Psycho-Socio Impediments of Media Advertising in the 21st Century Health Education Practice in Nigeria

It is the opinion of researchers that media advertising has positive effect on health education practice. However, this study examines psycho-socio impediments of media advertising in the 21 st century health education practice in Nigeria. In addressing this study, information were gathered through content analysis, documentary or literature review. The study adopted expository method. Critical areas of media advertising and their major impeding variables among others were x-ranged in the study especially, with regard to the 21 st century health education practice in Nigeria. Various concepts and theory that are related to the study were well utilized. Based on the literatures explored, the paper recommended that media advertising agents should always pay more attention on issues of health education in order to improve the wellbeing of individuals in the society.


Introduction
The importance of health education or literacy remains a vital tool in developed and developing nations because of its role in bettering the living standard of people. Health education provides good opportunity through which people gain access to health information and improve their life spam and, perform optimally in their day to day functions.
Health education provides opportunity for promoting good nutrition, best means relaxation among different individuals, disease prevention and positive prevention of teenage pregnancy among others. There is need for proper media advertising of health information as to meet the health need of the growing population of people in this 21 st century. Amadi (2019) noted that the 21 st century is characterized by rapid population growth which also requires rapid health communication for healthy living.
However, the media is an indispensible organization in providing necessary information to individuals including health information. The media advertising helps in quick and better understanding of most health information and also provides communication in health education. To guide this study properly the following emerging components where treated below:

Meaning of Health
The World Health Organization defines health as a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity (WHO in Okoye, 2018). This definition is an acknowledgement that health is more than non-disease. Health education has been described as any planned activity, which promotes learning about illness or health so that there is some relatively permanent change in a person's knowledge and ideas (Royle & Walsh in Openi, 2016). Health education involves the whole person throughout the entire life, regardless or how ill or well that person may be at any given time. It involves helping people to help themselves, either individually, in families, or in larger communities, by using a wide range of teaching techniques to achieve goals which often involve changing behaviours, attitudes and social circumstances (Royle & Walsh in Openi, 2016). Health education may be defined as a process with intellectual, psychological and social dimensions relating to activities which increase the abilities of people to make informed decisions affecting their personal, family and community well-being.

Significance of Health Education
Health education imparts knowledge to the individuals, which is essential to be put into operation to maintain good health. It is comprehensively understood that all the individuals are focused towards achievement of personal and professional goals. All individuals carry out different types of tasks and activities. Hence, in order to carry out one's tasks and activities in an appropriate manner, the individuals need to maintain good health, physically as well as psychologically. When the individuals are healthy, they are able to put into operation, their tasks and activities in a satisfactory manner and generate the desired outcomes (Obi, 2020).
The primary aim of health education is to impart information to the individuals in terms of methods and approaches, which are essential to maintain good health. To maintain good health, there are various factors, in terms of which the individuals need to generate awareness. These include, measures to maintain body weight, measures to prevent diseases and health problems, information in terms of diet and nutrition, ways of overcoming eating and sleeping disorders, significance of exercises and physical activities, techniques of yoga and meditation, measures of coping with psychological problems of anger, depression, anxiety, stress, trauma and loneliness and creating a clean and pleasant environment within as well as outside the homes.

Significance of Health Education
(1) It improves practical ways of using health information to better our health.
It provides a level playing ground for patients and care providers to interact.

Principles of Health Education
The principles of health in health education practice are highlighted as follow: credibility, interest, motivation, comprehension, reinforcement and participation.

Aims of Health Education
The aims of health education have been stated as follows: Provide information in terms of health as community asset: One of the indispensable aims of health education is to provide information in terms of health as community assets. The main reason being, when the individuals will maintain good health, only then they will be able to carry out their tasks and functions in a well-organized manner, participate in various activities, promote well-being and enrich their overall quality of lives (Obasi, 2010).

Maintain Norms of Good Health:
To maintain good health, there are various factors, which need to be taken into consideration. These are, diet and nutrition, exercises and physical activities, maintaining a clean environment within as well as outside the homes.
To take precautionary measures against communicable diseases: Taking precautionary measures against communicable diseases is of utmost significance for all individuals. The individuals belonging to all communities are imparted information in terms of the measures against communicable diseases.

Promote Mental and Emotional Health:
Mental and emotional health of the individuals is important as physical health. To lead to enrichment of one's overall lives and achieve personal and professional goals, the individuals need to focus upon promotion of mental and emotional health.
Provide Assistance to Children in Understanding Nature and Purpose of Health Care Services and Facilities: From the stage of early childhood, the parents as well as teachers make provision of knowledge to the individuals in terms of health education and nature and purpose of health care services and facilities.

