Health Education, Advocacy and Community Mobilisation, Part 1

162 Pages·2011·4.95 MB·English

Federal Democratic Republic of Ethiopia
Ministry of Health
Health Education, Advocacy and
Community Mobilisation, Part 1
Blended Learning Module for the
Health Extension Programme
HEAT
HealthEducationandTraining
HEATinAfrica

Federal Democratic Republic of Ethiopia
Ministry of Health
The Ethiopian Federal Ministry of Health (FMOH) and the Regional Health Bureaus (RHBs)
have developed this innovative Blended Learning Programme in partnership with the HEAT
Team from The Open University UK and a range of medical experts and health science
specialists within Ethiopia. Together, we are producing 13 Modules to upgrade the theoretical
knowledge of the country’s 33,000 rural Health Extension Workers to that of Health Extension
Practitioners and to train new entrants to the service. Every student learning from these Modules
is supported by a Tutor and a series of Practical Training Mentors who deliver the parallel
Practical Skills Training Programme. This blended approach to work-place learning ensures that
students achieve all the required theoretical and practical competencies while they continue to
provide health services for their communities.
These Blended Learning Modules cover the full range of health promotion, disease prevention,
basic management and essential treatment protocols to improve and protect the health of
rural communities in Ethiopia. A strong focus is on enabling Ethiopia to meet the Millennium
Development Goals to reduce maternal mortality by three-quarters and under-5 child mortality
by two-thirds by the year 2015. The Modules cover antenatal care, labour and delivery,
postnatal care, the integrated management of newborn and childhood illness, communicable
diseases (including HIV/AIDS, malaria, TB, leprosy and other common infectious diseases),
family planning, adolescent and youth reproductive health, nutrition and food safety, hygiene
and environmental health, non-communicable diseases, health education and community
mobilisation, and health planning and professional ethics.
In time, all the Modules will be accessible from the Ethiopian Federal Ministry of Health
website at www.moh.gov.et; online versions will also be available to download from the HEAT
(Health Education and Training) website at www.open.ac.uk/africa/heat as open educational
resources, free to other countries across Africa and anywhere in the world to download and
adapt for their own training programmes.
Dr Kesetebirhan Admasu
State Minister of Health
Ethiopian Federal Ministry of Health
i
Acknowledgements
Health Education, Advocacy and Community Mobilisation is one of the 13 Blended Learning
Modules for the Ethiopian Health Extension Programme. Together with the practical skills
training sessions that accompany each of the supported self-study texts, this programme will
upgrade the Health Extension Workers who complete the curriculum to Health Extension
Practitioners at Level-IV of the Ethiopian Occupational Standards. The upgrading programme
is sponsored by the Ethiopian Federal Ministry of Health (FMOH) and the Regional Health
Bureaus (RHBs). The FMOH gratefully acknowledges the receipt of funding for this
programme from the Ethiopian Office of UNICEF (the United Nations Children’s Emergency
Fund), The Open University UK, the Alan and Nesta Ferguson Foundation Trust UK, and
AMREF (the African Medical and Research Foundation). We are also thankful for the support
of the Ethiopian Offices of Jhpiego and the World Health Organization (WHO) for freely
enabling their experts to participate in the development of this Module.
