Community Health Nursing

1. SCHOOL OF POST BASIC PAEDIATRIC
UDUTH SOKOTO
 COURSE- TITLE:COMMUNITY HEALTH NURSING
 COURSE CODE : PAN 422.
 PLACEMENT 2ND SEMESTER.
 Unit IV: IMMUNIZATION PROGRAMME
 LECTURER: LD. PENI.

2. INTRODUCTION
 VACCINATION: is one of the greatest health
intervention ever known in the history of
“man” existence. India and China are
known to have been practicing inoculation
against smallpox over 200 years ago.
However, Edward Jenner, a British physician
is generally credited with introducing the
concept of modern vaccination.

3. INTRODUCTION CONT’S
 In 1796, he inoculated an 8- year old boy,
James Phipps with cow pox {less virulent
/milder disease}and subsequently exposed
the boy to the more virulent smallpox and
the boy didn’t suffer the disease. This led
to the development of smallpox vaccine
and the subsequent eradication of the
deadly disease in 1979.

4. INTRODUCTION CONT’S
Collaboration, and unprecedented effort that
brought the following together health and
immunization experts. International organization
like {WHO,UNICEF, GAVI Alliances} Bill and
Melinda gate foundation, governments agencies,
industries, the civil society, the media etc.
The GVAP was endorsed by 194 members, states
of world health assembly in may 2012.

5. INTRODUCTION CONT’S
 Its a frame work {involving six strategies} to
prevent millions of deaths by 2020 through
ensuring that vaccines are more equitably
accessed by people in all communities.

6. PRINCIPLES OF IMMUNIZATION
/VACCINATION.
 Vaccination is based on the natural
principles of immunity or immune response.
 IMMUNITY is the natural ability of a host to
resist infection or a second exposure having
gained “experience from the first
infection.This is based on the principle of
Antigen- Antibody reactions.

7. PRINCIPLES OF IMMUNIZATION CONT’S
 Antigen is any substance that is capable of inducing
an immune response in the body especially the
production of Antibodies.
 Antibodies, also known as immunoglobulins are
protein produced by the immune system in response
to specific antigens. They also bind to the
antigens.
 There are 5 main classes of antibodies, namely lgG,
lgA, lgM, lgD and lgE. In oder of serum
concentration.

8. PRINCIPLES OF IMMUNIZATION CONT’S
 Only lgG crosses the placenta to protect the
newborn since it has a low molecular weight.
 lgM is the first and major antibody produced
during primary response and it is not boostable.
 lgG is minimally produced in the late phase of
primary response and it is the main antibody
produced in secondary response. It can be
boosted.

9. PRINCIPLES OF IMMUNIZATION CONT’S
 lgA is either in the blood form or secretory
form and is the therefore present in breast
milk {colostrum} to protect the infant.
 lgE is involved in allergic /anaphylactic
reactions via mast cell degranulation.

10. TYPES OF IMMUNITY
 Immunity could be innate or adaptive.
Innate immunity is the body’s first line of
defence.
 It is present from birth and non –specific
adaptive immunity is the second line of
defence, it is learned and it is specific.

11. IMMUNITY
NATURAL NATURAL
 Passive natural
{maternal antibody
transfers to foetus-
transplacentally/
through breast
milk.
 Active natural{past
infections}.

12. IMMUNITY
ACQUIRED/ARFICIA ACQUIRED/ARFICIAL
 Passive Artificial
{injection of
antibodies
immunoglobulin
 Passive
immunization.
 Active Artificial
{exposure to
antigen .
 Active
immunization.

13. IMMUNITY
 NOTE: The main function of antibodies are
to act as antigen receptors on the B cell
and to circulate and bind to pathogens,
thus identifying them for immune response.

14. IMMUNIZATION.
 Immunization: is a process of protecting an
individual from a disease through introduction
of live or killed or attenuated organisms in the
individual system.
 It is one of the best buy’s in community health
and one of the most cost- effective health
interventions. Immunization against vaccine-
preventable disease is essential to reduce the
child mortality, morbidity and handicapped
condition.

15. IMMUNIZATION CONT’
 It is also a mass means of protecting the largest
number of people from various diseases.
 It gives resistance to an infections diseases by
producing or augmenting the immunity .
 Artificial acquired immunity is developed by
immunization.
 Immunity is the security against a particular
diseases and nonsusceptibility to the invasive or
pathogenic effects of foreign micro organism.

