Welcome

Health Promotion &

Vector Borne Diseases

Dr Mohan Lal

Associate Professor

Department of Community Medicine

Government Medical College

Amritsar

Learning Objective

1. Importance of Health promotion

2. Understand components of communication process

3.Behaviour Change Communication

4.Diffusion of Innovation

5.Strategies & Actions to achieve health promotion

Determinants of Health

Health

Heredity

Health & Medical

Services

Lifestyle &Behaviour

Biological, Social,

Economic, Cultural

&Environmental

Conditions

Why people did or did not take advantage of preventive services ?

Health behaviour is determined by two interrelated factors: a person's perception both of threat of a health problem & of his or her accompanying appraisal of a recommended behaviour for preventing or managing the problem.

For early detection for some conditions, such as infectious

diseases (malaria), that people might find frightening, especially if they are uncertain about the effects of treatment methods and therefore accept services.

Define Health Promotion

" Science & art of helping people change their lifestyle to move toward a state of optimal health” (American Journal of Health Promotion,1986)

"The process of enabling people to increase control over their health and its determinants, and thereby improve their health, in addition to methods to change lifestyles. (WHO's 2005 , Bangkok Charter ).

Health Promotion represents

Comprehensive social & political process,Not only embraces actions directed at

strengthening skills & capabilities of individuals Action directed towards changing social,

environmental & economic conditions To minimize impact of determinants on public

& individual health. Participation is essential to sustain health

promotion action.

Health Promotion

Provision of information &/or education to individuals, families, & communities that-encourage

-Family unity, -Community commitment, -Traditional spirituality Make positive contributions to health status by

changing behaviour & life styles.

Promotion of healthy ideas & concepts to motivate individuals to adopt healthy behaviours

Media

Receiver

Feedback

Sender

Own Feature Own Feature

Message

Message

Message

Message

Communication Process

Communication

Communication is a continuous process where sender sends some message, concept or information through a medium with specific objective to a receiver that create a kind of reaction to receiver & accordingly latter reflects on that message.

Receiver is key in communication.

Depending on the nature of receiver, message & media are determined.

Communication: A Process

Response or reply is what the receiver reflects after getting the message in communication response is also significant.

If response is not made communication is not complete & objective of communication cannot be achieved.

Only after getting response sender understands to what extent his message is communicated & can initiate actions accordingly.

Response may be immediate or delayed.

Important ingredients of communication together make process of communication complete.

Feedback

Sender Receiver

Feedback

receiver sender

Source: CGAP Direct

Communication Goals

To change behaviour

To get action

To ensure understanding

To persuade

To get & give information

Behaviour vs. Lifestyle

Health behaviour can be something that is done once, or something that is done periodically—like getting JE immunizations .

It can also be something that one does only to oneself, such as using medicated bed nets in malaria endemic area, or a behaviour that affects others, like providing bed nets to others so that children are protected from malaria.

Sustained pattern of complex behaviour, that are called "lifestyle" behaviours.

A composite of various healthful behaviours is often referred to as "healthy lifestyle."

Behaviour Change Communication

Refers to systematic attempt to modify/influence behaviour, or practices & environmental factors related to that behaviour, which indirectly or directly promote health, prevent illness or protect individuals from harm.

Behaviour Change Communication The behaviour change communication (BCC) is a process that motivates people to adopt & sustain healthy behaviours & lifestyles.

Sustaining healthy behaviour usually requires a continuing investment in BCC as part of an overall health programme .

"A fully aware, well informed and properly trained population is best guarantee of safety and of successful response to any disaster."

Behaviour Change Communication Enhances awareness , address & promote attitudinal & value changes

Informed decision-making & modification in behaviour

Adoption of timely & Appropriate practices at individual, family & community levels

Stimulates increased & sustained demand for quality prevention

Health care services & optimal utilization of available services.

Steps Of Effective Communication For Behaviour Change In Vbds Knowledge: (Provide information, personalize benefits & risks)

Approval: (create trust, information to appeal to head and heart)

Practice: (build skills)

Advocacy: (build social support, develop confidence to speak up)

Steps to Behaviour Change

Community Participation in Health Promotion Various activities are carried out involving

community leaders in planning process.

Role of community participation is to provide facilities to community worst affected especially with malaria by

Providing medicated mosquito net,Synthetic Pyrethroids Indoor Residual Spraying

(IRS)Guppy fish introduction, etc.

Role of Public Private Partnership in Health Promotion Public Private Partnership (PPP) work as a

bridge between Government & community.

Essential in removing myths & misconception in the community.

Their proposed area of operation is to see treatment seeking behaviour of community, their participation during indoor residual spraying, feasibility study of social marketing and creation of awareness in biological control of malaria, etc

Steps to Behaviour change Robinson's solution is to identify seven steps to social change:

1. KNOWLEDGE – knowing there is a problem

2. DESIRE – imagining a different future

3. SKILLS – knowing what to do to achieve that future

4. OPTIMISM – confidence or belief in success

5. FACILITATION – resources and support infrastructure

6. STIMULATION – a compelling stimulus that promotes action

7. REINFORCEMENT – regular communications that reinforce the original message/s

THE DIFFUSION OF INNOVATION THEORY

(Rogers - 1962)

DIFFUSION OF INNOVATION -1

The adoption of ideas in a community diffuses among individuals in that community at varying rates

Early in the introduction of a new idea, it is picked up by ‘innovators’ (between 2 and 3% of the target population) who are venturesome, independent, risky and daring.

