Title: Approaches of health education
Course: Level 3 - Health Education and Promotion > Section: Principles and challenges of health education

In the previous session, you have learned about different principles of health education and now you will discuss approaches to health education. Approaches to health education tell you the way you follow to get particular behaviour change through health education.

There are two different methods in health education:

- Persuasion.
- Informed decision-making.

The Persuasion Method

Persuasion approach of health education is the deliberate attempt to influence the other persons to do what we want them to do. It is sometimes called directive approach or done forcefully. It is coercion approach. Such method is used in a situation where there is a serious treat such as epidemics and natural disaster and the action needed are clear-cut. This method will be used when the expected behaviour change should be urgent and does not permit time until the community member process the new knowledge and decide. (You will learn about epidemics in the communicable disease control module of this curriculum)

During such condition, Health Extension Workers will provide fear arousal types of messages to alert the public easily. For example, if flooding is occurred in your community, the environmental conditions by them self will not allow health education session to take place. So the Health Extension Workers order the community what to do and they should follow his/her recommended activities. During persuasion approaches of health education, Health Extension Workers should confirm that the suggested activities are scientifically accepted and can be applied with that current condition. Most of the time persuasion approaches of health education use clear and easily understandable communication words.

The Informed Decision-Making Method

In informed decision-making approach, Health Extension Workers give people information, problem-solving and decision-making skills to make decisions but the actual choice will is left to the people. For example, for a mother that comes to you looking for family planning methods, you will give her information about the advantages and disadvantages of available family planning services. The mother will have a full right to choose one of the methods and she may also have right not to use any of them. Here Health Extension Workers responsibility is to enable the people to make an informed choice.

Many health educators feel that it is better to work with their communities to develop their problem-solving skills and provide the information to help them make informed decisions. However, in situations where there is a serious threat such as an epidemic, and the actions needed are clear cut, it might be considered justified in persuading people to adopt specific behaviour changes. This approach involves raising awareness, consciousness and building confidence that they have the power to make decisions and control their life (empowerment).

Challenges of Health Education

Good health education activity does not just happen. Much time, efforts, and practice, are required to create successful health education program. Even the most experienced health educators find program development challenging because no two days are the same in health education (the constant changes in settings, resources, and priority population).

HEWs also should know delivering health education session has certain challenges and be ready to adjust it and introduce successful health education program for their community. These challenges come from different sources: community, health professionals and the concept of health education itself.

The following points are common challenges of health education:

a) Health education is not considered as important during healthy status. People are concerned about their health status and related information when the encounter certain health problem. This makes most people not to follow health education sessions in different settings.

b) People are preoccupied with many daily activities. Our community members are preoccupied with everyday life activities to support their family which hinder them from giving their ear to the messages of health education. To address these challenges, Health Extension Workers should plan and give health education in their work areas.

c) Health professionals failure to provide health education. There is a failure to see the value of health education by many health professionals. Sometimes they consider health education as traditional activities that haven't any value for community health and wellbeing. When they provide health education, they are not well prepared. As a result, they will miss the major concept/ message to be transferred to the audience.

d) Health education is largely related to behaviour. The ultimate goal of health education is a positive behavioural modification. It is much more than "transfer of information." Changing health behaviour is conditioned by many factors: social, psychological, economic, cultural, accessibility and quality of services, political environmental, etc. which are difficult to deal with simultaneously. However, HEWs are expected to use their capacity to create awareness. Behaviour change will come after cumulative learning.