Behaviour Change Communication

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Behaviour Change Communication

• Responsibilities of the Provinces

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Causes of Deaths, 1980 to 1996 Source Sri
Lankan Govt. Register General, Vital Statistics
1980-1996
Infectious and parasitic diseases
500
Nutritional deficiencies and diseases of
blood
Continuing Problem
450
Congenital abnormalities, immaturity
and birth trauma
Maternal deaths
400
350
Emerging Problem
Suicide
Accidents
300
Homicide other violence
250
Diseases of musculoskeletal system,
skin and subcutaneous tissue
200
Diseases of genitourinary system
Endocrine and metabolic disorders
Evolving Problem
150
Diseases of GIT
100
Diseases of respiratory system
Diseases of nervous system
50
Neoplasm (benign and malignant)
0
Diseases of cardiovascular system
1980
1996
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Diarrhoeal Diseases Morbidity, Mortality Case
Fatality Rates, Sri Lanka 1970-2002
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HEALTH EDUCATION WHY CHANGE TO HEALTH PROMOTION?

• Hearing is not KNOWING
• Knowing is not UNDERSTANDING
• Understanding is not PRACTICING (doing)
• HOW DO WE ACHIEVE DESIRED BEHAVIOR CHANGE?

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Behaviour change
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Behaviour change
INPUTS
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Behaviour change
Conducive environment
INPUTS
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Behaviour change
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Health education

• Any combination of learning experiences designed
  to facilitate voluntary adaptations of behaviours
  conducive to health.
• It is a process which bridges the gap between
  health information and practices.
• It motivates the person to take the information
  and do something with it to keep himself
  healthier by avoiding actions that are harmful
  and by forming habits that are beneficial.
• The word process implies that health education
  needs systematic programme planning,
  implementation and evaluation of outcome in
  behavioural terms. It enables people to
• Understand their own problems and needs
• Understand what they can do about their problems
  with their own resources combined with outside
  support
• Decide most appropriate actions to promote
  healthy living and community well-being
• Adopt the appropriate behaviours
• Health education activities are not autonomous,
  free standing programmes themselves. They are
  embedded in other programmes and may not identify
  as health education.

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Behaviour Change communication

• Set of organised communication interventions and
  processes aimed at influencing community and
  social norms and promote individual behaviour
  change or positive behaviour maintenance for a
  better quality of life.

Family
Individual
Community
Society
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Behavior change communication

• Human behaviour is the key factor in development
  of people
• Behaviour of people influence the health of the
  people and the community as well as the community
  influence the behaviour of people
• Paradigm shift
• IEC to BCC
• Integral part of a programme
• Focus on individual and group behaviours as well
  as contextual factors in the broader
  socio-economic and cultural environment

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Planning of BCC
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Monitoring evaluation of BCC
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Responsibilities of HEOs

• Objective
• To develop a resource pool both within and
  outside the health sector throughout the country
  which is
• competent,
• confident,
• independent and
• interdependent
• in promoting health of people enabling them to
  increase control over and promote their own
  health.

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Responsibilities of HEOs

• Behaviour Change Communication
• - Capacity building of Health workers other
  health related workers on BCC
• - Capacity building of Health workers other
  health related workers on life skill
  development
• Community mobilisation intersectoral actions
  for health development
• - Capacity building Health workers other
  health related workers on Community
  mobilisation for health development
• - Advocacy on Community mobilisation for Health
  development
• - Capacity building of Health workers on
  intersectoral actions
• - Capacity building of other sectors on
  intersectoral action
• - Capacity building of Health workers other
  health related workers on PRA

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Responsibilities of HEOs

• Health Promotion
• - Capacity building of Health workers other
  health related workers on HP
• - Capacity building of workers on different
  settings on HP
• Counselling
• - Capacity building of Health workers other
  health related workers on counselling
• Communication material production
• - Capacity building of Health workers on
  communication material production
• - Production of communication materials

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Responsibilities of HEOs

• Advocacy and Mass communication
• - advocacy in regard to health maters
• - Conduct regular mass media meetings
• - Produce publicity programmes
• - Capacity building of Health managers on
  Advocacy
• Training, Monitoring, evaluation and research
• - Monitoring evaluation of Health Promotive
  activities
• - Conduct regular research on Behaviour change
  on different target groups
• - Coordinate training programme
• Publication
• - Regular production and printing of
  publications
• - Documentation of success stories

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PATHWAYS TO IMPROVED OUTCOMES
Poor health of people
Household behaviours risk factors
Health service supply
Health reforms
Other parts of health system
Health outcomes
Household resources
Actions in other sectors
Supply in related sectors
Community factors
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PATHWAYS TO IMPROVED OUTCOMES
Poor health of people
Household behaviours risk factors
Health service supply
Health reforms
Other parts of health system
Health outcomes
Household resources
Actions in other sectors
Supply in related sectors
Community factors
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PATHWAYS TO IMPROVED OUTCOMES

• Determinants
• Child health
• Improper feeding practices
• Improper dietary practices
• Poor personal hygiene
• Inadequate health knowledge
• Ante natal mothers
• Inadequate care at home
• Inadequate health knowledge
• Poor health seeking behaviours
• Youths
• Inadequate life skills
• Bad influence by media
• Inadequate access to youth friendly services
• Elders
• Inadequate access to health care which is
  friendly to elderly people
• Neglect by children

