This document provides an overview of health promotion and education. It discusses the historical background and definitions of health promotion. Key frameworks for conceptualizing health promotion are described, including models by Beattie, Tones and Tilford, and Caplan and Holland. The document outlines five approaches to health promotion - medical, behavioral change, educational, empowerment, and social change. Principles of health promotion according to the WHO are also summarized.
Concept and definitions
Health education
Beliefs and approaches in health promotion
Health promotion strategies and priority actions
Public health, social movement, health inequity and millennium goals
Canadian experience in health promotion
Conclusion
Concept and definitions
Health education
Beliefs and approaches in health promotion
Health promotion strategies and priority actions
Public health, social movement, health inequity and millennium goals
Canadian experience in health promotion
Conclusion
Health promotion is, as stated in the 1986 World Health Organization Ottawa Charter for Health Promotion, "the process of enabling people to increase control over, and to improve, their health
This presentation describes what is new public health with adapted components from the previous eras of public health. Health promotion and evolution of public health is covered here.
A presentation by Karen Nelson, MBA, MSW, RSW, of the Ottawa Hospital, made to social workers at their 2013 Annual Meeting. A very thorough overview with significant research supporting the link between Social Determinants of Health and healthcare outcomes.
Health promotion is, as stated in the 1986 World Health Organization Ottawa Charter for Health Promotion, "the process of enabling people to increase control over, and to improve, their health
Health promotion is, as stated in the 1986 World Health Organization Ottawa Charter for Health Promotion, "the process of enabling people to increase control over, and to improve, their health
This presentation describes what is new public health with adapted components from the previous eras of public health. Health promotion and evolution of public health is covered here.
A presentation by Karen Nelson, MBA, MSW, RSW, of the Ottawa Hospital, made to social workers at their 2013 Annual Meeting. A very thorough overview with significant research supporting the link between Social Determinants of Health and healthcare outcomes.
Health promotion is, as stated in the 1986 World Health Organization Ottawa Charter for Health Promotion, "the process of enabling people to increase control over, and to improve, their health
Shaping public health in south africa through health yogan pillayNCAS1
Health Promotions Foundation South Africa, Benefits of a Health Promotions Foundation, National Council Against Smoking, Soul City, HPF, Soul City Phuza Wize Campaign,
The amazing strategic partnership between National Association for Health and Fitness and ACTIVELife resulting in the new and improved Employee Health & Fitness Month is truly historic in the arena of workplace wellness. Business and industry can encourage positive behavior change in the supportive context of workplace policies and culture and provide support that assists today's workforce with their daily struggles.
This presentation offer critical insight on health promotion and how it can effectively impact policy.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
PUBLIC HEALTHPromoting Public health. Introducti.docxamrit47
PUBLIC HEALTH
Promoting Public health.
Introduction:
In order to understand what public health means we need to begin with what health means.
We will use the definition of health that was adopted by the World Health organization (WHO).
The definition of health originated in the Alma Ata Declaration which was signed by participants at a WHO international conference in 1978 on Primary Health Care.
By defining what health means, we will be able to get a firm foundation for then by identifying what differentiate public health from other arenas.
2
Health
Definition of health
According to Alma Ata Declaration, it states that health is a state of complete physical, social and mental wellbeing and not just the absence of disease or infirmity.
Apart from providing the definition of health, The Alma-Ata Declaration also said some important things about health that PHANZ also endorses.
Health is characterized as a fundamental human right as well as attaining the highest possible level of health that is an important social goal worldwide.
3
Continuation:
Alma-Ata Declaration also said some important things about health that PHANZ also endorses.
Apart from providing the definition of health, health is characterized as a fundamental human right as well as attaining the highest possible level of health that is an important social goal worldwide.
The Alma-Ata Declaration recognizes that by realizing the goal, it also required the actions of other social and economic sectors apart from the health sectors.
Continuation
Our own Public Health Advisory Committee further emphasized the importance of recognizing the breadth of the determinants of health. According to the research of the committee, they revealed that the strongest influences on the health of individuals normally comes from the factors that are outside the health system.
