III YR MBBS [1.03.

23]

IEC, BCC & Methods of health education [1.03.23]

[Competency – CM 4.1 & CM 4.2]

INFORMATION EDUCATION AND COMMUNICATION [IEC]

IEC is pre-planned concerted educational endeavor with specific objectives, focused towards
specific progress goals in order to reach audience either in individual, group or mean setting
through skillfull use of proper methods and media.

Aims of IEC:
• To change health behaviour of individuals, family and community.
• To prepare basis for change in health behaviour.
• To change the norms of the community.
• To facilitate public health education and to create awareness.

Scope of IEC in relation to health:

• Primary health care
• Prevention & control on communicable diseases.
• Reproductive, maternal and child health services.
• Family welfare
• Nutritional services
• Personal hygiene

BEHAVIOUR CHANGE COMMUNICATION:

Stages of behaviour change:

1. Unaware
2. Aware
3. Concerned
4. Knowledgeable
5. Motivated to change
6. Trial behaviour change
7. Sustained behaviour change

Steps in BCC strategy:

1. Establish program goals
2. Involve stakeholders
3. Identify target audiences
4. Conduct formative BCC assessment
5. Segment target audiences
6. Define behaviour change objectives
7. Design BCC strategy and monitoring and evaluation plan

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8. Develop communication products and activities

9. Pre-test communication products and activities
10. Implement and monitor program
11. Evaluate program
12. Analyse feedback and re-design

BCC Example - Family planning: Behaviour change

Stage1: Unaware to Aware: If most of the people are unaware, then first of all we have to
make awareness among people about the family planning.
Stage 2: Motivation: Second steps is, we have to motivate them for taking family planning.
Stage 3: Action: We have to identify for them how to take an action about this planning.
Then they will start acting on this family planning.
Stage 4: Maintenance: After staring action many people leave this. [ After BCC, there was
62% contraceptive use in Bangladesh. But 46% of them don’t continue it.] So we have to
show for them an effective way how to maintain family planning program for long time with
benefits.
Stage 5: Feedback and redesign: We have to make sure that they won’t relapse their new
practice about family planning.

Challenges in BCC:
• Creating an enabling environment
• Constant monitoring
• Capacity building and training
• Confusion between IEC and BCC
• Sustainability
• Budgets
• Linkage and coordination

IEC BCC
• Used for generating awareness. • Used for enabling action.
• It is a process to develop • It is a process of providing
communication strategies in order to supportive environment which
promote positive behaviour. enables people, to initiate and
• It provides information to the people sustain positive behaviour.
and tells them how they should • It not only provides information, but
behave. also helps people to take decision.

HEALTH EDUCATION:

Definition Of Health Education Alma-Ata Declaration ( 1978)

A process aimed at encouraging people
To want to be healthy
To know how to stay healthy
To do what they can to maintain health
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To seek help when needed

Contents of health education:

1. Human Biology
2. Nutrition
3. Hygiene
4. Family Health
5. Disease prevention & control
6. Mental Health
7. Prevention of Accidents
8. Use of health services

Approaches to health education:

1. Regulatory approach
2. Service approach
3. Health education approach
4. Primary health care approach

Models of health education:

1. Medical model
2. Social intervention model
3. Motivational model

METHODS OF HEALTH EDUCATION:

1. Individual
2. Group
3. Mass

Individual approach:
1. Personal contact
2. Home visits
3. Personal letters
Advantages:
• Can discuss, argue and persuade the individual to change his behaviour.
• Provides opportunities to ask questions in terms of specific interests.
Limitation:
• The numbers reached are small
• Health education is given only to those who come in contact.

Group approaches:
1. Lectures [Chalk and talk]
2. Demonstrations
3. Discussion methods
• Group discussion
• Panel discussion

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• Symposium
• Workshop
• Conferences
• Seminars
• Role play

1.Lecture [Chalk and talk]

A lecture may be defined as carefully prepared oral presentation of facts, organized thoughts
and ideas by a qualified person.
Advantages:
• Economical
• Covers larger group in small time
• Minimal resources required
Disadvantages
• Students are involved to a minimum extent
• Learning is passive
• Do not stimulate thinking or problem-solving capacity
• The comprehension of a lecture varies with the student
• The health behaviour of the listeners is not necessarily affected.

