HEALTHY PROMOTION QUESTIONS.
Some examples of health promotion activities include:
• Water and sanitation activities
• Nutrition program for a community
• Infection prevention activities such immunization
• Awareness campaign on HIV testing
Main objectives of health promotion
Prevent disease (preventive and early medical treatment) and early medical treatment,
Prevent complications of diseases by making sure that actions are taken to prevent death
Help people acquire the skills and confidence to take greater control over their health
Change policies and environments to facilitate healthy choices (empowerment and social
change that aims to promote individual’s ability to make positive decisions about health).
Health Promotion Priority Action Areas
• Build healthy public policy
• Create supportive environment
• Strengthen community actions
• Develop personal skills
• Reorient health services
• Moving into the future
• Work with individuals, families and communities
Principles of Health Promotion
• Equity in health Means that the needs of people should guide the distribution of opportunities for wellbeing
• Empowerment for health
• Participatory
• Intersectoral
• Sustainable
• Multi-strategy
• Holistic
Health Promotion Strategies and Approaches
Three Main Strategies Used in the Implementation of Health Promotion
• Enabling, this means taking action in partnership with individuals or groups to empower them,
• Creating environments that are supportive of health
• Advocacy to create the essential conditions for health
Health Promotion Approaches
Preventive Approach
• This approach aims to reduce premature deaths (mortality) and avoidable diseases
(morbidity).
Behavior Change Approach
• This approach aims to bring about change in individual behavior through changes in
individuals’ knowledge.
Self-Empowerment Approach- Educational
• The goal of this approach is to empower individuals to make healthy choices.
Community Development Approach or Social Change Approach
The Ecological Approach
• View health as a product of the interdependence between the individual and subsystems of
the ecosystem (e.g. family, community, culture, and the physical and social environment).
Session 2: Community Assessment
Community
o A group of people who share common interests and experiences.
Community assessment
o A process of gathering, analyzing and reporting information about the needs of the
community and the capacities or strengths that are also currently available in the
community to meet those needs.
Importance of Community Assessment
promotes people’s interests in making change
• It is a foundation for funding (some funding institutions require a formal assessment of needs and resources).
• Provides data for decision-making
• Promotes awareness and action
The Characteristics of Successful Community Assessments
• Understanding the current situation first by conducting assessing of the current situation
• Define a vision of the future
• Allow questions to drive the assessment process.
• Address issues that stakeholders believe are important
• Communicate information back to the community
Steps in Conducting Community Assessment
• Develop a vision for the future of the community, and creating a list of questions that need to be answered by the community assessment.
• Compile existing information about the community.
• Identify gaps in the existing information.
• Collect new data which will answer the planned
• Design data collecting tools: Creating the list of questions
• Decide on data collectors or people who are going to assist in collecting data, if needed
• Collect the data
• Compile the data
• Analyze and interpret data
• Compiling the report and sharing with the community and other partners
Utilization of Assessment Results
• Planning to Solve the Identified Problems with the Community
• Implementing the Plan
• Monitoring and Evaluation of the Implementation
Steps to Address Goals & Objectives
• Identify your population.
• Specify your goal(s) and objectives.
• Consider what final results you want to accomplish in your target population.
• Ensure that your goals and objectives are developed as a result of the needs and resources.
• Consider the information you collected in Needs and Resources.
• Make sure that your goals and objectives are realistic and measurable.
• Describe what specific outcomes (changes) you expect as a result of your program; the
objective should be specific and measurable‚ within a specific time frame.
