HARAR HEALTH SCIENCE COLLEGE

Perform Community
Mobilization and Provide
Health Education
for
Pharmacy
1
 LO -1
Conduct health
education
and
communication
 objectives
At the end of this chapter the students are expected to:
 Define health and heath education
 Differentiate among health information, health education and
health promotion.
 Explain the ultimate goals and educational objectives
of health education.
 List principles of health education.
 Describe levels of health education in diseases prevention.
 Explain the role of health education in Primary Health Care
3
 Definition and concepts of health
 Health:- is a very abstract concept to conceptualize and
measure and it is too difficult to put in words.
 It is a broad concept and its definition also differs among
social classes, cultures, religion and ethnic groups.
 Generally, there are two opposing models concerning the
definition of health:
I. Negative model
 This model views health as:
 Absence of diseases or disability or infirmity

 Biological integrity of the individual

 Physical and physiological capabilities to

4 perform routine tasks.
 II) The positive model

 It is broader and more holistic concept.

 Probably the most widely known of such models is that
of the constitution of World Health Organization (1948),
which defines health, as:
 “A state of complete physical, mental, and
social well-being not merely the absence of
disease or infirmity.”
 To more fully understand the meaning of health, it is
important to understand each components of health
 1. Physical health
 It is the absence of diseases or disability on the body
parts (negative definition).
2. Mental health
 Termed as psychological health and it is subjective sense of

well being. It has two components

A) Cognitive component
 It is the ability of an individual to learn, perceive and,

think clearly.
B) Emotional component
 Is the ability of expressing emotions (e.g. fear, happiness,

and to be angry) in an “appropriate” way.

 3. 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 and role fulfillment
 More recently, the WHO (1986) has restated that
“health is a resource for every day life, not the
objective of living.”
 In other words, good health should not be the goal of
life, but rather a vehicle to reach one‟s goal in life
 Generally, the different aspects of health are interrelated
and interdependent. Physical problems could lead to
mental consequences and vice versa.
 Therefore, health is a holistic concept and wellness is
expressed through integrated mental, physical,
emotional, spiritual and social health at any point of
health and illness spectrum.
 Health Education
Health education has different definitions
 But almost all mentioned that health education is the

process of behavior change towards healthy life

 A person‟s behavior may be the main cause of a health

problem, but it can also be the main solution

 Through health education we help people to understand

their behavior and how it affects their health and

encourages people to make their own choices for a
healthy life
 “Health education ;is a process that Informs, Motivates,

and Helps people to adapt and maintain healthy practices

and life styles;
 HE …..
HE is “Any combination of learning experiences designed
to facilitate voluntary action conducive to health”
Elaboration of the definition:
 Combination: the matching multiple
determinants importance of of multiple learning
experiences or educational
behaviors intervention
with
 Designed: health education is not incidental learning
experiences. It is a systematically planned and organized
activity
 Facilitate: creating favorable condition such as
predispose, enable, reinforce
 HE …..
 Voluntary: with full understanding and acceptance of the
purpose of the action
 In health education we do not force the people to do
what we want them to do, instead our effort is to help
people to make decisions and choices by themselves.
[Informed decision making]
 Action: behavioral steps/measures taken by individuals,
groups or community to achieve the desired health effect.
 .

HEALTH INFORMATION
 It is health message disseminated to the target
audience focusing on the basic facts related to the
health issue under consideration.
 HEALTH INFORMATION…
Generally, HI is the scientific facts (e.g. the causes, mode
of transmission, prevention methods of particular
diseases) content of health education which primarily
aimed at increasing of knowledge on that particular
health problems;
 But HE address the other factors that affect health
behaviors other than knowledge such as beliefs, attitude
,reinforcing factors etc.
 HI is not necessarily HE. But correct HI is
certainlya
1 basic part of HE .
3
 HEALTH PROMOTION
Health promotion defined as:
 “A combination of educational and environmental

supports for actions and condition of living conducive to

health.”( GREEN AND KRUETR ,1991)
Elaboration of the definition:
Educational: refers to the communication part of health
promotion. That is HE
Environmental: refers to the social, political, and
economic, organizational, policy and regulatory
circumstances influence behavior or more directly health
 Health Education and its Relationships with
Public Health and Health Promotion
 Health Education is one of the strategies of Health
Promotion; whereas,
 Health Promotion is one of the central Public Health
Disciplines.
 While Public Health is the science & art of preventing
disease, prolonging life & promoting health through the
organized efforts of society,
 Health Promotion is specifically concerned with the
socio-behavioral processes for improving personal health
behaviors and factors influencing those behaviors
 Health promotion

