By the end of this session participants should be able to:
1-Define Health Education (HE), Counselling, and Communication.
2-Identify the principles for effective communication.
3-Describe good counseling and HE components.
2. Objectives of this presentation
By the end of this session participants should be able to:
1. Define Health Education (HE), Counselling, and Communication.
2. Identify the principles for effective communication
3. Describe good counselling and HE components
3. Communication
Communication is a process of sharing information using a set of
common rules.
-Linear approach:
One person sending a message along a channel to another
person.
-Transactional approach:
Both the sender and the receiver are affected by and affect each
other.
4. Successful communication brings satisfaction to the physician and to
the client/patient
• The physician used his knowledge and skills to be a useful person
• The patient feels well taken care of, the doctor is concerned and
understands
5. The result
• Patient comply
• Change
• Get well
Communication for Behaviour Change (CBC)
Behaviour Change Communication (BCC)
6. Both the physician and the patient brings to the relationship the
properties common to all communication:
• Perception
• Evaluation
• Expression
11. Effects of Communication
1. Intentional effects: The direct predictable change in Knowledge,
Attitude, and Practice (KAP)
2. Unintended effect: The indirect influences and unpredictable
results of communication
13. Improving verbal communication
1. Clear language
2. Appropriate language:
• Words are meaningful and suitable to the listener
• Consider relevant factors as age sex, education, culture, interest of
the listener,…
3. Vocabulary building and improving your language
14. Non-verbal communication
• The term non-verbal communication describes all human
communication that is not written or spoken
• Reinforces/complements the verbal message
• May replace the verbal message
• Regulates the verbal message
• It may contradict the verbal message!
15. Categories of non-verbal
communication
• Body movements, gestures, posture.
• Facial expressions and eye contact.
• Space and distances:
• -Intimate (45 cm).
• -Personal (45-120 cm).
• -Social (120-360 cm).
• -Public (>360 cm).
• Touch.
• Time factor: respect and utilization.
• Personal appearance.
• Para Language:
• -Vocal characteristics.
• -Vocal interferences.
16. Communication Barriers
• Failure to introduce self
• Not addressing the receiver by name
• Talk too much / too much is said
• Talk in an impersonal way
• Use technical language
• Failure to respond to the client expectations/needs
17. Communication Barriers (Cont)
•Social and cultural gap between the educator and the
client; (Social class, beliefs &sex).
•Limited receptiveness of the client:
•(Confusion, tiredness, distress, distraction).
•Negative attitude to the health educator. (client
thinks he knows everything/ cannot perform the
advice given to him).
•Limited understanding and memory.
•Contradictory messages.
18. Successful Communication
• Friendly interest
• Attendance to receiver concerns
• Specific instructions
• Expression of trust in the ability of the receiver to follow
instructions
• Non-medical / social conversation
• Consider the receiver need to understand and be understood
19. How can the physician communicate
skilfully
• Physician patient relationship
• Information gathering skills
• Information giving skills and patient education
20. Physician Patient Relationship
• Appropriate physical environment.
• Greeting the patient.
• Respect the patient and put his interest first.
• Respond to the patient’s questions
• Active listening, listen, reflect and encourage.
• Give the patient sufficient information.
• Negotiate .
• Build trust.
• Never pass your patient to someone else.
• Express empathy in certain situations.
• Accept the benign health beliefs of the patients.
• Summarize your points at end of meeting.
21. Active listening
• Hearing is a physiological function, listening is a psychological
activity
• Listening is an active inner/outer process
• By active listening you can catch what other people don’t say; you
can gain information about how they feel and what is happening
inside their emotional and psychological world
23. Information Gathering Skills
• Questions:
• Open ended and closed ended.
• Silence (pause).
• Try to know expectations of the patient.
24. Information Giving Skills
• Sequencing the events.
• Directing the flow of information.
• Summarize your points at the end.
• Follows the rules of health education messages.
• Put important things first.