• For whom is your program designed? (e.g.‚ seventh grade students)
• What will change? (e.g. certain risk factors)
• By how much? (e.g. decreased approval of peer smoking by 20%)
• When will change occur? (e.g. by the end of your program, at a 6-month follow-up)
• How will it be measured? (e.g. pre- and post-test surveys)
Session 3: Developing Plan for Health Promotion (HP)
Intervention
Intervention: A specific activity (or set of related activities) intended to bring about a
required outcome (e.g. risk reduction) in a particular target population using a common
strategy
• Plan: A method of doing something which is worked in advance or a system for achieving
objectives
• Intervention plan: A road map for your activities that facilitates your program’s systematic
implementation to bring about an intended outcome/change in a particular target population
The Process of an Intervention
• Identify health outcome or health behavior to address
• Identify the target audience(s)
• Assess influential factors:
• Determine objective and strategies of the plan
• Determine evaluation measures/methods
• Implementation: The phase where the plan is put into action
• Evaluate the intervention
Five categories of health promotion interventions have been developed including:
• Screening, individual risk factor assessment and immunization
• Social marketing and health information
• Health education and skill development
• Community action (for social and environmental change)
• Settings and supportive environments
Session 4: Community Involvement and Participation.
Benefits of Community Participation
• Increases community responsibility and accountability
• Builds community capacity
• Motivates community participation and vice versa, community involvement is motivational
• Increases resource utilization
• Attracts support from other stakeholders
• Allows for re-planning
• Easier to achieve goals and objectives because of common vision and unity
Challenges/Barriers of Community Participation
• Inadequate information, skills and training
• Weak networks, poor coordination and lack of consistency (e.g. in messages)
• Cultural and traditional barriers
• Lack of understanding the community and environment
• Lack of appropriate representation by community groups
• Competition and duplication of efforts
• Poor governance
Community Involvement/Participatory Strategies
• Participatory baseline surveys
• Participatory planning
• Holding community meetings and giving feedback through regular reviews
• Networking with other stakeholders
• Raising community awareness (advocacy)
• Educating the community
• Local resource mobilization
• Identifying entry points (e.g. gate keepers, influential community leaders)
The process of Community Participation/Involvement
In the process of doing community participation the following are key steps involved
• Community entry process
• Problems identification
• Problems analysis
• Problems prioritization
• Plan for interventions
• Implementation and
• Evaluation
Session 5: Health Education Principles and Strategies
Health Education
The process by which people learn about their health and more specifically, how to improve
their health.
Principles of Health Education
• Know what to change decide what the key problems are
• Know your audience
• Know the environment for health education
• Timing for HE
• Know what to talk-to
Characteristics of Effective Health Education
• Directed at people who have influence in the community
• Repeated and reinforced over time using different methods
• Adaptable, and uses existing channels of communication -for example, songs, drama, and story telling
• Entertaining and attracts the community's attention
• Uses clear simple language with local expressions and emphasizes short term benefits of action
• Provides opportunities for dialogue and discussion to allow learner participation and feedback on understanding and implementation
• Uses demonstrations to show the benefits of adopting practices
Roles of Health Education
• Promoting good health practices, for example, sanitation, clean drinking water, good
hygiene, breast feeding, infant weaning, and oral rehydration;
• Promoting use of preventive services for example, immunization, screening, antenatal and
child health clinics
• Promoting the correct use of medications and the pursuit of rehabilitation regimens for
example for tuberculosis and leprosy respectively;
• Enhances recognition of early symptoms of disease and promoting early referral
• Promotes community support for primary health care and government control measures
Purposes of Health Education
The ultimate aim of health education is to change behavior in a positive way by:
• Positively influence the health behavior of individuals and communities, as well as living
and working conditions that influence their health
• Promote, maintain, and improve individual, family, and community health
• Increases knowledge of people on health and health related matters
• Modifies beliefs and clarifies attitude and values
• Enables people to change behavior
Strategies for Health Education
Information, education and communication (IEC)
• A technique used to communicate important information by employing a wide range of
communication media aiming at changing behavior by providing information to
individuals and communities through, mass media, print, electronic, sermons, drama.
Behavior change communication (BCC)
• A process for developing messages and approaches using a mix of communication channels to encourage and sustain positive and appropriate behavior at individual, small groups, community level.
• Advocacy, communication and social mobilization (ACSM)
Session 6: Advocacy Communication and Social
Mobilization (ACSM)
Advocacy
• A combination of individual and social actions designed to gain political commitment, policy support, social acceptance and systems support for a particular goal or program.