Materials used for Health Education
The following are some materials used in delivering health education (knowledge): (1) Social media, e.gWhatsApp platform, twitter, Facebook, to go, e-mails, YouTub. (2) Textbooks, journals, periodicals, pamphlet, newspapers, tracts and publications of different types.

Methods of Achieving Health Education
There are several ways of achieving health education but we shall group into three basic methods such as: Manual method, Electronic method and mechanized method.
(1) The Manual method of achieving health education deals with the application of physical strength and much effort to achieve knowledge, which can be very stressful. E.g the community leaders using town criers, churches using pastors on pulpits, teachers using textbooks, journals, periodicals, pamphlets, newspaper in talking to their students about their health, opinion leaders gathering groups with the use of slogans just to pass information.
The electronic method of achieving health education entails the use of electronic devices to transmit structured information relating to the populace's health at any given point in time, example of materials used here are: social media i.e. WhatsApp, twitter, YouTube, to-go, Facebook, e-mail, skype, etc.
The mechanized method deals with the use of highly mobilized techniques with machines to deliver the health related information to enhance knowledge among the populace to change their perception on some health issues. Examples of materials used here are as follows: television, radio, telegram, multimedia projector, tape records, videos, films, etc (Nwialu, 2021).

Materials used in Media Advertising of Health Education
There are several materials used by the media in advertising health information technologically within and outside the hospital for effective health care services; they include the following: Social media e.gWatsApp, twitter, YouTube, skype, internet, etc., multimedia projector, computers, scanners, television, videos, films, digital cameras, digital versatile disk (DVD), video Compact Disk (VCD), tapes, close circuit television (CCTV), etc. Some of them are discussed as follows: (a) Videos: These are captured or recorded vital events for records purposes which serve as a means of communication and data preservation medical record profession.
(b) Films: These are also used in capturing moving objectives as pictures that can be shown on the screen of a television, which tells stories of real life situations that are movable. This can be used in theatres or in preserving patient's records.
(c) Television: These are mechanical or electronic set that are used in communication as a system of sending pictures and sound through a signal over a distance where people can receive them at home. This serves as one major means through which people gather information.
(d) Social Media: This depends on computers and their related network which provides knowledge or services to users provided you can afford to pay for the services. This has become a major source of information which is accurate and reliable. It engages the use of community support to deliver information (Yine, 2016).
(e) Close Circuit Television (CCTV): This electronic gadget is used to enhance security network within the hospital environment to protect lives and properties from being destroyed.
(f) Multimedia Projector: This is used in presenting synchronized data or information to persons who are in direct need of such information in organized settings. They are used in delivering audio-visual information, to entertain educate, inform and to communicate to the audience the needed information (Nwialu, 2021).

Theoretical Framework
Health education is based on the theory that health behaviours can be changed. Behavioural change theories are used to explain and influence health behaviours of both individuals and social groups. One theory or a combination of theories may be used to influence health related behaviour (Murphy in Oguogu, 2019). At individual level, stages of change model and Health belief model may be utilized. Stages of change model describe individual's readiness to change or attempt to change toward healthy behaviours. Five distinct stages identified are: pre-contemplation, contemplation, decision, determination, action and maintenance. This is a circular model and not a linear model. The basic premise of this model is that behaviour change is a process and not an event, and that individuals are found at varying levels of motivation or readiness to change. Therefore, if health education is to be effective in changing negative health behaviours towards positive health behaviour, then health educators should design programmes that will facilitate health education at various level of society (Ahmed, 2013).

Concept of Media Advertising
The term 'media' means "channels of communication". Advertising media refers to the various media channels through which advertising is done. Advertising media is used for showcasing promotional content which is communicated in various forms such as text, speech, images, videos using TV, radio, online, outdoor etc. Basically these are channels through which issues and activities are communicated to people (Nwogu, 2016).
Advertising is an act of priority useful information to the general public on any contemporary issues through radio, television newspaper or internet for their benefits (Obasi, 2010).
Traditional media has been used in the advertising world for years. These include newspaper, magazines, radio, television, outdoor, cinema advertising and direct mail and so on. Traditional media are the most common form utilized by advertisers since decades. Over the course of last years, more businesses are making use of new age media to reach target audience.