They includes the social, physical, cultural and economic environment in which we live
Public Health
It is a science and art of promoting health preventing disease as well as prolonging life through education, research as well as promotion of healthy lifestyle.
Public health focuses on health promotion as well as disease or injury prevention which contrast to the medical model of care.
Medical model of care focuses more on diagnosis and treating illnesses as well as conditions after they occur.
How to differentiate Public health from other health care?
Based on the definition of public health, there are a number of key things that differentiate it from personal health and public health interventions from person health services. These include;
Public health is all about keeping people well instead of treating their diseases, disorders as well as disabilities after they emerged hence this is why the definition of public health emphasizes more on promoting health, prolonging life as well as preventing disease.
Public health focuses more on populations and not individuals hence it is oft ...
reference articel used in this essayKumar, S., & Preetha, G. (2012.pdfdavid16271
reference articel used in this essay
Kumar, S., & Preetha, G. (2012). Health Promotion: An Effective Tool for Global Health. Indian
Journal of Community Medicine: Official Publication of Indian Association of Preventive &
Social Medicine, 37(1), 5–12. http://doi.org/10.4103/0970-0218.94009
Health promotion is more significant today than any time in recent memory in tending to general
medical issues. The wellbeing situation is situated at one of a kind junction as the world is
confronting a \'triple weight of infections\' constituted by the unfinished motivation of
transferable ailments, recently rising and re-developing maladies and also the extraordinary
ascent of noncommunicable perpetual illnesses. The components which help advance and
improvement in this day and age, for example, globalization of exchange, urbanization,
simplicity of worldwide travel, propelled advances, and so forth., go about as a twofold edged
sword as they prompt to positive wellbeing results on one hand and increment the helplessness to
weakness then again as these add to stationary ways of life and unfortunate dietary examples.
There is a high pervasiveness of tobacco use alongside increment in undesirable dietary practices
and abatement in physical action adding to increment in natural hazard elements which thusly
prompts to increment in noncommunicable sicknesses.
Wellbeing, as the World Health Organization (WHO) characterizes, is the condition of finish
physical, social and mental prosperity and not only the nonattendance of sickness or ailment. The
satisfaction in most elevated achievable standard of wellbeing is considered as one of the
principal privileges of each human being.(5) Over the previous couple of decades, there is an
expanding acknowledgment that biomedical mediations alone can\'t ensure better wellbeing.
Wellbeing is intensely impacted by variables outside the area of the wellbeing part, particularly
social, financial and political strengths. These powers to a great extent shape the conditions in
which individuals develop, live, work and age and additionally the frameworks set up to manage
wellbeing needs at last prompting to disparities in wellbeing between and inside nations. Along
these lines, the achievement of the most elevated conceivable standard of wellbeing relies on
upon a thorough, comprehensive approach which goes past the conventional therapeudic mind,
including groups, wellbeing suppliers and different partners. This all encompassing methodology
ought to engage people and groups to take activities for their own wellbeing, cultivate authority
for general wellbeing, elevate intersectoral activity to fabricate sound open approaches and make
supportable wellbeing frameworks in the general public. These components catch the
quintessence of \"wellbeing advancement\", which is about empowering individuals to take
control over their wellbeing and its determinants, and in this way enhance their wellbeing. It
incorporates intercessions at the i.
Position and role of health education in health promotion. Niru Magar
This ppt explores the Position and role of health education in health promotion.Health education is the process of providing individuals and communities with the knowledge, skills, and motivation they need to make informed choices about their health and well-being.
It's more than just learning facts; it's about developing the ability to understand, critically evaluate, and apply that knowledge to your life.
HE is aimed at bringing about behavioral changes in individuals, groups, and larger populations from behaviors that are presumed to be detrimental to health, to behaviors that are conducive to present and future health.
Health promotion is the process of enabling people to take control over and improve their health and its determinants. Health promotion is about creating the conditions and conducive environment for healthy choices for all and where people live, work, age and play.
Health promotion is an umbrella term that includes disease prevention, improvement of health, and enhancing well-being.
Through various platforms and strategies, HE aims to improve health outcomes, reduce health disparities, and foster a culture of informed decision-making and wellness.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
2. Topics
Historical Background, Concept, Philosophy, Definition, Process,
Theory & Scope, Framework, Principles, Approaches & Aims, and
Objectives of Health Promotion.