Goals of ACSM
• Create awareness on health issues
• Motivate people to learn
• Increase awareness
• Influence social norms
• Create behavioral change among selected individuals or subpopulations in the public
• Promotes trust and transparency among various actors in health
• Facilitates community participation through advocacy and dialogue
• Enhances and sustains effective networking and consultative process
• Encourage individuals or groups to take actions to improve their health through:
Importance or Roles of ACSM
• Influence changes in policies, programs, and environments.
• Mobilizing resources and opinions to support the changes.
• Increase the power of people and groups and to make institutions more responsive to human
needs.
• Widen the range of choices that people can have by increasing their power to define
problems and solutions and participate in the broader social and policy issues.
• Influencing decision makers to adopt policies that improve public health.
• Facilitate the capacities of communities and vulnerable populations to make their needs and
interests known.
• Increase people’s participation in the processes of allocating societal resources and values
among its members.
Barriers to ACSM
• Powerlessness is a key barrier to ACSM
• Lack of law and code of ethics act as barriers to advocacy role
• Time constraints
• Limited communication is viewed as an important barrier to ACSM
• Lack of motivation when people are working with frustration and reluctance affects quality
care and advocacy
• Knowledge and skills are essential to advocacy. Clinical knowledge and some skills are
crucial factors to effective advocacy
• Inadequate resources (money, human, materials,)
Steps in ACSM
• Conduct community assessment
• Develop action plan for ACSM
ACSM Plan of Action
Set goals and objectives that are:
• Specific, measurable, achievable, realistic and time-bound
Choose approaches: what approaches will work for each? What is your message for each?
To influence changes in policies, programmes, and environments
Identify channels of communication which can include:
• Radio, meetings, televisions one to one talks or group talks
Build support through forming alliances with groups, individuals, organizations (government and NGOs)
Mobilize funds for advocacy by identifying and attracting resources
• Money, equipment, supplies, donations, volunteers
Approaches of ACSM (35 minutes)
• Involving leaders
• Building partnership
• Mobilizing the community groups
• Capacity building
• Working with mass media
Universal Principles of ACSM
• Decide what you want to change/ achieve, or want them to do
• Decide who you need to target with your message
• Decide how you are going to reach them
• Decide why they should support you and when you want them to do it
Session 7: Behaviors Change Communication (BCC)
• BCC is a process for developing messages and approaches using a mix of communication
channels in order to encourage and sustain positive and appropriate behaviors.
The goal of BCC is to
• Promote behavioral change at the individual, community and policy level and create an
environment that fosters the maintenance of that changed behavior.
• Increase knowledge on basic facts about health and allows people to change behavior
towards health living.
• Stimulate community dialogue on factors that fuel the HIV epidemic.
• Promote advocacy in cases of need to change policies.
• Reduce stigma and discrimination through provision of accurate information e.g. HIV
and AIDS.
• Promote services for prevention care and support e.g. HIV and AIDS.
• BCC is oriented to helping people understand issues and to act in ways that improve them
health, education or economic well-being.
Factors influencing behavior change can be further categorized into internal and external
factors:
• Internal factors come from within a person for example knowledge, beliefs, attitude, and
values.
• External factors come from person’s environment for example social pressure
• Both internal and external factors have to be addressed to bring about behavior change
Steps in Conducting BCC
• Step 1: Advocacy and stakeholder involvement
• Step 2: Identification and segmentation of target populations
• Step 3: Formative assessment for BCC
• Step 4: Development of a BCC strategy
• Step 5: Development of communication support materials
• Step 6: Implementation of the BCC program
• Step 7: Monitoring and evaluation
• Step 8: Feedback and revision
Characteristics of effective messages
Effective messages
Command attention
Are clearly stated
Communicate a benefit
Are consistently repeated
Reach the heart and the head
Create trust; and
Call for action
Session 8: Promoting Partnership with the Community
Partnership
A mutual search for information and solutions.
Types of Partnership
There are two types of partnerships described in this module
The first type of partnership is between organizations providing health and health-related
care in a community.
The second type is between organizations providing health and health-related care and the
community.