Organization

Regulator Social
y
Environm
Environme Health Education enta l
ntal
Economic
al

Polic1
y6 Political

Health
 Health Education in PHC

 Primary Health Care (PHC):-

 Is essential health care based on practical, scientifically
sound, and socially acceptable methods and technology
made accessible to individuals and families in the
community through their full participation and at a cost
that the community and country can afford to maintain in
the spirit of self-reliance and self-determination” (WHO,
1978)
 Components/Elements of PHC
1. Health Education
2. Promotion of food supply and proper nutrition
3. Adequate supply of safe water and basic sanitation
4.Maternal and child health care, including family planning
5.Immunization
6.Communicable Diseases Control
7.Prevention and control of locally endemic diseases;
8.Appropriate treatment of common diseases and injuries
and
9.Provision of essential drugs
 Components/Elements of PHC….

Elements added after Alma Ata

declaration
11. Oral health
12. Mental health promotion
13. Use of traditional medicine
14.Occupational health
15.Prevention of HIV/AIDS
 Main Principles of PHC

1. Equity: Services should be physically, socially,

and financially accessible to everyone
2. Community Participation:
 Creating and preserving a healthy environment,

 Maintaining preventive and Promotive health activities,

 Sharing information about their needs and wants

with higher authorities,
 Implementing health care priorities and managing clinics

and hospitals,
 Main Principles of PHC…

3. Inter-Sectoral Approach

4. Appropriate Methods and Technology

5. Health Promotion and Prevention - PHC requires a

comprehensive approach that is based on the
following interventions:

 Promotive - addresses basic causes of ill-health at the

level of society
 Main Principles of PHC…

 Preventive - reduces the incidence of disease by

addressing the immediate and underlying causes at the
individual level

 Curative - reduces the prevalence of disease by

stopping the progression of disease among the sick

 Rehabilitative - reduces the long-term effects or

complications of a health problem.
The ultimate goal and educational objectives of HE

The ultimate goals of health education

 To help each individual and family exercise the right to

achieve a harmonious development of the physical,
mental and social potential.

 To promote health, prevent illness, self-adjust to live with

disabilities and decrease morbidity and mortality
 Educational objectives of health education
 To promote proper use of health services
 To encourage people to adapt healthy lifestyles and practice
 To help develop positive attitude: has a lot to do with
changing opinions, feelings and beliefs of people.
 To help exercise health practice/behavior: concerned with
helping people in decision-making and actually performing.
 To arouse interest, provide new knowledge, improve skills
and change attitudes in making rational decisions to solve
their own health problems
 Basic principles of health education
1. Principle of educational diagnosis:
 The first task in changing behaviors is to determine its
causes.
 If the causes of the behaviors understood health educator
can intervene with the most appropriate and efficient
combination of education, reinforcement and motivation
 Principles of health education…
2. Principle of Participation:-
 The prospect for success in any attempt to change
behaviors will be greater if the individuals, families,
community groups, etc…have been participated in
identifying their own needs for change and have
selected the methods that will enable them to take action.
3.Principle of multiple methods:
 In so far as multiple causes will invariably be found for
any given behaviors.
 For each of the multiple factors identified, a different
methods or components of comprehensive behavioral
change must be provided
 Principles of health education…
4. Principle of planning and organizing:
 Planning and organizing are fundamentals for HE
 It involves deciding in advance the when, who,
what, how and why of health education.
 It also requires the planning for resources, methods and
materials to be used, identification of target groups
etc.
5. Facts: HE is given based on scientific findings/facts
and current knowledge.
6. Segmentation: HE should be designed for a
specific group of people/ specific target groups.
Principles of health education…
7. Need based:
 Health education is to ensure a desired health related
behavior after real need identification.
There are three types of needs
 Felt need: what the people feel, their wants, their real
needs.
 Expressed needs: It is need brought to attention of the
authorities by request, petition or complaints etc.
 Agency determined needs: is what external services
such as health workers and planners have decided the
community needs.
 Principles of health education…
8. Culture:
 Health education should not consider as artificial

situation or formal teaching –learning process.