2.Demonstrations:
A demonstration is a carefully prepared presentation to show how to perform a skill or
procedure.
Advantages:
• Dramatizes by arousing interest
• Persuades the onlookers to adopt recommended practices
• Upholds the principles of "seeing is believing" and "learning by doing”
• Can bring desirable changes in the behaviour.
Disadvantages:
• Time consuming if target group is large
• May be expensive
• Not appropriate for all topics

3.Discussion methods:

i. Group discussion
It permits the individuals to learn by freely exchanging their knowledge, ideas and opinions.
The group should comprise of 6 - 12 members.
The participants are all seated in a circle.
There should be a group leader who initiates the subject, helps the discussion in the proper
manner.
A person to record whatever is discussed and prepare a report.

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ii. Panel discussion

4 to 8 persons who are qualified to talk about the topic sit and discuss a topic, in front of a
large group or audience.
The panel comprises, a chairman or moderator and from 4 to 8 speakers.
There is no specific agenda, no order of speaking and no set speeches.
After the main aspects of the subject are explored by the panel speakers, the audience is
invited to take part.
The discussion should be spontaneous and natural.

iii. Symposium
It is a series of speeches on a selected subject.
Each person presents an aspect of the subject briefly.
There is no discussion among the symposium members.
In the end, the audience may raise questions.
The chairman makes a comprehensive summary at the end.

iv. Workshop
It consists of a series of meetings, with emphasis on individual work, within the group, with
the help of consultants and resource personnel.
The individuals work, solve a part of the problem through their personal effort with the help
of consultants and also contribute to group work.
Learning takes place in a friendly, happy and democratic atmosphere, under expert guidance.

v. Roleplay
Role playing is based on the assumption that many values in a situation cannot be expressed
in words.
The group members who take part in the socio-drama enact their roles as they have observed
or experienced them.
It is a useful technique to use in providing discussion of problems of human relationship.
It is a particularly useful educational device for school children.
Role playing is followed by a discussion of the problem.

vi. Conferences and Seminars

The programmes are usually held on a regional, state or national level.
They range from once half-day to one week in length and may cover a single topic in depth or
be broadly comprehensive.
They usually use a variety of formats to aid the learning process from self instruction to
multi-media.

Mass approaches/ Mass media

1. Television

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2. Radio
3. Internet
4. News paper
5. Printed material
6. Direct mailing
7. Posters, billboards
8. Health museums and exhibitions
9. Folk media

1. Television:
It is effective in not only creating awareness, but also to an extent influencing public opinion
and introducing new ways of life.
It is raising levels of understanding and helping people familiarise with things they have not
seen before.
TV is a one-way channel.
It can only be an aid to teaching and cannot cover all areas of learning.
It has much potential for health communication.

2. Radio:
It can reach illiterate population not accessible through printed word.
It is a purely didactic medium.
It can be valuable aid in "putting across" useful health information, in the form of straight
talks, plays, questions and answers and quiz programmes.
Doctors and health workers can speak about local health issues leading to increased general
awareness.

3. Internet:
A fairly large number of persons are using this media, and the numbers are growing.
Vast amount of health related literature from WHO and other health agencies is available
The Health related information from the ministry of health and family welfare Govt. of India,
is also available on their website.

4. Newspapers:
Newspapers provide more factual, detailed and even statistical material.

5. Printed materials:
Magazines, pamphlets, booklets and hand-outs etc.
Convey detailed information.
Can be produced for very little cost and can be shared by others.

6. Direct mailing:
These are sent directly to village leaders, literate persons, panchayats and local bodies and
others who are considered as opinion leaders.

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It is possibly the most personal of mass communication.

7. Posters, billboards and signs:

The message to be communicated must be simple, and artistic.
Displayed in places where people have some time to spend (e.g., bus stops, railway stations,
hospitals, health centres) the poster can present more information.

8. Health museums and exhibitions:

If properly organized, health museums and exhibitions can attract large numbers of people.
By presenting a variety of ideas, they increase knowledge and awareness.

9. Folk media:
The folk (or indigenous) media – Keerthan, Katha, Folk songs, Dances and dramas , Puppet
shows have roots in our culture.

Difference between health education and propaganda:

Health education Propaganda

1. Knowledge acquired through self- 1. Knowledge is installed or forced into
reliant activity. mind through passive spoon feeding.
2. Behaviour centered. 2. Information centered.
3. Makes people to think 3. Discourages thinking
4. Disciplines primitive desires. 4. Stimulates primitive desires.
5. Develops reflective behaviour 5. Develops reflexive behaviour
[Judgement before acting] 6. Thought process is suppressed
6. Thought process is promoted which appeals emotions.
which appeals reasoning. 7. Develops attitudes.
7. Develops personality.

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