PLANNING, IMPLEMENTING,

MONITORING, & EVALUATING OF

HEALTH EDUCATION AND
PROMOTION PROGRAMMES

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 Community diagnosis:- is a process of
identification and detailed description of
important health and health related
problems of a given community.
 It involves statistical and epidemiological
knowledge in addition to the clinical
skills. (Recall community diagnosis vs.
clinical diagnosis)

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“A healthy program is like a healthy
organism with the planning process
as a central nervous system
responding to the sensory feedback
of evaluation and directing the
muscle of implementation”

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 Health program planning is a systematic
process for assessing health needs of
community, the identification of the
factor which influence health and
possible way outs, as well as selection of
appropriate interventions for prevention
of disease and the promotion of health.

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  Planning is about drawing sound and
feasible goal to solve practical problem at
hand.
 It is about drawing SMART objective
 It is about drawing guiding
directions/strategies that shows where to
go and how to go about.
 Planning is about outlining activities to be
undertaken
 It is about setting time frame that
specifies when to do certain things
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  Itprovides future direction
 Provides a unifying framework
 Create efficient use of resources
 Helps to adjust to changing
environment
 Base for team work

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 1. Collecting baseline data and information
2. Identifying health and HE/HP needs on
priority basis
3. Establishing goals and objectives
4. Deciding content to be taught
5. Deciding target group
6. Deciding for appropriate methods and
media
7. Identifying necessary and available
resources
8. Developing a detail plan of action
9. Determining time and techniques for
evaluation
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 Action plan
Specific Content Tar. Approach Method Material Who? Where? When? Eval.
obj. group method

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 Importance and/or urgency
HIGH LOW
changeability HIGH A C
LOW B D

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 By right Person?
 At the right time?
 The right amount (or reach and
frequency)
 To the right persons (audience)
 Using the right method or approach

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 What do you understand by
monitoring?
 What is evaluation?
 What is the difference and
similarities between monitoring and
evaluation

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 Monitoring is a set of activities that routinely
tracks and reports priority information about
a program and its intended outputs and
outcomes
 Monitoring requires attention to:
process,
performance, and,
 to a lesser extent, outcomes
 It also provides information that can be used
to evaluate the program
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 Here evaluators must measure whether
activities occurred
 with the planned frequency,
 with the planned intensity,
 with the appropriate timing, and
 as directed to reach the intended audience
 Ideally, monitoring begins at the start of
the program activities and continues
throughout the length of a program or
campaign
 Retrospective monitoring is less reliable
than ongoing monitoring
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 the quality, quantity, and distribution of
communication outputs must be closely
followed; for example:
were the expected numbers of posters
printed and distributed to the designated
locations?
Were the expected numbers of health care
providers or others trained in the proper
use of communication materials?
Did all members of the management and
communication team carry out their
functions as planned?

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Were the quality and volume of the
outputs, whether posters, serial
dramas, or community events, at the
expected and desired levels?
In what ways did the performance of
the management team meet
expectations and work plan
requirements?

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 Here the monitoring focus shifts from activities
and actions back toward original objectives
 If the objectives were:
Increased attendance at certain specific
clinics,
Increased purchase of certain products,
or
 Increases/decreases in a specified
behavior, such as partner reduction or
condom use,
 To what extent did these changes take place?

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 In short, monitoring is essential to be sure
that the program is being carried out as
planned and that no unintended,
unforeseen, or unexpected events or shifts
are taking place

 Whether the planned activities are in fact

responsible for producing whatever changes
may be observed (for example, the question
of causality) usually cannot be determined
at this stage during the progress of a
campaign

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 Evaluation is the process of systematic
collection of information on the activities,
characteristics and outcomes of a program to
provide the answer to an evaluation question
 Determines the merit or worth of a specific
program and explains the relationship
between the program and its effects

 Used to improve the program and to inform

intelligent management decisions
 Mind you, evaluation is not to prove the
program, it is to improve it
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 Three phases of evaluation
1. Get ready to evaluate
2. Collection of information/data/,
Analysis and interpretation
3. Dissemination of the results &
actions

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 PRECEDE is an acronym for
Predisposing, Reinforcing, Enabling,
Causes in, Educational Diagnosis and
Evaluation

 PROCEED is an acronym for Policy,

Regulatory, Organizational Constructs
in Educational and Environmental
Development

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 The precede–proceed model is a
combination of all the other models.
 The model is the most frequently
utilized model in health promotion
programs.
 and the model was complete for
health promotion, planning,
implementation and evaluation.

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The two fundamental propositions are
emphasized by this model are;
1. health and health related risk are
caused by multiple factors
2. efforts to effect behavioral,
environmental and social change must
be multidimensional.

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 The precede frame work directs initial
attention to outcomes rather than
inputs
 The planner begins the planning
process from the outcome end i.e. ask
why before how?
e.g. the desired final out come for
HIV/AIDS Is decreased morbidity and
mortality .
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 Then from this end, one should
systematically work out the multiple
factors contributing to the solution.

