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UNIT – 1
OVERVIEW OF
HEALTH
PROMOTION
Mrs. D. Melba Sahaya Sweety RN,RM
PhD Nursing , MSc Nursing (Pediatric Nursing), BSc
Nursing
Associate Professor
Department of Pediatric Nursing
Enam Nursing College, Savar,
1
INTRODUCTION
• Good health is the best resource for personal, economic, and social progress.
Health Promotion constitutes a global, political, and social process that
encompasses actions aimed at modifying social, environmental, and economic
conditions in order to favor its positive impact on individual and collective
health. Ottawa Charter (WHO).
• The Health Promotion approach implies a particular way of collaborating: it
starts from the various needs of the population, fosters its abilities and
strengths, and empowers. It is participatory, intersectoral, sensitive to the
context, and operates at multiple levels.
• “Communities, organizations, and institutions working together to create
conditions and settings that ensure health and well-being for all people, leaving
no one behind.” 2
DEFINITION
• “Health promotion is the process of enabling people
to increase control over, and to improve their
health.” WHO Health Promotion Glossary, 1998
• Health promotion is the process of implementing a
range of social and environmental interventions that
enable people and communities to increase control
over and to improve their health. It’s focused on
addressing and preventing the root causes of illness,
rather than focusing solely on treatment and cure.
3
IMPORTANCE OF
HEALTH PROMOTION
• Health promotion improves the health status of
individuals, families, communities, states, and the nation.
• Health promotion enhances the quality of life for all
people.
• Health promotion reduces premature deaths.
• By focusing on prevention, health promotion reduces the
costs (both financial and human) that individuals,
employers, families, insurance companies, medical
facilities, communities, the state and the nation would 4
HISTORY OF HEALTH
PROMOTION
ANCIENT HEALTH PROMOTION PRACTICES:
INDIAN:
Indian system of medicine trace back to 5000 BC where ayurvedic practices focused on
personal hygiene, sanitation, water supply and engineering practices that supported
health.
CHINESE:
Chinese medicine dates back to 2700 BC and included attention to hygiene, diet,
hydrotherapy, massage and Immunization.
EGYPTIAN:
From 200 BC, the Egyptian developed community system for collecting rainwater,
disposing of waste, inoculating people against small pox, and method of avoiding the
plaque by controlling the rat population. They also used mosquito nets, encouraged
frequent bathing, and advocated against excess use of alcohol. 5
HISTORY OF HEALTH PROMOTION
HEBREW:
Early references of health promotion are found in the Code of
Hammurabi and Mosaic Law. These references address disease
prevention, disposal of waste, and segregation of infectious
persons, including those suffering from leprosy.
Mosaic Law encouraged a weekly day of rest for health and eating
pork could result in illness.
GREEK ANTIQUITY (460 to 136 BC):
The Pythagoreans placed a great deal of emphasis on hygiene.
They ate little meat, practiced moderation, and worked on
maintaining self-control and calm- ness at all times.
6
HISTORY OF HEALTH
PROMOTION
 Plato suggested that health is a state of being in harmony with the universe and experiencing a
sense of completeness and Contentment.
 Hippocrates defined Health as Equilibrium between environmental factors(Temperature, water
and food) and individual habits (diet, alcohol, sexual behavior, work and leisure) .
THE ROMAN EMPIRE:
 The Romans focused on community health measures, including the transportation of clean
water, paved streets, street cleaning, and sanitary waste disposal.
THE MIDLEVEL PANDEMICS:
 Between 1000 and 1453 AD, bubonic plague (Black Death) and pulmonary anthrax moved
from Asia to Africa, the Crimea, Turkey, Greece, and then Europe. Quarantine was used, in
which travelers from plaque infected areas has to stop at designated areas and remain there for
2 months, without demonstrating any symptoms, before being allowed to continue their
journey.
7
HISTORY OF HEALTH
PROMOTION
MODERN-DAY HEALTH PROMOTION HISTORY:
 Kickbush and Payne (2003) identified three major revolutionary steps in the
quest to promote healthy individuals and healthy communities.
 The first step, which focused on addressing sanitary conditions and infectious
diseases, occurred in the mid - nineteenth century.
 The second step was a shift in community health practices that occurred in
1974 with the release of the Lalonde report, which identified evidence that an
unhealthy lifestyle contributed more to premature illness and death than lack of
health care access (Lalonde, 1974). This report set the stage for health promotion
efforts.
8
HISTORY OF HEALTH
PROMOTION
 The third and current revolutionary step in promoting health for everyone
challenges us to identify the various combinations of forces that influence the
health of a population.
 In the mid - nineteenth century, John Snow, a physician in London, traced the
source of cholera in a community to the source of water for that community. By
removing the pump handle on the community’s water supply, he prevented the
agent (cholera bacteria) from invading community members (hosts). This
discovery not only led to the development of the modern science of
epidemiology but also helped governments recognize the need to address
infectious diseases.
9
HISTORY OF HEALTH
PROMOTION
 The Lalonde report set the stage for the third and current revolution in
promoting health by laying the groundwork for the World Health
Organization meeting in which the Ottawa Charter for Health Promotion
(World Health Organization, 1986) was developed. This pivotal report was a
milestone in international recognition of the value of health promotion.
• The report outlined five specific strategies (actions) for health promotion:
1. Develop healthy public policy.
2. Develop personal skills.
3. Strengthen community action.
4. Create supportive environments.
5. Reorient health services. 10
HISTORY OF HEALTH
PROMOTION
• In the United States, the Lalonde report formed the foundation for Healthy
People: The Surgeon General ’ s Report on Health Promotion and
Disease Prevention (U.S. Department of Health and Human Services,
1979), which set national goals for reducing premature deaths
• In 1997, the Jakarta Declaration on Leading Health Promotion into the
21st Century (World Health Organization, 1997) added to and refined the
strategies of the Ottawa Charter by articulating the following priorities:
1. Promote social responsibility for health.
2. Increase investment for health developments in all sectors.
11
HISTORY OF HEALTH
PROMOTION
3. Consolidate and expand partnerships for health.
4. Increase community capacity and empower individuals.
5. Secure an infrastructure for health promotion.
• The breadth of the work is represented in the Canadian Centre for
Health Promotion ’ s quality of life model, which conceptualizes health
promotion as aligned with a quality life
• Today, 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.
