Health communication in primary health care

INTRODUCTION

Primary health care (PHC) has been singled out as the most suitable health care setting to meet the increasing need for health promotion interventions and to curb the rising number of chronic diseases.^1-3 A majority of people depend on health care services for health information, yet PHC is poorly equipped to provide this service.⁴ Developing information communication technology (ICT) supported health communication in PHC could contribute to increased health literacy and empowerment, which are foundations of health promotion and the notion of enabling people to increase control over their health and its determinants, and thereby improve their health.^5,6 It is however essential to conduct a detailed analysis of the setting and context prior to implementing an intervention in order to “avoid murky water and increase the likelihood of success^”.⁷ The aim of this study was to gain a better understanding of health communication for health promotion and factors affecting such communication in a PHC setting, as a first phase in the development of an ICT supported health channel.

ALTERNATIVES

Health communication

The development of health communication for promoting health has mainly taken place outside the health care services.¹ When health communication does occur within the health care services, it lacks a broad socio-ecological health promotion approach, needed to tackle lifestyle related ill health and health inequalities.^8,9 An ecological health promotion approach addresses socioeconomic and cultural factors that determine health as well as providing information and life skills to make appropriate health decisions. Such an approach includes both promoting health and preventing diseases, and is referred to as a health promotion approach in this paper.¹⁰ Consistent with this health promotion approach, health communication in this article is defined as ‘the art and technique of informing, influencing and motivating individuals, institutional and public audiences about important health issues’.¹¹ The communication adopts a participatory approach whose main aim is empowerment through dialogue and mutual learning; the process is as important as the outcome.¹²

PROPOSED SOLUTION

Participatory communication could facilitate collaborative learning for both provider and receiver of health communication.¹³ Health communication providers can learn about receiver’s needs and preference for health communication through collaboration process; an insight that could enable them to construct health communication resources that is relevant and accessible to intended receivers. Likewise, receivers may gain more knowledge on health and health management as well as relationship between health and lifestyle through the same dialogue process.¹⁴ Raising health literacy of both parties is important for sustainable health care services.

As a concept, health literacy encompasses more than transmitting health information and developing skills. It entails improving people’s access to health information and support capacity to use it effectively; in order for them to make informed choices, reduce health risks and increase quality of life. In this light, health literacy is an important public health goal to reduce inequity.⁶

RECOMMENDATIONS

ICT- mediated health communication

ICT mediated health communication media, with internet at the forefront should become an accepted strategy for communicating health. Internet’s flexibility and accessibility through different channels makes it an ideal platform for communicating health.

Health channel is defined as a mode of transmission that enables messages to be exchanged between “senders” and “receivers.” In the context of internet, senders of the communication may have to contend with participants who engage, contest, reframe and deepen the messages in the communication process. This may take place either in an on-going dialogue in real-time or via other feedback avenue. Implementation of ICT for health communication or aspects of ICT in health communication, as in eHealth applications, is essential to meet growing demands for cost-effective, appropriate and individually tailored health care as well as to increase accessibility to health services, improve population health outcomes and to achieve health equity.

CONCLUSION

Health communication is an integral part of health promotion practice in PHC in this case study. However, there was a lack of consensus among health professionals on what a health promotion approach was, causing discrepancy in approaches and practices of health communication. Health communication practiced in PHC is individual based, preventive and reactive in nature, as opposed to population based, promotive and proactive in line with a health promotion approach. The most significant challenge in developing an ICT supported health communication channel for health promotion is profiling a health promotion approach in PHC. Addressing health promotion values and principles in the design of ICT supported health communication channel could facilitate health communication for promoting health, i.e. ‘health promoting communication’.

ACKNOWLEDGEMENTS

It is proud privilege to record my heartfelt gratitude and indebtedness to my esteemed teacher Dr S. Gopalkrishnan (MD), Professor & Head, Department of Community Medicine, Sree Balaji Medical college, Chennai who able guidance, untiring constant supervision, sympathetic attitude and encouraging polite expressions are really unforgettable, without it, it would have been impossible to give shape to this piece of work.

I am equally indebted to Dr. J. Krishnakumar for his kind suggestion and technical know-how in setting up this work. Words are inadequate to express my deep sense of gratitude for his constant encouragement and meticulous scrutiny at every stage of this work. Before I conclude, I pause to bow with deep gratitude and unfounded obligations before them whose names have not been mentioned but have stood to my cause, rendered me unconceivable help and infused substantial moral and encouragement at every step of my work.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not Required

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