 One has to get into the culture of the community and

introduce novel ideas with a natural ease and caution.

 contrary to existing belief, culture, practices
will not be liked.
9. Principle of motivation:
 Motivation is mental direction /desire for
doing or rejecting something.
 It is something that happens within the person,
not something done to a person by others
 Principles of health education…
10. Principle of reinforcement
 Those individuals, group who started to undertake
health behaviors should verbally encouraged or received
positive feedback (positive reinforcement ) until the
started health behaviors will develop its full potential
and on the other hand, unhealthy behaviors should be
discouraged until it disappear(negative reinforcement )
11. Principle of feedback
 It is a mechanism of assessing what has been happened
in the target Population after receiving the
message..
 Targets of health education
Depending on the type of the problem there are three
broadly classified targets of health education programs.
 Individuals: this includes clients of services, patients and

healthy individuals.
 Groups: includes gatherings of two or more people who

have a common interest.

 Community: include a collection of people who have

common interests, a feeling of belongingness, and who

usually share common values, culture, beliefs and
interests.
 The levels of health education in disease
prevention & control
1. Primary health education
 Is comprised of those preventive measures that forestall the

onset of illness or injury during the pre-pathogenesis

period (before the disease process begins), and health
education program that aimed specifically at forestalling
the onset of illness or injury among health individuals is
called primary health education
Examples
 Wearing safety belt, Immunization, Physical exercises
and Breast feeding
 The levels of health education…
2. Secondary health education
 Any health education/promotion programs that aimed at

promoting early diagnosis and prompt treatment of a

disease to cure or to limit disability and prevent more
serious pathogenesis is secondary health
called
education
Example
 breast-cancer screening

 Blood pressure examination

 Cholesterol level examination

 treating malaria patients

 The levels of health education…
3. Tertiary health education
 Health education programs that specifically aimed at

patients with irreversible, incurable, and chronic

condition for social and psychological adjustment is
called tertiary health education
 It is at this level the health educator work to retain,

reeducate, and rehabilitate the individual who

has already incurred disability, impairment, or
dependency.
Example
 Educating after lung cancer surgery

3
 Working with the diabetes individual to ensure
4
 levels of health education in
disease prevention and limitation of
disease
Healthy person early signs disease
disability/death

Primary Secondary Tertiary

prevention prevention prevention
 Challenges of health education
1. For many people it is easier to sell symptomatic relief of illness

or cure than to sell health and prevention of disease.

2. Changing health behavior is conditioned by factors such as

social, psychological, economical, cultural, accessibility

and quality of services, political environment, etc.
which are difficult to deal with simultaneously.

3. People are preoccupied with many daily activities to support

their life which impedes them to give their ear the messages
of health education.
 Challenges of health education …

4. Health education does not have high prestige.

5. charged with health education programs lack

special training and are not qualified.

6. Health education is much more than “transfer

of information.” With out changes in attitudes and
actions it remains a useless exercise.
 Performing assessment and identify gaps

Assessment Techniques

 Community‟s especially rural communities have limited

resources to address many health-related needs.

 Conducting a community health needs assessment can

help your program to determine where and how
resources may best be targeted.

 This assessment will help to identify topics and issues

3 relevant to a community.
8
 Performing assessment and identify gaps…

Assessment Techniques…
 Data for determining community needs can be collected
through
 surveys, questionnaires, focus groups, public meetings,
direct observations, and interviews.
 Secondary data sources such as
 demographic data, and literature reviews also provide
valuable information
 Organizing community and all available
resources

Community organizations
o Community :-defined as organized groups of people who
share a sense of belonging, beliefs, norms, and leadership
and who usually interact within a defined geographical
area.
E.g. People living in a “Kebele” or Woreda”, People
organized under one religion etc
 Organizing community and all available
resources…
Community organizations…..
 Community organizing is the process by
which community groups are helped to identify common
:
 problems or goals,
 mobilize resources, and
 develop and implement strategies to reach goals
they have set collectively.
 Available resources
 To reach the stated goals and objectives,must be
supported with appropriate resources.