12
WORLD HEALTH ORDANIZATION”S
HEALTH PROMOTION
• The first International Conference on Health Promotion was
held in Ottawa in 1986, and was primarily a response to
growing expectations for a new public health movement around
the world.
• It launched a series of actions among international
organizations, national governments and local communities to
achieve the goal of "Health For All" by the year 2000 and
beyond.
• The basic strategies for health promotion identified in the
Ottawa Charter were: advocate (to boost the factors which
encourage health), enable (allowing all people to achieve health
equity) and mediate (through collaboration across all sectors).
13
WORLD HEALTH ORDANIZATION”S
HEALTH PROMOTION
• Since then, the WHO Global Health Promotion
Conferences have established and developed the global
principles and action areas for health promotion.
• Most recently, 10th Global Conference on Health
Promotion was held on December 2021 virtually Health
Promotion charters a path for creating ‘well-being
societies’
• It highlighted the need for global commitments to achieve
equitable health and social outcomes now and for future
generations, without destroying the health of our planet.
14
WORLD HEALTH ORDANIZATION”S
HEALTH PROMOTION
• The World Health Organization (WHO) has identified health
promotion in urban and local settings as critical to achieving the
Sustainable Development Goals (SDGs) and health equity.
• The Initiative is expected to contribute to achievement of SDG
targets 3 and 11 and the Triple Billion Targets of the WHO 13th
General Programme of Work 2019–2025 by addressing key
issues in urban health, including social, environmental and
economic determinants, and promoting healthier lives for
individuals and communities in cities.
• Building on good practices in the WHO Healthy Cities
programme, WHO is collaborating with the Swiss Agency for
15
WORLD HEALTH ORDANIZATION”S
HEALTH PROMOTION
Development and Cooperation to promote good local urban
governance for health and well-being through civic
engagement and multisectoral coordination within the Initiative
on Urban Governance for Health and Well-being (2020–2028).
In the first phase of the Initiative, WHO is working with five
cities: Bogota (Colombia), Douala (Cameroon), Mexico City
(Mexico), Khulna (Bangladesh), and Tunis (Tunisia).
• The emphasis of health promotion in the Western Pacific
Region is on:
1. Strengthening health promotion capacity (financing and
infrastructure);
16
WORLD HEALTH ORDANIZATION”S
HEALTH PROMOTION
2. Promoting urban health (including healthy cities and
health equity through Urban HEART);
3. Building other healthy settings (including schools and
workplaces) and healthy islands; and
4. Developing health literacy
17
CONFRENCES AND
PROGRAM
The Lalonde Report (1974)
WHO: Declaration of Alma-Ata on Primary Health Care (1978)
Healthy People (1979–2020)
Achieving Health for All: The Epp Report (1986)
WHO: Ottawa Charter for Health Promotion (1986)
WHO: Adelaide Recommendations on Healthy Public Policy (1988)
18
CONFRENCES AND
PROGRAM
The New Public Health Movement (1980s)
WHO: Sundsvall Statement on Supportive Environments for Health (1991)
WHO: Jakarta Declaration on Leading Health Promotion into the 21st
Century (1997)
WHO : Fifth Global Conference on Health Promotion
June 2000 Mexico,
WHO: Bangkok Charter for Health Promotion (2005)
19
CONFRENCES AND
PROGRAM
WHO: Seventh Global Conference on Health Promotion “Promoting health
and development: closing the implementation gap”
WHO: The 8th Global Conference on Health Promotion, Helsinki, 2013
WHO: The 9th Global Conference on Health Promotion, Shanghai 2016
“Health promotion in the SDGs” Health for all and all for health
WHO: 10th Global Conference on Health Promotion Health Promotion for
Well-being, Equity and Sustainable Development “UAE”
20
CONFRENCES AND
PROGRAM
• The World Health Organization (1948–Present)
Since the United Nations created the World Health Organization (WHO) in 1948, it has been
focused on global health promotion. The WHO advocates for legislation, fiscal change, and
organizational and community efforts to promote health. In 984, the WHO defined health
promotion as the process of enabling people to take control over maintaining and improving
their health
• The International Union for Health Promotion and Education (1951–
Present)
The International Union for Health Promotion and Education (IUHPE) is a global,
professional, nongovernmental organization dedicated to advancing health promotion .
Its mission is to promote global health and equity between and within countries
around the world. 21
CONFRENCES AND
PROGRAM
• The Lalonde Report (1974)
 The first authoritative policy statement to suggest that health promotion was
determined by issues other than those associated with the healthcare system or
medical care came from the Lalonde Report (Lalonde, 1974). As a result, Canada became
recognized as a leader in the conceptual development of health promotion policy.
 The Lalonde report introduced the health field model which emphasized that
lifestyle/behavior, biology, environment, and healthcare organizations all impacted
health It advocated for viewing preventive care as important as treatment and cure .
22
CONFRENCES AND
PROGRAM
 The Lalonde report had the goal of prompting individual and organization to accept more
responsibility for their health, and it resulted in interventions to decrease automobile
accidents, eliminate drunken driving, increase seat belt use and minimize alcohol.
 This report was the source of the best known definition of health promotion, which is that it
is the art and science of helping people change their lifestyle and move toward an
optimal state of health. Influential as the Lalonde Report was, it was criticized for
emphasizing lifestyle issues more than environmental, economic, social, and health
system related influences
23
CONFRENCES AND
PROGRAM
• WHO: Declaration of Alma-Ata on Primary Health Care (1978)
In 1978, the WHO issued the AlmaAta declaration in support of the idea that health promotion was not
entirely in the purview of the healthcare sector.
The Alma-Ata declaration also emphasized that
(1) global cooperation and peace were vital,
(2) local and community needs must drive health promotion activities,
(3) economic and social needs shape health,
(4) prevention must be an integral part of health care,
(5) equity in terms of health status is needed, and
(6) multiple sectors and players must be involved
It emphasized the need for health promotion, as well as curative and rehabilitative services. It
emphasized issues of particular importance to developing country to an great extend. For example,
issues of food security, affordable health care, global peace, safe water, proper nutrition, and family
planning were highlighted .
24
CONFRENCES AND
PROGRAM
• Healthy People (1979–2030) :
 Motivated by the Canadian Lalonde report, the united states surgeon general
developed a comprehensive public health policy with associated 10
year prevention strategies and outcome targets designed to decrease mortality and morbidity.
Health promotion was separated from disease prevention, and both targets were given priority .
This policy was called Healthy People 1979.
