A synopsis of the field of health education in Malawi

Abstract

Health education can be defined as “any combination of learning experiences designed to facilitate voluntary actions conducive to health”1. Health education is therefore a planned activity, it is not haphazardly done. There are goals and means. Planning is the best predictor of success and “planning mistakes is the best predictor of failure”2. Health education is subsumed under the broader term “health promotion” which itself is said to be “a combination of educational and environmental supports for actions and conditions of living conducive to health”.1 This definition is broader and encompasses social, economic, political and environmental factors that come into play in influencing health behaviour. The field of health education is said to have been primarily a practice-based discipline throughout its history. Its origins can be traced to three traditions defined by the settings in which they operated. These settings were schools, communities and hospitals. One theme that has characterised the development of the field has been the search for an identity. School health education for example “Struggled for a professional identity separate from physical education”3. More recently within the last two decades health educators have attempted to borrow, develop and apply social and behavioural theories to guide practice. Freudenberg et al. point out that four trends have changed the practice of public health in recent years. First the distinctions among chronic, infectious and “social” diseases have become blurred. Health is now seen in a more holistic perspective rather than in categories each requiring a different focus; they all relate to one another. The second change that has impacted public health is the gap in health status between the rich and the poor. Third, the increased multiethnic environments in which health education practitioners work in the west. This has meant that the increased plethora of cultural values related to health has led to the recognition of the need to appreciate variety in approach to dealing with health education related issues4.