Rahman Institute of Nursing and Paramedical Sciences, Radhanagar, Guwahati
Rahman Institute of Nursing and Paramedical Sciences, Radhanagar, Guwahati
Rahman Institute of Nursing and Paramedical Sciences, Radhanagar, Guwahati
SEMINAR
ON
HEALTH NURSING
INTRODUCTION
DEFINITION OF IEC
IEC TRAINING SCHEME
OBJECTIVES OF IEC
IMPORTANCE OF IEC
MAJOR COMPONENTS OF IEC
STEPS IN DEVELOPING IEC ACTIVITIES
INFORMATION
HEALTH EDUCATION
DEFINITION
CONCEPT AND MEANING
OBJECTIVES OF HEALTH EDUCATION AND PROMOTION
PROCESS OF HEALTH EDUCATION
HEALTH ADUCATION AGENCIES
SCOPE
CONTENT
METHODS AND MEDIA OF COMMUNICATING HEALTH MESSAGES
CRITERIA TO SELECT MASS MEDIA/AV AIDS
PRINCIPLES
COMMUNICATION
PRINCIPLES
PROCESS
ELEMENTS
PURPOSES
TYPES
LEVELS
BARRIERS
METHODS OF OVERCOMING BARRIERS OF COMMUNICATION
TECHNIQUES OF EFFECTIVE COMMUNICATION
BLOCK TO COMMUNICATION
BEHAVIOR CHANGE COMMUNICATION
DEFINITION
STRATEGY
IMPLICATIONS
STEPS
NURSES RESPONSIBILITY
INDIVIDUAL LEVEL
COMMUNITY LEVEL
CONCLUSION
BIBLIOGRAPHY
RELATED RESEARCH STUDY
INTRODUCTION
IEC is an important approach to bring about changes in the knowledge, attitude and
behaviour of the people for betterment of their health and the health of the family and
community in which they live. Information, education and communication (IEC) are inter-
related to each other.
Information:
Education:
It is both the acquisition of knowledge and experience and the development of skills,
habits and attitudes that helps a person lead a full and meaningful life.
Communication:
The information education and communication training scheme was launch by the Ministry
of Health and Family Welfare, with financial assistance from USAID on 17 th November 1987
in four Hindi speaking states of UP, MP, Rajasthan and Bihar in phased manner. Thus, the
Ministry of Health and Family Welfare abroad the scheme to continuous a plan scheme under
the 8th plan and made budgetary provision as part of the IEC division of the Ministry.
OBJECTIVES OF IEC:
i. Increase the reach of services by making visit of worker and supervisor more
predictable and regular.
ii. Improve the quality of services through knowledge and skill development of worker.
iii. Make supervision more oriented towards problem solving.
iv. Link supervision with training at various levels.
v. Concentrate on local field problems both for development of traiing material and their
users.
vi. Combine interpersonal communication strategy with mass media approach.
vii. Improve performance level through continuous with village community volunteers.
IMPORTANCE OF IEC:
It creates awareness
It increases knowledge
It changes attitudes
It is not expensive
It ensures feedback mechanism
1. Visit schedules
2. Training
3. Supervision
4. Monitoring and evaluation
1. Visit schedules:
Under IEC scheme the tour programs of health worker one drawn as a weekly schedule rather
than date wise calendar schedule, new system attempts to make the visit regular, week days
in a fortnight of a particular village to establish a link between villager and workers. The
village is divided into units of twenty households.
2. Training:
Training should not only cover technical aspects of program but also focus on problem
solving skills of workers. This is possible only when the worker is given training in the work
situation by their immediate supervisor at regular intervals. Training in this project in
conducted sector of PHC level and district level according to a predetermined schedule.
3.Supervision:
Success of any program depends on ability to monitor and evaluate program adequately and
accurately and to take corrective action if necessary.
The information gathered through the needs assessment provides the framework for the
development of suitable IEC activities and materials must always be culturally sensitive and
appropriate. These are the major steps you should follow when designing an IEC activity.
I. Conduct a needs assessment: Set the goal. This is a broad statement of what you
would like to see accomplished with the target audience in the end.
II. Establish behavioural objectives that will contribute to achieve the goal: Develop the
IEC activities and involve as many other partners as possible. After their successful
implementation, you should be able to have a significant impact on achieving the
behavioural objectives.
III. Identify potential barriers and ways of overcoming them.
IV. Establish an evaluation plan. The indicators should determine the level of
achievement of the behavioural objectives. Having such specific indicators makes
evaluating and monitoring the progress and impact of the activities much easier.