 Healthy people 1979 argued that 50% of mortality was due to unhealthy behavior of lifestyle,
20% to environmental factors, 20% to human biology, and 10% to inadequacies in health care”
 Healthy People 1990 focused on reducing mortality across the lifespan with priority
being assigned to accident/injury prevention, control of stress/violent behavior, family
planning, fluoridation of drinking water, high blood pressure, immunization, alcohol and drug a
buse, physical fitness, pregnancy, sexually transmitted diseases, smoking, and toxic agents.
25
CONFRENCES AND
PROGRAM
Healthy people 2000 focused on increased year of healthy life, reducing disparities,
and increasing access to preventative services. Priority areas were cancer, diabetes,
communitybased programs, environmental health, food and drug safety, heart
disease and stroke, HIV infection, maternal and infant health, mental health,
surveillance and data systems,and violent/abusive behavior, in addition to previously
unmet target goals from 1990
 Healthy people 2010 was based on the same goal as Healthy people 2000 with
priority being given to access to health services, arthritis, osteoporosis, kidney
disease,health communication, medical product safety, public health infrastructure,
and respiratory diseases, in addition to all previously unmet target priorities.
Another goal was increasing quality and years of healthy life by assisting people to
gain knowledge, motivation, and opportunity tomake informed decisions about their
health
26
CONFRENCES AND
PROGRAM
 Determinants of health that are addressed in Healthy People 2020 include:
(1) social, economic, cultural, and environmental conditions and policies of global,
national, state, and local levels;
(2) living and working conditions;
(3) social, family, and community networks; and
(4) individual behaviors and traits, such as age, gender, race, and biological heritage
that shape health.
The priorities of Healthy people 2020 are to
i. Eliminate preventable disease, injury, disability and premature Death
ii. Achieve health equity eliminating health disparities;
iii. create social and physical environments that promote health; and
iv. Support healthy development and behavior across the lifespan.
27
CONFRENCES AND
PROGRAM
The priorities of Healthy people 2030 are to
• Attain healthy, thriving lives and well-being, free of preventable disease,
disability, injury, and premature death.
• Eliminate health disparities, achieve health equity, and attain health literacy to
improve the health and well-being of all.
• Create social, physical, and economic environments that promote attaining full
potential for health and well-being for all.
• Promote healthy development, healthy behaviors, and well-being across all life
stages.
• Engage leadership, key constituents, and the public across multiple sectors to take
action and design policies that improve the health and well-being of all. 28
CONFRENCES AND
PROGRAM
• Achieving Health for All: The Epp Report (1986)
 In 1986, the Canadian Minister of National Health and Welfare created a report titled
“Achieving Health for All: A Framework for Health Promotion,” which has come to be know
n as the Epp Report. This report documented that disadvantaged groups have lower life
expectacies and poorer health than those with more resources.
 The Epp Report posited that selfcare, mutual aid from others, and healthy environments were
major influences on health promotion. Mutual aid included emotional support and the sharing
of ideas, information, and experience in the context of a family, a neighborhood, a community
organization, or a self-help group .
 The Epp Report advocated for reducing inequities, increasing prevention and enhancing an
individual coping skills. It also sated that people often associate health promotion with posters
and pamphlets
29
CONFRENCES AND
PROGRAM
• WHO: Ottawa Charter for Health Promotion (1986)
• The first international health promotion conference sponsored by the WHO was held
in Ottawa, Canada, in 1986. It resulted in the Ottawa Charter for Health Promotion,
which is a quintessential document in the international health promotion arena. The
Ottawa Charter emphasized that individuals need to have supportive environments
and economic resources to lead healthy lives and experience well-being. It addressed
the role of health inequalities and the importance of political, economic, and social
influences on health.
The Ottawa charter put forth the ideas that health promotion:
• Includes the concept of well-being
• Rests on political, economic, social, cultural, environmental, behavioral, and biological
advocacy;
30
CONFRENCES AND
PROGRAM
• Necessitates attention be given to equity
• Require action by governments, voluntary organizations, local authorities, industry,
health care and the media and
• Should be adopted to local needs, cultural/economic norms
 The Ottawa charter stressed that health promotion is not the sole responsibility of
the healthcare sector but rather requires political, economic, and social interventions as
well as the involvement of voluntary organizations, local authorities, industry, a
nd the media.
Health promotion was defined by Ottawa charter as the “process of enabling the
individual and communities to increase control over the determinants of health,
thereby improving the health to live and active and productive life”.
-(Erickson and Lindstrom)
31
CONFRENCES AND
PROGRAM
WHO: Adelaide Recommendations on Healthy Public Policy (1988)
• The Second International Conference on Health Promotion was held in April 1988 in
Adelaide, South Australia.
• It emphasized the necessity of supportive environments in promoting health. In addition, a
call was issued for collaborations among governmental and private sector interests associated
with agriculture, trade, education, industry, and communications to the extent that health was
given priority over economic considerations.
• Conference presenters stressed that concern for equity in all areas of policy development
results in substantial health benefits. They argued for equal healthcare access for
indigenous peoples, ethnic minorities, and immigrants.
• They also stressed that education levels and literacy be taken into account when health
policy is being designed. The importance of creating health information systems capable of
evaluating the impact of policy change was highlighted. 32
CONFRENCES AND
PROGRAM
• An argument was made for developing nationally based women’s health policies that
supported women’s choice in terms of birthing practices. They also advocated for
parental/dependent healthcare leaves, and they created a larger role for women in the
development ofhealth policy. Issues such as the ecological impact of raising tobacco as
a cash crop and how such practices limit food production were discussed.
The New Public Health Movement (1980s)
 The New Public Health Movement (NPHM) was inspired by the Ottawa Charter on
health promotion and by the growth of the field of population health.
 The NPHM embodies a number of the concepts just discussed, emphasizing that a
socioecological rather than a biomedical approach is the most effective way to promote
health.
33
CONFRENCES AND
PROGRAM
 This socioecological View focuses on preventing rather than curing disease
by examining root causes of disease such as economic inequalities, social problems, and
environmental issues.
The priority is on establishing health policy, services, and educational programs to preve
nt disease before it occurs.
WHO: Sundsvall Statement on Supportive Environments for
Health (1991)
• The Third International Conference on Health Promotion was held in June 1991
in Sundsvall, Sweden.
