HEALTH EDUCATION OF THE PUBLIC pdf

Health Education of the Public Many types of health service are wholly or partly ineffective unless the people for whom the service is provided understand and accept its purpose and a

Health Education of the Public

Many types of health service are wholly or partly ineffective unless the people for whom the service is provided understand and accept its purpose and are shown by suitable methods how they can help and how much they can do for themselves For this reason, health education of the public has become a necessary part of nearly all WHO’s assistance to Member States

In the words of the first report of the WHO Expert Committee on Health Education of the Public:

The aim of health education is to help people achieve health by their own actions and efforts It begins therefore with the interest of people in improving their conditions

of living and aims at developing a sense of responsibility for their own health betterment

as individuals, and as members of families, communities, or governments

Health education may be indirect or direct The indirect method is addressed to governments, health departments, educators and health workers

of all kinds The direct method finds its occasion in projects in which WHO provides a government with help and advice and in which WHO workers make direct contact with the people

The approach to health education, and the methods used, have been widened in the last ten years The main emphasis formerly was on propaganda which employed various media to distribute “facts on health” to the people;

it has, however, been found that the most effective results are obtained when the approach is made through various health workers who are in regular direct contact with the people More reliance is now placed on individual, family and group education, practical demonstrations, projects in which the

1 Wid Hith Org techn Rep Ser 1954, 89, 4

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local population take part, and the inclusion of educational methods in various health services

Health education must be based on a knowledge of the psychology, culture, education and economic circumstances of the people themselves

It is necessary to know their beliefs, their mental attitudes, their health prac- tices, and the extent to which they will and can change their beliefs on matters affecting their health or their daily living

One of the possible methods of international assistance is to include health education specialists in the staff of field projects; the first two so em- ployed by WHO were assigned in 1949 to venereal disease projects in Egypt and India Since that date other health educators have been members of WHO teams for field demonstration projects in maternal and child health, venereal diseases and rural health Those projects were useful in demon- strating how, through practical health education, family and village partici- pation could be enlisted in health programmes

Some government authorities have decided to establish or reorganize health education services in their national health programmes and have asked for assistance The first requests for WHO advisers in health education to work with national health departments were made in 1952 by the Governments

of Honduras and Nicaragua, and, since 1952, full-time advisers have been assigned to national health ministries in Ceylon, Burma, Indonesia, Paraguay, and Haiti In 1957 a health education adviser was sent to assist the Govern- ment of Afghanistan, which has developed a five-year plan for health edu- cation, with help from the Regional Office for South-East Asia The Orga- nization has given advice on planning health education services in several countries that are being assisted by bilateral agencies: they include India, Liberia, the Philippines, Thailand, and a number of countries in Central and South America,

Consultants have been provided to assist several countries in Europe

to make preliminary surveys and to organize either general services of health education or education on special problems such as environmental sanitation, trachoma, or maternal and child health As part of country programmes, committees on health education of the public have been, or are being, set

up to advise and assist national and provincial health administrations As- sistance on similar lines has been given in several countries of Latin America

In the Western Pacific Region, the principal line of action has been to

emphasize health education in many of the WHO-assisted field projects, semi- nars and training programmes A good example is a health education study being made in connexion with the bilharziasis project on Leyte in the Philip- pines The main object was to find what practical measures could be used

to ensure the co-operation of the local population in this project A preli- minary study has been completed on some of the beliefs, customs and living habits, and other relevant questions A Philippine health educator has been assigned to the project staff in Leyte to assist in the continuation of the study and in organizing training conferences of the project personnel, agricultural and other workers concerned

In South-East Asia, particularly since 1953, the improvement of health education has been recognized as one of the chief priorities of the regional programme and much has been done in the countries of the Region to promote health education by training key workers in health, education, and community development, and by the demonstration of field techniques