There are several different types of resources that may be

used in health education activities.
 They can be broadly classified into three items:

 Personnel or labor power

 Material resources, including educational materials
 Financial resources
 Identifying target groups

 Every stage of life, each and every individual or social

group in the community and all occupations are appropriate
targets of health education programs.
 It is important to adapt health education methods and
activities to fit the group or audience in which the health
educations are targeting.
 There are two main target for health education programs.
 Identifying target groups……
1. Individuals
 Individuals include all health service users such as
women receiving antenatal care, school children,
adolescents and young children.
2. Groups
 Groups are gatherings of two or more people with a
common interest; they are a good target for health
education sessions.
 Preparing health education plan
Planning health education program
 A health education plan outlines the work of a health
department's health education staff over a certain period,
 A plan organizes the health education work and helps to
prioritize it.
 It helps the health educator to carry out planned rather
than spontaneous reactive work.
 A plan provides the basis for documenting, reporting and
monitoring progress
 Planning process

There are six steps to completing health education plan:

STEP 1: Identifying Public Health Program Goals
and Primary Target Groups
STEP 2: Identifying the Causes of the Health Problem
STEP 3: Analyzing the Causes of the Health Problem
STEP 4: Determining Health Education Objectives
and Activities
STEP 5: Determining Evaluation Measures and Procedures
46 STEP 6: Determining Needed Resources
 Designing methods and approaches of health
communication

 Teaching methods range from what is heard to what is seen

and done.
 Teaching materials include all materials that are used as
teaching aids to support the communication process and
bring desired effects on the audience.
 Materials could be classified broadly as audio, written words,
visuals, audio-visuals, direct experience, and multi-sensory
modalities.
 Health education methods
 Methods of Health Education are simply strategies or
approaches used by a health educator to deliver the health
education program or session.
 Health education provides opportunity for people to
learn, practice and experience health and health related
behaviors.
 Health education methods…..

 It should be noted that for any change of behavior to be

sustained and purposeful, there a need for proper
internalization of ideas and formation of favorable
attitude:-
 by acquire information, to identify problems, and
to adapt new behavior and to realize better ways of
living .
 Health education methods…..

 Learning, in general, is a process by which individuals

acquire information and idea which may latter result in
change in attitude and behavior.
 Education can be, simply, taken as a process by which
learning is facilitated.
 Health education methods…..

Domains of learning
 Domain of learning is one of the important factors that
affect health education method choice.
 Bloom has identified three domains of or areas of
learning:
 Cognitive,
 affective and
 psychomotor domains.
 Health education methods…..

A. Cognitive domain

 This is an educational objective which is concerned with

all knowledge (cognition, mental) creation processes,
and teaching method; appropriate for this domain
includes lecture (talks), discussion, etc.

 The hierarchical classifications are: knowledge,

comprehension, application, analysis, synthesis and
evaluation
 Health education methods…..
 Knowledge: refers to remembering previously
learnt materials
 Comprehension: refers to the ability to grasp
the meaning of some learnt materials.
 Application: refers to the ability to use learnt
materials in a new or unfamiliar situation.
 Analysis: refers to the ability to break down
learnt
materials into its component parts so that
its organizational structure may be
understood
 Synthesis: refers to the ability to put parts together
53 to form a new whole(summarizing)

 Health education methods…..

B. Affective Domain
Affective domain-cognition +feeling (connation)
 Attitude
 Beliefs affects or touches our
mind
 Value
 The hierarchical classifications are:
responding, valuing, organization Receiving, of
characterization by a value: value &

5
4
 Health education methods…..
 Receiving: refers to the willingness to attend a certain
session or information or phenomena .
 Responding: refers to the willingness to actively
participate or interact in a certain session or information
or phenomena
 Valuing: refers to displaying a behavior that is
consistent with a particular issue or value that a person
or a community holds
 Organization: refers to the state of bringing together
different extreme values resolving the conflict between
55 them(harmonizing conflicting values)
 Health education methods…..