Ottawa Charter, Bangkok Charter and global development of
Health Promotion.
Health promotion priority areas and strategies
2
3. Background of Health Promotion
The world at the beginning of the 21st century is a world of change. Politically
economically, technically, socio-culturally and demographically, countries and
communities are in transaction.
The world is significantly different today from some decades ago. New situations pose new
problems and at the same time present new opportunities.
New health promotion approaches are required to match them. Health promotion has to
be justified against competing claims for the societies resources.
We must strive to find even more effective ways of promoting supporting environments,
strengthening communities refocusing services and helping people acquire knowledge
and skills for health.
We need to explore the strategies and methods for effectiveness of these activities.
3
4. Background cont…
The information technology of today and tomorrow can enhance the ability of health promotion to
reach people everywhere. This however will require creativity and imitativeness, as well as commitment to
policy making. Achieving health for all, with the participation of all, based on the principles of equity and
solidarity, requires not only good management but a fresh approach.
Over the past years stretching from Ottawa (1986), the first International Conference on Health Promotion
and which gave its name to Ottawa Chatter from Health Promotion, to the second conference in
Adelaide (1988) and the third in Sundsvall (1991), Health Promotion has carried its mission of giving health
a high position on the political agenda.
Each of these conference has made a significant contribution to public health and to focusing our
attention to the necessity for a more holistic & comprehensive approach to addressing the determinants
of health. Jakarta conference is the fourth in a series of technical conferences on health promotion, all of
which have and continue to make major contributions to health promotion & public health.
4
5. History
The “first and best known” definition of health promotion, declared by the American
Journal of Health Promotion since 1986 is
“the science and art of helping people change their lifestyle to move
toward a state of optimal health”
Since then and even before there have been plenty of definitions for health promotion
1974 Lalonde Report form Canada
1979 Healthy People report of Surgeon general of united states
1984 WHO
1986 Canadian minister of national health and welfare
5
☼ Different conferences, important documentations and charters
6. 6
Health promotion is directed towards action on the determinants or causes of
health promotion, therefore, requires a close co-operation of sectors beyond
health services, reflecting the diversity of conditions which influence health.
Concept
Government at both local and national levels has a unique responsibility to act
appropriately and in a timely way to ensure that the ‘total’ environment,
which is beyond the control of individuals and groups, is conducive to health.
8. What is Health Promotion?
Today Health Promotion is more than
personal and population education.
Defined in a number of ways
“The process of enabling people to
increase control over and improve their
health”
(World Health Organisation 1986)
Health Promotion = health education x
healthy public policy.
(Tones and Tilford, 1994)
8
9. Phylosophy
Through the involvement of
home, school and
community,
including: the physical,
intellectual, emotional,
social and moral
development
Health promotion is any
combination of health, education, economic,
political, spiritual or organisational initiative
designed
to bring about positive attitudinal,
behavioural, social or environmental changes
conducive to improving
the health of populations.
9
10. DefinitionDefinition (learn this one)(learn this one)
Health promotion is the process
of enabling people to increase control over, and to
improve, their health. It is a positive concept
emphasising personal, social, political and institutional
resources, as well as physical capacities.
WHO (1990), Health Promotion Glossary
10
11. THE PROCESS OF HEALTH PROMOTIONTHE PROCESS OF HEALTH PROMOTION
FOCUS STRATEGIES IMPACT OUTCOMES
Individuals
Groups
Population
Education
couselling
Economic
change
Legislative
change
Policy or
organisation
change
Behavioural
educational
change
Social,
economic and
environment
change
Better
Health
Quality
of life
11
12. The scope of health promotion activity
Frameworks and Models are tools that help explain phenomena.
Many tools developed to explain the scope of health promotion.