Health Education, Advocacy and Community Mobilisation is in two separate Parts and was
produced by a team of Ethiopian experts, who were trained and supported by experts in blended
learning pedagogy from the HEAT (Health Education and Training) Team for Africa at The
Open University UK. The contributors of original material are:
Mr Abdulnaser Abagero, FMOH
Dr Binyam Ayele (Module Academic Coordinator) EPHA
Mr Zewdie Birhanu, Jimma University
Dr Tom Heller, HEAT Team, The Open University UK
Sr Atsede Kebede, FMOH
Mr Dejene Tilahun, Jimma University
The Academic Editor of Health Education, Advocacy and Community Mobilisation is
Dr Tom Heller, with contributions from Dr Anita Rogers and Professor Pam Shakespeare, all
from the Faculty of Health and Social Care at The Open University UK. The other members of
the HEAT Team are:
Lesley-Anne Long, HEAT Programme Director
Dr Basiro Davey, HEAT Deputy Director (Ethiopia)
Alison Robinson, HEAT Programme Coordinator
Dawn Partner, HEAT Senior Production Assistant
Jessica Aumann, HEAT Programme Assistant
Ali Wyllie, HEAT Lead eLearning Adviser
We acknowledge the vital contributions of the Programme Coordinators within Ethiopia:
Ato Mohammed Hussein Abeseko, UNICEF Ethiopia and the Federal Ministry of Health
Ato Tedla Mulatu, AMREF Ethiopia
The cover design for Health Education, Advocacy and Community Mobilisation is by
Chris Hough, Learning and Teaching Solutions, The Open University UK. The cover
photographs are reproduced with the permission of I-TECH/Julia Sherburne (large photo) and
Henk van Stokkom (small photo).
The opinions expressed in this Module are those of the authors and do not necessarily reflect the
views of any of the donor organisations whose generous support made the production of Health
Education, Advocacy and Community Mobilisation possible.
ii
Contents
Study
Session
Part 1
1 Starting your Health Education Work: Basic Principles
2 Approaches to Health Education
3 Factors Affecting Human Health
4 Human Behaviour and Health: 1
5 Human Behaviour and Health: 2
6 Principles of Learning
7 Introduction to Health Communication
8 Components of Health Communication
9 Methods and Approaches of Health Communication
10 How to Teach Health Education and Health Promotion
11 Counselling and Group Work in Health Education
Notes on the Self-Assessment Questions (SAQs) for Health Education, Advocacy
and Community Mobilisation, Part 1
Continued in Part 2
iii
Introduction to the Health Education,
Advocacy and Community Mobilisation Module
This Module comes early in your course of study for a very good reason: most of the
other parts of your work depend to some degree on how effective you are at your Health
Education, Advocacy and Community Mobilisation activities. For example there is not
much point knowing all there is to know about immunization if you haven’t been able
to persuade the people in your community to attend to have their injections. As well as
individual Health Education work, many things that will actually improve the health of
your community depend on community and communal action — a single person would
find it difficult to get clean water into their village, but the whole community working
together may well be able to do that — and latrines as well.
Of course even individual villages and communities might find it difficult to achieve
certain health goals — like getting clean water — and this is where your Advocacy
work will be so essential. Advocacy work will make sure that the people in authority,
higher up the decision-making ladder, know of the health needs of your locality and
will work together with you and others in your village to develop the infrastructure
that will improve the health of your community. And it’s not just people further up
the social structure who can help you in your Health Education activities. Advocacy
work will help you identify other sources of help and support to combine with you to
achieve health improvements in your locality. Perhaps there are non-governmental
organisations (NGOs) or other agencies with resources that you could use — certainly
working together with other agencies will increase the effectiveness of all your health-
related activities.
Although some people seem to be natural educators
and motivators, other health workers may feel daunted
by this aspect of their work. ‘Where can I start to do
the Health Education and Community Mobilisation
work that really will improve the health of the people
in my village and in my community?’ they might ask.
Hopefully your study of this Module will help you
both with the theoretical underpinning of your Health
Education work, but also with some practical ideas
of where to start and how to go about your work with
individuals, families and with the whole community.
This Module does contain some study sessions that
focus on theoretical issues such as helping you to learn
about human behaviour, or how people learn. We hope
that you will find this theoretical work interesting, but
Being methodical in data collection
also of great practical use as well. Understanding these
and recording all your activities is
issues will help you in your day-to-day work when you
an important part of all your Health
are actually faced with people who you need to engage
Education work.
with. Sometimes the people who most need to hear
(Photo: Professor Yesim Tozan)
Health Education messages are the least likely to want
to hear them.