C. Psychomotor Domain
 Psycho-mind & Motor – action
 Practice/action/behavior- often when our knowledge

and attitude are expressed in terms of action

 Health education methods…..
Selection of methods and materials
 For any teaching learning process, methods and
supporting materials should be selected, and the selection
depends on:

The type of the message

The purpose of the teaching

The people addressed

The circumstance

Availability of resources

Availability of skills
 Common teaching method in health
education

Informal methods Formal method

 1. Health talk 1. Conference
 2. Lecture 2. Workshop
 3. Brainstorming 3. Seminar
 4.group discussion 4.discussion
 5. Demonstration 5. symposium
 6. Role play
 7. Drama
 8. Case studies
 9. Traditional media 1/11/20
2 3
Types of HLM

There are four types of

health learning
materials:

1.Printed (HLM)
2. Audio HLM
3. Visual HLM
4. Audio-visual
HLM

1/11/20
2
3
 1. Printed HLM

Printed HLM: is the production of multiple copies of an

original image usually using ink pressed on to paper.
 It can be used as a medium in its own right or
as support for other kinds of media.
A. POSTER
 Poster is a large sheet of paper often with a size
of
40cm wide and 60cm high.
 A poster consists of words and pictures or symbols
1/11/20

that include a message on it. 2

3
B. Flip chart
 Are a series of pictures that are bound together, usually
at the top, and can be turned over by the educator.
 Is made up of a number of posters on a related subject .
 Are good to present several steps or aspects of a central
topic such as Flip chart on reproductive health .

1/11/20
2
3
 c. leaflets or flyer (handbill)
 The simplest leaflet is a single sheet of paper, printed
on both sides and folded in 1/2 or 2/3.
 Leaflets can be larger with two or more sheets of
paper. Once there are more than five sheets it is
common to use the term „booklets‟.

1/11/20
2
3
 2. Audio HLM

Includes any thing heard.

 Radio is a very powerful tool because no other mass
 media reaches more people than radio.
 main characteristics:
• Could be distorted or misunderstood when translated
• They are easily forgotten.
1/11/20
2
3
 3.Visual HLM
Include something seen.
 Visuals are one the strongest methods of
of
communicating messages, especially literacy
where status is low.
characteristics of visuals HLM
• Arouse interest
• Provide clear mental picture of the message
• Speed up and enhance understanding
• Help develop memory
 How ever, visuals are not universal language and
1/11/202

people may not see them the same

all
3
 Effective communication skills

 Ideas must be clear to one self before communicating to

others; if we are communicating ideas in which we are not
clear, it will be very difficult to create understanding.
 Thinking of the behavior, its calluses and effects will be
helpful.
 We have to also try to find out the most important reason
(s) for the behavior to happen.
 Effective communication skills…

1. Get prepared first

 Preparation is one quality of effective communication,
 Includes:- knowing the purpose or objective or relevance
of the ideas, identifying the targets, assessing the extent and
scope of the idea to be communicated, the place where the
communication takes place, and how best the idea could be
communicated, making it clear and brief, and making
presentation short and clear as this facilitates easy.
 Effective communication skills…
2. Develop natural style:
 Some communities commonly understand most reactions

in similar way but not all. Expression of emotions should

be natural and understandable.
3. Check whether you are understood or not:
 The communicator (sender) should develop a mechanism

of checking that he/she is being understood by the

audience for effectiveness, and this is usually done by
getting feedback! Posing questions and listening to the
audience.
 Effective communication skills…
4. Use simple straight forward language: Remember that
your audience could be of different background. Even with
the same background, people understand things not the
same way; simple language helps communicate the ideas in
understandable way.
5. Listen to ideas of people: Careful listening to the
problems and talking to people is important as it helps to
identify their feelings and establish good rapport.
 Note: The 5Cs of effective communication are Clear,

Concise (Brief), Complete, Convincing and Capable of

being duplicated.
 Health education models

 Models: are generalized hypothetical concepts that

directly or indirectly interact one another in an organized
manner.
 Models are important to propose a working set of
determinants or factors in situations where there are too
many determinants or factors, which differ by various
characteristics.
 Health education models…..
Health Belief model (HBM)
 Health Belief model is a behavior change model which

has been developed by a group of psychologists in the

1950s to help explain “why people would or would not use
health services”.
 It is one of the most frequently used and being used in

health behavior applications of health.

 Health education models…..