1.Beattie’s (1991) model of health promotion
2.Tones and Tilford’s (1994) empowerment model of health promotion
3.Caplan and Holland’s (1990) Four perspectives on health promotion
4.Naidoo and Wills (2000) typology of health promotion
12
13. Health promotion theories
There are many different theories that guide health promotion interventions
Most theories are based in the social sciences including sociology, education,
psychology and policy studies
Different approaches to health promotion tap into different theoretical
perspectives and academic disciplines
We will examine 4 contrasting models
13
14. Niandoo & Wills 2005
Models of health promotion may help to:
Conceptualize or map the field of health promotion
Interrogate and analyze existing practice
Plan and chart the possibilities for interventions
14
15. Beattie’s model of Health Promotion
Individual
Authoritative
Collective
Negotiated
Health persuasion
Needs to focus on
why behaviour is
happening
Legislative
Action
Focus
Act
Resources
Policy
Community
Development
Empowerment
community level
Skills
Personal Counselling
Greater control
15
16. Beattie’s model applied
Key features
Examines 2 axis
i) type of approach used top down (authoritarian) or bottom up (negotiated or
owned by clients)
ii) size of approach
Categorises 4 types of activities
a)Personal Counselling eg working with dietician on food and physical individual
personal plans and goals
b)Health persuasion eg Campaign of eating 5 fruit and vegetables a day on TV
c)Legislative action eg laws that subsidise the price of healthy food stuff
d)Community development eg communities producing and distributing food
themselves
16
17. Tones and Tilford’s (1994) model of health promotion
Key features
States interaction between two main sets of processes for health improvement
i)development and implementation of healthy public policy
ii) health education in which people are empowered to take control of their life.
Example attempts of Jamie’s School Diners campaign where school meals was brought
into public consciousness and lead to standards for meals and an increase in the budgets
for school meals.
Only when these two approaches work in parallel can the conditions for living and
individuals behavioural aspects of health be addressed
17
18. Caplan and Holland’s model of health promotion (1990)
Key features
More complex and theoretically driven
Attempts to unpick what determines health and ill-health and
therefore what activities can be used to address health issues.
One axis refers to a theory of knowledge and how knowledge
is generated in relation to health
The other axis refers to how society is constructed and how this
impacts on health.
18
19. TANNAHILL’S MODEL OF HEALTH PROMOTION (DOWNIE et al – 1990)
Health education
Prevention
Health
protectio
n
1
2
3
4
5
7
6
1. Preventive services, e.g..
immunization, cervical screening,
hypertension case finding,
developmental surveillance, use of
nicotine chewing gum to aid
smoking cessation.
2. Preventive health education, e.g..
smoking cessation advice and
information.
3. Preventive health protection, e.g..
fluoridation of water.
4. Health education for preventive
health protection, e.g.. lobbying for
seat belt legislation.
5. Positive health education, e.g. life
skills with young people.
6. Positive health
protection, e.g..
workplace smoking
policy.
7. Health education aimed
at positive health
protection, e.g.. pushing
for a ban on tobacco
advertising.
19
20. TANNAHILL’S MODEL OF HEALTH PROMOTION
(DOWNIE et al – 1990) (cont.)
Shows how these different approaches relate to each other in an
all-inclusive process termed health promotion.
Health education- communication to enhance well being and
prevent ill health through influencing knowledge and attitudes.
Prevention- reducing or avoiding the risk of diseases and ill health
primary through medical interventions.
Health protection safeguarding population health legislative, fiscal
or social measures.
20
21. A FRAMEWORK FOR HEALTH PROMOTION ACTIVITIESA FRAMEWORK FOR HEALTH PROMOTION ACTIVITIES
AREAS OF
HEALTH
PROMOTION
ACTIVITY
Preventive health
services(Primary,
secondary, tertiary
Preventive health
services(Primary,
secondary, tertiary
Community-based
work
Community-based
work
Organisation
development
Organisation
developmentHealthy
Public Policy
Healthy
Public Policy
Environmental
health measures
Environmental
health measures
Economic and
regulatory
activities
Economic and
regulatory
activities
Health education
programmes
Health education
programmes
21
22. A FRAMEWORK FOR HEALTH PROMOTION ACTIVITIESA FRAMEWORK FOR HEALTH PROMOTION ACTIVITIES
CLASS
AGE
GENDER
ETHNICITY
Housing tenure
Environment
Regional location
Access to health
services
Access to leisure
facilities
Nutrition
Smoking
Physical
activity
Psychosocial
factors, e.g.
stress
Cholesterol
Blood
pressure
Obesity
KEY SOCIAL
STRATIFICATION
FACTORS
ENVIRONMENT
FACTORS
LIFESTYLE
FACTORS
PHYSIOLOGICAL
FACTORS
C
H
D
22
23. 23
The five key principles of health promotion as determined by
WHO are as follows:
1.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.