Importance of Partnership
Isolated efforts have limited impact because experiences, expertise and lessons learnt are
neither shared nor concentrated.
With effective collaboration, each organization can focus on its strongest areas.
By cooperating with interested parties, district health management teams (DHMT) may be
able to provide broad-based and high quality health services to those who need them.
The importance of developing partnership with the community in health promotion include:
• Improved community perception about health indicators
• Full community participation leading to program, acceptability, ownership and
• sustainability
• Increase financial and programmatic resources
• Assists in individual and organizational networking
• More credibility and visibility of quality services in promoting health among community
members and influence of advocacy efforts
Organizations are characterized by:
• The purpose of the organization
• The people, who are associated with the organization, their attitudes and values, them
aspirations, their experience of different types of work
• The strategies and tactics, as evidenced from plans and policies. These strategies may
relate to services provided, intended target group and area, finances and personnel
• The technology or equipment they have
• The environment in which the organization is operating
• The structure of roles and relationships, which is partially revealed in organizational
charts and job descriptions, but extends to the content and form of control systems and
administrative structure.
• The culture of the organization, which consists of its shared values and beliefs.
Factors that promote partnership between organizations include:
• Clear purpose and commitment to inter-organizational partnership by all partners. This is
sometimes called ‘political will’.
• Partnership at all levels. Partnership is easier to achieve if there is a national framework
for facilitating a similar process at regional, community and community levels.
• Partnership is facilitated by decentralization.
• Decentralization provides community managers with decision-making authority over
resources that facilitate partnership.
• Joint planning makes a useful contribution to partnership because planners join in efforts
to identify and agree on problems, setting objectives, identification of resources, budgets,
timetables and procedures.
• Sometimes formal rules, regulations and procedures indicate where different agencies can
make common use of resources such as finance, personnel and transport.
• Agencies in various sectors should review their policies and regulations to make provision
for collaboration and joint decision-making procedures.
Session 9: Monitoring and Evaluation of Health Promotion
Intervention
The Importance of Monitoring
• To make sure that work progresses according to schedule
• To ensure that agreed upon rules and regulations are maintained
• Resources are used rationally as planned
• Required information is available and used
• Detection of problems during implementation and to take corrective action
• Verification whether plans are being implemented accordingly
• There are many tools which can be used to monitor health intervention, among them are:
• Plan of action
• Quarterly technical and financial reports on the implementation of the intervention
• Supervision reports
• Activity progress reports.
• Outputs/outcomes (are the intended objectives and expectations met?)
The Importance of Evaluation
To determine performance effectiveness and efficiency of services/or program which
include:
• Decision whether an activity is worth doing
• Determine whether the objective set were achieved
• Identify ways of improving a program, such as ensuring that all activities are relevant and
• appropriate to the health needs of community members, and removing potential barriers
to participation
• Determine (formative evaluation) whether activities should be continued or not
• Use of the evaluation information for a range of purposes, including promotion,
fundraising, attracting potential partners, and lobbying and advocating for policy changes
to create healthier communities
• Determine the project should be extended else where
• Justifying the program to management
• Providing evidence of success or the need for additional resources
• Increasing organizational understanding of and support for health promotion
• Encouraging ongoing cooperative ventures with other organization
Evaluation is the systematic collection, analysis, and reporting of information about a
program in order to improve it.
Evaluation done during implementation (formative evaluation) to identify areas for changes
or modifications.
Evaluation is done at the end of intervention (summative evaluation) to assess
outcome/effectiveness and efficiency of a program
Conducting outcome evaluation, quantitative and qualitative design methods are used
Evaluation process is done in steps: clarify program, engage stakeholders/community
members, assess resources, design evaluation method, determine measurement tools and
procedures, develop work plan, budget, and timeline, collect data, process data, analyze,
interpret and disseminate results and take action.
What is health promotion?
• Can someone please explain the goals, objectives and scope of health promotion?
• What are the principles of health promotion?
• What are the strategies for health promotion?
• What are the approaches in health promotion?
What is community assessment?
• What is the importance of community assessment?
