Overview of Health Promotion

Overview of Health Promotion

• Health education and health promotion are defined
• History of Health Promotion (HP) and its components are mentioned
• Significance of the Jakarta Declaration
• HP is contextualized with respect to South Africa
• The application to different settings is crucial

Definitions

• Public health involves societal efforts to protect, promote, and restore people's health
• Public health combines science and art to maintain and improve health through collective actions, according to the WHO

Health Promotion

• Health promotion enables people to increase control over and improve their health
• It goes beyond individual behavior and includes a range of social and environmental interventions, as defined by the WHO
• Health promotion includes health education and taking social and political actions to improve quality of life

Health Education

• Health Education involves two-way communication to enhance positive health

History

• Health education has been practiced for many years as part of healthcare
• Health promotion has recently gained credibility and acceptance among medical and health professionals
• The Declaration of Alma-Ata (1978) was one of the globally influential events
• The Ottawa Charter occurred in 1986
• Adelaide Recommendations on Healthy Public Policy occurred in 1988
• The Sundsvall Statement on Supportive Environments for Health occurred in 1991
• The Jakarta Declaration occurred in 1997
• Social Determinants of Health, WHO occurred in 2008

Ottawa Charter Key Actions

• Building healthy public policy
• Creating supportive environments
• Strengthening community action
• Developing personal skills
• Re-orienting health services

Building Healthy Public Policy

• Healthy choices are made easier through the support of government and other organizations
• Examples of healthy public policy include seat belt and helmet laws, smoking restrictions, workplace health and safety, and taxation on sugar-sweetened beverages
• Social and physical environments are designed to enhance health
• Health consequences of policy decisions are considered

Creating Supportive Environments for Health

• Involves linking natural and built surroundings to health
• It enhances the ability to make healthy choices in these settings
• Healthy workplaces, restrictions on junk food in schools, and healthy options in cafeterias/vending machines are other examples
• Also consider outdoor gyms, cyclist lanes, and promenade upgrades

Strengthening Community Participation

• Empowerment is emphasized, which allows people to gain understanding and control over forces in their lives, so they can improve their life situations
• Some examples includes school community and workers involvement in the workplace, community fun runs, soup kitchens with healthy options, and community-based ART adherence clubs
• It aligns with the Alma Ata (1978)
• More likely to be successful if there is support
• Shifts away from a top-down approach

Developing Personal Skills

• Knowledge is insufficient for behavior change
• Health-seeking behavior and increased self-efficacy are needed
• These include immunization of children, testing for TB/HIV, and consistent condom use

Re-orient Health Services

• Health Services need to focus on curative services
• Health promotion includes prevention of ill-health, promotion of good health, and need for timeous curative care and rehabilitation.
• Emphasis must be placed on PHC and COPC (Comprehensive Orientation Programs and Courses)

Ottawa Strategies

• WHO identifies three ways practitioners can promote health: advocacy, enablement, mediation

Advocacy

• Involves representing the interests of disadvantaged groups
• This incorporates speaking on their behalf or lobbying to influence policy
• Attempts to exert pressure on policy makers to recognize the nature of health disadvantages
• Community health needs should show implications for health of social and political issues

Enablement

• Enablement means reducing differences in current health status and ensuring equal opportunities for all to achieve their full potential
• Health promoters should work to increase knowledge, understanding, and individual coping strategies
• Essential skills for health promoters require them to act as a catalyst and then step aside, giving control to the community

Mediation

• HP requires coordination and cooperation by many agencies and sectors
• Health promoters mediate between different interests
• They provide evidence and advice to local groups
• They influence local and national policy through lobbying and media campaigns

Jakarta Declaration

• The Declaration reaffirms the Ottawa Charter
• It is linked to current and future priorities for HP at an international level
• Factors include promoting social responsibility for health
• Increasing investment for health development
• Consolidating and expanding partners for health
• Increasing community capacity and empowering the individual
• Securing infrastructure for health promotion

Health Promotion in South Africa

• Introduced into the SA health system in 1990
• There has been slow development of training opportunities, which has led to capacity gap in HP
• Has a national directorate located within the Social Sector Cluster, PHC, district and development operations

HP in SA

• The National Health Promotion directorate offers direction and support for initiatives and activities
• The Department of Health budget allocates funding by the national treasury
• Poor capacity and infrastructure development exists due to few qualified personnel to provide leadership direction

Influenced Policies in SA

• National Health Plan (1994, ANC document)
• National Policy for Health Promotion (2015 – 2019)
• The National Development Plan 2030
• Emerging diseases, HIV/AIDS, COVID 19
• Re-engineering of PHC

Application for HP

• Health should be promoted in various places: schools, hospitals, workplaces and cities

Health Promoting Hospitals

• Core dimension of quality in hospital services, along with patient safety and clinical effectiveness.
• Hospitals consume 40–70% of national health care expenditure and typically employ about 1–3% of the working population
• Hospitals are characterized by physical, chemical, biological and psychosocial risk factors

Health Promoting Workplaces

• Workplace has a direct influence on workers' physical, mental, economic, and social well-being
• Support the promotion of health of a large audience
• More private and public organizations recognize globalization can be achieved with a healthy, qualified and motivated workforce

Summary of Health Promotion

• Involves the population in the context of everyday life, not specific diseases
• It enables people to take control and responsibility for their health
• Requires full and continuing access to information for all the population using all methods available
• It aims at effective and concrete public participation
• Requires community development and spontaneous local activities against health hazards directed towards the determinants/causes of health.
• It requires close cooperation of sectors beyond health services, also
• The government has a unique responsibility at local and national levels to ensure that the "total" environment promotes health