2.Health promotion is directed towards action on the determinants or
causes of health therefore, requires a close co-operation of sectors
beyond health services, reflecting the diversity of conditions which
influence health
PRINCIPLES OF HEALTH PROMOTION
24. 24
PRINCIPLES OF HEALTH PROMOTION contd
3. Health promotion combines diverse, but complementary methods or approaches
including communication, education, legislation, fiscal measures, organisational
change, community change, community development and spontaneous local
activities against health hazards.
4. 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.
5. 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.
25. Main approaches to health promotion
Medical or preventative
Behavioral change
Educational
Empowerment
Social change
25
26. Aims
Reduce morbidity and premature mortality
Target: whole populations or high risk groups
Promotion of medical intervention to prevent ill-health
26The medical or preventative approach
27. Aims
Encourages individuals to adopt healthy behaviors which improve health
Views health as a property of individuals
People can make real improvements to their health by choosing to change lifestyle
It is people’s responsibility to take action to look after themselves
Involves a change in attitude followed by a change in behavior
27Behavior change approach
28. Aims To enable people to make an informed choice about their health
behavior by
providing knowledge and information
developing the necessary skills
Not similar the behavioral approach, it does NOT try to persuade or
motivate change in a particular direction
OUTCOME is client’s voluntary choice which may be different from
the one preferred by health promoter
28The educational approach
29. Empowerment approach 29
WHO defined health promotion as “enabling people to gain control over their lives” (empowerment)
Aims
Helps people identify their own concerns and gain the skills and confidence necessary to
act upon them
This is the only approach to use a ‘bottom-up’ (rather than ‘top-down’) approach
Empowerment may involve both self-empowerment and community empowerment
Self-empowerment:
Based on counseling
Uses non-directive ways
Increase person’s control over his/her own live
30. Aims (Cont.)
For people to be empowered they need to:
1. Recognize and understand their powerlessness
2. Feel strongly enough about their situation to want to change it
3. Feel capable of changing the situation by having information,
support and life skills
30
31. Aims
Radical approach which aims to change society not individual behavior
Aims to bring changes in the physical, economic and social environment
Healthy choice to become the easier choice in terms of cost, availability and accessibility
Targeted towards groups and populations
31Social change approach
32. These approaches have different
objectives
To prevent disease
To insure that people are well informed and are able to make
health choices
To help people acquire the skills and confidence to take greater
control over their health
To change polices and environments in order to facilitate healthy
choices
32
33. TOP-DOWN VS. BOTTOM-UP
Priorities set by health promoters
who have the power and
resources to make decisions and
impose ideas of what should be
done
Priorities are set by people
themselves identifying issues they
perceive as relevant
33
35. The medical approach
AIM: Free from lung disease, heart disease and other smoking
related disorders
ACTIVITY: Encourage people to seek early detection and treatment
of smoking related disorders
35
36. Behavioral change approach
AIM: Behavior changes from smoking to not smoking
ACTIVITY: Persuasive education to
– prevent non-smokers from starting to smoke
– persuade smokers to stop
36
37. Educational approach
AIM: Clients understand effects of smoking on health and will make
a decision whether to smoke or not and act on their decision
ACTIVITY: Giving information to clients about effects of smoking
Helping them explore their values and attitudes and come to a
decision
Helping them learn how to stop smoking if they want to
37
38. The empowerment approach
AIM: Anti-smoking issue is considered only if clients identify it as a
concern
ACTIVITY: Clients identify what, if anything, they want to know and do
about it
38
39. Social change approach
AIM: Make smoking socially unacceptable so it is easier not to
smoke than to smoke
ACTIVITY
– No smoking policy in all public places
– Cigarette sales less accessible
– Promotion of non-smoking as a social norm
– Limiting and challenging tobacco advertisements and sports
sponsorships
39
40. Models
1. The medical model
2. The behaviour change model
3. The educational model
4. The empowerment model
5. The social change model
40
42. Alma Ata Declaration, 1978
On Primary Health Care: Essential health care that’s practical,
scientifically sound and social acceptable methods and
technology made UNIVERSALLY accessible and affordable to
individuals and families in the community.
