Health promotion foundation south africa - Davison Munodawafa

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Financing Health Promotion: WHO Africa Region Perspective.

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Health promotion foundation south africa - Davison Munodawafa

  1. 1. Financing Health Promotion: WHO African Region perspective Dr Davison MUNODAWAFA, Coordinator,Determinants & Risk Factors (DRF), Health Promotion Cluster, WHO Regional Office for Africa, Brazzaville, Congo E-mail: munodawafad@afro.who.int
  2. 2. Outline Introduction – Health promotion definition and Functions Current Situation - Major risk factors and key determinants (tobacco, alcohol and key determinants) and Opportunities Challenges Required actions Way forward and Conclusion
  3. 3. HEALTH PROMOTION DEFINITION A PROCESS OF ENABLING PEOPLE TO INCREASE CONTROL OVER THEIR HEALTH AND ITS DETERMINANTS, THEREBY IMPROVE THEIR HEALTH. (OTTAWA CHARTER, 1986). IT IS A SOCIAL AND JUST INVESTMENT; IT INVOLVES VARIOUS PLAYERS TO ADDRESS HEALTH RISK FACTORS AND THE DETERMINANTS OF HEALTH USING A MULTISECTORAL APPROACH.
  4. 4. The Health Promotion Foundation Manage and coordinate funds; Ensure adequate and sustainable financing arrangements; Increase awareness about health gains; Produce country-specific evidence; Create the demand for health promotion; Ensure broad participation and commitment; and Providing effective stewardship.
  5. 5. Current Situation Risk Factors Key Determinants Health Promotion Funding sources in the WHO African region and world
  6. 6. Tobacco use in the African region* Prevalence among adults: 6%-36%; 1 in 10 adolescents use tobacco; 1 in 2 adolescents is exposed to tobacco smoke in public places; 1 in 5 adolescents is influenced by tobacco advertising. * WHO Report on the Global Tobacco Epidemic, 2008 and 2009
  7. 7. The WHO Framework Convention on Tobacco Control (WHO FCTC) In the African Region 41 countries have ratified the treaty; Full implementation of the Convention is an obligation including: – Comprehensive legislation: taxation; smoke-free places; advertising; health warnings; protection of public health policies from tobacco industry interference; awareness raising; – Coordination mechanism: multi-sectoral committee, action plan; – Monitoring and evaluation: data dissemination and use. Mobilisation of resources and partnership
  8. 8. Alcohol Consumption and Consequences Drinkers drink at a markedly higher level (average of 37L pure alcohol/per person /per yr) Highest prevalence of heavy episodic drinking in the world (25% of drinkers engage in harmful drinking) Most of the alcohol-related deaths are attributable to injuries (43%) 7 out of 10 adults in the region abstain from alcohol;
  9. 9. The key determinants of health requiring Health promotion: TheFactors that Produce Disease, Disability and Premature Deaths Upstream Intermediate Downstream Education system  Gender  Living conditions Welfare state  Socioeconomic  Working conditions Labor market  Ethnicity  Individual and collective behavior Political system  Social cohesion  Health and social care Economic system  Literacy  Distribution of power, money and resources Social Structure Individual’s social status Intermediary FactorsStructural Determinants of IntermediaryHealth Determinants of Health
  10. 10. Health Promotion Financing experiences Social protection schemes (Education, nutrition Social health insurance Earmarking or special levy through Act of Parliament (Zimbabwe AIDS Fund 3% of taxable income set aside for HIV/AIDS) South-East Asia (Thailand, India, Nepal); Western Pacicific Region (Australia, New Zealand,Tonga, Mongolia, Malaysia); Europe and United State States
  11. 11. Opportunities for Health Promotion Fund 1. Strengthen national capacity and leadership for health promotion; 2. Supporting health systems based on the PHC approach; 3. Putting the health of mothers and children first; 4. Accelerate actions for communicable and noncommunicable diseases prevention; 5. Accelerate response to addressing the key determinants of health; 6. Support attainment of national goals e.g., MDGs and immunization etc.,
  12. 12. Challenges to establishing a Health Promotion Fund  Organized opposition or resistance from outside and within health sector including competing interests;  Leadership for multisectoral and interdisciplinary actions e. g., civil society, NGOs, health experts, private sector;  Participation of all stakeholders including communities  Funding to implement agreed actions; e.g. FCTC, global alcohol strategy, etc  Documentation, monitoring and evaluation of HPR fund actions (accountability, transparency and value for money)  Integration of HPR fund activities into national priorities, plans and systems.
  13. 13. Required Actions for financing Health promotion Fair financing of health promotion actions Market responsibilities Empowerment of individuals and communities Gender equity Good governance Health equity in all policies
  14. 14. Way Forward – Convergence of Actions Price and tax measures to reduce demand for tobacco and alcohol Ban sales of tobacco and alcohol products to and by minors Ban on tobacco and alcohol advertising, promotion and sponsorship
  15. 15. ConclusionA national social dialogue on establishing Health PromotionFoundation using tobacco and alcohol tax should be convenedat all levels. This debate should take place at the political anddecision-making levels, civil society and with parliamentariansfocusing on legislative action, policy options and innovativefinancing respectively.Who shall floss between the fangs of cobra?There is need for a strong leadership and collective solidarity among various players ( A coalition of the willing).

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