They want to be the first to do things.

DIFFUSION OF INNOVATION -2

The second group of people, the ‘early adopters’ (about 14% of the target population) are very interested in the innovation but they are not the first to sign up.

They wait until the innovators are already involved to make sure the innovation is useful.

They are respected by others in the social system and

looked at as opinion leaders.

DIFFUSION OF INNOVATION -3 The next group ‘early majority’ (about 34% of the target

population) may be interested in the innovation but will need external motivation to become involved.

They will deliberate for some time before making a decision.

The ‘late majority’ (also about 34% of the target population) are next and it will take more time to get them involved for they are skeptical and will not adopt an innovation until most people in the social system have done so.

DIFFUSION OF INNOVATION -4The last group the ‘laggards’ (about 16% of the target

population are not very interested in innovation and would be the last to become involved.

They are very traditional and are suspicious of innovations.

Laggards tend to have limited communication networks, so they really do not know much about new things.

This situation calls for different strategies for different categories of people and at different stages of the adoption process.

DIFFUSION OF INNOVATION PROCESS

Cumulative number or % of adopters

Time

Innovators

Early adopters

Early majority

Late majority

Late adopters

Source: Green & MCAlister 1984.

Role of Health Personnel in health promotion

Assess health needs

Assess social , environmental & cultural influences on health behaviors

Lifestyle modifications is a comprehensive approach for effective change in heath promotion behaviors

Innovative Approaches for BCC for the VBDs

Use of Senior Citizens for propagating Health messages.

Use of executive members of the Residential Welfare

Association.

Announcement through mosque loud speakers.

Preach through the priest in the temple.

Preach during poojas/festivals

Sending Leaflets regarding health messages through

newspapers.

Sending health messages through sales girls and boys.

Barriers in Health Promotion and Integration of the NVBDCP

· Lack of knowledge & non –availability preventive measures

·Non- Availability of field staff & Inappropriate use of anti-malaria drugs

· Poor felt need & utilization of health services

· Lack of effective strategies for community participation

· Reluctance of local self-government & shortage of budget;

· Local beliefs of people (belief in Tantra-Mantra, Jaadu-Tona, etc.)

What can be done to prevent VBD ?

Install and maintain screens on windows and doors.

Consider minimizing the amount of time you spend outdoors from dusk to dawn.

Spray exposed skin & clothing with repellents

Eliminate mosquito breeding sites.

Support community‐based mosquito control programs

Health Promotion Principles

Involves population as a whole in context of their every day life, rather than focusing on people who are at risk from specific diseases.

Directed towards action on the determinants or causes of ill health.

Combines diverse, but complementary, methods or approaches.

Aims for public participation.

Health promotion is basically an activity in health and social fields - and not a medical service, … but health professionals should work outwards, in education and health advocacy. (WHO, 1984)

Strategies for Health promotion

Advocacy Political process by an individual or a large

group which normally aims to Influence public-policy & resource allocation decisions within political, economic, and social systems and institutions.

Activities undertakes include:-- Media campaigns - Public speaking- Commissioning- Publishing research.

Lobbying (often by lobby groups) is a form of advocacy where a direct approach is made to legislators/policy or decision makers on an issue which plays a significant role in influencing health of a community.

Health Advocacy

Supports & promotes patient's health care rights

Enhance community health & policy initiatives that focus on:-

- Availability -Safety - Quality of care

Actions for Health Promotion Create Suppor

tive environment for

health

Build Health

y Public Policy

Strength

Community

Action for

health

Develop

Personal

Skills

Re-orient Health Service

s

Supportive Environment for Health

Environment & health are interdependent & inseparable, both be made central objectives in setting of priorities for development.

People living in extreme poverty and deprivation in an increasingly degraded environment threatens their health, making goal of health for all hard to achieve.

Making environment- physical environment, social environment, & political environment-supportive to health rather than damaging to it.

Everyone has a role in creating supportive environments for health-policy makers, decision makers, and community activists in the health and environment sectors.

Initiatives have to come from all sectors that contribute to the creation of supportive environment for health.

2.Build Healthy Public Policy

Health promotion puts health on the agenda of policy makers in all sectors and at all levels, directing them: To be aware of the health consequences of their

decision To accept their responsibilities for health.

Aim of healthy public policy is to

create a supportive environment to enable people to lead healthy lives.

Strengthen Community Action(3)

Effective community action in setting priorities, making decisions, planning strategies in implementing them to achieve better health.

At the heart of the community action is

“Empowerment of the communities - their ownership.”

Develop personal Skills (4)HP supports personal and social development through

providing information, education for health, and enhancing life skills.

It increases the options available to people to exercise more control over their own health and over their environment, and to make choices conducive to health.

Enabling people to learn throughout life, to prepare themselves for all of its stages and cope with illnesses and injuries is essential.

Facilitated at schools, home, work and community settings through educational, professional, commercial and voluntary bodies.

Reorient Health Services(5).Role of health sector must move increasingly in a health promotion

direction, beyond its responsibility for providing clinical & curative services.

Health services should be sensitive & respect cultural needs.

Need to embrace an expanded mandate that should support the needs of individuals and communities for a healthier life.

Open channels between the health sector and broader social, political, economic & physical environmental components.

Stronger attention to health research as well as professional education & training.

Thank You….