Additionally, process indicators could be established to track to what extent and how
well the planned activities have been carried out.
INFORMATION
HEALTH EDUCATION
Health education is the part of health care that is concerned with promoting healthy
behaviour. Historically, health education has been committed to disseminating information
and change human behaviour. In the Alma Ata declaration in 1978, the emphasis has shifted
from:
Prevention of disease to promotion of healthy lifestyles.
The modification of individual behaviour to modification of social environment in
which an individual lives.
Community participation to community involvement.
Promotion of individual and community self-reliance.
“Health education is like ageneral education which is concerned with changes in knowledge
of people inits most usual forms, it concentrates on developing such practices as are believed
to bring the best possible state of well being.”
- WHO
“Health education is a process that informs, motivates and helps people to adopt and maintain
healthy practices and lifestyles, advocates environment changes as needed to facilitate this
goal and conduct professional training and research to the same end.”
“The process by which individuals and groups of people learn to behave in a manner
conductive to promotion, maintenance and restoration of health.”
- Joha M Last
Health education is an important component of health work that enables people to have right
concept to raise the level of knowledge; to develop positive attitude to bring about behaviour
change voluntarily, and consequently to be able to solve own health problems by own effort.
Health education is the tool which enables people individually or in group to:
Care for health, prevent diseases, and develop improved health status.
Enable to develop knowledge and capability for solving health problems by own
accord.
Communicate, transmit right message and receive information.
Create conducive atmosphere for translating health need to action.
It may be recalled that according to the definition adopted by the National Conference on
Preventive Medicine. Health education is a process that informs motivates in helps people to
adopt and maintain healthy practices and life styles. There are two objectives:
I. Informing people:
Information is a basic right. It is also a prerequisite to proper awareness and
assessment of once duties and rights. Health is a basic right of all human beings and
health information help people. Become aware of their health problems in developing
proper perception about them is seeking appropriate solution for the same.
Assessment:
Planning:
Develop initial strategy, plan for audience, key message, methods of communication.
Set clear objectives, goals
Plan for preparation of appropriate IEC materials
Developing linkage with existing organization like rotary club, community
Implementation:
Monitor and evaluate the degree to which stated objectives have been achieved
Reassessment and the process of planning
Documentation and feedback
International
National
State
District
Local
Village
It denotes the places or social setting where it can be given and its relationship with other
social science or the field of study. So the scope of health education covers two different
fields as described below:
The content of health education is based on interest of the group and their needs, what the
group knows already, age, sex of target group, health problems of the community.
Human biology
Nutrition
Hygiene
Family planning and maternal and child health
Prevention of disease e.g. Immunization
Prevention of accidents-child and elderly
Mental health behavioural problem in children
Utilization of health services
Sex education
There are various methods for communicating health messages such as individual, groups
and mass approaches.
1. Individual approaches
Personal contact
Home visit
Personal letters
2. Group approach
Lectures
Demonstrations
Discussion methods
Group discussion
Panel discussions
Symposium
Workshop
Conference
Seminar
Role play
3. Mass approach
Television
Radio
News paper
Printed material
Direct mailing
Posters
Health museums and exhibition
Internet
Folk method
Films
Puppet show
Health education must firstly create a need in the mind of the people and also
stimulate interest in them to fulfil that need. Only then will health education succeed.
Such situation calls for a proper educational diagnosis about different factors
influencing the community such as beliefs, prejudices, resources perception and
attitude.
ii. Health education is not an artificial teaching learning exercise
Health educator should start not by demolishing the present attitudes and values but
by building upon those that the community already has but slowly trying to bring
about change and guiding peoples thinking onwards the desired change..
There should be a free flow of communication between the people and the health
educator. The health problem their possible solution and the good and bad points of
the solution should be thoroughly and honestly discussed, without trying to conceal
anything. This helps in clearing all doubts in the mind of people.
It is important that the health educator, especially, if he is an expert, should not start
telling all that he knows about the subject, he should clearly understand the health
problem. He should limit the content of health education to telling only that which is
necessary important and relevant using simple language.
Health educator should be consistent in what he tells to the people. Different health
worker should not give contradictory message regarding a particular problem.
The health educator should always remember that he assumes the role of a professor
appeared his task is to use the ability of the people to understand their problem to find
solution for the same to put that solution into practice.
Health educator has to communicate with people so as to get this message across to
them.
It is futile to try to give too many health messages to the community at the same time.
