This paper describes the need for Health Education Component in the National Tuberculosis Programme (NTP). The potential achievement of the programme activities viz., prevention, Case-finding and treatment has been established by studies conducted by the National Tuberculosis Institute. Corrective measures to achieve the potential would no doubt have to tackle all the three constituents of the programme viz., objectives, activities and resources. However, incorporation of a health education component in the crucial activities of the programme would help, where under achievement is due to the lack of knowledge and proper attitude both on the part of the patient and the health worker. In order to evolve an effective methodology, the goals of the health education component should be synchronised with those of the programme. While the health education aspects in the Case-finding and treatment activities can be incorporated at health institutions and on an individual or group basis, education for the preventive activities has to be on a mass or community basis. While the nucleus of the community education should be on BCG vaccination, the mass media could be utilised for the overall tuberculosis education in the general population. Thus, there is scope for employing a variety of material, methods and media of health education in the NTP.

This paper critically describes the place of Health Education in National Health Programmes. Health Education is one of the recognised ways of health promotion in the primary prevention of diseases in the community. Probably it may be required even at secondary and tertiary prevention levels. This implies that health education has to be directed towards the community for accepting the health services provided and participate in all activities which promote their own health. Health education is part of any health programme and its component and implementation depend on the nature and organisation of the health programme itself. Integrated programmes are more acceptable to the community and economically feasible. Health education of the community under the integrated health services has to have new dynamics and priority over the conventional approach hitherto adopted in vertical programmes. Health education in all national health programmes has to be made into a comprehensive one, rather than planning individually for each programme. Community health education should go along with the "health education" of the health workers. The efforts to do former alone without improving the latter, has not been able to give good dividends.

As a part of the supervised field training of the students of health education from Rural Health Training Centre, Gandhigram, Tamil Nadu, a pilot project of short term intensive health education was undertaken at 11 selected villages under Primary Health Centre (PHC), Hesarghatta. The objectives were to measure the impact of an intensive health education effort in increasing the attendance of patients with symptoms suggestive of pulmonary tuberculosis at a PHC and to study the impact of health education in terms of increase in knowledge and change of attitude of the people towards the PHC. For participation of the community all the three health education approaches viz., individual approach, group approach and mass approach were planned along with audio visual aids as and when required. Application of a specific approach depended on the level of awareness about tuberculosis and the availability of services which was measured by a base line survey conducted in the selected villages.

As expected this short term intensive health education has shown that the knowledge on tuberculosis in the population increased, following it. When it was measured by the yardstick of increase in the proportion of out patients with chest symptoms, attending the PHC, no significant change was noticed during the period of observation. The likely reason could be that it was too early to measure the effect of health education within a period of 6 weeks. In this project the intensive health education work was done almost continuously for a short time which was probably not appreciated by the people. Though in all the villages following the health education programme, the people had understood the importance of getting the chest symptoms examined to rule out tuberculosis, they have not approached the PHC for the same. The other possible reason could be that the people are not satisfied with the services provided by the PHC. It goes without saying that when the services provided by the PHC itself are not upto the expectation of the people, the outcome of health education could only be