• The conclusion of the conference was that a supportive environment is of paramount
importance to health. Supportive environments meant both the physical and social
aspects of where one lives, works, socializes, is educated, and seeks care. 34
CONFRENCES AND
PROGRAM
 Four main aspects of supportive environments were emphasized:
(1) the social dimension, including norms, customs, purpose, and heritage;
(2) the political dimension, including participation in decision making and a
commitment to human rights and peace;
(3) the economic dimension, including sustainable development; and
(4) the need to recognize and use women’s skills and knowledge.
The conference also called for four key public health action strategies:
(1) strengthening advocacy through community action,
(2) empowering and educating communities to take control of their own health,
(3) building alliances between environmental- and health oriented groups and
(4) Mediating conflicts to ensure equitable assess to health environment. 35
• WHO: Jakarta Declaration on Leading Health Promotion into the
21st Century (1997)
• The Fourth International conference on health promotion was held in July 1997 in
Jakarta, Indonesia. It was the first WHO conference to be held in a developing country
and the first to involve the private sector.
• The Jakarta Declaration, which derived from that conference, emphasized that poverty is the
greatest threat to health, while summarizing that peace, shelter, education, social relations,
food, income, the empowerment of women, a stable ecosystem, sustainable resources, social
justice, respect for human rights, and equity are requirements for health.
• A call for action to establish a global health promotion alliance was issued. Goals for that
alliance were to:
(1) raise awareness of changing determinants of health, 36
CONFRENCES AND
PROGRAM
(2) support collaborations dedicated to health promotion,
(3) mobilize resources for health promotion,
(4) accumulate best practice knowledge,
(5) enable shared learning,
(6) promote solidarity in action, and
(7) foster transparency and public accountability in health promotion
Fifth Global Conference on Health Promotion 5 – 9 June
2000 Mexico,
• The Fifth Global Conference on Health Promotion (5GCHP) – Health Promotion: Bridging the
Equity Gap – was held 5-9th June, 2000 in Mexico City. This conference built on the advances
of the previous four International Health Promotion Conferences, particularly taking forward
37
CONFRENCES AND
PROGRAM
the priorities of the last International Conference on Health Promotion held in Jakarta, Indonesia
in 1997
• WHO: Bangkok Charter for Health Promotion (2005)
 In 2005, the WHO issued the Bangkok Charter, which built on the Ottawa Charter by
adding a focus on coherence of health policy and a commitment to partnership within
and between governments, international organizations, and the private sector.
 The Bangkok Charter encouraged people to “advocate for health based on human
rights, invest in sustainable policies, actions, and infrastructure to address the
determinants of health, target knowledge transfer and research, and address health
literacy”.
 It advocated for equal opportunity for the health and wellbeing for all people. Health
was now seen as a critical part of foreign policy, national security, trade, and geopolitics
38
CONFRENCES AND
PROGRAM
CONFRENCES AND PROGRAM
Seventh Global Conference on Health Promotion
“Promoting health and development: closing the
implementation gap”
7th Global Conference on Health Promotion organized by WHO
and Kenya Ministry of Public Health will be held in Nairobi,
26-30 October 2009.
The financial crisis threatens the viability of national economies
in general and of health systems in particular. Global warming
and climate change exert a toll in human life, especially in lower
income countries. Security threats create a sense of shared
uncertainty for communities around the world.
39
CONFRENCES AND PROGRAM
The 8th Global Conference on Health Promotion, Helsinki, 2013
• This conference was co-hosted by WHO and the Ministry of Social
Affairs and Health, Finland. The main theme of the conference was
“Health in All Policies” (HiAP) and its focus was on
implementation, the “how-to”. It was structured around six themes.
• The conference aims to:
• facilitate the exchange of experiences and lessons learnt and give
guidance on effective mechanisms for promoting intersectoral
action;
• review approaches to address barriers and build capacity for
implementing Health in All Policies;
• identify opportunities to implement the recommendations of the
Commission on Social Determinants of Health through Health in All
Policies;
40
CONFRENCES AND PROGRAM
• establish and review economic, developmental and social case for
investing in HiAP;
• address the contribution of health promotion in the renewal and reform of
primary health care; and
• review progress, impact and achievements of health promotion since the
Ottawa Conference.
• The 9th Global Conference on Health Promotion, Shanghai
2016 “Health promotion in the SDGs” Health for all and all
for health
The People’s Republic of China and WHO are the joint-organizers of the
Global Conference on Health Promotion in Shanghai on 21-24 November
2016. The Conference is entitled “Promoting health in the Sustainable
Development Goals: Health for all and all for health,” and is being hosted by
the Government and China and the Municipal Government of Shanghai. 41
CONFRENCES AND PROGRAM
Goals
• To highlight the critical links between promoting health and the 2030
Agenda for Sustainable Development.
• Objectives
• To provide guidance to Member States on how to reflect promoting
health into national Sustainable Development Goal (SDG) responses,
and how to accelerate progress on SDG targets.
• Exchange national experiences in:
 strengthening good governance for health through action across
government sectors;
 broadening and strengthening social mobilization; and
 promoting health literacy.
42
CONFRENCES AND PROGRAM
• To highlight the health sector’s changing role as the key advocate for
promoting health.
• To highlight the crucial role that cities – and municipal leaders,
especially Mayors – play in promoting health (creating Healthy
Cities), in the context of an increasingly urbanized global population.
• 10th Global Conference on Health Promotion Health
Promotion for Well-being, Equity and Sustainable
Development
• On 13–15 December 2021, WHO will hold the 10th Global Conference on
Health Promotion. The virtual conference is organized by the World
Health Organization (WHO) with the support of the United Arab Emirates,
United Nations agencies and partners. It will mark the first time that WHO
has used well-being as the theme of a major conference.
43
CONFRENCES AND PROGRAM
• Discussions will focus on the contributions that health promotion can
make to well-being in the broad areas of people, the planet and prosperity,
culminating in a high-level political statement recommending how
governments can use health promotion to advance well-being.
The conference objectives are to:
• discuss how to extend health promotion to advance well-being and equity,
building on evidence and experience, to foster healthier populations.
• identify realistic interventions for health promotion and well-being to
accelerate progress in achieving the SDGs.
• emphasize the role of health promotion in public health emergency
preparedness and response, and seize opportunities to build healthier, fairer
societies.
• explore innovative health promotion approaches to enable societies and
communities to flourish.