People have limited power for comprehending what a technical expert may think to be
very simple themes.
xiii. The health educator should put into practice the principles of community
organization
The health educator should put into practice the principles of community organization
for effective health education.
COMMUNICATION
Communication deals with transmission of information or ideas and sharing and exchanging
the same. Education implies transfer of knowledge. Communication is an essential
component of education. The essential part of a communication system is the communicator
is sender. The dimension of messages are the code (the symbols e.g. the alphabet in which it
is transmitted the content 9th subject matter) and the treatment. Treatment of a message refers
to the manner in which the message is prepared.
PRINCIPLES OF COMMUNICATION
Communication is effective when more than one sense organ is involved. When a
message is delivered on radio only auditory and visual senses are involved.
Unilateral communication from the sender to the receiver is not fully effective. It does
not allow for any feedback from the receiver of the communication. Hence it is not
possible for the communicator to improve and modify his message and technique of
communication according to needs of receiver.
PROCESS OF COMMUNICATION
Communication which is the basis for human interaction, is a complex process. It requires
SMCR where S stands for Source, M for Message, C for Channel and R for Receiver.
1) Source - it is the sender or encoder who initiates the message. The message may be
verbal or non-verbal. The sender needs to have similar communication skills, attitude,
knowledge, understanding level, social system and culture as the receiver or decoder.
2) Message – message should have all the elements properly coded. Content should be
clear from the source of the message or sender to receiver.
3) Channel – various channels are used by the sender to communicate a message, i.e.
seeing, hearing, touching, smelling and tasting.
4) Receiver – receiver is the person who is receiving the message and interpreting it. To
interpret the message correctly, the receiver needs to have similar communication
skills, attitude, knowledge, social system and culture as the source or sender.
ELEMENTS OF COMMUNICATION
Sender
Receiver
Message
Channels
Feedback
PURPOSES OF COMMUNICATION
TYPES OF COMMUNICATION
Verbal communication
Nonverbal communication
Two-way communication
One-way communication
Formal and informal communication
Visual communication
Telecommunication
LEVELS OF COMMUNICATION
Intrapersonal communication
Interpersonal communication
Small group communication
Organizational communication
Intrapersonal communication - It occurs within an individual. It is also
called self-talk, self verbalization, self instruction, inner thought and
inner dialogue.
Interpersonal communication – Occurs when two or more people
interact and exchange their idea to each other. It occurs face to face.
Small group communication – Occurs when nurse interacts with two or
more individuals face to face or uses a media such as a conference call.
Organizational communication – occurs when individuals and groups
within an organization communicate to achieve an established goal.
BARRIERS OF COMMUNICATION
Physical barriers
Perceptual barriers
Emotional barriers
Cultural barriers
Language barriers
Gender barriers
Interpersonal barriers
Muddled barriers
Stereotyping
Wrong channel
Lack of feedback
Physical barriers – physical distraction is the physical thing that gets in the way
of communication. E.g. telephone, desk, an uncomfortable meeting place, noise,
etc.
Perceptual barriers – the problem of communicating with others is that we all see
the world differently.
Emotional barriers – it is comprised of fear, worry, anxiety, suspicion, etc.
Cultural barriers – every culture has its own symbol of behaviour. If these
symbols are not understood by an individual then their is a barrier in their
communication.
Language barriers – language describes what we want to say. Our terms may
present barrier to others who are not familiar with our expressions, buzzwords and
jargon.
Gender barriers – there are distinct differences between speech patterns in men
and women. Men talk in a linear, logical and compartmentalized way and features
of left brain thinking, whereas women talk more freely mixing logic, emotions and
features of both sides of brain.
Interpersonal barriers – withdrawal, rituals, working and closeness.
Muddled message – the sender leaves the receiver unclear about the intent of the
sender which leads to confusion.
Stereotyping – causes people to act as if they already know the message that is
coming from the sender, as if no message is necessary because everybody already
knows.
Wrong channel – ‘good morning’, an oral channel is highly appropriate than
writing ‘good morning’ on the chalkboard.
Lack of feedback – without feedback, communication is one way.
Conversational skill
control the tone your voice
be knowledgeable about the topic
be flexible
be clear and concise
avoid words that may be interpreted differently
keep an open mind
take advantage of available opportunity
Listening skill
Whenever possible, sit with a person. During conversation, do not cross your
arms or legs because body language conveys message of being closed.
Be alert but relaxed and take sufficient time so that the patient feels at ease
during conversation.
Keep the conversation as natural as possible and avoid overly eager.