16. IMMUNIZATION CONT’S
 Or to the toxic effect of antigenic substances
 Acquired immunity is produced by stimulating
immunological defence mechanism through
administration of antigen usually prior to
natural exposure to infection. Active
immunizing agents are known as vaccine.
Passive immunity is produced temporarily by
supplying preformed exogenous animal or
human antibody to suppress the disease, given
soon after or prior to exposure of an infection.

17. IMMUNIZATION CONT’S
 It is ready made antibodies. Passive
immunity agents are anti sera and
immunoglobulins.
 VACCINE PREVENTABLE DISEASES
 Some infection diseases can be prevented
by vaccines. The diseases against which
vaccine are currently available.

18. VACCINE PREVENTABLE DISEASES
 {a} six-killer vaccine preventable disease i.e.
poliomyelitis, tuberculosis, diphtheria,
pertussis, tetanus and measles.
 {b} other vaccine preventable diseases include
hepatitis “B”, mumps, rubella, Hemophilus
influenzae type B {Hib} infection, typhoid
,meningococcal meningitis, Japanese
encephalitis, influenzae, pneumococcal
pneumonia, chicken pox, rotavirus diarrhea.

19. VACCINE PREVENTABLE DISEASES CONT,S
 Yellow fever, cholera, malaria, hepatitis
“A” plaque and rabies.

20. IMMUNIZATION AGENTS.
 The immunizing agent may be classified as
 VACCINES, IMMUNIOGLOBULINS , AND ANTISERA.
 1. Vaccines are immunobiological substances which
produces specific protection against a given
disease. It stimulates active production of
protective antibody and other immune mechanisms.
Vaccine are prepared from live attenuated
organism or inactivated or killed organisms,
extracted cellular fraction, toxoids or combination
of sub-unit vaccine.

21. IMMUNIZATION AGENT CONT,S
 And recombinant vaccines.
 The ideal vaccines should includes
permanent immunity be free of toxic
substance, have minimal side effect, not
produce diseases to the recipient and be
easy to administer.
 The following immunizing agent are
currently used.

22. CONT,S OF THE ABOVE
 LIVE ATTENUATED VACCINES.
 Bacterial-BCG, Typhoid {oral} plaque
 Viral- oral polio, measles, mumps rubella, yellow
fever, influenza.
 KIILED OR INACTIVATED VACCINE.
 Bacterial-pertussis, typhoid, cholera, plaque cs
meningitis.
 Viral- rabies, hepatitis “B”, influenza, polio
Japanese encephalitis.

23. CONT’S AS ABOVE.
 Toxoids- Bacterial. Diphtheria, and tetanus.
 Cellular fractions- meningococcal and
pneumococcal vaccines.
 Combination-DPT {diphtheria pertussis,
tetanus.}MMR {mumps, measles, rubella}
 DT {diphtheria, tetanus} Hib- Hep. B{H.
influenzae” B”, Hepatitis B”}

24. IMMUNOGLOBULINS
 The human immunoglobulin {lg} system is
composed of 5 major classes { lgG, lgM, lgA,
lgD, and lgE} and subclasses within them.
 The various classes and subclasses of lgs
represent different functional groups that are
required to meet different types of antigenic
challenges. All antibodies are immunoglobulins
but it is still an open question whether all
immunoglobulin are antibodies.

25. IMMUNOGLOBULIN CONT’S
 The WHO recommends that the term
gamma globulin should not be used as a
synonym for immunoglobulin.
 Two types of immunoglobulin preparations
are available for passive immunization.
These are normal human immunoglobulin
and specific {hyper immune }human
immunoglobulin. They are used in the
prophylaxis of viral and bacterial in
immunodeficient patients.

26. IMMUNOGLOBULINS CONT’S
 The available human immunoglobulin are:
Normal Human lg-Hepatitis “A”, measles,
rabies, tetanus and mumps.
 Specific human lg – hepatitis “B” Varicella
and diphtheria.

27. ANTISERA OR ANTITOXINS
 The term antisera is applied to the
materials prepared in animals. Originally
passive immunity was achieved by the
administration of antisera or antitoxins
prepared from non-human sources like
horses. Human lg preparations exist only
for a small number of diseases.
Administration of antisera may have
adverse effect like serum sickness and
anaphylactic shock due to abnormal
sensitivity of the recipient.

