2 TBC Health promotion.pdf

Iheb Bougmiza MD, MPH Associate Professor, Consultant Preventive & Community Medicine PHCC, Doha, Qatar Learning objectives: 1. Define HP 2. Name principles of HP as determined by WHO 3. Identify HP activities 4. Cite areas for consideration in HP according to Ottawa Charte...

Iheb Bougmiza MD, MPH Associate Professor, Consultant Preventive & Community Medicine PHCC, Doha, Qatar Learning objectives: 1. Define HP 2. Name principles of HP as determined by WHO 3. Identify HP activities 4. Cite areas for consideration in HP according to Ottawa Charter Iheb Bougmiza Health education Health promotion 1  Introduction § Health “ a state of complete physical, mental and social well- being, and not merely the absence of disease or infirmity. ” (WHO, 1947) — What does complete state look like? § Most of us can identify when we are sick or have some infirmity, but, identifying the characteristics of (complete physical, mental, and social well-being) is often difficult. Iheb Bougmiza Health education Health promotion 2  Historic review § In 1986, the first International Conference of HP , held in Ottawa,, issued the “Ottawa Charter for HP ” A response to a need for a new public health approach § WHO (1986), considered health as: “A resource for everyday life, not the object of living”. — It is a positive concept emphasizing social and personal resources as well as physical capabilities. Iheb Bougmiza Health education Health promotion 3  10th Global Conference on Health Promotion : December 2021 Health Promotion for Well- being, Equity and Sustainable Development Iheb Bougmiza Health education Health promotion 4  Historic review § Arnold and Breen (in 2006) identified the characteristics of health not only as well-being, but also as a balanced state, including growth, functionality, and empowerment. They also considered it as a resource. § The view of health as a balanced state between the individual (host), agents (bacteria, viruses, and toxins), and the environment, is one of the most known balances. § Occasionally host - agent interaction becomes unbalanced making the individual sick. Iheb Bougmiza Health education Health promotion 5  Historic review § McLeroy, Bibeau, Steckler, and Glanz (in 1988) identified 3 levels of influence for health - related behaviors and conditions: § the intrapersonal or individual level § the interpersonal or family level § the population level encompasses 3 types of factors § Institutional or organizational factors § Social capital factors § public policy factors). Iheb Bougmiza Health education Health promotion 6  Ecological Health Perspective: Levels of Influence Concept Definition 1- Intrapersonal level: Individual characteristics that influence behavior, such as (knowledge, attitudes, beliefs, and personality traits). 2- Interpersonal level: Interpersonal processes and primary groups (family, friends, and peers), that provide social identity, and support. 3- Population level: A- Institutional or Rules, regulations, policies, and informal structures that organizational factors may constrain or promote recommended behaviors. B- Social capital factors Social networks and norms or standards that may be formal or informal among (individuals, groups, or organizations). C- Public policy factors Local and national policies and laws that regulate or support healthy actions and practices for prevention, early detection, control, and management of disease. Iheb Bougmiza Health education Health promotion 7  Historic review § Health promotion can be applied among individuals in varied settings, and at any stage in the natural history of illness. § Health promotion programs can help prevent new cases or incidents of a health problem (e.g. preventing falls among the elderly, smoking and drug abuse among middle school and high school students, or risky sexual behavior among college students). Iheb Bougmiza Health education Health promotion 8  What is HP (1) ? § It is a process which empowers individuals, families and communities to improve their quality of life, and achieve and maintain health and wellness. Iheb Bougmiza Health education Health promotion 9  What is HP (2) ? § It is the process of “Enabling the people to increase control over, and improve their health”. (Ottawa H.P. Charter) § It is a process which empowers individuals, families and communities to improve their quality of life, and achieve and maintain health and wellness. Iheb Bougmiza Health education Health promotion 10  What is HP (3) ? § It emphasizes not only prevention of disease but the promotion of positive health. § It is a positive concept making use of (personal, social, political and institutional/organizational) resources, as well as physical capacities. Iheb Bougmiza Health education Health promotion 11  What is HP (4) ? § HP is any combination of (health, education, economic, political, spiritual or organizational) initiative, designed to bring about positive changes (attitude, behavior, social or environmental),to improve the health of populations. § 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 / promoting health. Iheb Bougmiza Health education Health promotion 12  What is HP (5) ? § “Any combination of health education and related organizational, economic and political interventions designed to facilitate behavioral and environmental changes conductive to health”. (Green LW 1979) § HP is the “Science and art of helping people change their lifestyle to move toward a state of optimal health”. § Optimal health is defined as “A balance of physical, emotional, social, spiritual, and intellectual health”. § Lifestyle change can be facilitated through a combination of efforts to (enhance awareness, change behavior and create environments )that support good health practices”. (American Journal of Health Promotion, 1989) Iheb Bougmiza Health education Health promotion 13  Strategies for prevention applied in HP and disease prevention § Primary 1. Identifying and strengthening protective ecological conditions that are conducive to health. 2. Identifying and reducing various health risks. § Secondary health promotion and disease prevention strategies address low-risk factors and high protective factors through: 1. Identifying, adopting, and reinforcing specific protective behaviors. 2. Early detection and screening Iheb Bougmiza Health education Health promotion 14 Strategies for prevention applied in HP and disease prevention § Tertiary strategies include: 1. Improving quality of life of individuals affected by health problems (e.g. prevention of disability). 2. Avoiding deterioration, reducing complications from specific disorders, and preventing relapse into risky behaviors. Iheb Bougmiza Health education Health promotion 15  Principles of HP (1) The five key principles of HP as determined by WHO 1. HP involves the population as a whole in the context of their everyday life, rather than focusing on people at risk from specific diseases. 