44
CONCLUSION
• Promoting Healthier Populations is the strategies of WHO, The
Sustainable Development Goals (SDGs) provides a bold and ambitious
agenda for the future. WHO is committed to helping the world meet the
SDGs by championing health across all the goals. WHO’s core mission
is to promote health, alongside keeping the world safe and serving the
vulnerable. Beyond fighting disease, we will work to ensure healthy
lives and promote well-being for all at all ages, leaving no-one behind.
• WHO target is 1 billion more people enjoying better health and well-
being by 2023.
45
46

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Overview of Health promotion.pptx

  • 1. UNIT – 1 OVERVIEW OF HEALTH PROMOTION Mrs. D. Melba Sahaya Sweety RN,RM PhD Nursing , MSc Nursing (Pediatric Nursing), BSc Nursing Associate Professor Department of Pediatric Nursing Enam Nursing College, Savar, 1
  • 2. INTRODUCTION • Good health is the best resource for personal, economic, and social progress. Health Promotion constitutes a global, political, and social process that encompasses actions aimed at modifying social, environmental, and economic conditions in order to favor its positive impact on individual and collective health. Ottawa Charter (WHO). • The Health Promotion approach implies a particular way of collaborating: it starts from the various needs of the population, fosters its abilities and strengths, and empowers. It is participatory, intersectoral, sensitive to the context, and operates at multiple levels. • “Communities, organizations, and institutions working together to create conditions and settings that ensure health and well-being for all people, leaving no one behind.” 2
  • 3. DEFINITION • “Health promotion is the process of enabling people to increase control over, and to improve their health.” WHO Health Promotion Glossary, 1998 • Health promotion is the process of implementing a range of social and environmental interventions that enable people and communities to increase control over and to improve their health. It’s focused on addressing and preventing the root causes of illness, rather than focusing solely on treatment and cure. 3
  • 4. IMPORTANCE OF HEALTH PROMOTION • Health promotion improves the health status of individuals, families, communities, states, and the nation. • Health promotion enhances the quality of life for all people. • Health promotion reduces premature deaths. • By focusing on prevention, health promotion reduces the costs (both financial and human) that individuals, employers, families, insurance companies, medical facilities, communities, the state and the nation would 4
  • 5. HISTORY OF HEALTH PROMOTION ANCIENT HEALTH PROMOTION PRACTICES: INDIAN: Indian system of medicine trace back to 5000 BC where ayurvedic practices focused on personal hygiene, sanitation, water supply and engineering practices that supported health. CHINESE: Chinese medicine dates back to 2700 BC and included attention to hygiene, diet, hydrotherapy, massage and Immunization. EGYPTIAN: From 200 BC, the Egyptian developed community system for collecting rainwater, disposing of waste, inoculating people against small pox, and method of avoiding the plaque by controlling the rat population. They also used mosquito nets, encouraged frequent bathing, and advocated against excess use of alcohol. 5
  • 6. HISTORY OF HEALTH PROMOTION HEBREW: Early references of health promotion are found in the Code of Hammurabi and Mosaic Law. These references address disease prevention, disposal of waste, and segregation of infectious persons, including those suffering from leprosy. Mosaic Law encouraged a weekly day of rest for health and eating pork could result in illness. GREEK ANTIQUITY (460 to 136 BC): The Pythagoreans placed a great deal of emphasis on hygiene. They ate little meat, practiced moderation, and worked on maintaining self-control and calm- ness at all times. 6
  • 7. HISTORY OF HEALTH PROMOTION  Plato suggested that health is a state of being in harmony with the universe and experiencing a sense of completeness and Contentment.  Hippocrates defined Health as Equilibrium between environmental factors(Temperature, water and food) and individual habits (diet, alcohol, sexual behavior, work and leisure) . THE ROMAN EMPIRE:  The Romans focused on community health measures, including the transportation of clean water, paved streets, street cleaning, and sanitary waste disposal. THE MIDLEVEL PANDEMICS:  Between 1000 and 1453 AD, bubonic plague (Black Death) and pulmonary anthrax moved from Asia to Africa, the Crimea, Turkey, Greece, and then Europe. Quarantine was used, in which travelers from plaque infected areas has to stop at designated areas and remain there for 2 months, without demonstrating any symptoms, before being allowed to continue their journey. 7
  • 8. HISTORY OF HEALTH PROMOTION MODERN-DAY HEALTH PROMOTION HISTORY:  Kickbush and Payne (2003) identified three major revolutionary steps in the quest to promote healthy individuals and healthy communities.  The first step, which focused on addressing sanitary conditions and infectious diseases, occurred in the mid - nineteenth century.  The second step was a shift in community health practices that occurred in 1974 with the release of the Lalonde report, which identified evidence that an unhealthy lifestyle contributed more to premature illness and death than lack of health care access (Lalonde, 1974). This report set the stage for health promotion efforts. 8
  • 9. HISTORY OF HEALTH PROMOTION  The third and current revolutionary step in promoting health for everyone challenges us to identify the various combinations of forces that influence the health of a population.  In the mid - nineteenth century, John Snow, a physician in London, traced the source of cholera in a community to the source of water for that community. By removing the pump handle on the community’s water supply, he prevented the agent (cholera bacteria) from invading community members (hosts). This discovery not only led to the development of the modern science of epidemiology but also helped governments recognize the need to address infectious diseases. 9
  • 10. HISTORY OF HEALTH PROMOTION  The Lalonde report set the stage for the third and current revolution in promoting health by laying the groundwork for the World Health Organization meeting in which the Ottawa Charter for Health Promotion (World Health Organization, 1986) was developed. This pivotal report was a milestone in international recognition of the value of health promotion. • The report outlined five specific strategies (actions) for health promotion: 1. Develop healthy public policy. 2. Develop personal skills. 3. Strengthen community action. 4. Create supportive environments. 5. Reorient health services. 10
  • 11. HISTORY OF HEALTH PROMOTION • In the United States, the Lalonde report formed the foundation for Healthy People: The Surgeon General ’ s Report on Health Promotion and Disease Prevention (U.S. Department of Health and Human Services, 1979), which set national goals for reducing premature deaths • In 1997, the Jakarta Declaration on Leading Health Promotion into the 21st Century (World Health Organization, 1997) added to and refined the strategies of the Ottawa Charter by articulating the following priorities: 1. Promote social responsibility for health. 2. Increase investment for health developments in all sectors. 11
  • 12. HISTORY OF HEALTH PROMOTION 3. Consolidate and expand partnerships for health. 4. Increase community capacity and empower individuals. 5. Secure an infrastructure for health promotion. • The breadth of the work is represented in the Canadian Centre for Health Promotion ’ s quality of life model, which conceptualizes health promotion as aligned with a quality life • Today, 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. 12