28. CONT’S OF THE ABOVE
 The current trend is to use the
immunoglobulin when ever possible. The
important antisera which are still used for
passive immunization are:
 Bacterial –diphtheria, tetanus, gas-
gangrene, botulism.
 Viral –rabies.

29. IMMUNIZATION PRACTICES {EPI}
 The EPI was established in may 1974 by
WHO by WHO with the aim of making
vaccine available to all children. In 1984,a
standard {minimum} EPI vaccination
schedule was established and the original
schedule include bacillus Calmette Guerin
{BCG} ,diphtheria- tetanus- pertussis {DTP}
oral polio and measles vaccine. Since then
new vaccines have been steady added to
the schedule as more data and

30. EPI CONT’S
 New vaccines becomes available over the
years. The vaccine subsequently added so far
include hepatitis B.{Hep B} yellow fever, {in
countries endemic for diseases}.Hemophilus
influenzae b {Hib} inactivated polio {IPV in
OPV-only using countries} and pneumococcal
conjugate vaccines in countries with high
burden of diseases as well as rotavirus
vaccines and inactivated polio vaccine.

31. EPI CONT’S
 The Expanded programme on immunization
was established in Nigeria in 1979.It was later
renamed the National programme on
immunization. Vaccine preventable diseases
are responsible for 17% of global under- five
mortality and 22% of Nigeria under-five
mortality. It therefore implies that if every
child is reached with the basic vaccines under-
five mortality will be drastically reduced.

32. EPI CONT’S
 In 1974 when the EPI was launched, less than
5% of children globally were immunized in
their first year of life against the six- killer
diseases. By 2011, the coverage raise to more
than 80%.New data {WHO 2014} show that
between 1990 and 2013 under-five mortality
rate dropped by 49% due to affordable life
saving interventions like vaccination.

33. EPI CONT’S
 How ever much still need to be done as
data show that in 2013, 2.8 million neonate
died {44% of all under five deaths) in 2011,
about 20% of the worlds children {22.4
million infants} were not immunized. Out of
which 70% live in 10 countries. Also 1.5
million children died from vaccine
preventable diseases.

34. EPI CONT’S
 Challenges to EPI include
 lack of public and government awareness,
 poor programme management,
 inadequate funding.
 Inadequate skilled personnel and equipment as well as
 inadequate supervision monitoring and evaluation.
Others are vaccine hesitancy
 inadequate cold chain equipment and logistics, poor
accountability framework and data management, sub-
optimal surveillance systems.

35. EPI CONT’S
 vaccine stock- out/poor vaccine
forecasting, missed immunization
opportunities, funding sustainability and
non- integration of vaccination with other
health services.

36. TYPES OF IMMUNIZATION SERVICES
 Routine immunization- refers to the routine
administration of vaccines to every new born
infant according to the National specified
schedules. It also include women of child
bearing age. Strategies for routine
immunization include fixed post and out reach
services.
 Supplemental immunization. Activities /mop-
up this is often referred to as immunization-

37. TYPES OF IMMUNIZATION SERVICES
CONT’S
 Campaigns or pulse immunization. It is used to
improve immunization coverage in countries
where routine immunization is not optimal.
Examples include polio and measles
immunization campaigns. Mop-up campaigns
are carried out in small areas where outbreaks
of diseases are reported when data show
pockets of high number of unimmunized
children.

38. NIGERIAN NATIONAL ROUTINE
IMMUNIZATION SCHEDULE
AGE ANTIGENS {VACCINE}
 Birth
 6 Weeks
 10 Weeks
 14 Weeks
 9 Months
 BCG,opvo,Hep Bo
 Opv1,,Pentavalent1, pcv1,
Rota1+
 Opv2 pentavalent2, pcv2,
Rota2+
 Opv3, pentavalent 3, pcv3,
ipv
 Measles, yellow fever,
meningococcal.

39. NOTE ON ABOVE
 Must be given within two weeks of birth to be
introduced soon.
 Pentavalent vaccine contains-vaccines against
diphtheria, pertussis, tetanus, hepatitis and
haemophilus influenza type B.
 The paediatric Association of Nigeria
[PAN]however, advocates that government
reasons not with standing, children should get
more vaccines and the schedule could be

40.  Adjusted for better immune response. Even
if the government is unable to fund it at
least the private sector and individuals who
wish to immunize their children optimally
should be guided by the schedules .The PAN
therefore proposed a routine immunization
schedule in 2012.