If culturally appropriate, maintain eye contact with the person.
Indicate that you are paying attention to what the person is saying by using
appropriate facial expression and body gesture.
Think before feedback.
BLOCK TO COMMUNICATION
Failure to listen
Inappropriate comments and questions
Changing the subject
Conflicting verbal and non-verbal messages
Failure to interpret with knowledge
Studies revealed that IEC method have stopped giving information and creating awareness
but BCC is characterized by its direct approach towards changing behaviour.
DEFINITION
Behaviour Change Communication can be defined as a process that motivates people to adopt
and sustain healthy behaviour and lifestyles.
STRATEGY
User identification.
Community mobilization: Mass media for making mindfulness for national projects
like adolescent well being, MCH well being administrations and so forth.
Platform: Home visits, gatherings.
Target population: Identify the key target population of the message.
Advancement of healthy behaviour messages: MCH, Nutrition, Contraception,
Adolescents, Health, Hygiene, Sanitation, Epidemics and so on.
Figure. 1
IMPLICATIONS
BCC is an effective method for dealing many community and group related problems.
BCC has been adapted as an effective strategy for community mobilization health and
environment education and various public outreach program.
Enhanced knowledge about the behaviour change process has facilitated the design of
communication programs to reduce the risk of HIV transmission and AIDS.
A wide variety of health promotion strategies use communication as either on
educational or norm forming strategy.
In addition, specific strategies must be designed for risk groups such as women,
young people, injecting drug abusers, homosexuals and HIV positive groups.
STEPS OF BCC
1. ANALYSIS
Comprehend the idea of the issues and hindrances to change.
Tune in to a potential group of spectators, survey existing project approaches,
assets, qualities, and shortcomings and investigate correspondence assets.
2. STRATEGIC DESIGN
Settle on destinations, recognize crowd portions, position the idea for the
group of spectators.
Explain the conduct change model to be utilized, select channels of
correspondence, plan for relational discourse, draw up an activity plan and
structure for assessment.
3. DEVELOPMENT, PRETESTING, REVISION AND PRODUCTION
Create message ideas, pre-test with a group of spectator’s individuals and
guards.
Amend and produce messages/materials and pre-test new and existing
materials.
4. THE EXECUTIVES, IMPLEMENTATION AND MONITORING
Implement of BCC and carry out continuous monitoring to see the positive
and negative effects.
Conduct critical analysis of the approach.
Make sure that the messages coherent with the objective of the BCC.
5. MAKING ARRANGEMNTS FOR CONTINUITY
Acclimate to changing conditions and plan for progression and independence.
NURSES RESPONSIBILITIES
At Individual Level:
Provides opportunity to develop personality, knowledge, skills and
confidence.
Increases awareness.
Reinforcement to sustain behavioural change.
Communication is very important in nursing practice.
At Community Level:
The role of a nurse in family planning programs with IEC are;
Informing
Persuading
Motivating
Encouraging
CONCLUSION
Thus, it is concluded that information, education and communication are interrelated to each
other. If health professionals have some information regarding health issues then it is their
responsibility to educate the community through different channels of communication. If we
want that health information must be properly communicated to the community then we
should know everything about communication.
BIBLIOGRAPHY
Date of Published: January 2019, Indian Journal of Public Health Research and
Development.
Abstract: A true experimental study to assess the effectiveness of information, education and
communication on knowledge, attitude, practice towards obesity and obesity reduction
among the obese adolescence population at selected government schools of Kancheepuram
district.
Materials and methods: A true experimental research design was adopted for the study.
Samples: The samples of the study were all obese adolescents between the age group of 12-
15 years.
Sampling Technique: The Probability multi-stage sampling technique was used to select the
schools and samples for the study.
Tools: The data collection instrument was the Structured Interview Questionnaire to assess
the knowledge on obesity, five point attitude scale to assess the attitude towards obesity,
Dietary, physical activity and lifestyle practices check list to assess the practice towards
obesity, and bio physiological measurements of BMI, BMR and Fat percentage to assess the
level of obesity.
Findings: Regarding Obesity reduction, the analysis revealed that in the post-test of the
experimental group, the overall mean BMI, was 25.52 with an S.D of 2.89. In the control
group, the overall mean BMI was 28.00 with an S.D of 3.11. The unpaired‘t’ test value was t
6.12, t=2.52 and t=2.14 which was greater than the table value at p=0.001, p=0.01 and p=0.03
for all three components and revealed that there was a high significant difference between the
experimental and control groups.