless it leads to motivation. Motivation includes the stages of interest, evaluation and decision making. The individual evinces interest in the subject; he may seek more detailed information about the useful ness, limitations or applicability of the new idea or practice. He then evaluates the various aspects (social, psychological, economic) of the information received, if necessary by consulting others. Such an evaluation is a mental exercise and results in decision – making. He finally decides whether to accept or reject the new idea, programme or proposal. At this stage, interpersonal communication (friends, kinship groups, technical persons) is vital to lend support to his decision; Conviction leads to action, adoption or acceptance of the new idea. The new idea or acquired behaviour becomes part of his own existing values. This is called internalization. Effective communication strategy should be evolved to help the individual in passing from one stage to another.

The above stages are not necessarily rigid; there may be skipping of stages. It is also found that in the same community, people may be in different stages of the adoption process. Adoptions arc slow at first and increase as more and more people accept the practice.

3. Social Intervention Model

Soon, however, it was realized that the public health problems facing us today are so complex that the traditional motivation approach is insufficient to achieve behavioural change, as for example, reducing smoking, adoption of small family norm, raising the age of marriage, elimination of dowry, etc.

The motivation model ignored the fact that in a number of situations, it is not the individual who needs to be changed but the social environment which shapes the behaviour of individual and the community. It is often found that people will not readily accept and try something new or novel until it has been “legitimated” (or approved) by the group to which they belong. Most of us prefer to do only the things commonly done by our group. This highlights the importance of group support in helping reaching the decisions and taking action. Adoption of a new idea such as vasectomy or loop insertion is facilitated if there is a group support. This gave birth to the development of social intervention model of health education. An effective health education model is based on precise knowledge of human ecology and understanding of the interaction between the cultural, biological, physical and’ social environmental factors.

In sum, a coherent strategy needs to be developed involving all the ways to change behaviour and to recognize that the approach will differ for different behaviour one wants to change. The need is for a programme of pacts. Reliance on only one method is likely to lead to failures. A combination of approaches using all methods to change life – style and appropriate use of medical care will be necessary.

CONTENT OF HEALTH EDUCATION

The scope of health education extends beyond the conventional health sector. It covers every aspect of family and community health. While no definite training curricula can be proposed, the content of health education may be divided into the following divisions for the sake of simplicity. Since health education has a limited impact when directed from general education, most of the needed information must be integrated into the educational system (by way of books, class – room material, etc.) and must have the young population as the principal target.

1. Human biology

Understanding health, demands an understanding of the human biology, i.e., the structure and functions of the body; how to keep physically fit – the need for exercise, rest and sleep; the effects of alcohol, smoking and drugs on the body; cultivation of healthy life-styles, etc. Reproductive biology is another area of current interest. UNICEF’s “State of the World’s Children report 1989” has drawn up a basic list of health information which it believes; every family has a right to know. The list comprises of child spacing, breast feeding, safe motherhood, immunization, weaning and child growth, diarrhoeal disease, respiratory infections, house hygiene – which could enable families to bring about significant improvements in their own and their children’s health.

The best place to teach human biology is the school. It is only the school, through its sequential health curriculum, which can provide continuous in-depth learning experiences for millions of students. The provision of information and advice on human biology and hygiene is vital for each new generation.

2. Nutrition

The aim of nutrition education is to guide people to choose optimum and balanced diets, remove prejudices and promote good dietary habits – not to teach the familiar jargon of calories and the biochemistry of nutrients. Nutritional problems such as ignorance about the value of breast feeding beyond the first year of life, misconceptions about proper weaning, ignorance of the appropriateness of certain diets for infants and pregnant women, traditional1 food allocation pattern within the families, etc. can be best solved by nutrition education. In recent years, the link between dietary habits and certain chronic diseases of middle age such as obesity, diabetes and cardio-vascular diseases has been established. Nutrition education is a major intervention for the prevention of malnutrition, promotion of health and improving the quality of life.