41. NATIONAL ROUTINE IMMUNIZATION
SCHEDULE.
 The WHO through it’s EPI has made a basic routine
immunization schedule which individual countries
may wish to adopt or modify to suit their needs.
This is the schedule adopted for use in Nigeria.
 Many countries have also adopted this schedule
others have modified it, while others {especially
developed countries} have developed their own
unique schedules. One major draw-back is that EPI
schedules does not have booster doses of vaccines.

42. PAN RECOMMENDED ROUTINE
IMMUNIZATION SCHEDULE
AGE VACCINE
 Birth
 6weeks
 10weeks
 14weeks
 6months
 9months
 12-15months
 18 months
 BCG, OPV, Hep Bo
 opv-1,penta1,Rota1, pcv-1
 opv-2, Rota-2
 Opv-3, penta-2,pcv-2
 Penta-3, pcv-3
 Measles-1, yellow fever.
 Opv, D Tap
 Hepatitis A, MMRV.

43. PAN {RRIS} CONT’S
AGE VACCINE
 2 years
 5 years
 10-14 years
 15 years
 Typhoid
 Opv, DTap MMR.
 Tdap, yellow fever,
HPV [male & female]
 5dose TT schedule {
female only}

44. ELEMENTS OF ROUTINE IMMUNIZATION
 Includes:-
 cold chain/logistic service delivery social
mobilization,
 injection safety,
 data management,
 waste management,
 monitoring and evaluation,
 surveillance and supportive supervision.

45. Immunization in special
circumstance
 Childrenin various special health conditions
require some adjustment in vaccination according
to their individual needs.These include primary
and secondary immunodeficient children
{gammaglobulinaemia, hypocomplementaemia,
HIV/AIDs}. Certain chronic diseases {CKD,Renal or
other issue transplant} cancer patients, children
on immunosuppressant therapies.

46. IMMUNIZATION ON SPECIAL
CIRCUMSTANCE CONT’S
 {Chemotherapy, radiotherapy and steroids etc.
children exposed to certain infectious diseases
by contact or vertical exposure, splenectomy
or a splenic children etc. Generally premature
babies are vaccinated according to their
chronologic age without correcting for pre-
maturing as studies have shown that there is
adequate and protective immune response to
the common routine vaccine in spite of their
more immature immune system compared to

47. CONT’S OF THE ABOVE.
 That of a full term infant. Sickle cell
anemia patients should receive usual
routine vaccines including the
pneumococcal conjugate vaccine and
Hemophilus influenzae type B {Hib}
conjugate vaccine.

48. VACCINE STORAGE AND HANDLING.
 Each office should develop and maintain a
detailed written storage and handling
protocol, assign storage and handling
responsibilities to a single person. Designate a
back up person and provide training on
vaccine storage and handling.
 It is also important to prevent storage and
handling errors, maintaining vaccines at the
correct temperature is critical to maintaining

49. VACCINE STORAGE AND HANDLING
CONT’S
 Potency and protection. Vaccines must be
stored properly from the time they are
manufactured until they are administered to
patients vaccines stored at incorrect
temperature can cost thousands of dollar in
wasted vaccine and revaccination. The cold
chain, which is a temperature-controlled
supply chain, begins with the manufacturer
and continues with the transfer of vaccine

50. CONT’S OF THE ABOVE.
 To the distributor, transfer from the distribute
to the provider’s office and administration to
the patient. Proper storage temperatures must
be maintained at every link in the chain.
These temperatures are defined in their
package inserts for each product. Vaccine
storage units must be selected carefully and
used properly.

51. CONT’S THE ABOVE.
 Refrigerator without freezers and stand alone
freezers are preferred because they are better
than combination, refrigerator-freezer units at
maintaining the required temperatures. Any
refrigerator or freezer used for vaccine,
storage must have it’s own exterior door and
must be able to maintain the required
temperature range throughout the year’s
largest vaccine inventory

52. CONT’S THE ABOVE
 And must be dedicated to the storage of
biologics.
 Proper temperature monitoring is vital to
proper cold chain management, check the
storage temperatures twice a day-once in the
morning and once before you leave at the end
of the workday- and record the temperature
readings twice daily. How ever, documentation
is not enough. Equally important is taking

53. CONT’S THE ABOVE
 Immediate corrective action. When the
temperature fall outside the recommended or
incorrectly stored vaccine should not be
administered. It is especially important that
inactivated vaccine that has been exposed to
freezing Temperature not be administered.
 If you discovered the refrigerated vaccine has
been exposed to freezing temperatures even if
the vaccine do not appear to have been

54. VACCINE STORAGE AND HANDLING
CONT’S
 Frozen- you should remove and identify the
exposed vaccine so it will not be used.
 The contact the manufacturer or your state
or local immunization program for advice,
you should do the same thing if your
freezer temperature rise above 5of during
other than the normal defrost cycle.