The other major theme throughout the Module concerns the need for planning,
monitoring, evaluation and being generally methodical in all your Health Education
work. Without careful collection of data and keeping records of all your activities
nobody will know how effective your Health Education work is — not even you.
iv
We hope that you enjoy working through this Module — and that you enjoy your
Health Education, Advocacy and Community Mobilisation work in the community
with all the extra knowledge and information you will gain from your study of these
20 study sessions.
v
vi
Blackplate(5,1)
Study Session 1 Starting your Health Education Work: Basic Principles
Study Session 1 Starting your Health
Education Work: Basic Principles
Introduction
In this first study session you will learn about the nature of health, health
education, health promotion and some related concepts. This will help you as
a Health Extension Practitioner to understand the social, psychological and
physical components of health. You will also learn about the principles of
health education and have the opportunity to consider these basic ideas while
planning and carrying out your health education sessions.
Learning Outcomes for Study Session 1
When you have studied this session, you should be able to:
1.1 Define and use correctly all of the key words printed inbold.
(SAQ 1.1)
1.2 Discuss the concepts of health, health education, health promotion and
some related terms. (SAQ 1.2)
1.3 Describe and discuss the basic health education principles you are
expected to apply. (SAQ 1.3)
1.1 Definition and concepts of health
Your job as a Health Extension Practitioner will be to prevent health problems
in your community. Malaria, diarrhoeal disease, measles, tuberculosis,
pneumonia, HIV/AIDS, substance abuse and harmful traditional practices are
among the health problems you will become familiar with in your community
setting. Let’s begin with a definition of health (Box 1.1).
Box 1.1 Defining health 1
In the Oxford English Dictionary health is defined as: ‘the state of being
free from sickness, injury, disease, bodily conditions; something
indicating good bodily condition’.
■ Now stop for a moment and think about someone you think is healthy
and someone else who you would consider to be not healthy. Look at the
definition of health again. Is it similar to the things you thought about
when you thought of a healthy and an unhealthy person?
□ This definition of health is a widely publicised one. But you may have
thought of someone who has a disability or wondered about someone
who looks OK but who you know does no exercise. Clearly health is not
quite as simple as the definition implies.
The concept of health is wide and the way we define health also depends on
individual perception, religious beliefs, cultural values, norms, and social
class. Generally, there are two different perspectives concerning people’s own
definitions of health that you as a Health Extension Practitioner will be
expected to understand; a narrow perspective and a broader perspective.
1
Blackplate(6,1)
1.1.1 Narrow perspectives of health
People with a narrow perspective consider health as the absence of disease or
disability or biological dysfunction. According to this view (or model), to call
someone unhealthy or sick means there should be evidence of a particular
illness (Figure 1.1). Social, emotional and psychological factors are not
believed to cause unhealthy conditions. This model is narrow and limits the
definition of health to the physical and physiological capabilities that are
necessary to perform routine tasks.
According to this definition, the individual is healthy if all the body parts,
cells, tissues and organ systems are functioning well and there is no apparent
dysfunction of the body.
Figure 1.1 Concentrating only on cells and tissues can lead to a narrow definition
of health. (Photo: I-TECH/Julia Sherburne)
Using this model people view the human body in the same terms as a
computer, or mechanical device — when something is wrong you take it to
experts who maintain it. Physicians, unlike behavioural experts, often focus on
treatment and clinical interventions with medication rather than educational
interventions to bring about behaviour change.
■ About two months ago Serena lost her six month old twins. She is grief
stricken. She was always slender but now she looks very thin. She cannot
sleep, she cannot eat and she doesn’t want to talk to anyone. Do you
think the view of health you have just read about applies to Serena?
□ This view of health ignores many of the social and psychological causes
of ill health. Serena’s grief is not an illness but it is certainly affecting
her health.
In the next section we will discuss the broader perspective of health which
includes other factors in addition to physical ones. In your work as a Health
Extension Practitioner you will be expected to diagnose the overall social,
psychological and physical factors which affect the health of your community
and you will have to think about effective interventions accordingly.
2