Health Promotion.presentation slides for NE

Session objectives
By the end of the session participants should;
 Explain the concept of health promotion
 Discuss approaches used during health promotion
activities
 Be able to plan and implement health promotion
programs
 Analyze factors affecting health promotion activities
and how to address them
3/10/2024
joseph.kungu@mihs.ac.ug 2

Presentation Outline
 Define the concept of Health Promotion
 Examine origin of health promotion activities
 Planning and implementing health promotion programs
 Factors affecting health promotion in our communities
3/10/2024

What is Health?
3/10/2024

Introduction ..
 ‘Health Promotion’ as a term was used for the first time by Marc
Lalonde in 1974 and quickly became an umbrella term for a wide
range of strategies designed to tackle the wider determinants of
health. After reviewing the evidence, the Lalonde Report suggested
that health care services were not the most important determinant of
health and there were four “health fields”– lifestyle, environment,
health care organization, human biology—and that major
improvements in health would result primarily from improvements in
lifestyle, environment and our knowledge of human biology
3/10/2024

What is health promotion?
 Health promotion is about raising the health status of individuals and
communities. Promotion in the health context means improving,
advancing, supporting, encouraging and placing health higher on
personal and public agendas. Given that major socioeconomic
determinants of health are often outside individual or even collective
control; a fundamental aspect of health promotion is that it aims to
empower people to have more control over aspects of their lives that
affect their health. These twin elements of improving health and
having more control over it are fundamental to the aims and
processes of health promotion
3/10/2024

What is health promotion….
• Health promotion is “a process of enabling people to increase control
over their health.”
• Health promotion is a way of thinking and working that considers the
continual advancement and maintenance of individual and population
health to be integral to the functioning of a community.
• Health promotion focuses on the social determinants of health as well
as on specific health issues.
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Definition
 Health promotion is the process of enabling people to
increase control over, and to improve, their health’. It
moves beyond a focus on individual behavior towards a
wide range of social and environmental interventions. It is
a positive concept emphasizing personal, social, political
and institutional resources, as well as physical capacities.
WHO (1990)
3/10/2024

Health Promotion….
 Is any combination of health, education, economic, political, spiritual or
organizational initiative to bring about positive attitudinal, behavioral,
social, or environmental changes conducive to improving the health of
population. Health Promotion is directed towards action on the
determinants or causes of health. Health Promotion, therefore, requires
a close co-operation of sectors beyond health services, reflecting the
diversity of conditions which influence health. Govt at both local and
national levels has a unique responsibility to act appropriately and in
timely way to ensure that the ‘total’ environment, which is beyond the
control of individuals and groups, is conducive to health
3/10/2024

Health Education Vs Health Promotion
 Health education involves giving information and teaching individuals
and communities how to achieve better health. Health education
seeks to motivate individuals to accept a process of behavioral change
through directly influencing their values, beliefs, and attitude
systems”. In contrast, health promotion “involves social, economic,
and political change to ensure the environment is conducive to health
. The two concepts, Health Education and Health Promotion are
symbiotic strategies. This means that they are closely associated or
related and that they benefit from each other
3/10/2024

Cont…
 A key feature that distinguishes Health Promotion from
Health Education is that Health Promotion involves
environmental and political action. Similarly, it is possible
to distil the concept of Health Promotion into an essential
formula: Health Promotion = Health Education x Healthy
Public Policy (Tones and Tilford, 1994)
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Example of Health Promotion
 A popular example of successful health promotion is the warning label
that now exists on cigarettes. Historically, cigarettes were considered
socially acceptable, and commonly sold without any warning about
the risk to the health of the user. However, health experts noted the
increased incidence of disease and began to educate the public on the
risks of smoking and tobacco use. Eventually, these health promotion
activities led to a change in public policy, which now requires the
manufactures to add a warning label directly to the package.
3/10/2024

Why Health Promotion
 Health promotion programs play a role in creating healthier
individuals, families, communities, workplaces, and organizations.
They contribute to an environment that promotes and supports the
health of individuals and the overall public. Health promotion
programs take advantage of the pivotal position of their setting (for
example, schools, workplaces, health care organizations, or
communities) to reach children, teenagers, adults, and families with
the knowledge and skills they need to make informed decisions about
their health.
3/10/2024

