Thursday, May 30, 2013


Though it is obvious that nobody would like to fall sick, the occurrence of illness sometime or the other seems to be inevitable. We do fall sick now and then. In prehistoric times, human beings lived very much like animals. Everything was left to nature and man knew very little about how diseases were occurring and how to overcome them. With the march of time and scientific advancement man has been trying to ward off sickness and striving to live as long a life as possible.

Gradually through the ages knowledge has been accumulating about the body in health and disease and various specialized sciences have been developing concerning not only man but all other forms of life. Beginning from the ancient systems of medicine invented by Greeks, Romans, Arabs, Egyptians, Indians, and Chinese there has been rapid and sustained expansion of the healing arts. Medical science of modern day has unraveled quite a lot of mysteries about the normal and abnormal mechanisms taking place in the human body and the remedial and corrective measures.

In the medieval period and closely following the industrial revolution in Europe a number of discoveries were made which helped in the determination of the causation of many of the infective diseases. Further experimental work has sharpened the epidemiological tools to determine the multiple causes of various diseases affecting mankind. Serious wide-spreading epidemic scourges like plague (Black death) and cholera were wiped out in the European countries in the early part of the century by applying the knowledge gained. From the latter half of the 19th century there has been increasing emphasis on prevention of diseases. In the present day importance is given to 'pro-motive health'.

Health is defined by World Health Organization as "a complete state of physical, mental and social well being. Not merely free from sickness or infirmity.: This definition has been so framed that it reminds one about the need for living a life of robust and sound health by enjoying which diseases should be avoided. All the world over health care services have the goal of attaining a highest level of health. For ensuring a continued state of a high level of health for every human being it is necessary not only to provide adequate and suitable facilities for prompt detection of illness, treatment, rehabilitation, etc., but also to arrange for suitable preventive care and pro-motive facilities.

However much we may cherish the goal of highest health and the necessary facilities are provided to everyone in the community, the actual living of a healthful life depends on each individual and also the community in different forms of groups like family, kinship, caste, communal, etc. It is easy to say that everybody should enjoy good health and observe all practices necessary for healthful living. As already mentioned no one is keen or happy to fall sick. Everyone would like to be healthy. However, in daily life man tends to do many things knowingly or unknowingly by which he makes himself susceptible to disease.

Many of the diseases which are due to infection can be avoided by proper personal hygiene and sanitation and immunization. Nutritional deficiencies can be avoided by eating the proper kind of food in adequate quantity but it is commonly observed that many of the diseases are contracted by not fully observing healthful practices.

Lack of observance of health practices can be seen in any community whether educated, illiterate or literate, rich or poor and so on. Wrong or right practices are the part of the cultural. Habits, customs, traditions are mainly the factors that govern human behavior in any community. They are also influenced by beliefs, values, attitudes, etc.

For people to be made to understand and practice proper ways of living for the maintenance of health and avoidance of illness, there is need to mould the behavior. Suitable education is required to ensure such behavior consisting of proper health practice. Throughout life people have to realize what are the correct things to do and what are the wrong things to be given up or avoided if proper health has to be maintained. The art and science of engaging people in a process of learning for the desired behavior for the preservation of health is 'health education'  

Health education has been defined in many ways by different authors and experts, In a W.H.O. Technical Report it was defined as follows:

Health education like general education is concerned with changes in knowledge, feelings and behaviour of people. In its most usual forms it concentrates on developing such health practices as are believed to bring about the best possible state of well being.

What is to be understood about this definition is that it is a process that aids people to find out their health needs and activate them for suitable behaviour. The behaviour necessary for health in any situation is referred to as health related behaviour. The education given for identifying the health need and matching it with suitable behaviour can be termed as health education.

As has already been mentioned behaviour of people shows that many things concerned with health are not properly known. Even after falling sick many people do not seek treatment promptly. On many occasions the advice given by doctors or nurses or other health personnel is not correctly followed. In other words, the health need even at the time of sickness is not fully appreciated or realized by people. It is to make people understand why they fall sick and what they should do to prevent falling sick or to remedy a sick condition that a health need has to be created in the minds of the people.

The means of fulfilling the need or the necessary action for satisfying the need should also be fully understood by each and every individual. After knowing what can be done and should be done, the individual or the people have necessarily to adopt the course of action that is available and practically feasible.