3. Hygiene

This has two aspects – personal and environmental. The aim of personal hygiene is to promote standards of personal cleanliness within the setting of the condition where people live. Personal hygiene includes bathing, clothing, washing hands and toilet; care of nails, feet and teeth; spitting, coughing, sneezing, personal appearance and inculcation of clean habits in the young. Training in personal hygiene should begin at a very early age and must be carried through school age. ENVIRONMENTAL HYGIENE has two aspects – domestic and community. Domestic hygiene comprises that of the home, use of soap, need for, fresh air, light and ventilation; hygienic storage of foods; hygienic disposal of wastes need to avoid pests, rats, mice and insects. Improvement of environmental health is a major concern of many governments and related agencies throughout the world. In the developing countries, the emphasis is on the improvement of basic sanitary services consisting of water supply, disposal of human excreta, other solid and liquid wastes, vector control, food sanitation and housing which ate fundamental to health. In many areas, poor sanitary practical among the people have their roots in centuries – old customs styles of living and habits. These are not easily altered.

An environmental sanitation programme should include health education. It is not enough to provide sanitary wells, latrines and waste collecting facilities. People will continue to suffer from the diseases caused by poor sanitation if they do not use the facilities. If a health education approach is taken the people will participate from the beginning in identifying their sanitation problems and will choose the solutions and facilities they want. They will then be more likely to use these facilities and improve their health.

4. Family health

The family is the first defense, as well as the chief reliance for the well – being of its members. Health largely depends on the family’s social and physical environment and its lifestyle and behaviour. The role of the family in health promotion and in prevention of disease, early diagnosis and care of the sick is of crucial importance. One of the main tasks of health education it to promote the family’s self – reliance, especially regarding the family’s responsibilities in child-bearing, child rearing, self-care and in influencing their children adopt a healthy life­style.

5. Disease prevention and control

Drugs alone will not solve health problems without health education, a person may fall sick again and again from the same disease. The experiences of western countries have shown the role of education in the eradication of cholera, typhoid, malarii and tuberculosis etc. Education of the people about the prevention and control of locally endemic diseases is the first of eight essential activities in primary health care. Several public health programmes are in operation on a national scale to eradicate diseases such as malaria, tuberculosis, leprosy, filaria, goitre, etc. The recent experience of malaria eradication has indicated that anti – malarial spray with insecticides cannot solve the problem without health education.

6. Mental health

Mental health problems occur everywhere. They become more prominent when major killer diseases are brought under control. There is a tendency to an Increase In the prevalence of mental diseases when there is a change in the society from en agricultural to an industrial economy, and when people mow from the warm intimacy of a village community to the isolation found in big cities. The aim of education in mental health is to help people to keep mentally healthy and to prevent a mental breakdown. People should enjoy their relationships with often and learn to live and work without mental breakdown. There are certain special situations when mental health is of great importance – mother after child birth; child at entry into school for the first time, school child entering the secondary school, decision about a future career, starting a new family and at the time of widowhood. These are critical periods of life when external pressure tends to breakdown mental health. Health workers should help people achieve mental health by showing sympathy, understanding and by social contact.

7. Prevention of accidents

Accidents are a feature of the complexity of modern life. In the developed countries, they are taking an increasing toll of life and limb. Accidents occur in three main areas: the home, road and the place of work. Safely education should be directed to these areas. It should be the concern of the engineering department and also the responsibility of the police department to enforce rules of road safety. Accidents occur in workshops, factories, railways and mines. Management must provide a safe evironment and promote general order and cleanliness. There should be a place for everything, and everything should be in its place in the factory, in the home, and in the office. The predominant factor in accidents is carelessness and the problem can be tackled through health education.

4. Use of health services

Many people particularly in rural areas do not know what health services are available in their community and many more do not know what signs lo look for that indicates a visit to the doctor is necessary. Studies indicate that the public attitude towards health services is still apprehensive. There is a communication gap between the public and the state health administration in the form of “feedback” for further improvement of health services.

One of the declared aims of health education is to inform the people about the health services that are available in the community and how they can utilize them {e.g., screening programmes, immunization, family planning services etc.) and use the health care resources.

PRINCIPLES OF HEALTH EDUCATION

Before we come to the practice of health education, we must know the principles involved. Health education brings together the art and science of medicine, and the principles and practice, of general education. The link is to be found in the social and behavioural sciences-sociology, psychology and social anthropology.