Why Health Promotion…
 Promotes quality of life
 Reduce inequalities in health
 Reduces pressure on services
 “Adds life to year, Adds year to life”.
 “Health promotion is concerned with making healthier
choices, easier choices”.
 It is cost effective and efficient
3/10/2024

Principles of Health Promotion
The 5 key principles of health promotion as determined by WHO are as follows:
 Health promotion involves the population as a whole in the context of
their everyday life, rather than focusing on people at risk from
specific diseases.
 Health promotion is directed towards action on the determinants or
cause of health. This requires a close co-operation between sectors
beyond health care reflecting the diversity of conditions which
influence health.
 Health promotion aims particularly at effective and concrete public
participation. This requires the further development of problem-
defining and decision-making life skills, both individually and
collectively, and the promotion of effective participation mechanisms
3/10/2024

Principles…
 Health promotion combines diverse, but complementary methods or
approaches including communication, education, legislation, fiscal
measures, organizational change, community change, community
development and spontaneous local activities against health hazards.
 Health promotion is primarily a societal and political venture and not
medical service, although health professionals have an important role
in advocating and enabling health promotion.
3/10/2024

Health Promotion Programs
 The World Health Organization (1947) defined health as “ a state of
complete physical, mental and social well - being, and not merely the
absence of disease or infirmity. ” While most of us can identify when
we are sick or have some infirmity,
 Identifying the characteristics of complete physical, mental, and
social well – being is often a bit more difficult. What does complete
physical, mental, and social well - being look like? How will we know
when or if we arrive at that state? If it is achieved, does it mean that
we will not succumb to any disease, from the common cold to cancer?
3/10/2024

Health Promotion programs…
 In 1986, the first International Conference of Health Promotion, held
in Ottawa, Canada, issued the Ottawa Charter for Health Promotion ,
which defined health in a broader perspective: “ health has been
considered less as an abstract state and more as a means to an end
which can be expressed in functional terms as a resource which
permits people to lead an individually, socially, and economically
productive life ” (World Health Organization, 1986).
 Arnold and Breen (2006) identified the characteristics of health not
only as well-being but also as a balanced state, growth, functionality,
wholeness, transcendence, and empowerment and as a resource
3/10/2024

Factors influencing our health
 The health of individuals as well as the health of our communities
reflects the unique combination of biological, psychological, social,
intellectual, and spiritual components as well as the cultural, economic,
and political environment in which we live.
 Exploration of the interaction that occurs between individuals and their
environment in regard to health has been a hallmark in the progress of
nations in promoting and improving the health of individuals and the
community at large.
 This ecological perspective on health emphasizes the interaction between
and interdependence of factors within and across levels of a health
problem
3/10/2024

 The ecological perspective highlights people ’ s interaction with their
physical and sociocultural environments. McLeroy, Bibeau, Steckler,
and Glanz (1988) identified three levels of influence for health -
related behaviors and conditions: (1)the intrapersonal or individual
level, (2) the interpersonal level, and (3) the population level. The
population level encompasses three types of factors: institutional or
organizational factors, social capital factors, and public policy factors
3/10/2024

Cont…
 The ecological health perspective helps to locate intervention points
for promoting health by identifying multiple levels of influence on
individuals ’ behaviour and recognizing that individual behaviour both
shapes and is shaped by the environment. Using the ecological
perspective as a point of reference, health promotion is viewed as
planned change of health - related lifestyles and life conditions
through a variety of individual, interpersonal, and population-level
changes.
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 Health promotion is a specialized area in the health fields that
involves the planned change of health - related lifestyles and life
conditions through a variety of individual and environmental changes.
Figure 1.1 illustrates the dynamic interaction between strategies
aimed at the individual and strategies targeting the entire population.
3/10/2024

