**1. Introduction**

Health promotion is a broad concept that can be interpreted differently by different disciplines since numerous health-oriented activities, which are based on different philosophies, can be found under this term [1]. The history and development of the health promotion movement can be traced back to seven conferences for health promotion held in Ottawa (1986), Adelaide (1988), Sundsvall (1991), Jakarta (1997), Mexico (2000), Bangkok (2005) and Helsinki (2013) [2]. The most important historical milestone for health promotion was the first international conference in Ottawa, where the Ottawa Charter introduced the concept of citizen empower‐ ment, the need for multi-sectoral and multi-agency operations, the media as one of the key promoters of health and the decentralization of health promotion in a manner that involves more active involvement of people in the implementation of strategies for health promotion at the local and community levels [3]. Within the context of health promotion, we are attempt‐ ing to have an impact on individuals and the community so that they care for, maintain and strengthen their health. Health should be seen in conjunction with the natural and social environments in which people live and work, so the "Ottawa Charter for Health Promotion" defined the creation of environments that depict health as a priority area and an important value and is striving to create conditions for healthy choices (supportive environments) [4].

Health promotion in practice utilizes seven key strategic approaches: health communication, health education, self-help and mutual assistance, community development and mobilization, advocacy and policy development [1]. Health education is a component of health promotion and not a synonym for it. Health professionals often equated the concept of health education with health promotion [5, 6, 7]. Health promotion is a versatile social and political process, involving not only activities aimed at strengthening the skills and abilities of people but also activities aimed at changing social, environmental and economic circumstances so as to mitigate their impact on the health of both individuals and communities [1]. The purpose of health education is to help people assume a healthy lifestyle, motivate them to this end and

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enable them to become actively involved in the care of their health [8]. Through health education, we improve both individual and community knowledge as well as values and skills to ensure effective action in the direction of health [9].

In the context of health promotion and health education, midwives act as promoters of healthy sexuality, being the ones that help people adopt and maintain healthy sexual behaviour. Healthy sexuality is a topic to which sufficient time must be devoted already in early childhood which should continue and be supplemented all the way up to late old age. Sexuality is an important part of a person's life throughout the entire life cycle and, thus, may promote or inhibit the development of personal identity, well-being and health [10, 11]. People experience sex very subjectively because it is associated with love and anger, with tenderness and aggression, with intimacy and adventure, and with pleasure and pain [12]. In society, the subject of sex has always been taboo which is spoken of "quietly" [13]. It is a topic that is strongly linked to the individual's intimacy; therefore, the manner in which the midwife explains healthy sexuality is very important. Numerous definitions exist regarding what healthy sexuality is. "The definition of sexuality includes many components including (but not limited to): sexual attitudes, sexual desires, sexual behaviours engaged in, sexual prefer‐ ences, sexual identification, and sexual function" [14]. The World Health Organization (WHO) defines healthy sexuality as "a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled" [15].

If the midwife finds that a person's life does not include healthy sexuality, she can assist the individual in changing risky sexual behaviour. Theories and models of individual health behaviour can prove helpful, such as the health belief model (HBM), theory of reasoned action (TRA), theory of planned behaviour (TPB), integrated behavioural model, transtheoretical model and stages of change (TTM), and precaution adoption process model.

This chapter will present the health education for the individual or couple in a more compre‐ hensive manner using the transtheoretical model and stages of change and prior determination of his/her health literacy.