Types of Media
Media advertising is categorized into five and they are: i.
Outdoor or out of home (OOH) media iv. Internet (i) Newspaper: newspaper is a major source of information for a large number of readers. It may be national or local, daily or weekly newspaper. Newspapers allow presentation of detailed messages which can be read at reader's conveyance. It allows prompt delivery of detailed coverage of news and other information with interesting features for readers. It is a high involvement media as readers are required to devote some effort in reading the message. It is classified into the following: National newspaper, daily newspapers (local / regional), special audience newspapers.Its types include; magazine, classified advertisement, display advertisement, special inserts, free standing insert.
(2) Broadcast Media-Television Advertising: TV is a principal source of information and entertainment for people exposed to mass media, it is believed to be the most authoritative, influential, exciting medium for reaching very large audience. It combines visual images, sound, motion and colour to achieve viewer's empathy. It allows development of creative and imaginative and messages in a unique way. It is considered intrusive in nature as the audience has no control over the nature and pace of advertisements.
(3) Radio: Radio is a premier mass medium for users and advertisers. It has a wide spread reach, it delivers the ad message to a large number of people across the length and breadth of a country. Commercial broadcasting is undertaken in major cities even rural areas (Ahmed, 2013).
(4) Outdoor Advertising: It is usually used as a supportive medium by advertisers. It includes bill boards, boarding, neon signs posters etc. It can generate considerable reach and frequency level at low cost, useful when introducing a new product.helps to remind the customers, helps to generate sales at point of purchase / point of sale.
(5) Internet: Internet is a worldwide medium that provides means of exchanging information through a series of interconnected computers. It is a rapidly growing medium of advertising. It is a future medium which offers limitless advertising opportunities. It involves use of worldwide web to showcase a website or e-commerce portal to the world. Advertising through internet involves email marketing, social media marketing, online ads and mobile marketing. It provides a sophisticated graphic user interface to users.

Types of Internet Advertisements
Websites -Online Brochure of product / services, virtual office Ad buttons -icons which provide link to advertiser's website. Ad bannerscreative & dynamic display ads. Sponsorshipcompanies sponsor bloggers to write about them. Classified adssimilar to newspaper ads E-mail -Electronic mails carrying ad message.

Importance of advertising media in health education
(1) It helps in quick transmission of health knowledge (2) It makes health information accessible in different forms.
It helps in proper interaction and evaluation of health issues. (4) It helps in discouraging factors that may affect health practice among practitioners.

Psycho-Socio Impediments of Media Advertising of Health Education
The following have been stressed as psycho-socio of the impediments of media advertising of health education (Edem, 2015;Oguogu, 2019).
(1) Interest: Media advertisers pay interest to areas of their concern in advertising health information. There cases where health issues are being skipped by advertising agent due to their lack of interest in such information which could affect the interest of others in the society positively. (2) Attitude of Individuals: The poor attitude of individuals towards health related information when it is been advertised discourages advertisers from subsequent attention to such area. Lack of motivation of Media Advertising Personnel: The lapses by employers in media industry in terms of alround payment motivation and other social security creates serious barriers in commitment of personnel in media advertising including advertisement of health education issues for individuals in the society. Media personnel need high motivation in areas of high payment and other entitlement. This will encourage them in the discharge of their functions effectively especially, on health education issues. (6) Lack of security: In a developing nation like Nigeria a lot of social issues that will enhance the wellbeing of individuals are carefully managed due to the fear of unknown. Most health issues are inter-related with a good number of social issues in the society and this in most cases calls for carefulness and reservation in health education. (7) Lack of cooperation between health workers and media personnel: Obasi (2020) explained that the synergy between health and media personnel's are crossly poor in most developing nations like Nigeria and this affects the ability of the two sectors in working together for knowledge enhancement and communication of health information effectively to the society.
(8) Government Factor: The inability of the government to create conducive atmosphere through their policy and programme and through ministry of health and information affects media advertising of health education negatively.

The Role of Advertising Media in Health Education
(1) Provision of proper health information to the individual in the society. (2) Provision of information to the government on outbreak of health disease in a particular society.
Collaborating with necessary government agencies and non-governmental agencies in solving health related disease in any area of the society.

Conclusion
Despite the challenges confronting the media advertising in our society, the role of the media in health education remains very essential in the actualization of healthy health information for optimal utilization and enhancement of the total wellbeing of the members of the society.

Recommendations
The following recommendations were made in this study.
(1) Media advertising agents should always pay more attention on issues of health education. This will help in improving the wellbeing of individuals in the society.
Government should provide constant conducive social environment that will encourage media advertising in our society.
Professional in the health sector should always cooperate with the media in providing relevant health information that will enhance the wellbeing of members of the society. (4) Individuals in the society should always utilized relevant health information for their optimal health benefits at all time.