3/10/2024

Planning Health Promotion Programs
 The first phase in the process of creating, operating, and sustaining a
health promotion program is program planning. In all of the models, one
of the first steps in planning a health promotion program is conducting a
needs assessment.
 A needs assessment gathers information about individuals ’ health needs
and a site ’ s support and resources to inform the process of planning,
implementing, and evaluating a program.
 Critical to a successful health promotion program is making sure the
program addresses the needs of the people at the program site, whether
it is a school, workplace, health care organization, or community
 How do we ensure this???? 3/10/2024

Defining a Needs Assessment
 Understanding how the nutrition status of a group of individuals in
a community might be improved requires information on both their
current nutrition status and their ideal nutrition status. Collection
of that information is called a needs assessment
 Needs assessments can reflect the three levels of influence in the
ecological health perspective: intrapersonal, interpersonal, and
population
 Consistent with the goal of eliminating health/nutrition disparities,
the assessment needs to be culturally appropriate
3/10/2024

Cont….
 The questions asked and the information sought during the needs
assessment can be derived from health promotion theories and
behavior change communication models (discussed later)
 The results of a needs assessment provide a foundation for the
work of planning a nutrition promotion program that addresses
identified nutrition problems and concerns.
 The results can be used to help allocate resources and to establish
a baseline against which to assess the effectiveness of the program
(through evaluation of interventions).
3/10/2024

Cont….
 Finally, to fully answer the question, what is a needs assessment?
we need to answer the question, what is a need? A need is usually
conceptualized as the difference between “ what is ” at the
present time and “ what should be ” under more ideal
circumstances (Witkin & Altschuld, 1995).
 A needs assessment is a formalized approach to collecting data in
order to identify the needs of a group of individuals.
3/10/2024

Collecting data for needs assessment
 Data collection plays a pivotal role in assessing the quality of life
of the population of interest and in establishing priorities for
health promotion programs. There are two major categories of
data: primary data and secondary data.
 Primary data are new, original data that did not exist before,
obtained directly from individuals at the site, usually by means of
surveys, interviews, focus groups, or direct observation. Primary
data constitute new information that will be used to answer
specific questions
3/10/2024

Collecting data…
 Secondary data already exist because they were collected
by someone for another purpose. The data may or may
not be directly from the individual or population that is
being assessed. Secondary data sources include UDHS
reports, vital records, census data, and peer- reviewed
journals
3/10/2024

Cont…
 Primary data are more expensive and time consuming to collect than
secondary data. Collection of quality primary data requires technical
expertise in order to identify representative samples, design
instruments, and complete data analysis. The problems with
secondary data are that some information may not exist for some
settings, the data may be old, or the data may not have been
correctly collected
3/10/2024

Data collected…
 Can be divided into two broad categories: quantitative and
qualitative. Quantitative data are statistical information (for
example, percentages, means, or correlations)
 However, numbers alone do not provide sufficient insights to allow
program staff to completely understand nutrition problems or
decide how to intervene in order to reduce the problem
 Qualitative data are more narrative, with fewer numbers. They
include the perceptions and misperceptions of community members
in regard to quality of life issues in the community
3/10/2024

Data Collection Techniques
 Specific data - gathering techniques to be used depend on what one
wants to know, the resources available, and the constraints of the
target population (for example, lack of reading ability, absence of
telephones, or mobility problems). For initial phases of primary data
collection, interactive group processes are recommended (for
example, focus groups) because they allow those conducting the
needs assessment to clarify both their own questions and respondents
’answers
3/10/2024

Steps in Conducting a Needs Assessment
 Four basic steps:
 Determining the scope of the assessment,
 Gathering data,
 Analyzing the data, and
 Reporting the findings
3/10/2024

Determine the scope
 Work with the key informants and stakeholders to determine the
scope of the work and the purpose of the needs assessment. Think
carefully and critically about what information is needed in order
to make the decisions. Who ultimately will use the results to make
decisions about the intervention or prevention programs?
3/10/2024

Gather the data
 Gather only the needed data. Consider culturally
appropriate data - gathering approaches tailored to the
target population and setting
3/10/2024