In the plans that are being made to start or reorganize health education

in national public-health programmes, a distinct change of emphasis can now

be seen, and a trend towards a wider view of health education While, ten years ago, many countries were still engaged in some form of hygiene propaganda, the technical health education services in national central health departments are now considered as having such functions as: co-operation with other sections of the health service to ensure that health education is included in

all technical health projects and services that call for the co-operation of the

public; training various categories of professional and auxiliary health workers

in the principles and methods of health education; co-ordinating the health education work done by other government agencies or by voluntary organi- zations; helping to provide visual materials used in health education and testing these materials before they are produced in large quantities Health education is accepted as part of the functions of all health workers who are

in contact with the public and the importance of training professional and auxiliary medical and health workers in the principles, concepts and methods

of health education is now recognized

Some countries are incorporating health education training in post- graduate courses in their institutes of hygiene or schools of public health, and WHO has assisted by providing instructors in health education and by helping

to organize courses of instruction—either as special courses or as part of the

general training of many different types and grades of health workers in all regions

There is still a great need in most countries for a corps of well-trained specialists in health education, particularly for full-time service with national health departments, with institutions for training health workers or with state or provincial health departments This type of full-time technical adviser

is required to assist health administrators in the planning, organization and running of the health education aspects of national health programmes, and

to assist in training health workers, school-teachers and others in contact with the public in health education There has been a gradual increase each year in the number of fellowships for post-graduate training in health education requested by governments from WHO and from bilateral agencies: but the number trained to date is far short of the minimal requirements for a corps

of health education specialists

Health Education in Schools

Co-operative planning between official health and education authorities and voluntary societies is a promising method for improving health education

in schools and in the training of teachers Action on these lines has been stimulated by the technical discussions on school health education held in New Delhi during the session of the Regional Committee for South-East Asia in 1956, as well as by previous work with governments In three countries joint national committees of health and education leaders have been formed

to co-ordinate health education in schools In India, there was in 1957 a conference of principals of training colleges for secondary-school teachers, the main purpose of which was to review a suggested revision of the syllabus for teacher training courses WHO assisted with the health education parts

of the revised syllabus

WHO and UNICEF have provided consultants and equipment for government school-health projects and WHO has assisted in-service training courses for teachers of school health education WHO and UNESCO have jointly prepared a guide on the preparation of teachers for health education

in schools, in order to assist health and education authorities in their plans for strengthening health education in schools and in teacher training institutions

Cultural Patterns and Methods of Health Education

One of the most serious handicaps to health education work is inadequate knowledge of the attitudes and beliefs of various peoples about health and disease, the influence of family and group sanctions, traditions and customs, patterns of social organization andso on WHO has in some instances employed social anthropologists to obtain cultural data which would facilitate the adjustment of health programmes to the needs of the population Seminars and conferences have also emphasized the need to know the beliefs and customs of people whom it is proposed to educate, and social psychologists and anthropologists have helped in the planning of most such meetings Social scientists are employed by some national health administrations and institutions

Since 1953, regional conferences or seminars on health education have been held in five of the six WHO regions— Africa, the Americas, South-East Asia, Europe and the Western Pacific The discussions covered the needs and resources for health education in different countries, ways by which health education services could be strengthened and combined with health and training programmes; and the types of assistance that could be provided by international agencies The regional seminar held in the Philippines in 1955 was concerned primarily with health education on nutrition and was organized jointly by FAO and WHO A second conference in Europe, in 1957, concen- trated on the training of health workers in health education; it emphasized the importance of co-ordinating between professions the training facilities and programmes provided Because health education should be a concern of all workers who are in close contact with the people, care has been taken that there should be at such conferences and seminars a wide representation of different types of health worker: they have included national and provincial medical officers of health, professors of preventive medicine and public health, nurses, health education specialists, school physicians, supervisors of teacher training, social psychologists, anthropologists, adult educationists and pub- licists These regional seminars and conferences have been followed by national conferences and seminars on health education in many countries, particularly

in Europe and the South-East Asia and Western Pacific Regions, to spread among national health workers interest and knowledge about the matters discussed in the regional conferences