Components of the HBM

 Perceived Susceptibility-the belief that one is at risk of
contracting a health problem
 Perceived severity-the belief that a health problem is
serious
 Perceived benefit-the belief that changing one's
behavior will reduce the threat
 Perceived barriers-a perception of the obstacles to
changing one's behavior eg. Cost, side effect,
culture…
 Self efficacy-the belief that one has the ability to change
one's behavior
7
1
 Cues to Action - may be internal or external.
 Health education models…..
Social learning (Cognitive) Theory
 The Social learning (Cognitive) theory examines
behavior in relation to the environment.
 It emphasizes that people self-regulate their
environments and actions. The interaction of people with
their environment is multilateral (environment, people, and
behavior) interaction.
 Self-efficacy is the core concept in Social learning theory
(SLT).
 Health education models…..
 According to this theory, learning takes place through the
following ways:

Direct experience; learning through doing

Indirect experience; learning observing
through others doing the job

Cognitive learning; storing and processing
of complex information (evidence based).
 Health education models…..

Trans theoretical model

 This model critically assumes that behavior change is

Complex and a process that involves sequences of change.

The stages are both stable and open to change.
 The model has two dimensions: stage of change and

process of change.
 The constructs of the model are stage of change, process

of change, decisional balance and self-efficacy.

 Health education models…..

Trans theoretical model….

 The stage of change includes:

Pre contemplation stage: Force able, resistance to change

Contemplation stage: Willing but poor commitment

Preparation stage: Intending change(in one month)

Action Stage: Overt modification of behavior(For greater
than six months)

Maintenance stage: Sustainable behavior change
 Health education models…..

Trans theoretical model….

 Health education models…..

Trans theoretical
model….
The stage of change
 Monitoring of service utilization
 Human being is also called a social animal that actually
thinks and acts logically
 The issue of accessibility, affordability, and acceptability

health service doesn‟t guarantee health care service

utilization for the social aspects of human life is equally
important factor in this regard.
 The community, itself, cares for its members in all cases

where there is acceptable and proper social intercalation.

 Evaluation of behavior change
 Change in behavior could be natural or planned in its
nature based on natural events or based on plan
respectively.

Natural change in behavior- people‟s behavior changes
all the time; some changes take place because of natural
events or processes such as age and sex related
behaviors.

Planned change in behavior – people make plans to
improve their life or to survive, for that matter, and they
act accordingly.
 Evaluation of behavior change….

Readiness to change behavior- is experienced after the
stages of unawareness, awareness, concern, acquisition
of knowledge and skill, and motivation are attained one
after the other or overlapping one over the other.

Helping people change their lifestyle will be effective
and efficient when done in accordance with the behavior
change stage processes attained by the individual or
group of individuals.
 LO- 2
TRAIN MODEL
FAMILY
 Identifying better performing households
 Training model family is a means of enabling and
empowering selected family members with certain healthy
behaviors or with some important health messages so that
they can enable and teach the rest of other community
members.
 Training model families is one of the important

strategies, and is adapted from theories of mass

communication/diffusion of innovation.
 Identifying better performing households …
 Using criteria based on social and economic status with
the community, individuals who are likely to be early
adopters of new behaviors will be selected.
 Then, training provided to parents on health behaviors

such as hygiene and sanitation, accessing services,

medication administration, infant feeding practices, and
nutrition.
 The family uses these lessons to make changes to its

home and health care, and then it can graduate and become
a model family.
 Identifying better performing households …
 Those family members who are active participants and
those who are models in the day-today developmental
activities will be considered for the trainings.
 Moreover, the training is given by a Health care provider