55. VACCINE ADMINISTRATION
 Vaccine administration is a critical component
of a successful immunization program. We
label the 7 steps to successful immunization
the “right” of medication administration. The
word “right” implies “correct” the correct
steps to ensuring successful administration.
 Right: the right patient make sure you are
vaccinating the right person in the room

56. VACCINE ADMINISTRATION CONT”S
 And also that screening has been performed to
identify which vaccine are needed and which
vaccines should be avoided because of medical
condition.
 Right: the right vaccine. Check your vials 3
times to make sure you have the correct
vaccine in hand.
 Right: the right time, make sure the patient is
the appropriate age and is being vaccinated

57. VACCINE ADMINISTRATION CONT’S
 At an appropriate interval from other doses
of the same or different vaccine. Vaccines
and their diluents might expire as well so
check those dates.
 Right: the right dosage, vaccine dosage is
based on the age of the patient, not the
weight. Vaccine differ from medications in
this respect.

58. CONT’S THE ABOVE
 Right: the right rout, whether oral
intranasal, subcutaneous or intramuscular,
this varies by the type of vaccine and
requires the appropriate administration
technique. Correct needle length is also
essential.
 Right: the right site, this is partially
dependent on the correct route, and is also

59. CONT’S THE ABOVE
 Related to the age of the patient. Resources
are available to assist in the determination of
route, site technique and needle length for
instance for intramuscular route a table in
jaunary 2012 which is generally recommended
for immunization also there is a guide for
administration by this route according to age
site, and technique.

60. CONT’S THE ABOVE
 right: the right documentation, this is crucial
to ensure not only that your patient receives
the correct number of doses to be adequately
protected but that excessive doses are not
provided, which can cause mild local reaction
and can waste valuable vaccine.
 All staff {permanent and temporary} who
administer vaccines should receive

61. VACCINE ADMINISTRATION.
 Competency based training and education
on vaccine administration before
administering vaccines to patients. Staff
knowledge and skill should be validated
with a skills checklist. Further more, all
staff should receive continuing education
when there are new schedules, vaccines or
recommendations.

62. COLD CHAIN
 The cold chain is a system of storage,
transport and distribution of vaccine in the
state of efficacy and potency at recommended
temperature from the manufacturer to the
actual recipient of the vaccine.
 The failure of cold chain system may lead to
ineffective protection against the vaccine
preventable diseases.

63. Cold chain cont’s
 Maintenance of cold chain is the corner stone
for the success of immunization program.
 All vaccines must be stored, transport and
distributed at the recommended temperature
by the manufacture in the literature
accompanying the vaccine, otherwise they
may become denatured and totally ineffective
with loss of potency.

64. COLD CHAIN CONT’S
 For successful cold chain system, three
elements are essential .i.e. Cold chain
equipment, transportation system,
motivation and training of the workers for
maintenance of cold chain link.
 among all vaccines, polio is the most heat
sensitive, requiring storage at -20c.polio and
measles vaccines must be store in the freezer
compartment. DPT, DT, TT, BCG,

65. COLD CHAIN CONT’S
 Typhoid and diluents of vaccines must be
stored in the cold part and never allowed to
freeze. Vaccines must be protected from
sunlight and contact of antiseptic. At the
health centers, most vaccines, except polio
can be stored at 4 to 8c for 5 weeks. Multi
doses opened vail, which is not used fully must
be discarded within one hour, if no
preservation is present.

66. C&C CONT’S
 It should be discarded within 3 hours or at the
end of a session when preservative is used.
 Necessary instruction for the particular
vaccine must be followed regarding
maintenance of required temperature.
Instruction for maintenance of vaccine vial
monitor {VVM} especially for oral polio vaccine
should be followed strictly.

67. COLD CHAIN EQUIPMENT
 The cold chain equipment's consist the
following:
 WALK IN COLD ROOMS: in the regional level,
vaccines are stored for 4-5 districts in the
walk in cold rooms at recommended
temperature up to 3months.
 DEEP FREEZER: is a top opening cold chain
equipment and available as 300 liters or 140
liters capacity.