It expressed the need for urgent action by all governments, all
health and development workers, and the world community to
protect and promote the health of all the people of the world.
42
43. Important Policy Documents 43
First ICHP Ottawa, Canada 1986 Resulted in the “Ottawa Charter for Health Promotion”
Second ICHP Adelaide, Australia 1988 Resulted in the “Adelaide Recommendations on Healthy Public
Policy”
Third ICHP Sundsvall, Sweden 1991 Resulted in the “Sundsvall Statement on Supportive Environments for
Health”
Fourth ICHP Jakarta, Indonesia 1997 Resulted in the “Jakarta Declaration on Leading Health Promotion
into the 21st
Century”
Fifth GCHP Mexico City, Mexico 2000 Resulted in the “Mexico Ministerial Statement for the promotion of
health”
Sixth GCHP Bangkok, Thailand 2005 Resulted in the “Bangkok Charter for Health Promotion in a
Globalized World”
7th Global Conference on Health Promotion: Nairobi 2009
8th Global Conference on Health Promotion: Helsinki 2013
44. Ottawa Charter (1986)
Health promotion should be a part of public policy, documents and measures.
Health promotion should be a part of a community policy and practice.
Environment should enable and promote health.
People should be able to gain information, knowledge and skills enabling
development of health.
Health services should more orient on health promotion and support.
44
45. THE FIVE MAJOR AREAS/STRATEGIES IN HEALTH PROMOTION (OTTAWA CHARTER)
Healthy public policy is a pre-requisite for successful health promotion.
A Healthy Public Policy is characterized by a concern for health and equity and
an accountability for health impact.
Health should be made a priority item on the agenda of policy-makers in all
sectors.
Policy-makers should be made aware of the health consequences of their
decisions. They should create pro-health policies, whether in the area of
development, legislation, taxation etc.
1. Healthy Public Policy
45
46. Healthy public policy covers a combination of diverse but complementary
measures and approaches such as legislation, taxation, fiscal incentives and
disincentives, policy analysis and review, and organizatioanl change
Joint action by all sectors will contribute to achieving safer and healthier goods
and services, healthier public services, and cleaner and more healthy
environment.
The aim is to make the healthier choice the easier choice for all people.
HPP should lead to the creation of a supportive environment to enable people to
lead healthy live
1. Healthy Public Policy
46
THE FIVE MAJOR AREAS/STRATEGIES IN HEALTH PROMOTION (OTTAWA CHARTER)
47. According to the Adelaide Conference (1988), “The main aim of HPP is to
create a supportive environment to enable the people to lead healthy lives.
Healthy choices are thereby made possible and easier for citizens”.
All relevant government sectors like agriculture, trade, education, industry and
finance need to give important consideration to health as an essential factor
during their policy formulation.
1. Healthy Public Policy
47
THE FIVE MAJOR AREAS/STRATEGIES IN HEALTH PROMOTION (OTTAWA CHARTER)
48. A supportive environment is essential for health.
Supportive environments cover the physical, social, economic, and political
environment.
Supportive environments encompass where people live, work and play. This
is what is envisaged by the “settings” approach.
Everyone has a role in creating supportive
environments for health.
2. Create Supportive Environment
48
THE FIVE MAJOR AREAS/STRATEGIES IN HEALTH PROMOTION (OTTAWA CHARTER)
49. According to the Ottawa Charter, “health promotion works through concrete and
effective community action in setting priorities, making decisions, planning
strategies and implementing them to achieve better health”.
There are many ways of defining community. Factors used are geography, culture
and social stratification.
Community action is any activity undertaken by a community in order to effect
change (including voluntary and self-help services).