on all the packages, first to bring behavioral change and

then to enable model families to teach the rest of the
community members.
 Pre training preparation phase
 After selecting households for trainings, pre training
preparation will be done. In this phase, the following
activities are done:
 Baseline survey on family size, sex, age, environmental
and personal hygiene, health status of the family through
observation, water handling and proper utilization...etc.
of the model family.
 Health care practitioner and other Kebele leaders should
select and arrange appropriate time and place of training
for about 100-150 households and introduce them the
overall activities in Health care program.
 Providing training according to
MOH guidelines
 A Health care practitioner should consider the following
activities
 Health care practitioner should select the appropriate
methods and materials for the training and should
develop a lesson plan for each phase of the training.
 Determine the content and arrange the flow "start from
the simplest then come to the complex one" Sessions
covered during the training
 Providing training according to
MOH guidelines…
 Theoretical session----theoretical trainings should be
given with a simple language in a ways that the participants
can understand the concepts. It is good for assessment of
the current understanding level of the trainees.
 Practical session:-encourage learning by doing. i.e., the
participants should be given a chance to exercise what they
have learned.
 LO-3
Plan and Undertake
advocacy on identified
health issues
 Preparing advocacy plan to address
health issues
 Health advocacy or health activism encompasses direct
service to the individual or family as well as activities that
promote health and access to health care in communities
and the larger public.
 Advocates support and promote the rights of the

patient in the health care arena.

 Health advocates are best suited to address the challenge

of patient-centered care in our complex healthcare

system.
 Stages of Advocacy
 There are 8 stages which are important to have good
advocacy techniques.
 These are:

1. Define Your Goals

 What needs changing?

 Long term/short term?

 What do we want to ask for?

 Does it require to: Legislation, Policy,

change
Regulation, Programs and Funding
 Stages of Advocacy…

2. Know Your Audience

 Multi-layered: policy makers, media, key constituencies,
public
 Different strategies for each target – research
 Provincial and Territorial governments, health authorities
and general public
 Stages of
Advocacy….
3. Craft Your Message
 Be clear and Keep it simple and focused

 Use positive language

 Appeal to audience‟s self-interest

 Acknowledge environment/context- be pragmatic

 Need to look at the problem, the solution(s) and

the benefit(s)
 Be consistent

 Distribute clear concise position statements

 Use evidence - facts carry more weight than

anecdotal evidence Economic arguments are important
 Stages of Advocacy….
4. Identify the Messenger
 The target audience will determine the messenger.

 As we cultivate champions, they will also

become messengers
 Media is best handled by a designated person(s)

5.Identify Delivery Methods

 Advocacy is relationship building

 Tactics change by target audience

 Tactics to reach general public, media, government

 Stages of Advocacy….

6. Identify Resources and Gaps

 Information, political intelligence, capacity of staff,

opportunities
 Develop capacities which are lacking research,
media, outreach
7. Plan Next Steps
 Priority area

 Set out clear steps – including timelines

 Be clear on who needs to do what and when

 Communicate the plan with partners and be flexible

 Keep focused on long term goal

94
 Stages of Advocacy….
8. Evaluate Effectiveness
 Regularly revisit each of the steps to make sure
the strategy is effective
 Discard any tactics which are not working and build on
those that do
 Re-evaluate as new opportunities and challenges emerge
 Remember…
 Communications are key! Build a coalition of voices
 Planning is crucial
 Positive messaging is important
95  Advocacy is about relationship building
 Advocacy tool and approaches
 In advocacy, each issue demands different approaches
and strategies, partners, tactics, methods, resources,
materials etc.
 In embarking upon an advocacy campaign, it is

important to have the capacity to consider all available

options and to make strategic choices amongst them.
 We call these options the "tools" of advocacy.

 Skilled and informed use of these tools results in greater

advocacy impact.
 Advocacy tool and approaches…..
The most important of these tools include:

Information: Gathering, managing and disseminating
information lays the basis for determining the direction of
an advocacy campaign.

Research: Conducting research and policy analysis uses
the information from various sources and develops it into
policy options which become the key content of an
advocacy campaign.

Media: Various media are used to communicate the
campaign‟s message(s) to the different stakeholders.
 Advocacy tool and approaches…..

Social mobilization: Mobilizing the broadest possible
support from a range of stakeholders.

Lobbying: Convincing the decision-makers who have
the power to make the desired change involves a set of
special knowledge and skills.

Litigation: Sometimes, using the court system to
challenge a policy or law can reinforce an advocacy.