68. CONT’S OF DEEP FREEZER.
 big deep freezer {300ltr.} is supplied to all
districts and the walk cold room locations
along with ice lined refrigerators. Deep
freezers are used for making ice packs and for
storing polio and measles vaccines. A pair of
deep freezer and ILR {ice line refrigerators } is
connected to a common voltage stabilizer.
 Small deep freezer {140 liter} along with ILR

69. CONT’S OF DF
 Are supplied to PHC, urban family planning
centers and postpartum centers.
 COLD BOXES: cold boxes are available at all
peripheral centers . They are used for
transporting vaccines and also for storing
vaccines during failure of electric supply.
Fully frozen ice packs are placed at the
bottom and sides of the cold box before

70. COLD BOX CONT’T
 Placing the vaccines in it. The vaccines should
be first packed in cartons or polythene bags
then to be kept inside the cold box. DPT,
DT,TT vaccines and diluent should not be
kept in direct contact with the frozen ice
packs.

71. DAY CARRIERS
 Day carriers are used for near by areas and
only for few hours period with two fully frozen
ice packs . It is used to carry small quantities
of vaccines i.e. 6 to 8 vial only.

72. VACCINE CARRIER
 Vaccine carriers are used to carry 16 to 20 vial
of vaccines to out reach sites to the
subcenters, village, vaccination clinic or camp.
Four fully frozen ice packs are packs placed for
lining the sides of the carriers. DPT, DT, TT
and diluents should not be placed in direct
contact of frozen ice packs. The carrier must
be closed tightly.

73. ICE PACKS
 Ice pack are used for cold boxes and vaccine
carriers. It is prepared in the deep freezer, ice
pack contains water, filled up to the level
marked on the side. No salt is added to it, leak
ice pack should not be used.

74. ICE LINE REFRIGERATORS
 Ice lined refrigerators is top opening
refrigerator two types of {ILR} are available,
one with ice tube {Electrolux} and other with
ice packs {vest frost} as the ice lining. The
bottom of ILC is coldest part. DPT, DT, TT
and diluents should not be kept directly on
the floor of the ILC as they can freeze and get
denatured.

75. ILR CONT’S
 These vaccines should be kept in the basket
provided within the ILR. Temperature of the
ILR should be recorded twice a day with the
dial thermometer which should be kept inside
the ILR, even if there is an in build
thermometer. Defrosting should be done at
regular interval with alternative arrangement
of storing the vaccines, during electric supply,

76. ILR CONT’S
 Failure or equipment failure, vaccines should
be transferred to cold boxes and then to
alternate storage.
 Deep freezer and ILR should be kept in cold
room away from wall. They will be kept in
levelled and to be fixed through voltage
stabilizer. The vaccine should be kept inside

77. ILR CONT’S
 The ILR neatly with space in between for air
circulation. The ILR should be kept locked
and open only when necessary, never stored
any other drugs, drinking water, foods or date
expired vaccines or more than one month
requirement all PHC level and do not open
these equipment unless required.

78. NOTE.
 At present, house hold refrigerator and
flask are not recommended as cold chain
equipment. Cold chain failure is commonly
observed at subcenter and village level, so
vaccines are not stored at sub centers and
supplied for the day of use only Nurses,
especially the community health Nurses
have to play major role in maintaining cold

79. CONT’S THE ABOVE NOTE.
 Chain to protect the potency of vaccines.
Successful implementation of immunization
program depends up on maintenance of
vaccine potency at the delivery end of
actual vaccination site.

80. HEALTH EDUCATION
 Is a process of informing motivating and
helping people to adopt and maintain
healthy practices and life styles.
 OR it is a process of promoting health and
reducing behavior induced disease.

81. AIMS AND OBJECTIVES OF
HEALTH EDUCATION.
 INFORMATION: it involves creating
awareness on people about health needs,
disease prevention and health promotion
and as well inform people about scientific
knowledge with regards to illness
/diseases.

82. MOTIVATION
 INFORMATION: information when not
backed up with motivation may not be
acted up on. Motivation is a way of
encouraging people to embark on positive
health behavior after providing them with
learning experience, which will influence
their habits, attitudes and knowledge.

83. ACTION GUIDE
 When fully informed and motivated, people
need to be guided into appropriate and
judicious utilization of the knowledge. Such
actions include utilizing health services.
Undertaking various healthful self help
programmes/measures.