25. Counselling
Counselling is a process that uses communication skills to help
client/patient to reach an informed decision/choice
Counselling will provide customized, client-oriented information and
negotiate available alternatives to help take a decision based on
clear information
26. Principles for good counselling
• Treat each client well
• Interact actively
• Give the right amount of information
• Tailor and personalize the information
• Use and provide memory aids
• Provide the services that satisfy the client’s expectations. Help
clients remember instructions.
27. The Elements of Counselling
G A T H E R
Greet
Ask
Tell
Help
Explain
Return visit
28. Greet
• Give the clients your full attention as soon as you meet them.
• Be polite, friendly and respectful.
• Introduce your self and offer them seats.
• Ask how you can help?
• Explain what will happen during the visit.
• Conduct counselling privately
29. Ask about
• Reasons for coming.
• Their experience with the health matter that concerns them.
• Any information needed to complete client records.
• Ask Clients about themselves and their families as appropriate.
30. Help Client
-To decide what choices and decisions they face.
-To express their feelings, needs, wants, and any doubts,
concerns or questions.
• Keep questions open, simple and brief.
• Look at your client as you speak.
• Listen actively to what the client says.
• Show your interest and understanding all the time.
• Tell the clients about their condition or Choices
• Help clients understand their possible condition
• Information should be: Simple, correct and relevant
31. Help client to understand
• Help the clients think about the results of each
possible choice.
• Ask if the client wants anything made clearer,
repeat and rephrase information as needed.
• Check whether the client has made a clear
understanding .
• “What have You understood?”
• “What have you decided to do?”
• Wait for the client to answer.
32. Explain what to do
• Give supplies, if appropriate.
• If the service cannot be given at once, tell the
client how, when and where it could be provided.
• Describe possible side effects and what to do if
they occur.
• Ask the client to repeat instructions .make sure
the client remembers and understands.
• If possible give the client printed materials to take
home.
• Explain when to come back and why
33. Return visit
• Check if the client is using the treatment correctly.
• Ask if the client has any question or anything to discuss.
Consider all concerns seriously.
• Ask if the client is satisfied, has there been any problems since
last visit???
• Help the client handle any problems.
• Refer client who need specialized care.
34. Useful messages for the provider
• Be nice
• Focus on the person
• Segment information
• Use and provide health education material
35. Health Education (HE)
HE is a process of transferring (conveying health relate information
to the target group.
Successful HE should lead to change of behaviour and adoption of
healthy practices
37. Characteristics of the educator
•Motivated.
•Know all details about the topic.
•Know as much as possible about socio demographic
characteristics of the target group.
•Have sufficient information about KAP of the target
group.
•Act as a model.
•Trained on
•Panning, implementing and evaluating (PIE) health
education intervention.
•Communication skills.
38. Role of the educator
• Conduct needs assessment.
• Plan effective HE program.
• Implement HE programs.
• Evaluate effectiveness of HE programs.
• Coordinate the provision of HE programs.
• Acting as a source person of HE.
• Communicating HE needs, concerns and resources.
39. Message design
• Address one major concern at a time.
• Simple, clear and easily understood.
• Cheap and doable (action oriented)
• Does not contradict with traditions or religions.
• Physically accessible .
• Acceptable; socially and religiously.
40. Examples of target groups
•Pregnant and lactating women.
•Mothers of infants and children for:
•Nutrition, hygiene, accidents prevention, diarrhoea
prevention and dietary management &
immunizations.
•School and university students.
•Occupational workers.
•Elderly.
•Patients with chronic diseases.
•All Public “Social Marketing”.
41. Methods of HE
• One: one contact (1:1):
-Like patient and physician meeting.
-Counselling.
• One: More than one contact (1:>1):
-Seminars.
-Group discussions.
-Lectures.
-Social marketing (mass media).
-Public speaking.
43. Materials
Materials are classified according to their price and
technicalities from cheap and simple to expensive and
sophisticated:
• Chalk and board.
• Flip chart.
• Handouts and written materials. News papers and
magazines.
• Slide projector.
• Data show projection.
• Video and TV.
• Film projection.
• Cassettes /Radio.