In this Study Session, you have learned that:

• Predisposing factors: These are an internal mental apparatus which provide a rational or motivation for a behaviour to occur. These internal mental apparatus includes--knowledge, belief, attitude, values and self-efficacy of a person before performing a behaviour.
• Enabling factors: These are characteristics of the environment that facilitate the healthy behaviour to occur and any skill or resource required to attain that behaviour. Examples of enabling factors include: availability, affordability of access, affordability of health resources, conditions of living, social support, Government laws, (priority and commitment to health), and the presence of health-related skills. Moreover, to attain desirable behaviour from a person, behavioural intentions ( personal attitude, subjective norms and perceived behavioural control towards the behaviour) are important provided that enabling factors (resources) are available.
• Reinforcing factors: This refers to the pressure from the significant individuals to influence the behaviour of other individuals. The most important reinforcing factors for a behaviour to occur or avoid include family, peers, teachers, employers, health providers, community leaders, decision makers-- these and others are known as influential individuals or significant others who encourage or discourage us from performing certain health-related behaviours.

• These reinforcements or influences may be positive---refers to the praise or reward because it is followed by the presentation of something desirable or negative reinforcement---it is punishment followed by the presentation of undesirable behaviour.
• Disease: It is a negative health state identified by a health worker through the application of scientific methods like physical examinations, history taking, blood smear test and X-rays.
• Illness: This is also a negative health status of a person stated by a person himself. This is a subjective state of being not well;
• Sickness: This is a third state of being not well as determined by the society.
• There are two types of explanations about the cause of diseases:
• Naturalistic. It assumes that the cause of the disease is impersonal and can be potentially understood and cured by the application of the scientific method. Therefore, according to this assumption, the cause of a disease might be bacteria, viruses, parasites and other scientifically known factors.
• Personalistic: It assumes that the cause of diseases is traditionally known and determined. Therefore, according to this assumptions, diseases are caused by a curse of the supernatural beings.
• The role of a Health Extension Worker as a health educator is to understand and identify the individual and community-level perceptions towards disease and educate people towards naturalistic explanations of the cause of illnesses while being aware of their personalistic ideas.