84. TYPES OF HEALTH EDUCATION
 INDIVIDUAL: patient or people with
particular need
 GROUP: group of diabetic, alcoholic,
student or occupational.
 MASS.{public}: mixed group, safety aids.

85. FUNCTION OF HEALTH
EDUCATION
 Assess the health need of the people
 Plan and organize suitable materials for
health education at work places, schools,
homes, communities etc.
 Liaises and trains other health worker in
order to solve health problems.

86. CONT’S OF FUNCTION OF HEDT.
 Prepares relevant audio-visual aids
 Take part in evaluating local health
education programmes.

87. PRINCIPLES OF HEALTH
EDUCATIONS.
 Clarity: such that the message has a
favorable impact on the listener, Ambiguity
should be avoided.
 Simplicity: use language that the people
understand and straight to the point. It
should be according to the level of the
learner age experience education.

88. PHE CONT’S
 Interest: educate people based on their felt
need to draw their attention and interest.
 Participation: encourage participation to
facilitate learning
 Adaptability: should be such that the
community can implement. This goes with
acceptability of the message.

89. PHE CONT’S
 Comprehension: use simple language as
people would understand. Choose right
topic correct method and media.
 Diplomacy: not rigid but able to carry the
people along.
 Motivation: encourage or create a driving
force in the learner to enable them

90. PHE CONT’S
 Learn with eagerness, prizes, praises and
other incentives are useful stimulants
/motivators.
 Leadership: it involve the communities,
local leaders and school teachers, who
must be close to the people for easy
access.

91. ELEMENTS OF EFFECTIVE
COMMUNICATION.
 Sender {encoder} : this refers to the person
or communicator of the message.
 Message: this means, the idea being
transmitted. It should be objective, need
oriented, clear and understandable to the
audience.
 Channel: this is the medium used to pass
information to audience e.g. face to face,

92. CONT’S
 {interpersonal communication, mass
media {print-newspapers, posters, journal,
pictures, leaflets} and electronics {radio
television}.
 Receiver {decoder}-: this is the target
audience {communicatee} to who the
message is meant. It may be specific group
or whole population.

93. CONT’S
 Feed back: the receiver of the message
must comprehend and give a response. A
feed back may be positive or negative
thereby confirming the effect of the
message {whether or not the set objective
have been achieved} it makes
communication a 2-way process

94. BARRIERS TO EFFECTIVE
COMMUNICATION.
 Physiological: deafness, dumb, poor
planning wrong uses of media, use sign
language, copious visual aids.
 Psychological: emotion, poor
communication skill, inadequate
knowledge, distrust. Guard against own
emotion and prepare to control that of
others, be honest and knowledgeable.

95. CONT’S
 Environmental: noise, inadequate space,
socio-economic differences, power failure.
Control noise and avoid distracting
environment.
 Cultural: personality, beliefs, language
differences, attitudes and perceptions
religion, customs. Give clear explanation of
the message, carry out community
mobilization.

96. ISSUE TO CONSIDER IN
EFFECTIVE COMMUNICATION.
 Use same or familiar language
 Use local example
 Relate message to prevailing cultural outlook
of society, which will receive the health
information
 Be credible, use credible sources for the
message
 Be brief, accurate, coherent, concise, clear

97. CONT’S
and simple.
- Avoid information overload.

98. METHODS OF HEALTH
EDUCATION.
 Role- playing: e.g. Act out a character in a
short drama on causes of meningitis.
 Story telling: it could be a true or imaginary
story of e.g. a community that utilizes their
resources and their benefits.
 Group discussion and brain storming: it is a
participatory method in which the health
educator guides and help,

99. CONT’S
 The audience to share their experiences on
a selected topic.
 Panel discussion, simulation and counseling.
 Singing dancing and drama.
 Lecture: this method could be boring but
could be made interesting and effective if
well prepared, using visual aids.

100. CONT’S
 Demonstration: it is a practical method in
which e.g. oral rehydration solution or
locally available food sources are shown
and skillfully prepared following which the
group asks question and repeat the
exercise.
 Interview, project, field trip, home visits
campaigns, community mobilization.

101. NOTE.
 Health education could be delivered to an
informal group, seminar or workshop and
other formally organized groups. It could be
face to face to an individual group or
through mass media or when a larger
population is to be reached. Encourage
appropriate inter-personal{ 2- way, face to
face communication skills.