Networks, alliances and coalitions: Sharing of
information and resources, and strength in unity and
commonality of purpose are key to the success of
98 advocacy work.
 Principles of effective
Advocacy
Six core principles for effective health advocacy are
identified.
1. Community centered: The community is at the center
of interaction.
2. Opportunities: Stakeholders promote and support
opportunities
for both individual and systemic advocacy.
3. Recognition: Stakeholders recognize that advocacy is lawful and
that it can take many forms
4. Relationships: All those involved work together with respect and
recognize each other’s roles and contribution to the process.
5. Response: Matters raised are acknowledged and responded to
9
9 6. Resolution:Have good strategic planning and effective monitoring
 Consult community representatives health
needs and priorities
 Consult community representatives‟ health needs and
priorities
 A classification was developed to enable the selection of

the priority problem for intervention.

 The prioritization phase include

Grouping of health needs according to their level
of similarity;

Classification of the grouped needs by the
community intervention team
1
0
0
 Identifying and consulting influential community
representatives and health development armies to
disseminate IEC-BCC activities

 IEC is a process through which information is

disseminated to masses.

Information- Useful and representative data on a related
issue.

Education- The process of transferring and
embedding information.

Communication- A process through which two or more
people share transfer of information.
10
1
  BCC is a process through which the information
prevailing in the IEC process is implemented in the
behavior by the target person, which brings in a sustainable
change for better in them” So IEC though interrelated
terms are two different process, where saying that IEC is
sub process component of the mother process BCC.

10
2
 Planning, Implementation and evaluation of advocacy
and community mobilization

You need well-planned activities to achieve your advocacy

goals and objectives.
These steps are:

A.Identifying a problem: In this step you must think more

specifically about what you aim to do. You need to identify
the problem that requires a policy action

10
3
 Planning, Implementation and evaluation of advocacy
and community mobilization…

B. Knowing your audience: This means you should

decide which audience to target through advocacy, and you
must carefully determine the advocacy goals and
objectives.
C. Building support: Build alliances with other groups,
organizations and individuals who need to become
committed to support you in your advocacy work on health
issues.
10
4
 Planning, Implementation and evaluation of
advocacy and community mobilization…

D, Developing your message: An advocacy message is a

statement that may be tailored to different audiences.
E. Identifying the channels of communication: Identify
the channels and the messages to be delivered to the
various target audiences through radio, television, flyers,
press conferences, or during meetings.
F. Resource mobilization: This means you need to
identify and attract resources such as money, equipment,
1
0
5 volunteers, supplies and space.
 Planning, Implementation and evaluation of advocacy
and community mobilization…
G.Advocacy activity: Once you have mobilized all
necessary resources, you will be in a position to implement
a set of planned activities.
H. Monitoring and evaluating the activities: After you
have already implement your advocacy you need to
monitor the process of an activity and gather information
about how it is going, in order to measure progress towards
your advocacy goal.

10
6
 Community mobilization
Basic concept of community mobilization
 Community refers to an area or a village with families
who are dependent on one another in their day-to-day,
thereby creating mutual advantages.
 To mobilize means to organize or assemble power, force,
wealthy and other resources to increase a full stage of
development.

10
7
 Community mobilization….

 Community mobilization is a process through which

action is stimulated by a community itself, or by
others, that is planned, carried out, and evaluated by a
community„s individuals, and groups.
 It is an organization on a participatory and sustained
basis to improve the health and education levels so as to
enhance the overall standard of living in the community.

10
8
 Organizing and providing continuous advocacy
services in partnership with stakeholders

 To undertake effective advocacy it is important to

identify those who are most likely to be your allies,
including those who can be persuaded to become allies, or
at least facilitators to help you.
 You will also need to identify those who stand in the way
of you achieving your advocacy goals.

10
9
  Benefits of stakeholder involvement in advocacy
services:
 It can lead to informed decision-making, as stakeholders

often possess a wealth of information, which can benefit

advocacy towards building an enabling environment for
evaluation.
 Stakeholder involvement contributes to transparency in

undertaking advocacy as the different stakeholders that

are involved can monitor it.
 The involvement of stakeholders can possibly lead to

long-term collaborative relationships that can further

evaluation advocacy agendas
1
1
0
 Using feedback for planning
 Provision of feedback forms an integral part of the
learning process.
 Receipt of feedback enriches the learning experience,

and helps to narrow the gap between actual and desired

performance.
 Effective feedback helps to reinforce good practice,

motivating the learner towards the desired outcome.

 Failure to provide feedback may bring upon an

additional unwanted outcome.

11
1
 THANK YOU !!!

11
2