• What are the characteristics of a successful community assessment?
• What are the steps in conducting a community assessment?
• What is an intervention plan?
• What is the process of developing health promotion intervention?
What is community involvement and community participation?
• What are the benefits of community participation?
• What is the process of community involment/participation?
• What is health education?
• What is the importance of health education?
• List the principles of health education
• What is the role of health care providers as health educators?
• What are the appropriate media for communicating health issues?
• How do you develop IEC messages?
• What does ACSM stand for?
• What are the goals of ACSM?
• What is the importance of ACSM
• What are the steps in ACSM?
What is behaviour change communication?
• What are the purposes of and goals of BCC?
• What factors influence behaviour change?
• What are the goals of BCC in HIV prevention and control?
ation
• What are the benefits of partnership with the community in health promotion?
• Which are the main areas of partnership between the community and health care providers?
• What are the key elements of effective networking with the community?
• Are there any obstacles to partnership with the community? Please elaborate
What is monitoring and evaluation in health promotion?
• What is the importance of monitoring and evaluation?
• What are the key steps in evaluating any HP program?
SECTION A – MUTIPLE CHOICE (10 MARKS)
• Encircle the most correct answer.
1. Health education is:
A. Preparing a health talk considering the true available language, and audience mix
B. The process by which people learn about their health and more specifically how to improve their health
C. Timing for health promotion convenient time for the audience
D. To direct people who have influence in the community about health
E. To meet people on a felt need of the community
2. Concepts of health education includes:-
A. To change behavior by changing attitudes
B. Direct people who have influence in the community
C. Meet a felt need of the community
D. To attempt to introduce practices which are compatible with local beliefs and practices
E. Enhances the quality of life for all people
3. Among the goals of ACSM – Advocacy communication and social mobilization is:
A. Create awareness to health issues
B. Provide technical guidance
C. Communicate the verbal or non verbal
D. Improves case detection, treatment adherence
E. Create awareness to political issues
4. ACSM = Advocacy communication and social mobilization in HIV and
Tb can be used to:-
A. Encourage support for Tb treatment completion
B. Influence behavior change in the community
C. Increase the number of clients or testing
D. Reduce fear and sigma among the public
E. Improve services
5. The goal of BCC (Behavior change communication) is:-
A. To form an essential part of comprehensive HIV prevention, curative and control programmers
B. Promote behavioral change at the individual, community and policy level and create an environmental that fosters the maintenance of that changed behavior
C. Advocacy stalk holder involvement
D. To develop solutions to factors that contribute to the epidemic, such as risk behaviors, poverty sexually transmitted infections stigma Local customs and beliefs
E. Promote behavioral change at community level only and create an environmental that fosters the maintenance of that changed behavior
6. The advantage of partnership in health care are:-
A. Mutual search for information and solutions
B. Full community participation leading to programme acceptability, ownership and suitability
C. When resources are scarce there is an obvious need to shape the limited resources
D. To provide clients with the best and most accessible health services possible
E. To provide health workers with the best and accessible health services possible
7. Monitoring is:-
A. Activity progress report
B. A contribution to developmental goals
C. A systematic and continuous assessment of the progress of an activity over time
D. Supervision reports
E. An action of plan
8. Evaluation is:-
A. Systematic collection, analyzing are reporting of information about a program in order to improve activities
B. Process of tasks being done according to interments
C. It is a process of colleting, coordinating, measuring and communicating information to assist management to make decisions
D. It is encouraging ongoing cooperative ventures with other organization
E. It is decouraging ongoing cooperative ventures with other organization
9. Motivation is:-
A. A continues process through which attention is drown, demand is created and changes take pace in behavior towards that demand