  • 13. WORLD HEALTH ORDANIZATION”S HEALTH PROMOTION • The first International Conference on Health Promotion was held in Ottawa in 1986, and was primarily a response to growing expectations for a new public health movement around the world. • It launched a series of actions among international organizations, national governments and local communities to achieve the goal of "Health For All" by the year 2000 and beyond. • The basic strategies for health promotion identified in the Ottawa Charter were: advocate (to boost the factors which encourage health), enable (allowing all people to achieve health equity) and mediate (through collaboration across all sectors). 13
  • 14. WORLD HEALTH ORDANIZATION”S HEALTH PROMOTION • Since then, the WHO Global Health Promotion Conferences have established and developed the global principles and action areas for health promotion. • Most recently, 10th Global Conference on Health Promotion was held on December 2021 virtually Health Promotion charters a path for creating ‘well-being societies’ • It highlighted the need for global commitments to achieve equitable health and social outcomes now and for future generations, without destroying the health of our planet. 14
  • 15. WORLD HEALTH ORDANIZATION”S HEALTH PROMOTION • The World Health Organization (WHO) has identified health promotion in urban and local settings as critical to achieving the Sustainable Development Goals (SDGs) and health equity. • The Initiative is expected to contribute to achievement of SDG targets 3 and 11 and the Triple Billion Targets of the WHO 13th General Programme of Work 2019–2025 by addressing key issues in urban health, including social, environmental and economic determinants, and promoting healthier lives for individuals and communities in cities. • Building on good practices in the WHO Healthy Cities programme, WHO is collaborating with the Swiss Agency for 15
  • 16. WORLD HEALTH ORDANIZATION”S HEALTH PROMOTION Development and Cooperation to promote good local urban governance for health and well-being through civic engagement and multisectoral coordination within the Initiative on Urban Governance for Health and Well-being (2020–2028). In the first phase of the Initiative, WHO is working with five cities: Bogota (Colombia), Douala (Cameroon), Mexico City (Mexico), Khulna (Bangladesh), and Tunis (Tunisia). • The emphasis of health promotion in the Western Pacific Region is on: 1. Strengthening health promotion capacity (financing and infrastructure); 16
  • 17. WORLD HEALTH ORDANIZATION”S HEALTH PROMOTION 2. Promoting urban health (including healthy cities and health equity through Urban HEART); 3. Building other healthy settings (including schools and workplaces) and healthy islands; and 4. Developing health literacy 17
  • 18. CONFRENCES AND PROGRAM The Lalonde Report (1974) WHO: Declaration of Alma-Ata on Primary Health Care (1978) Healthy People (1979–2020) Achieving Health for All: The Epp Report (1986) WHO: Ottawa Charter for Health Promotion (1986) WHO: Adelaide Recommendations on Healthy Public Policy (1988) 18
  • 19. CONFRENCES AND PROGRAM The New Public Health Movement (1980s) WHO: Sundsvall Statement on Supportive Environments for Health (1991) WHO: Jakarta Declaration on Leading Health Promotion into the 21st Century (1997) WHO : Fifth Global Conference on Health Promotion June 2000 Mexico, WHO: Bangkok Charter for Health Promotion (2005) 19
  • 20. CONFRENCES AND PROGRAM WHO: Seventh Global Conference on Health Promotion “Promoting health and development: closing the implementation gap” WHO: The 8th Global Conference on Health Promotion, Helsinki, 2013 WHO: The 9th Global Conference on Health Promotion, Shanghai 2016 “Health promotion in the SDGs” Health for all and all for health WHO: 10th Global Conference on Health Promotion Health Promotion for Well-being, Equity and Sustainable Development “UAE” 20
  • 21. CONFRENCES AND PROGRAM • The World Health Organization (1948–Present) Since the United Nations created the World Health Organization (WHO) in 1948, it has been focused on global health promotion. The WHO advocates for legislation, fiscal change, and organizational and community efforts to promote health. In 984, the WHO defined health promotion as the process of enabling people to take control over maintaining and improving their health • The International Union for Health Promotion and Education (1951– Present) The International Union for Health Promotion and Education (IUHPE) is a global, professional, nongovernmental organization dedicated to advancing health promotion . Its mission is to promote global health and equity between and within countries around the world. 21
  • 22. CONFRENCES AND PROGRAM • The Lalonde Report (1974)  The first authoritative policy statement to suggest that health promotion was determined by issues other than those associated with the healthcare system or medical care came from the Lalonde Report (Lalonde, 1974). As a result, Canada became recognized as a leader in the conceptual development of health promotion policy.  The Lalonde report introduced the health field model which emphasized that lifestyle/behavior, biology, environment, and healthcare organizations all impacted health It advocated for viewing preventive care as important as treatment and cure . 22
  • 23. CONFRENCES AND PROGRAM  The Lalonde report had the goal of prompting individual and organization to accept more responsibility for their health, and it resulted in interventions to decrease automobile accidents, eliminate drunken driving, increase seat belt use and minimize alcohol.  This report was the source of the best known definition of health promotion, which is that it is the art and science of helping people change their lifestyle and move toward an optimal state of health. Influential as the Lalonde Report was, it was criticized for emphasizing lifestyle issues more than environmental, economic, social, and health system related influences 23
  • 24. CONFRENCES AND PROGRAM • WHO: Declaration of Alma-Ata on Primary Health Care (1978) In 1978, the WHO issued the AlmaAta declaration in support of the idea that health promotion was not entirely in the purview of the healthcare sector. The Alma-Ata declaration also emphasized that (1) global cooperation and peace were vital, (2) local and community needs must drive health promotion activities, (3) economic and social needs shape health, (4) prevention must be an integral part of health care, (5) equity in terms of health status is needed, and (6) multiple sectors and players must be involved It emphasized the need for health promotion, as well as curative and rehabilitative services. It emphasized issues of particular importance to developing country to an great extend. For example, issues of food security, affordable health care, global peace, safe water, proper nutrition, and family planning were highlighted . 24
  • 25. CONFRENCES AND PROGRAM • Healthy People (1979–2030) :  Motivated by the Canadian Lalonde report, the united states surgeon general developed a comprehensive public health policy with associated 10 year prevention strategies and outcome targets designed to decrease mortality and morbidity. Health promotion was separated from disease prevention, and both targets were given priority . This policy was called Healthy People 1979.  Healthy people 1979 argued that 50% of mortality was due to unhealthy behavior of lifestyle, 20% to environmental factors, 20% to human biology, and 10% to inadequacies in health care”  Healthy People 1990 focused on reducing mortality across the lifespan with priority being assigned to accident/injury prevention, control of stress/violent behavior, family planning, fluoridation of drinking water, high blood pressure, immunization, alcohol and drug a buse, physical fitness, pregnancy, sexually transmitted diseases, smoking, and toxic agents. 25