2. HP is directed towards action on the determinants of health. This requires a close co-operation between sectors beyond the health care, reflecting the diversity of conditions which influence health. Iheb Bougmiza Health education Health promotion 16  Principles of HP (2) 3. HP aims at effective and concrete public participation. This requires further development of problem-defining and decision-making skills in life, both individually and collectively, and promotion of effective participation mechanisms. 4. HP combines diverse, but complementary methods / approaches including: (education, communication, legislation, economic measures, organizational change, community development and spontaneous local activities) against health hazards. Iheb Bougmiza Health education Health promotion 17  Principles of HP (3) 5. HP is primarily a societal and political venture and not medical service, although health professionals have an important role in advocating and enabling health promotion. Iheb Bougmiza Health education Health promotion 18  Health Promotion activities 1. Promoting healthy lifestyles. 2. Recognition of “lifestyle related diseases” that are major causes of illness and death. 3. Creating an environment that makes it possible to live a healthy life. 4. Getting people involved in their own health care. 5. Strengthening community participation. Iheb Bougmiza Health education Health promotion 19  Inter-sectoral approach HP brings together many sectors to work towards the achievement and maintenance of health and wellness: § The Health sector alone cannot achieve a healthy society. § All sectors, both government and non-government, need to work together — Education / Schools / Universities — Sport / Youth, Media — Community Groups and Services — Agriculture, Non-Governmental Organizations (NGO’s) § HP can provide the link between the various sectors. Iheb Bougmiza Health education Health promotion 20  Health sectors with an input into Health Promotion § Community Medicine / Preventive Medicine / Family Medicine § Community Nursing § Epidemiology, Environmental Health § Mental Health, Nutrition § Occupational Health / Industrial Hygiene § Dental Health Services, Hospitals (2ry care) Iheb Bougmiza Health education Health promotion 21  Areas for consideration in HP § The Ottawa Charter for Health Promotion (WHO, 1986) developed a crucial report, that was a milestone in international recognition of the value of HP. § The report outlined 5 specific strategies (actions) for HP: 1. Develop healthy public policy. 2. Develop personal skills. 3. Strengthen community action. 4. Create supportive environments. 5. Reorient health services. Iheb Bougmiza Health education Health promotion 22  Areas for consideration in HP 3 health promotion strategies Health promotion action aims at making conditions at multisectoral level favourable through advocacy for health  Areas for consideration in HP Health promotion action aims at reducing differences in current health status and ensuring equal opportunities and resources to enable all people 3 health to achieve their fullest health potential. promotion strategies  Areas for consideration in HP 3 health promotion strategies 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. 1. Strengthen community actions to achieve health and well-being § Involvement of the community in problem determination and health related decision making, a multi-sectoral and participatory approach. § Provide communities with the information and tools / skills to take actions to improve the collective health and well-being. Iheb Bougmiza Health education Health promotion 26  2. Developing personal health skills § Health education and information for persons and families. § Taking in account: values, beliefs and customs of the community. § Build on the existing knowledge and attitudes. § In developing skills: guide and support (not to be imposed on them). § It is a continuous process at all stages of life. Iheb Bougmiza Health education Health promotion 27  3. Formulating a healthy public policy § Promotes healthy policies in all sectors , e.g. healthy workplaces, schools, homes, buildings, villages and communities. § Health aspect should be thought of and included in policies of various sectors. § Health Policies should always emphasize the prevention of disease and promotion of health. Iheb Bougmiza Health education Health promotion 28  4. Creating supportive environments § Healthy (physical, emotional, social and economic) environment. § All development activities should aim for a healthy environment: (Healthy buildings, roads, workplaces, homes, surroundings and schools). Iheb Bougmiza Health education Health promotion 29  5. Reorienting health services Since the lifestyle is linked to many of today’s diseases, prevention and promotion should decrease the burden on secondary (curative) health care. § Greater emphasis and resources should be placed on HP and primary health care. § With time, it will lead to less emphasis on purchase of high technical equipment for secondary health care. § Availability and equity in health care provision should be always maintained. Iheb Bougmiza Health education Health promotion 30  Building alliances with special emphasis on the media An additional point to the five areas of action § Media is a key player that influence the health of people. § Partnership with media ensures their collaboration and that correct information will be passed on. § Free flow of information both ways, on matters vital to health. Iheb Bougmiza Health education Health promotion 31  Health Promotion Programs (1) § It can improve physical, psychological, educational, and work outcomes for individuals. § It can help control or reduce overall health care costs by emphasizing (prevention of health problems, promoting healthy lifestyles, improving patient compliance, and facilitating access to health services and care). § HP programs play a role in creating healthier individuals, families, communities, workplaces, and organizations. Iheb Bougmiza Health education Health promotion 32 Health Promotion Programs (2) § They contribute to an environment that promotes and supports the health of individuals and the overall public. § Take advantage of the crucial position of their setting (e.g. schools, workplaces, health care organizations, or communities) to reach (children, teenagers, adults, and families) to make informed decisions about their health. Iheb Bougmiza Health education Health promotion 33 Iheb Bougmiza Health education Health promotion 34 Exercise § Show different possible participatory activities the community sectors (governmental and non governmental – health and non health) could share in promoting health against the following community health problems: 1. Hypertension 2. Game addiction Iheb Bougmiza Health education Health promotion 35