Rapid review of health promotion components of paramedics’curriculum

Authors: Panday, S., Simkhada, P.P. and van Teijlingen, E.

Conference: 1st National Health Promotion Conference in Nepal

Dates: 30 March-1 April 2013


Background: Despite the growing recognition of and the need for health promotion in health staff’s curricula there has been no review of the Nepalese curricula. This rapid review identifies the gaps in health promotion components within the paramedical curriculum.

Methods: A framework was prepared for the evaluation of health promotion components using WHO Ottawa Charter guidelines, European health promotion strategies and the general health promotion literature. A basic Content Analysis approach was used to record the presence or absence of each health promotion component in each curriculum.

Results: Curricula of General Medicine (Health Assistant), Auxiliary Nurse Midwife (ANM) and Community Medicine Assistant (CMA) were reviewed with the above framework. The second year of the Health Assistant curriculum involved a course on “foundation of health education and health promotion”. This course mainly explained the health education process in detail, determinants of health and key factors of health education such as learning, motivation and change process. The health promotion content involved five hours of theory classes with description on scope, principles and Ottawa Charter. Both ANM and CMA curriculum do not include any formal health promotion. Likewise, the CMA course involved detailed content of health education and communication but, as with the health assistant course, doesn’t discuss active participation of community members in recognising their health need. The CMA course merely explains the role of CMA to prevent disease in the community or schools. The community health nursing part of the ANM curriculum has some health promotion content, however, the content reflects more on public health interventions than health promotion.

Conclusion: All three curricula (Health Assistant, CMA and ANM) lacked major components of health promotion. Despite the inclusion of the term health promotion in the subject heading of Health Assistant, health promotion is a peculiarly small sub-unit with less clear notion of how the course will deliver its different components. None of the curricula reviewed provides a comprehensive account of health promotion components such as community participation, capacity building, and approaches of health promotion interventions which were vital to health promotion. As health promotion is integral to improve the health of individuals and their communities, and is substantial for community empowerment, steps should be taken to revise and incorporate the health promotion component in paramedical curricula.


Source: Manual

Preferred by: Edwin van Teijlingen