  • 26. CONFRENCES AND PROGRAM Healthy people 2000 focused on increased year of healthy life, reducing disparities, and increasing access to preventative services. Priority areas were cancer, diabetes, communitybased programs, environmental health, food and drug safety, heart disease and stroke, HIV infection, maternal and infant health, mental health, surveillance and data systems,and violent/abusive behavior, in addition to previously unmet target goals from 1990  Healthy people 2010 was based on the same goal as Healthy people 2000 with priority being given to access to health services, arthritis, osteoporosis, kidney disease,health communication, medical product safety, public health infrastructure, and respiratory diseases, in addition to all previously unmet target priorities. Another goal was increasing quality and years of healthy life by assisting people to gain knowledge, motivation, and opportunity tomake informed decisions about their health 26
  • 27. CONFRENCES AND PROGRAM  Determinants of health that are addressed in Healthy People 2020 include: (1) social, economic, cultural, and environmental conditions and policies of global, national, state, and local levels; (2) living and working conditions; (3) social, family, and community networks; and (4) individual behaviors and traits, such as age, gender, race, and biological heritage that shape health. The priorities of Healthy people 2020 are to i. Eliminate preventable disease, injury, disability and premature Death ii. Achieve health equity eliminating health disparities; iii. create social and physical environments that promote health; and iv. Support healthy development and behavior across the lifespan. 27
  • 28. CONFRENCES AND PROGRAM The priorities of Healthy people 2030 are to • Attain healthy, thriving lives and well-being, free of preventable disease, disability, injury, and premature death. • Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all. • Create social, physical, and economic environments that promote attaining full potential for health and well-being for all. • Promote healthy development, healthy behaviors, and well-being across all life stages. • Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all. 28
  • 29. CONFRENCES AND PROGRAM • Achieving Health for All: The Epp Report (1986)  In 1986, the Canadian Minister of National Health and Welfare created a report titled “Achieving Health for All: A Framework for Health Promotion,” which has come to be know n as the Epp Report. This report documented that disadvantaged groups have lower life expectacies and poorer health than those with more resources.  The Epp Report posited that selfcare, mutual aid from others, and healthy environments were major influences on health promotion. Mutual aid included emotional support and the sharing of ideas, information, and experience in the context of a family, a neighborhood, a community organization, or a self-help group .  The Epp Report advocated for reducing inequities, increasing prevention and enhancing an individual coping skills. It also sated that people often associate health promotion with posters and pamphlets 29
  • 30. CONFRENCES AND PROGRAM • WHO: Ottawa Charter for Health Promotion (1986) • The first international health promotion conference sponsored by the WHO was held in Ottawa, Canada, in 1986. It resulted in the Ottawa Charter for Health Promotion, which is a quintessential document in the international health promotion arena. The Ottawa Charter emphasized that individuals need to have supportive environments and economic resources to lead healthy lives and experience well-being. It addressed the role of health inequalities and the importance of political, economic, and social influences on health. The Ottawa charter put forth the ideas that health promotion: • Includes the concept of well-being • Rests on political, economic, social, cultural, environmental, behavioral, and biological advocacy; 30
  • 31. CONFRENCES AND PROGRAM • Necessitates attention be given to equity • Require action by governments, voluntary organizations, local authorities, industry, health care and the media and • Should be adopted to local needs, cultural/economic norms  The Ottawa charter stressed that health promotion is not the sole responsibility of the healthcare sector but rather requires political, economic, and social interventions as well as the involvement of voluntary organizations, local authorities, industry, a nd the media. Health promotion was defined by Ottawa charter as the “process of enabling the individual and communities to increase control over the determinants of health, thereby improving the health to live and active and productive life”. -(Erickson and Lindstrom) 31
  • 32. CONFRENCES AND PROGRAM WHO: Adelaide Recommendations on Healthy Public Policy (1988) • The Second International Conference on Health Promotion was held in April 1988 in Adelaide, South Australia. • It emphasized the necessity of supportive environments in promoting health. In addition, a call was issued for collaborations among governmental and private sector interests associated with agriculture, trade, education, industry, and communications to the extent that health was given priority over economic considerations. • Conference presenters stressed that concern for equity in all areas of policy development results in substantial health benefits. They argued for equal healthcare access for indigenous peoples, ethnic minorities, and immigrants. • They also stressed that education levels and literacy be taken into account when health policy is being designed. The importance of creating health information systems capable of evaluating the impact of policy change was highlighted. 32
  • 33. CONFRENCES AND PROGRAM • An argument was made for developing nationally based women’s health policies that supported women’s choice in terms of birthing practices. They also advocated for parental/dependent healthcare leaves, and they created a larger role for women in the development ofhealth policy. Issues such as the ecological impact of raising tobacco as a cash crop and how such practices limit food production were discussed. The New Public Health Movement (1980s)  The New Public Health Movement (NPHM) was inspired by the Ottawa Charter on health promotion and by the growth of the field of population health.  The NPHM embodies a number of the concepts just discussed, emphasizing that a socioecological rather than a biomedical approach is the most effective way to promote health. 33
  • 34. CONFRENCES AND PROGRAM  This socioecological View focuses on preventing rather than curing disease by examining root causes of disease such as economic inequalities, social problems, and environmental issues. The priority is on establishing health policy, services, and educational programs to preve nt disease before it occurs. WHO: Sundsvall Statement on Supportive Environments for Health (1991) • The Third International Conference on Health Promotion was held in June 1991 in Sundsvall, Sweden. • The conclusion of the conference was that a supportive environment is of paramount importance to health. Supportive environments meant both the physical and social aspects of where one lives, works, socializes, is educated, and seeks care. 34
