Title: Basic concept of health and illness
Course: Level 3 - Health Education and Promotion > Section: Concept and principles of health education

The Health Extension Program is a community-based health care approach which aims at preventing our community from different health problems. One of the major ways of preventing diseases such as HIV/AIDS, malaria, tuberculosis and hypertension is providing health education. Before looking at the definition of health education, it is helpful and important to discuss the definition and concepts of health.

What is Health?

The concept of health 's hard to understand precisely. Many people consider themselves healthy if they are free of disease or disability. Individuals who have an illness or disability may also see themselves as healthy if they can do their daily live activities. Health means different things to different people, and its meaning varies according to social classes, cultures, and religion and ethnic groups' context. In the Oxford English Dictionary:

health is defined as: "the state of being free from sickness, injury, disease, bodily conditions; something indicating good physical condition".

There are two models concerning definition of health

- Negative (narrow) model
- Positive (broad) model

A. Negative View of Health

People with this view of health consider health as the absence of diseases and disability as well as the biological integrity of an individual. This model limits health to anatomical integrity and physiological functioning of the body. According to this definition, the individual is healthy if all the body parts, cells, tissues, organs, and systems are functioning well.

This view of health ignores many of other social and psychological causes of health problems which ask for educational and behavioural intervention.

- Abebe is grade 10 student. He always wakes up early in the morning to finish his home duty and then go to school. Abebe gets a lower grade than expected by his mathematics course exam. As a result, he feels discomfort and develops certain desperation and stress. Do you think the view of health you have just read about applies to Abebe?
- People with a negative view of health will consider Abebe as a healthy student. A negative view of health does not consider social and psychological factors of ill health.

B. Positive View of Health

This view of health sees as a broader and more holistic concept. And probably the most widely known of such models is that of the constitution of World Health Organization (1948), which defines health, as;-

"Health" is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity."

As a HEW, this model of health definition provides you with broader views of factors that are determining the health status of your community.

- Think back to Abebe. Describe his state of health? He is mentally distressed.

Physical Health

According to WHO definition of health, one of the major components of health is physical health. It is concerned about individual's ability to perform their daily life activities without any physical barriers or difficulties.

Physical health refers to anatomical integrity and physiological functioning of the body. To say a person is physically healthy all the body parts should be there in their natural place and position, none of them has any pathology, all of them are doing their physiological functions properly, and they work with each other harmoniously.

When we see some examples of physically unhealthy peoples

- A person who has been harmed due to an accident.
- A person infected with tuberculosis and sleep at health care giving area.

Fig1.1 physical health problem

Mental Health

A person with good mental health can handle day-to-day events and obstacles, work towards meaningful goals, and function effectively in society ability to learn and think clearly. Mental health refers to a human individual's emotional and psychological well-being. Mentally unhealthy peoples might be apparent that they are not looking after themselves and are without a proper purpose in their life. You may also notice that they have an inability to maintain their personal autonomy and are unable to maintain healthy relationships with people around them. E.g. A person is said to be mentally retarded if he cannot learn something new at a pace in which an ordinary person learns.

While you are working as aHEWs mentally, unhealthy people may show happiness, anger or sadness. People might cry or laugh. Think about how you might react to such peoples while you are working as a Health Extension Practitioner. What do you feel about such feelings?

According to WHO, an individual is mentally healthy if he/she realises his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully, and can make a contribution to his or her community. You will learn more about mental health and ill health in the Module on Non-Communicable Diseases.

Social Health

Social health is the ability to make and maintain "acceptable" and "proper" interaction and communication with other people and the social environment; satisfying interpersonal relationship; role fulfilment. E.g., to feel sad when somebody close family to you passes away.This component of health is very important in creating and maintaining a good friendship with people we are living with.

- Which of the following examples could be considered to contribute to social health? Explain your answers.

(a) Mourning when a close family member dies
(b) Involvement in a community meeting
(c) Celebrating traditional festivals within your community
(e) Creating and maintaining a friendship.

Mentally healthy people should have something to be contributed in the above listed social activities in socially acceptable manner.

Health Education

For HEWs, health education is among the most important tasks that you are going to perform.

- From your previous experiences, what do you think health education is?

Through health education, we help peoples to understand their behaviours and how it affect their health and encourage them to make their choices for healthy life, but we do not force them to change. HEWs help their community to develop healthy behaviour by modifying ill health behaviour that harms their health status.Through health that we can also encourage promotive, preventive, curative and rehabilitative heath cares activities. Therefore, health education is required for each component of health care to promote healthy behaviours and to modify unhealthy behaviours. E.g. If you deliver appropriate health education messages about immunisation to mothers in your community, you can easily encourage child vaccination. This intern increases health care utilisation behaviour.

In the simplest terms, health education is the process of educating people about health. But let see currently used definition

"Health education is a combination of learning experiences designed to facilitate voluntary actions conducive to health."Lawrence Green

- Combination-emphasizes the importance of matching the multiple determinants of behaviour with various learning experiences or educational interventions.
- Designed: distinguishes health education from incidental learning experiences as systematically planned and organised activity.
- Facilitate-means create favourable conditions for action.
- Voluntary action- means behavioural measures are undertaken by an individual, group or community to achieve an intended health effect without the use of force, i.e., with full understanding and acceptance of purposes.

Therefore, health education is a multiple educational strategies or intervention targeted at the identified gaps on the multiple determinants of behaviours. That means the focus of health education is not only to increase awareness of health problems but also to address all the factors related to the identified health problems.