Health education cannot be “given” to one person by another. It involves, among other things, the teaching, learning and inculcation of habits concerned with the objective of healthful living. Psychologists have given a great deal of attention to the learning process. Every individual learns and through learning develops the modes of behaviour by which he lives. Learning and teaching is a two-way process of transactions in human relations, between the teacher and taught. The teacher caot teach unless the pupil wants to learn. Learning takes place not only in the class room, but also outside in the wider world. There is internal learning by which a man grows into an adult individual. It is possible to abstract certain principles of learning and use them in health education. These include:

(1) Credibility: It is the degree to which the message to be communicated is perceived as trustworthy by the receiver. Good health education is based on facts – that means it must be consistent and compatible with scientific knowledge and also with the local culture, educational system and social goals. Unless the people have trust and confidence in the communicator, no desired action will ensue after receiving the message.

(2) Interest: It is a psychological principle that people are unlikely to listen to those things which are not to their interest. It is salutary to remind ourselves that health teaching should relate to the interests of the people. The public is not interested in health slogans such as “Take care of your health” or “be healthy”. A health education programme of this kind would be as useless as asking people to “be healthy”, as a nutrition programme asking people to “eat good food”. Health educators must find out the real health needs of the people. Psychologists call them “felt-needs”, that is needs the people feel about themselves. If a health programme is based on “felt needs” people will gladly participate in the programme; and only then it will be a people’s programme. Very often, there are groups who may have health needs of which they are not aware. This is especially true in India where about 50 per cent of the people are illiterate. The health educator will have to bring about recognition of the needs before he proceeds to tackle them.

(3) Participation: Participation is a key word in health education. It is based on the psychological principle of active learning. Health education should aim at encouraging people to work actively with health workers and others in identifying their own health problems and also in developing solutions and plans to work them out. Participation of family members in patient care will create opportunity for more effective, practically based health education. A high degree of participation tends to create a sense of involvement, personal acceptance and decision making. It provides maximum feedback. The Alma – Ata Declaration states: “The people have a right and duly to participate individually and collectively in the planning and implementation of their health care”. If community participation is not an integral part, health programmes are unlikely to succeed.

(4) Motivation: In every person, there is a fundamental desire to learn, Awakening this desire is called motivation. There are two types of motives – primary and secondary. Primary motives (e.g. sex, hunger, survival) are driving forces initiating people into action; these motives are inborn desires. Secondary motives are based on desires created by outside forces or incentives. Some of the secondary motives are praise, love, rivalry, rewards and punishment, and recognition. In health education, motivation is an important factor; that is, the need for incentives is a first step in learning to change. The incentives may be positive (the carrot) or negative (the stick). To tell a lady, faced with the problem of overweight, to reduce her weight because she might develop cardiovascular disease or it might reduce her life span, may have little effect; but to tell, her that by reducing her weight she might look more charming and beautiful, she might accept health advice. When a father promises his child a reward for getting up early everyday, he is motivating the child to inculcate a good habit. In health education, we make use of motivation to change behaviour. Motivation is contagious; one motivated person may spread motivation throughout a group. For example, men who have already had vasectomies are among the best advertisements for male sterilization.

(5) Comprehension: In health education we must know the level of understanding, education and literacy of people to whom the leaching is directed. One barrier to communication is using words which cannot be understood. A doctor asked the diabetic to cut down starchy foods; the patient had no idea of starchy foods. A doctor prescribed medicine in the familiar jargon “one teaspoonful three times a day’; the patient, a village woman, had never seen a teaspoon, and could not follow the doctor’s directions. In health education, we should always communicate in the language people understand, and never use words which are strange and new to the people. Teaching should be within the mental capacity of the audience.

(6) Reinforcement: Few people can learn all that is new in a single period. Repetition at intervals is necessary. If there is no reinforcement, there is every possibility of the individual going back to the pre – awareness stage. If the message is repeated in different ways, people are more likely to remember it.

(7) Learning by doing: Learning is an action – process; not a “memorizing” one in the narrow sense. The Chinese proverb: “If I hear, I forget; if I see, I remember; if I do, I know” illustrates the importance of learning by doing.

(8) Known to unknown: In health education work, we must proceed “from the concrete to the abstract”; “from the particular to the general”; “from the simple to the more complicated;” “from the easy to more difficult”; and “from the known to the unknown”. These are the rules in teaching. We start where the people are and with what they understand and then proceed to new knowledge. We use the existing knowledge of the people as pegs on which to hang new knowledge. In this way systematic knowledge is built up. New knowledge will bring about a new, enlarged understanding which can give rise to an insight into the problem. The way in which medicine has developed from religion .to modern medicine serves us as an illustration, the growth of knowledge from the unknown to the known. It is a long process full of obstacles and resistance, and we must not expect quick results,

(9) Setting an example: The health educator should set a flood example in the things he is teaching. If he is explaining the hazards of smoking, he will not be very successful if he himself smokes. If he is talking about the “small family norm”, he will not get very far if his own family size is big.

