Health education in China has been characterized by centrally led top-down
messages and methods. This is exemplified by the Patriotic Health Campaign,
established in the 1950s and still operating today. Through this campaign,
millions of Chinese were told what they should and should not do in order
to improve their health. These traditional public health efforts have been
successful in contributing to a reduction in some infectious diseases, but
have had limited impact on others, notably in the control of schistosomiasi
s. This paper argues that health education in China has to further evolve t
o respond to social and political changes over the years. Health literacy i
s introduced as a new concept which implies a more participatory and more l
ocally empowering approach to health education and communication than was t
ypical of past efforts. improving the control of schistosomiasis is used as
a case study to illustrate how improved health literacy can lead to improv
ed health outcomes. It is argued that health education programs aimed at in
creasing critical health literacy involve more than simply the transmission
of health information. They should also provide information on social, eco
nomic and environmental determinants of health as well as assessment of opp
ortunities to promote policy and organizational change. The paper concludes
by outlining some of the challenges involved in adopting this new approach
, indicating that it will require formative research and the re-training of
health educators.