Household behaviours risk factors
Health service supply
Health reforms
Other parts of health system
Health outcomes
Household resources
Actions in other sectors
Supply in related sectors
Community factors
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PATHWAYS TO IMPROVED OUTCOMES
Household behaviours risk factors
Health service supply

• Determinants
• Inadequate resources for care
• Poverty
• Waste of money for alcohol, drugs
• and gambling by poor people
• Inadequate support by husband
• and other family members

Health reforms
Other parts of health system
Health outcomes
Household resources
Actions in other sectors
Supply in related sectors
Community factors
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PATHWAYS TO IMPROVED OUTCOMES
Household behaviours risk factors
Health service supply
Health reforms
Other parts of health system
Health outcomes
Household resources
Actions in other sectors

• Determinants
• -Inadequate community support
• -Negative customs and traditions
• Myths and beliefs of people

Supply in related sectors
Community factors
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PATHWAYS TO IMPROVED OUTCOMES
Household behaviours risk factors
Health service supply

• Improve capacity of health workers on
• - Technical aspects
• Behaviour change of
• people
• Community mobilisation
• development of
• community leadership
• Counselling
• Health promotion
• Production use of IEC
• material
• Intersectoral actions
• Monitoring of behaviour
• change of people

Health reforms
Other parts of health system
Health outcomes
Household resources
Actions in other sectors
Supply in related sectors
Community factors
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Learning organisation
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Capacity building of Health workers

• No. of Health Education Officers capable of
  developing Field level workers and other related
  sector workers
• No. of districts resource pools developed
• No. of grass root health workers competent in BCC
• No. of other sector workers competent in BCC
• No. of health sector workers capable of using
  triple A approach in solving individual and
  family problems
• No. of Health Education Nursing Officers capable
  of giving health education

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Community mobilisation

• No. of community Health promotive villages/
  cities developed
• No. of Health Promotive hospitals developed
• No. of work places made health promotive
• No. of Youth communities made health promotive
• No. of schools which school children mobilised
  for health promotive work through School Health
  clubs
• No. of communities mobilised for Early child Care
  Development and Nutrition Promotion

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Health education programmes

• Public Health Midwife
• Little mothers seminars - Once a month
• Clinic Health education - Every clinic
• Nutrition demonstration - Every GMP clinic
• Education at pre schools - Once a month
• Parent meetings of pregnant mothers
• - Once a month
• Meeting of community leaders volunteers
  - Once a month

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Health education programmes

• Public Health Inspectors
• School Health education - Once a month
• Youth meetings - Once a month
• Community leader meetings - Once a month
• Education of food handlers - Once a month
• Education in work settings - Once a month
• Training of community leaders Annually
• Community mobilisation for dengue prevention in
  high risk areas -Continuously

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Health education programmes

• Medical Officer of Health
• Education of Samurdhi Agriculture Development
  Officers
• - Annually according to a set programme
• Education of Youth Officers
• - Annually according to a set programme
• Education of other government officers Monthly
• Education of non governmental organisations
  Community based organisation
• - Annually according to a set programme

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Health education programmes

• Health education Officers
• Night film shows - Once a week
• Exhibitions - 0nce a month
• HRD of health staff on Health promotion,
  Behaviour change communication and use of Triple
  A methodology in BCC at family level
• - Once a week
• Monitoring of health education programmes
• - Continuously

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Guidance of health workers on health education

• Medical Officer of Health - Once a month
• Public Health Nursing Sisters - Twice a month
• Supervising Public health Midwives - Once a week
• Supervising Public Health Inspectors - Once a
  week
• Health Education Officers - Once a week

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Printing of leaflets and posters

• Posters on different subjects
• Leaflets on different subjects

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Mass media programmes

• Local level mass media programmes
• Health talks / discussions at local level

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Planning monitoring of Health education
programmes

• 01.Plan has to be developed at the local
  conference and to be approved by the MOH
• 02.Need analysis has to be done to identify
  target audience and subjects before planning
• 03.Annual targets for different Health education
  programmes have to be developed according to
  resources available
• 04.Quarterly plans have to be developed based on
  the annual targets
• 05.Following format to be used to develop the
  quarterly plan
• 06.Quarterly plan has to be reviewed at monthly
  local conferences and necessary changes to be
  done with the approval of the MOH

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Quarterly health education plan
MOH area- .. PHI area -

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Community Health education Return
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Local conference report

• Area. Month...
• Attendance
• Name Designation
• 01)
• 02)
• 03)
• 04) ...
• 05)
• A) Health education activities conducted
• (To be presented using the return)
• B) Long term Health Promotive programmes
  conducted
• Health Promotive activity
• No. No.
• Planned Active
• Healthy villages/ cities
• Healthy work settings
• Health promotive hospital

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C) Problems encountered
C) Problems encountered
D) Health education activities to be conducted
during next month
D) Health education activities to be conducted
during next month
.. .. Signature of
the Chairman of LC Signature of the Secretary of
the LC
.. .. Signature
of the Chaiman of LC Sgnature of the Secretary
of the LC
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Resource centres
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IssuesPoor affinity to work with other sectors
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"Health Japan 21"Supported by Everyone
Conventional health enhancement efforts
Health Japan 21
Provision of knowledge and skills
Health
Provision of knowledge and skills
Participation of local residents (local group
activities)
Local residents
Rich and fulfilling life
Health
Creation of environments that support health
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thank you!