(10) Good human relations: Sharing of information, ideas and feelings happen most easily between people who have a good relationship. Building good relationship with people goes hand In hand with developing communication skills.

(11) Feedback: Feedback is one of the key concepts of the systems approach. The health educator can modify the elements of the system (e.g., message, channels) in the light of feedback from his audience. For effective communication, feedback is of paramount Importance.

(12) Leaders: Psychologists have shown and established that we learn best from people whom we respect and regard. In the work of health education, we try to penetrate the community through the local leaders – the village headman, the school teacher or the political worker. Leaders are agents of change and they can be made use of in health education work. If the leaders are convinced first about a given programme, the rest of the task of implementing the programme will be easy, The attributes of a leader are: he understands the needs and demands of the community; provides proper guidance, takes the initiative, is receptive to the views and suggestions of the people; identifies himself with the community; self-less, honest, impartial, considerate and sincere; easily accessible to the people; able to control and compromise the various factions in the community; possesses the requisite skill and knowledge of eliciting cooperation and achieving coordination of the various official and non-official organizations.

PRACTICE OF HEALTH EDUCATION

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. Audiovisual 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:

(1) AUDITORY AIDS

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.  

Knowledge   of   the   advantages,   disadvantages and limitations of each audio-visual aid is necessary in order to make proper use of them. Audiovisual aids are means to an end, not an end in themselves.

2. Methods in health communication

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

A rundown of the assets of mass media and personal communication methods is shown in Table 2.


FIG. 3

Methods in Health Communication

 

TABLE 2

A rundown of assets of mass media and personal communication

Mass Media (TV, radio, news paper)

Personal communication (Interpersonal, and group methods)

1. Reaches the widest population

 

1. Capitalizes on warmth and understanding and knowledge of communication

2. Gets public attention

 

2. Provides the opportunity for involvement, for asking questions, expressing fears, and learning more

3. Gives greater support for concentrated programmes such as those for a week or month

 

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

4. More affective among those with above average educational level

4. More influential with average and below average educational level

 

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.

1. Individual approach

There are plenty of opportunities for individual health education. It may be given in personal Interviews in the consultation room of the doctor or in the health centre or in the homes of the people. The individual comes to the doctor or health centre because of illness: Opportunity is taken in educating him on matters of interest – diet, causation and nature of illness and its prevention, personal hygiene, environmental hygiene, etc. Topics for health counseling may be selected according to the relevance of the situation. By such individual health teaching, we will be equipping the individual and the family to deal more effectively with the health problems. The responsibility of the attending physician in this regard, is very great because he has the confidence of the patient. The patient will listen more readily to the physician’s health counseling. A hint from the doctor may have a more lasting effect than volumes of printed word. The nursing staffs 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.

2. Group approach

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 subject of tuberculosis control to a mother who has come for delivery; we should talk to her about child-birth and baby care. Similarly, school children may be taught about oral hygiene; tuberculosis patients about tuberculosis; and industrial workers about accidents. We have to select also, the suitable method of health education including audio-visual aids for successful group health education. A brief account of the methods of group teaching is given below:

(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 should not exceed 15 to 20 minutes. If the talk is too long people may become bored and restless.

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 and 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 pictures, 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 rough cloth and they adhere at once when put on the flannel. Flannelgraph offers the advantage that pre-arranged sequence of pictures displayed one after another helps maintain continuity and adds much to the presentation. The other advantages are that the flannetgraph is a very cheap medium, easy to transport and promotes thought and criticism

(c) Exhibits: Objects, models, specimens, etc. convey a specific message to the viewer. They are essentially mass media of communication, which can also be used in group teaching,

(d) Films and charts: These are mass media of communication. If used with discrimination, they can be of value in educating small groups.

Lectures can be faulted on a number of grounds. Their disadvantages include the following: students are involved to a minimum extent; learning is passive; do not stimulate 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 demonstrator 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 new 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.

(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 method 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. 4J. 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 record whatever is discussed. The “recorder” prepares a report on the issues discussed and agreements reached. In a group discussion, the members should observe the following rules: (a) express ideas clearly and concisely (b) listen to what others say (c) do not interrupt when others are speaking (d) make only relevant remarks (e) accept criticism gracefully and (f)  help to reach conclusions. Group discussion is .successful if the members know each other beforehand, when they, can discuss freely.