Analyze the data
 Use clear methods that people can understand
3/10/2024

Report and share the findings
 Identify your options for sharing the findings of the needs assessment.
Think about how best to communicate the findings.
 In sharing the information, identify any factors that are linked to the
health/nutritional problem.
3/10/2024

Sample questions for needs assessment
Interview or Focus Group Questions for a Community Assessment
 1. What do you think the main nutrition problems are in the
community?
 2. What do you think are the causes of these nutrition problems?
 3. How can these problems be reduced or eliminated in the
community?
 4. Are there any special nutrition problems or issues affecting children
and adolescents in the community?
 5. Are there any special nutrition problems or issues affecting the
elderly in the community?
3/10/2024

Cont…
 6. Is there a particular group of community residents that you would
consider more affected than the rest of the residents? If so, why are
they more affected?
 7. Which one of the previously mentioned problems do you consider to
be the most important one in the community?
 8. If you were given $1 million to correct the nutrition problems of
the community, what would you spend it on?
3/10/2024

Setting Priorities. why???
 Identifying which problems to address will require that criteria
(for example, importance, feasibility of change, magnitude of
problem, and cost) be established
 These priorities provide justification for starting new programs
and continuing or terminating existing programs. The following
issues might be factors to consider in establishing program
priorities at a site.
3/10/2024

Developing Nutrition Education Programs
3/10/2024

3/10/2024

Step 1: Situational analysis
 Proper planning is key to the success of a nutrition education
programme.
 There is need to start with an analysis of the situation as it is.
 This involves identifying areas in individual’s/community food
and nutrition practices that may be the cause of the nutritional
problem/s.
 After a situation analysis the objectives of the programme are
set depending on the nature and needs of the community.
 Community participation is vital at every stage of developing
and implementing a nutrition programme as it fosters
ownership and continuity of the programme.
3/10/2024

Step 2: Programme building
 This involves detailing the materials and methods of how
the programme is going to be implemented. E.g. what
does the community need to solve the identified
nutritional problem/s?, how will the nutrition education
session be conducted? etc. These questions have to be
answered during this step.
 This step involves developing a detailed action plan that
clearly shows what is needed, what has to be done, how it
has to be done, by who and within what time frame.
3/10/2024

Step 3: Implementation
 This step involves the development, production and pre-
testing of the teaching materials.
 Its also involves the training or obtaining of trainers or
facilitators.
 Pre-testing of the teaching material is aimed at
determining whether the materials will deliver the
intended message to the audience.
 After pre-testing of the teaching materials and the
necessary modifications made, the full training/educating
of the community commences. 3/10/2024

Step 4: Evaluation
 After the education programme, an evaluation needs to
be conducted.
 Programme evaluation helps to determine if the training
objectives have been achieved.
 Evaluation may be done to determine the immediate
impact of the programme or the long term impact such as
behavioural change.
 Evaluation also helps to provide guidance for expanding or
continuing a programme.
3/10/2024

Evaluating a programme
 Evaluation may take several forms, and one or more may
be appropriate, depending on the aims of the specific
programme to be evaluated.
 Types of evaluation
 Process evaluation
 Outcome evaluation
 Impact evaluation
3/10/2024

Process evaluation
Process evaluation examines whether the programme
was carried out as planned. The results help to identify
the strengths and weaknesses of the programme, and
where improvements may be made.
3/10/2024

Outcome evaluation
This is where the outcomes are measured to see if
the programme was successful.
3/10/2024

Impact evaluation
Impact evaluation examines whether the
programme has brought about a change. The
impact, or programme effect, refers to a change in
the target population that has been brought about
by the programme – that is, a change that would not
have occurred if the programme had not happened.
3/10/2024

Why community nutrition programs fail?
 Participants should discuss the various factors why
such programs may fail
3/10/2024

How to make such programs successful
 Participants should discuss ways to address the
above factors
3/10/2024

Sustainability of community nutrition
programs
 Define sustainability
 Why a program may not be sustainable
 How to make programs sustainable
3/10/2024

Health Promotion.presentation slides for NE

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Health Promotion.presentation slides for NE