4.3.2  Enabling factors

Enabling factors are factors that make it possible (or easier) for individuals or populations to change their behaviour or their environment. Enabling factors include resources (Figure 4.3), conditions of living, social support and the development of certain skills.

A local market place selling fresh fruit and vegetables.
Figure 4.3  The availability of affordable fresh fruit and vegetables is an enabling factor for good health in the community. (Photo: Derek White)

Among the factors that influence use of health services are two categories of enabling resources: community-enabling resources (health personnel and facilities must be available), and personal or family-enabling resources (people must know how to access and use the services and have the means to get to them).

Enabling factors refer to characteristics of the environment that facilitate or impede healthy behaviour. They also include the skills and resources required to attain a behaviour. For example enabling factors for a mother to give oral rehydration salts to her child with diarrhoea include having time, a suitable container and the salt solution itself.


A person or population may need to employ a number of skills to carry out all the tasks involved in changing their behaviour. For some positive health behaviours it might be necessary to learn new skills. For example if a breast feeding mother is not well trained on positioning and attachment of her baby she may have difficulty in properly breastfeeding her child. Similarly, if the mother is not well trained at a later stage on the preparation of complementary feeding, the child may not get the nutrition they require.

Healthcare resources

A number of healthcare resources may also need to be in place if an individual or population is to make and sustain a particular health-related behaviour change. The availability, accessibility and affordability of these resources may either enable or hinder undertaking a particular behaviour. For example, in a given health post the lack of availability of the family planning method of choice for a mother may discourage her from utilisation of the service in the future.

Changing behaviour may also be easier if other aspects of one’s environment are supportive of that change. For example policy initiatives or even laws might be in place that create a positive atmosphere for change.

  • From your experience as an educator or receiver of health education make a list of some of the enabling skills and enabling resources you have seen or experienced that support health education.

  • Enabling factors make it possible (or easier) for individuals or populations to change their health-related behaviour. Enabling skills, of course, include making sure people know how to do things. We used the example of breast feeding but knowing about how to identify healthy food would be another, or how to recognise a dehydrated child. In regard to resources we mentioned family planning facilities, but there are many others, such as facilities for the prevention of malaria, development of hygienic latrines (Figure 4.4) and so on.

A latrine.
Figure 4.4  A latrine is an enabling factor encouraging positive health behaviours. (Photo: WaterAid/Caroline Irby)

4.3.1  Predisposing factors

4.3.3  Reinforcing Factors