The entire process of involving people in learning about health and disease and aiding them to act suitably for overcoming illness and preserving a positive health is health education. It may be understood, therefore, that Health Education is not a one time affair or that it is meant for 'X' or 'Y' only; it is required for almost every one in society and is required off and on, in a continuous manner. It is wrong to assume that health education is required for only illiterates or people with a low level of general education. It so happens that even people with a high general education may not know sufficiently on health matters and even if they know, their behaviour may not be fully conducive to good health. For example, the evils of over eating, smoking and excessive consumption of alcohol may be well known to a well educated person but in his daily life he may not be observing enough to care for moderation.

Further it may be appreciated that health education is needed for all ages, both sexes, all classes of community literate or illiterate and in all parts of the world. Even in advanced countries health education becomes important with changing conditions of life. Science helps to find out many new aspects about diseases and health and therefore, health education has to be a never-ending process.

The behaviour part is of considerable importance in health education. Unless proper health behaviour is ensured health education can not be complete. At the same time the knowledge or understanding the reasoning behind a particular behaviour and the formation of a favorable attitude for behaviour are also equally important.

Health education should be an active process of learning and doing by one's self. The individual has to assimilate and internalize the information and ideas and adopt a behaviour necessary for health. The health education process must result in a permanent change or sustained behaviour.

By health education we mean the process by which one enables any individual or group of individuals to realize the health needs and match them with necessary health related behaviour for the attainment of positive health. It is implied that health education involves people individually in the adoption and practice of patterns of behaviour necessary for the preservation and enjoyment of normal and sound health.

It is the behaviour part which is of considerable importance. At the same time the knowledge or understanding of reasoning behind the behaviour and the formation of favorable attitude to result in a health related behaviour are also equally important.

Sometimes it may happen that people may observe certain hygienic or healthful practices without knowing why they are doing so. They may be imitating some others without realizing the purpose of their own behaviour. In certain circumstances health education will help in given them necessary meaning behind their own actions which are proper and useful. Health education will stabilize the good pattern of behaviour by providing necessary information and creating a positive attitude for the behaviour that has been already formed.

For example, a young child imitates the elders and begins the practice of brushing and cleaning the teeth in the morning. To begin with it may be a matter of pleasure to imitate. If the child is told why the teeth have to be cleaned and how the cleaning has to be done such an education will help the child to know the importance of brushing the teeth and also the methodology and it will do it with the sense of purpose and personal gain, rather than for merely imitating the adult.

In some other circumstances people may know sufficiently about certain health needs and their related behaviour also but at the same time they may not be practicing or manifesting the required behaviour. For example, very often people may be aware of what they are suffering from and also about the scope and possibilities of treatment but still they may be neglecting without going for treatment. In such cases health education will be necessary to make them understand the seriousness or their condition, the possibilities of treatment and the need for relief from symptoms and sickness. By involving them in the learning process about their own condition or the correction of it by treatment health education would have played its part.

Similarly health education may be necessary in some situations to change the attitude. The patient's attitude towards treatment or towards doctors should be essentially favorable. Vice versa the doctor’s attitude towards the patient has necessarily to be kind and sympathetic. For preventive actions like immunization, sanitary precautions, hygienic practice, medical check up, etc., the attitude is as important as acquiring the knowledge or information. Unless there is a desire or tendency to do something for the maintenance of health mere acquisition of knowledge will not help.

Health education, therefore, has to do with knowing the health needs, and the action for fulfillment of those needs. It is a process in which the people are helped to learn what is good for themselves and their health and to adopt patterns of behaviour which will ensure normal health. This process of health education implies that people should be able to do and follow healthful ways of living voluntarily after having understood the need for such behaviour.

To recapitulate health education is education for health or education about health. In health education in the context we refer to the attainment of positive health through adopting primary, secondary and tertiary levels of prevention as applicable to any disease.

Primary prevention in epidemiology refers to health promotion and specific protection. Health promotion means all practices and measures to be observed for maintaining normal health eating the proper type of food in proper quantities, optimum amount of exercise, rest, sleep, good clothing, shelter, personal hygiene, drinking wholesome water, breathing fresh and unpolluted air and such other observances. Specific protection is given by specific immunization for specific diseases, prophylactic drugs, protective appliances like mosquitoes nets, fly proof, etc.

Primary level of prevention is applied before occurrence of any disease. In other words, it is to prevent the occurrence of any disease. Secondary level of prevention refers to curative care or treatment given after the occurrence of any disease. It includes early diagnosis which is necessary for mitigating the effects of sickness.
Tertiary level of prevention refers to the disability limitation prevention of complication and deformity and rehabilitation if any handicap has already occurred.

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