A well conducted group discussion with adequate resources (Fig.4) is very effective in reaching decisions, based on the ideas of ALL people. The decision taken by the group tends to be adopted more readily than in situations where the decision is a solitary one. Thus the group acceptance has a binding effect on the individual member to translate their acceptance into action. A well-conducted group discussion is effective for changing attitudes and the health behaviour of people.


FIG. 4. A good group discussion

Limitations: Group discussion is not without limitations. Those 1 who are shy may not take part in the discussions. Some may dominate the discussion (Fig. 5). Thus there may be unequal participation of members in a group discussion, unless property guided. Some members may deviate from the subject and mete the discussion irrelevant or unprofitable.


FIG. 5 A dominated group. No.l and No.7 dominate the discussion

 

(4) Panel discussion

In a panel discussion, 4 to 8 persons who are qualified to talk about the topic sit and discuss a given problem, or the topic, in front of a large group or audience. The panel comprises, a chairman or moderator and from 4 to 8 speakers. The chairman opens the meeting, welcomes the group and introduces the panel speakers. He introduces the topic briefly and invites the panel speakers to present their points of view. There is no specific agenda, no order of speaking and no set speeches. The success of the panel depends upon the chairman; he has to keep the discussion going and develop the train of thought. After the main aspects of the subject are explored by the panel speakers, the audience is invited to take part. The discussion should be spontaneous and natural. If members of the panel are unacquainted with this method, they may have a preliminary meeting, prepare the material on the subject and decide upon the method and plan of presentation. Panel discussion can be an extremely effective method of education, provided it is properly planned and guided.

(5) Symposium

A symposium is a series of speeches on a selected subject. Each person or expert presents an aspect of the subject briefly. There is no discussion among the symposium members like in panel discussion. In the end, the audience may-raise questions. The chairman makes a comprehensive summary at the end of entire session.

(6) Workshop

The workshop is the name given to a novel experiment in education. It consists of a series of meetings, usually four or more, with emphasis on individual work, within the group, with the help of consultants and resource personnel. The total workshop may be divided into small groups and each group will choose a chairman and a recorder. The individuals work, solve a part of the problem through their personal effort with the help of consultants, contribute to group work and group discussion and leave the workshop with a plan of action on the problem. Learning takes place in a friendly, happy and democratic atmosphere, under expert guidance. The workshop provides each participant opportunities to improve his effectiveness as a professional worker.

(7) Rote playing

Role playing or socio-drama is based on the assumption that many values in a situation cannot be expressed in words, and the communication can be more effective if the situation is dramatized by the group. The group members who take part in the socio-drama enact their roles as they have observed or experienced them. The audience is not passive but actively concerned with the drama. They are supposed to pay sympathetic attention to what is going on, suggest alternative solutions at the request of the leader and if requested come up and take an active part by demonstrating how they feel a particular role should be handled, or the like. The size of the group is thought to be best at about 25. Role playing is a useful technique to use in providing discussion of problems of human relationship. It is a particularly useful educational device for school children. Role playing is followed by a discussion of the problem.

(8) Conferences and seminars

This category contains a large component of commercialized continuing education. The programmes are usually held on a regional, state or national level. They range from once half-day to one week in length and may cover a single topic in depth or be broadly comprehensive. They usually use a variety of formats to aid the learning process from self instruction to multi – media.

3. Mass approach – Education of the general public

No health worker or health team can mount an effective health education programme for the whole community, except through mast media of communication. The evolution of the media has been rapid Uptill the early 1920s, mass communication depended largely on what was printed – posters, pamphlets, books, periodicals and newspapers. Then came the radio and with it a new dimension of experience. TV went a gigantic step further and has become a very powerful weapon. The press caters primarily to the eye the radio appeals to the ear and TV to both eye and ear. A final word about radio and TV – they come close to the warmth and motivational effect of a person – to – person communication. They have become part of the fabric of modern civilization.

Mass media are a “one-way” communication. They are useful in transmitting messages to people even in the remotest places. The number of people who are reached usually count in millions. Their effectiveness can give high returns for the time and money involved.