3. Strengthen Community Action: Community Participation
49
THE FIVE MAJOR AREAS/STRATEGIES IN HEALTH PROMOTION (OTTAWA CHARTER)
50. Community participation covers a spectrum of activities
At the low end, it may be token participation in the form of consultation or
endorsing plans drawn up by the health authorities. At the high end, it may
be in the form of ‘people power’ where they have full say in identifying needs,
setting priorities, planning strategies and activities and implementing the
programme.
50
THE FIVE MAJOR AREAS/STRATEGIES IN HEALTH PROMOTION (OTTAWA CHARTER)
3. Strengthen Community Action: Community Participation
51. Full community participation occurs when communities participate in equal
partnership with health professionals as stakeholders in setting the health
agenda.
Community participation is a social process whereby groups with shared
needs living in a defined geographic area actively pursue identification of their
needs, take decisions and establish mechanisms to meet these needs
3. Strengthen Community Action: community Participation
51
THE FIVE MAJOR AREAS/STRATEGIES IN HEALTH PROMOTION (OTTAWA CHARTER)
52. According to the Jakarta Declaration (1997), “health promotion improves both
the ability of individuals to take action, and the capacity of groups,
organizations or communities to influence the determinants of health”.
Empowerment is an important strategy, based on the notion that health is
significantly affected by the extent to which one has control or power over
one’s life.
3. Strengthen Community Action: Community Participation
52
THE FIVE MAJOR AREAS/STRATEGIES IN HEALTH PROMOTION (OTTAWA CHARTER)
53. Strategies for empowering the community include leadership training, learning
opportunities for health, and access to resources including material and
funding
Empowerment helps people to identify their own needs and concerns, and gain
the power, skills and confidence to act upon them. It is a bottom-up strategy
which requires the health promoter to act as a facilitator and catalyst for
change.
4. Develop Personal Skills
53
THE FIVE MAJOR AREAS/STRATEGIES IN HEALTH PROMOTION (OTTAWA CHARTER)
54. Skills which can promote an individual’s health include those pertaining to
identifying, selecting and applying healthy options in daily life.
Health education is life-long, so that people can develop the relevant skills to
meet the health challenges of all stages of life, and to be able to cope with
chronic illness and disabilities.
Health education should be conducted in all settings.
4. Develop Personal Skills
54
THE FIVE MAJOR AREAS/STRATEGIES IN HEALTH PROMOTION (OTTAWA CHARTER)
55. Shift of emphasis from provision of curative services.
Health care system must be equitable and client-centered.
May necessitate reengineering and organizational change, especially in
the areas of professional education and training, management, recruitment
and deployment of health personnel, and planning, development and
delivery of services,
5. Reorient Health Services
55
THE FIVE MAJOR AREAS/STRATEGIES IN HEALTH PROMOTION (OTTAWA CHARTER)
57. Adelaide Recommendations on Healthy Public Policy
Second International Conference on Health Promotion, Adelaide, South Australia, 5-9 April 1988
The Conference strongly recommends that the World Health Organization
continue the dynamic development of health promotion through the five
strategies described in the Ottawa Charter. It urges the World Health
Organization to expand this initiative throughout all its regions as an
integrated part of its work.
Support for developing countries is at the heart of this process.
Healthy Public Policy
57
58. Sundsvall Statement on Supportive Environments
for Health
Third International Conference on Health Promotion, Sundsvall,
Sweden, 9-15 June 1991
The Sundsvall Conference has again demonstrated that the issues
of health, environment and human development cannot be
separated.