WHO has helped to plan and has taken part in a number of these national conferences on health education, and discussions on health education have formed part of regional and inter-regional technical seminars and conferences

on other health questions

Health ‘education of the public or school health education has been the theme of the technical discussions at several of the regional committee meetings (the Americas in 1954, South-East Asia and the Eastern Mediter- ranean—Sub-Committee A—in 1956, and South-East Asia again in 1957) and the Health Assembly decided that health education of the public should

be the subject for the technical discussions at the Twelfth World Health Assembly in 1959

It will be apparent from what is said earlier that at this stage the chief concern of most persons engaged in health education of the public is to find efficient methods of conveying new ideas to people of different cultures and customs The conferences and seminars that have been mentioned were largely designed to share and spread the information that had been acquired

in different countries and by different types of study An Expert Committee

on Health Education of the Public met in December 1953 to review the main problems It recognized that there could be no standard pattern for a “health education programme” that would work everywhere, but suggested principles

by which to arrive at the programme that would work best in given circum- stances It defined the purpose and scope of health education; outlined the way in which people learn and the place of the educator in health programmes; stated the broad principles on which a programme should be planned and how its effectiveness should be tested It also made some general recommen- dations on training for health education

People will learn if the new ideas put before them are related to things

in which they are interested, things that they consider important, and if that relation is expressed in accordance with their habits of thought and in terms

of their particular environment Scientific accuracy of presentation alone will often be irrelevant and vain If habits of thought and action are to be changed by education, it is necessary first to understand the original habits The educator must take into account the information and beliefs that people already have about health and the causes of illness; they may not square with modern scientific thought, but they should be built on and not rejected out of hand The good educator will accept people for what they are,

respect their personality and work with them in a friendly spirit, free from patronage

The report of the Expert Committee has been widely distributed and permission has been given for its translation inté several languages, most recently into Japanese and Chinese In the United States of America it was specially reviewed at a national meeting convened by a leading health orga- nization and was brought to the notice of their staffs by state and local health agencies and societies throughout the country

In 1957 an expert committee on training of personnel in health edu- cation of the public met in Geneva and discussed how health education can

be most effectively given by professional and auxiliary health workers It reviewed the main types of knowledge and skills desirable in health education work It advocated the training in health education methods of physicians, nurses, midwives and sanitation workers and laid down guiding principles for health education courses which would form part of the general basic education, advanced training and in-service training of such personnel

Co-operation with Other Agencies

Since 1949 WHO has co-operated with the United Nations, UNESCO, and the other specialized agencies, and with governments, on the health aspects

of several country projects and of training programmes in health education Two WHO health educationists, for example, were assigned to the initial fundamental education experiments in Haiti and Ceylon, and consultants were provided for the preliminary study of fundamer.tal education in Egypt and Iraq in 1950 under the auspices of UNESCO

WHO specialists in public health and health education have served on the teaching staffs of the UNESCO-sponsored Arab States Fundamental Education Centre in Egypt, and of the Regional Centre of Fundamental Education for Latin America at Patzcuaro in Mexico During 1955 and

1956, WHO took part in the inter-agency review, carried out jointly by the United Nations, UNESCO, FAO, ILO and WHO, of the objectives and accomplishments of the regional fundamental education centre programmes

in Mexico and Egypt, which led to some :po ‘>t administrative and technical adjustments

In 1956 and 1957, WHO co-operated with UNESCO in two special short courses, held in Mexico and Egypt, for technicians of various kinds, on the preparation and production of economical visual aids and other teaching material

WHO, in collaboration with UNESCO, has prepared two annotated bibliographies of health education refetences and publications, which have been widely distributed

Co-operation with International Non-governmental Organizations

The first international non-governmental organization founded speci- fically for promoting voluntary and professional interest in health education, the International Union for Health Education of the Public, was admitted into official relations with WHO in 1955 Since then it has sponsored three important international conferences on health education, in Paris and Rome; and in 1957 it set up a committee on studies and research in health education and a committee on professional training in health education