 It generates objectives and is used

for the identification of priorities
and the setting of objectives.

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 Provides additional steps for
developing policy and initiating the
implementation and evaluation
process.

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Surveillance, Planning and Evaluating for Policy and Action:
PRECEDE-PROCEED MODEL*

Phase 5 Phase 4 Phase 3 Phase 2 Phase 1

Administrative & Educational & Behavioral & Epidemiological Social
policy assessment ecological environmental assessment assessment
assessment assessment

Public Predisposing
Health
Health
education
Behavior
Reinforcing
Health Quality of
Policy life
regulation
organization Environment
Enabling

Phase 6 Phase 7 Phase 8 Phase 9

Implementation Process evaluation Impact evaluation Outcome evaluation

Input Process Output Short-term Longer-term Short-term Long-term

impact health outcome social impact social impact

*Green & Kreuter, Health Promotion Planning, 3rd ed.,

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1999.
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PRECEDE
PHASE 1 SOCIAL DIAGNOSIS
PHASE 2 EPIDEMIOLOGICAL DIAGNOSIS
PHASE 3 BEHAVIORAL & ENV’TAL Dx
PHASE 4 EDUCATIONAL & ORGANIZATIONAL Dx
PHASE 5 ADMINISTRATIVE & POLICY
DIAGNOSIS

PROCEED
PHASE 6 IMPLEMENTATION
PHASE 7 EVALUATION (PROCESS)
PHASE 8 EVALUATION (IMPACT)
PHASE 9 EVALUATION( OUTCOME)

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 Isto identify and evaluate the social problems
which impact the quality of life of a target
population
 This requires program planners to gain an
understanding of the social problems which
affects the quality of life of the patient,
consumer, student, or community, as those
populations see those problems.

 This followed by the establishment of a link

between these problems and specific health
problems which may become the focus of
health education.

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The link is essential in life and, in turn,
how the quality of life affects social
problems.
Methods used for social diagnosis
may be one or more of the following:
• Community Forums
• Nominal Groups
• Focus Group
• Surveys
• Interviews
• Central location intercept

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helps determine health issues
associated with the quality of life.
It helps identify behavioral and
environmental factors related to the
quality of life issues.
 The focus of this phase is to identify
specific health problem and non
health factors which are associated
with a poor quality of life.

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Examples of Epidemiological data:
• vital statistics
• years of potential life loss
• disability
• prevalence
• morbidity
• incidences
• mortality

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 This phase focuses on the systematic
identification of health practices and
other factors which seem to be linked to
health problems defined in Phase 2.
 This includes non-behavioral causes
(personal and environmental factors) that
can contribute to health problems, but
are not controlled by behavior.
 These could include genetic
predisposition, age, gender, existing
disease, climate, and workplace, the
adequacy of health care facilities, etc.

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This will allow all the planners to choose target
behaviors which will become the focus of
specific educational interventions.
 Behavioral Diagnosis is the analysis of
behavioral links to the goals or problems that
are identified in the Epidemiological or social
diagnosis.
 Environmental Diagnosis is a parallel analysis
of factors in the social and physical
environment other than specific Actions that
could be linked to behaviors.
 The Behavioral Matrix helps to identify targets
where the most effective intervention
measures can be applied.
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 This phase assesses the causes of
health behaviors which were
identified in Phase 3.
 The critical element of this phase is
the selection of the factors which if
modified, will be most likely to
result in behavior change.
 This selection process includes
identifying and sorting (positive and
negative) factors
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i. Predisposing Factors - any
characteristics of a person or
population that motivates behavior
prior to the occurrence of that
behavior
• knowledge
• beliefs
• values
• attitudes
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ii. Enablers - characteristic of the
environment that facilitate action and
any skill or resource required to attain
specific behavior
• accessibility, availability, skills, laws
(local, state, federal)
iii. Reinforces - rewards or punishments
following or anticipated as a
consequence of a behavior. They serve
to strengthen the motivation for
behavior.
• family, peers, teacher.
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 This phase focuses on the administrative and
organizational concerns which must be
addresses prior to program implementation.

 This includes the assessment of resources,

budget development and allocation,
development of an implementation
timetable, organization or personnel within
programs, and coordination of the program
with all other departments, and institutional
organizations and the community.
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 Administrative Diagnosis - the analysis of
policies, resources and circumstances
prevailing organizational situations that
could hinder or facilitate the
development of the health program.

 Policy Diagnosis - to assess the

compatibility of your program goals and
objectives with those of the organization
and its administration; does it fit into the
mission statements, rules and regulations

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An actual change in the quality of life is seen.
Phase 7 - Process Evaluation is used to evaluate
the process by which the program is being
implemented.

Phase 8 - Impact Evaluation measures the

program effectiveness in terms of intermediate
objectives and changes in predisposing,
enabling, and reinforcing factors.

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 measures change in terms of overall
objectives and changes in health and
social benefits or the quality of life.
It takes a very long time to get
results and it may take years before

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