Development must imply improvement in the quality of life and
health while preserving the sustainability of the environment. Only
worldwide action based on global partnership will ensure the
future of our planet
Supportive environment for Health
58
59. Jakarta Declaration on Leading Health Promotion
into the 21st Century
The Fourth International Conference on Health Promotion: New
Players for a New Era - Leading Health Promotion into the 21st
Century, Jakarta, Indonesia, 21-25 July 1997
The Jakarta Declaration included Five Priorities for Health Promotion in
21st
Century
1. “Promote Social Responsibility for health”
2. “Increase investments for health development”
3. “Consolidate and expand partnerships for health”
4. “Increase community capacity and empower the individual”
5. “Secure an infrastructure for health promotion”
59
60. The participants endorsed the formation of a Global health promotion
alliance
Priorities for the alliance include:
• Raising awareness of the changing determinants of health
• Supporting the development of collaboration and networks for health
development
• Mobilizing resources for health promotion
• Accumulating knowledge on best practice
• Enabling shared learning
• Promoting solidarity in action
• Fostering transparency and public accountability in health promotion
60
61. Mexico Ministerial Statement for the
Promotion of Health: From Ideas to Action
Fifth Global Conference on Health Promotion,
Health Promotion: Bridging the Equity Gap,
Mexico City, 5-9 June 2000
The attainment of the highest possible standard of health is a
positive asset for the enjoyment of life and necessary for social
and economic development and equity.
8 Statements and 6 Actions where signed by 88 Countries world
wide.
61
62. The ‘Bangkok Charter for Health Promotion in a
globalized world’
It has been agreed to by participants at the 6th Global
Conference on Health Promotion held in Thailand from 7-11
August, 2005
1. Make the promotion of health central to the global development agenda.
2. Make the promotion of health a core responsibility for all of government.
3. Make the promotion of health a key focus of communities and civil society.
4. Make the promotion of health a requirement for good corporate practice.
62
64. Advocate
Good health is a major resource for social,
economic and personal development and an
important dimension of quality of life. Political,
economic, social, cultural, environmental,
behavioral and biological factors can all favor
health or be harmful to it. Health promotion
action aims at making these conditions
favorable through advocacy for health.
64
65. Enable
Health promotion focuses on achieving equity in health.
Health promotion action aims at reducing differences in
current health status and ensuring equal opportunities
and resources to enable all people to achieve their
fullest health potential. This includes a secure foundation
in a supportive environment, access to information, life
skills and opportunities for making healthy choices.
People cannot achieve their fullest health potential
unless they are able to take control of those things which
determine their health. This must apply equally to women
and men.
65
66. Mediate
The prerequisites and prospects for health cannot be ensured by
the health sector alone. More importantly, health promotion
demands coordinated action by all concerned: by governments,
by health and other social and economic sectors, by
nongovernmental and voluntary organization, by local authorities,
by industry and by the media. People in all walks of life are involved
as individuals, families and communities. Professional and social
groups and health personnel have a major responsibility to mediate
between differing interests in society for the pursuit of health.
Health promotion strategies and programmes should be adapted
to the local needs and possibilities of individual countries and
regions to take into account differing social, cultural and economic
systems.
66
67. 6 Major Elements
Better Health policy.
Physical environment.
Social environment.
Community relationships.
Personal health skills.
Health services
67
68. Prerequisites for Health
The fundamental conditions and resources for health are:
peace,
shelter,
education,
food,
income,
a stable eco-system,
sustainable resources,
social justice, and equity.
68
69. HEALTH PROMOTION: WHERE DO WE START?
From disease/conditions.
From issues eg. Safety, environment, tobacco control.
From lifestyles.
From settings eg. workplace
home
schools
clinics
69
70. SETTINGS FOR HEALTH
This approach to health promotion arose from the Ottawa Charter:
“Health is created and lived by people within the settings of their
everyday life; where they learn, work, play and love”.
70
71. WHY SETTINGS?
Human health behaviour is determined by the physical and social forces which are present and interacting
in any setting.
Involves the target population as a whole in the context of their everyday life and in their unique
environment.
Holistic and comprehensive approach.
71
72. SETTINGS FOR HEALTH
The Settings For Health approach in concerned with creating health in our different settings.
Examples of Healthy Setting are:
Healthy Cities
Healthy Villages
Healthy Islands
Health Promoting Hospitals
Health Promoting Schools
72
73. CONCLUSION
The concept of health promotion is positive, dynamic and
empowering which makes it rhetorically useful and politically
attractive.
By considering the recommended principles, subject areas,
policy priorities and dilemmas it is hoped that future activities in
the health promotion field can be planned, implemented and
evaluated more successfully.
Further development work is clearly required and this will be an
ongoing task of the WHO Regional Office for Europe.
73