Описание: Описание: http://colission.com/wp-content/uploads/2011/02/television11.gifMass media alone are generally inadequate in changing human behaviour. For effective health communication, they should be used in combination with other methods. The power of mass media in creating a political will in favor of health, raising the health consciousness of the people, setting norms, delivering technical messages, popularizing health knowledge and fostering community involvement are well recognized. 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:

1. Television

Television has become the most popular of all media. It is effective iot 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 familiarize with things they have not seen before, including crime and violence which are shown as part of feature Описание: Описание: http://bonus-club.kiev.ua/wp-content/uploads/2010/08/radio.jpgprogrammes. TV is a one – way channel. It can only be an aid to teaching. It cannot cover all areas of learning. It has much potential for health communication.

2. 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 populatioot accessible through printed word. It is a purely didactic medium. It can be valuable aid in “putting across” useful health information, in the form of straight talks, plays, questions and answers and quiz programmes. Radio is much cheaper than TV. Doctors and health workers may speak out on radio. Local health issues may be identified and discussed leading to increased general awareness.

3. Internet

Описание: Описание: http://3.bp.blogspot.com/-JYNccbumkfQ/T5ROOhoZdhI/AAAAAAAAAAk/ERP9hTjsnQU/s1600/Why-internet-is-ideal-for-marketing-products.jpgThis new means of computer based communication system has opened vast capability of transfer of knowledge, and has made it possible to get into direct and instant communication across the world by means of e-mail and even a on-line chat. This is a fast growing communication media and holds very large potential to become a major health education tool. Already a fairly large number of persons in India are using this media, and the numbers are growing everyday. Vast amount of health related literature from WHO and other health agencies is available on line. The Health related information from the ministry of health and family welfare Govt. of India, is also available on their website.

Описание: Описание: http://us.123rf.com/400wm/400/400/clairev/clairev1002/clairev100200036/6520529-businessman-reading-newspaper--vector-illustration.jpg4. Newspaper

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 often seeking newspapers. Newspapers should, therefore provide more factual, detailed and even statistical material. 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.

5. Printed material

Описание: Описание: http://www.pawgraphics.com/sitebuildercontent/sitebuilderpictures/stuff.jpg

Magazines, pamphlets, booklets and hand-cuts 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

Описание: Описание: http://blogs-images.forbes.com/marketshare/files/2012/03/Direct-Mail1.jpg

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.). There 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 creating public awareness. It is possibly the most personal of mass communication.

Описание: Описание: http://4.bp.blogspot.com/-IIJ82CNhLko/UKbPyKYTxeI/AAAAAAAA4FQ/8bgS3sU_kbw/s1600/love+babygap+billboard.jpg7. 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 would hope. Indiscriminate use of posters by pasting them on walls serves no other useful purpose than covering the wall.

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.

Описание: Описание: http://sydney.edu.au/medicine/pathology/museum/2A.JPG 

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

The 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 conveyed through these media.

Описание: Описание: http://i312.photobucket.com/albums/ll330/folkmedia/TheFolkMediaShow.jpg

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. There is no single way to do public education. Health education is still art rather than a science. Each community and country’ should develop techniques that meet its oweeds.

PLANNING AND MANAGEMENT

Health education cannot be planned in a vacuum. It is planned in connection with a specific health programme or health service. Therefore the specifics of a health education strategy in a local community have to be formulated in – accordance with its socio – cultural, psycho-social, political, economic and situational characteristics. The planners should be fully conversant with the health educatioeeds of the particular programme for which health education is to be planned.

Health education planning follows the main steps in scientific planning, which are:

1. Collecting information on specific problems as seen by the community

2. Identification of the problem

3. Deciding on priorities

4. Setting goals and measurable objectives

5. Assessment of resources

6. Consideration of possible solutions

7. Preparation of a plan of action:

i) What will be done?

ii)   When?

(iii) By whom?

8.   Implementing the plan

9.  Monitoring and evaluating the degree to which stated objectives have been achieved

10. Reassessment of the process of planning. Planning and evaluation are essential for effective health education. The subject of planning is discussed more fully in chapter 20.

All health education work requires continuous evaluation to measure the effectiveness of health education activities in achieving stated objectives and to assess the Importance on programme performance of such variables as knowledge, attitudes, behaviour change and consumer satisfaction.

 

 

Leave a Reply

Your email address will not be published. Required fields are marked *

Приєднуйся до нас!
Підписатись на новини:
Наші соц мережі