  • 35. CONFRENCES AND PROGRAM  Four main aspects of supportive environments were emphasized: (1) the social dimension, including norms, customs, purpose, and heritage; (2) the political dimension, including participation in decision making and a commitment to human rights and peace; (3) the economic dimension, including sustainable development; and (4) the need to recognize and use women’s skills and knowledge. The conference also called for four key public health action strategies: (1) strengthening advocacy through community action, (2) empowering and educating communities to take control of their own health, (3) building alliances between environmental- and health oriented groups and (4) Mediating conflicts to ensure equitable assess to health environment. 35
  • 36. • WHO: Jakarta Declaration on Leading Health Promotion into the 21st Century (1997) • The Fourth International conference on health promotion was held in July 1997 in Jakarta, Indonesia. It was the first WHO conference to be held in a developing country and the first to involve the private sector. • The Jakarta Declaration, which derived from that conference, emphasized that poverty is the greatest threat to health, while summarizing that peace, shelter, education, social relations, food, income, the empowerment of women, a stable ecosystem, sustainable resources, social justice, respect for human rights, and equity are requirements for health. • A call for action to establish a global health promotion alliance was issued. Goals for that alliance were to: (1) raise awareness of changing determinants of health, 36 CONFRENCES AND PROGRAM
  • 37. (2) support collaborations dedicated to health promotion, (3) mobilize resources for health promotion, (4) accumulate best practice knowledge, (5) enable shared learning, (6) promote solidarity in action, and (7) foster transparency and public accountability in health promotion Fifth Global Conference on Health Promotion 5 – 9 June 2000 Mexico, • The Fifth Global Conference on Health Promotion (5GCHP) – Health Promotion: Bridging the Equity Gap – was held 5-9th June, 2000 in Mexico City. This conference built on the advances of the previous four International Health Promotion Conferences, particularly taking forward 37 CONFRENCES AND PROGRAM
  • 38. the priorities of the last International Conference on Health Promotion held in Jakarta, Indonesia in 1997 • WHO: Bangkok Charter for Health Promotion (2005)  In 2005, the WHO issued the Bangkok Charter, which built on the Ottawa Charter by adding a focus on coherence of health policy and a commitment to partnership within and between governments, international organizations, and the private sector.  The Bangkok Charter encouraged people to “advocate for health based on human rights, invest in sustainable policies, actions, and infrastructure to address the determinants of health, target knowledge transfer and research, and address health literacy”.  It advocated for equal opportunity for the health and wellbeing for all people. Health was now seen as a critical part of foreign policy, national security, trade, and geopolitics 38 CONFRENCES AND PROGRAM
  • 39. CONFRENCES AND PROGRAM Seventh Global Conference on Health Promotion “Promoting health and development: closing the implementation gap” 7th Global Conference on Health Promotion organized by WHO and Kenya Ministry of Public Health will be held in Nairobi, 26-30 October 2009. The financial crisis threatens the viability of national economies in general and of health systems in particular. Global warming and climate change exert a toll in human life, especially in lower income countries. Security threats create a sense of shared uncertainty for communities around the world. 39
  • 40. CONFRENCES AND PROGRAM The 8th Global Conference on Health Promotion, Helsinki, 2013 • This conference was co-hosted by WHO and the Ministry of Social Affairs and Health, Finland. The main theme of the conference was “Health in All Policies” (HiAP) and its focus was on implementation, the “how-to”. It was structured around six themes. • The conference aims to: • facilitate the exchange of experiences and lessons learnt and give guidance on effective mechanisms for promoting intersectoral action; • review approaches to address barriers and build capacity for implementing Health in All Policies; • identify opportunities to implement the recommendations of the Commission on Social Determinants of Health through Health in All Policies; 40
  • 41. CONFRENCES AND PROGRAM • establish and review economic, developmental and social case for investing in HiAP; • address the contribution of health promotion in the renewal and reform of primary health care; and • review progress, impact and achievements of health promotion since the Ottawa Conference. • The 9th Global Conference on Health Promotion, Shanghai 2016 “Health promotion in the SDGs” Health for all and all for health The People’s Republic of China and WHO are the joint-organizers of the Global Conference on Health Promotion in Shanghai on 21-24 November 2016. The Conference is entitled “Promoting health in the Sustainable Development Goals: Health for all and all for health,” and is being hosted by the Government and China and the Municipal Government of Shanghai. 41
  • 42. CONFRENCES AND PROGRAM Goals • To highlight the critical links between promoting health and the 2030 Agenda for Sustainable Development. • Objectives • To provide guidance to Member States on how to reflect promoting health into national Sustainable Development Goal (SDG) responses, and how to accelerate progress on SDG targets. • Exchange national experiences in:  strengthening good governance for health through action across government sectors;  broadening and strengthening social mobilization; and  promoting health literacy. 42
  • 43. CONFRENCES AND PROGRAM • To highlight the health sector’s changing role as the key advocate for promoting health. • To highlight the crucial role that cities – and municipal leaders, especially Mayors – play in promoting health (creating Healthy Cities), in the context of an increasingly urbanized global population. • 10th Global Conference on Health Promotion Health Promotion for Well-being, Equity and Sustainable Development • On 13–15 December 2021, WHO will hold the 10th Global Conference on Health Promotion. The virtual conference is organized by the World Health Organization (WHO) with the support of the United Arab Emirates, United Nations agencies and partners. It will mark the first time that WHO has used well-being as the theme of a major conference. 43
  • 44. CONFRENCES AND PROGRAM • Discussions will focus on the contributions that health promotion can make to well-being in the broad areas of people, the planet and prosperity, culminating in a high-level political statement recommending how governments can use health promotion to advance well-being. The conference objectives are to: • discuss how to extend health promotion to advance well-being and equity, building on evidence and experience, to foster healthier populations. • identify realistic interventions for health promotion and well-being to accelerate progress in achieving the SDGs. • emphasize the role of health promotion in public health emergency preparedness and response, and seize opportunities to build healthier, fairer societies. • explore innovative health promotion approaches to enable societies and communities to flourish. 44
  • 45. CONCLUSION • Promoting Healthier Populations is the strategies of WHO, The Sustainable Development Goals (SDGs) provides a bold and ambitious agenda for the future. WHO is committed to helping the world meet the SDGs by championing health across all the goals. WHO’s core mission is to promote health, alongside keeping the world safe and serving the vulnerable. Beyond fighting disease, we will work to ensure healthy lives and promote well-being for all at all ages, leaving no-one behind. • WHO target is 1 billion more people enjoying better health and well- being by 2023. 45
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