B. Is intention and participation of every family and society which can be generated for health promotion
C. Is a process by which changes take place in the person in terms of behavior and activities of man towards certain objectives
D. Is a state when people assess what is good or bad for them in health promotion
E. And (c) are correct
10. Awareness is:-
A. Is a condition in which people can assess what is good or bad for them in Health promotion
B. Activities that related to meet a desired objective
C. Insights into certain aspects of health related behavior in health promotion company
D. Messages and information resources at all stages in health promotion
E. A process that results in good basis for developing health promotion
SECTION B – MULTIPLE TRUE AND FALSE QUESTIONS (10 MARK)
• Write the word TRUE for a correct statement or FALSE for an incorrect statement
• Each option caries 1 mark
Q1. Groups which can be engaged in social mobilization include:-
(a) ……..…Faith based organizations
(b) ……..…Communities
(c) ………..Non verbal communication
(d) …….….Individuals
(e) ….…….Power lessness is the key barriers
Q2. The organizations found in the community that are involved in Health or
related services may be:-
(a) …………Religion organizations
(b) ………....Private four profit organization
(c) ………....NGO’s
(d) ………....Local governments
(e) ………....Water and community development
Q3. Partnership in health promotion is the same as:-
(a) ………….Mutual search for information and solutions
(b) …………Organizations providing health and health related care and the
community
(c) …………Voluntary joint action or decision making in a harmonious and
supportive way for a common goal and outcome
(d) …………Collaboration in bringing greater influence in health promotion
(e) ………….Involving all players or stake holders at community level who
through their actions influence health services delivery at any of the
health delivery points in the community
Q4. Characteristic of effective messages will have:-
(a) ………..A formative assessment
(b) ………..Effective messages
(c) ……….Call for action
(d) ………..Clearing stated
(e) ………Valve the messages
SECTION D – SHORT ANSWERS QUESTIONS (40 MARKS)
Q1. Write down 5 principles of health education (5 marks)
(a) …………………………………………………………………….…………………..
(b) …………………………………………………………………………………………
(c) …………………………………………………………………………………………
(d) …………………………………………………………………..…………………….
(e) …………………………………………………………………………………………
Q2. Mention 5 purposes of health Education (5 marks)
(a) ……………………………………………………………………………..…………..
(b) …………………………………………………………………………………………
(c) …………………………………………………………………………………………
(d) ……………………………………………………..………………………………….
(e) ……………………………………………………….…………………………………
Q3. List 3 health education media and examples (6 marks)
(a) ………………………………………………….
example
(b) …………………………………………..
example
(c) ………………………………………….
example
Q4. Write down 4 characteristics of communication process (4 marks)
(a) ……………………………………………………………………….………………..
(b) …………………………………………………………………………………………
(c) …………………………………………………………………………………………
(d) ………………………………………………………..……………………………….
Q5. List 10 groups which can be engaged in social mobilization (10 marks)
(a) ………………………………………………………………………………….……..
(b) …………………………………………………………………………………………
(c) …………………………………………………………………………………………
(d) ……………………………………………………………...………………………….
(e) …………………………………………………………………………………………
(f) …………………………………………………………………………..……………..
(g) ………………………………………………………………….………………………
(h) …………………………………………………………….……………………………
Q6. Mention 3 purpose of behavior change (3 marks)
(a) …………………………………………………………………………………..
(b) ………………………………………………………..…………………………
(c) ……………………………………………………………………………………
Q7. There are two 2 types of partnerships mention them (2 marks)
(a) …………………………………………………………………………………..
(b) ………………………………………………………..…………………………
Q8. Write down 5 goals of behavior change communication (5 marks)
(a) ………………………………………………………………………………….……..
(b) …………………………………………………………………………………………
(c) …………………………………………………………………………………………
(d) ……………………………………………………………...………………………….
(e) …………………………………………………………………………………………
SECTION E – ESSAY QUESTIONS (30 MARKS)
Q1. James 32 years old presents to the clinic within 5 days of worsening sore throat, fever lymphadenopathy, rush and headache. He had unprotected sex with several anonymous male partners he meets in bars. He also complains of pain and difficulty swallowing for the last 2 days.
(a) What are high risk behaviours?
(b) Write strategies could help change these behaviours
(c) What are some factors that could affect whether behavior change takes place?
(d) How can any change be monitored or followed (15 marks)
Q2. Describe 3 various media used for communicating health messages (15 marks)
