Lesson 4- Health Promotion- Ottawa Charter.pdf

LECTURER: DELPHINA ABBEY- 1 AWADZI (MRS) PUBLIC HEALTH NURSING KNUR 402 HEALTH PROMOTION (2) Lecturer: Delphina Abbey-Awadzi (MPH, BSCN, RN) QUOTE OF THE DAY ‘Believe you can and you’re halfway AWADZI (MRS) LECTURER:...

LECTURER: DELPHINA ABBEY- 1 AWADZI (MRS) PUBLIC HEALTH NURSING KNUR 402 HEALTH PROMOTION (2) Lecturer: Delphina Abbey-Awadzi (MPH, BSCN, RN) QUOTE OF THE DAY ‘Believe you can and you’re halfway AWADZI (MRS) LECTURER: DELPHINA ABBEY- there’ 3 OBJECTIVES By the end of the lecture, the students will be able to: Discuss the Ottawa Charter Emphasize the five areas of action of the Ottawa AWADZI (MRS) LECTURER: DELPHINA ABBEY- Charter Identify the three health promotion strategies 4  KEY ACTIONS AREAS IN HEALTH PROMOTION The Ottawa Charter defines health promotion as ‘the process of enabling people to increase control over, and to improve their health’. It articulates core values of equity, participation and empowerment and emphasizes five areas of action: ✓building healthy public policy, at all sectors and levels of AWADZI (MRS) LECTURER: DELPHINA ABBEY- government ✓creating supportive environments, to improve living and working conditions ✓strengthening community action in priority setting and in strategies ✓developing personal skills, through education for health and 5 life skills ✓reorienting health services towards health promotion  LECTURER: DELPHINA ABBEY- 6 AWADZI (MRS)  LECTURER: DELPHINA ABBEY- 7 AWADZI (MRS) BUILDING HEALTHY PUBLIC POLICY What does it mean? Ensuring that decisions or policies made at all levels of government / organizations work towards health improvement. Policies need to encompass every aspect of an AWADZI (MRS) LECTURER: DELPHINA ABBEY- individual’s life, if they are to be effective in improving the health status of a population. What is the aim? It aims to put health on the agenda for policy makers and to ensure legislation/policies have the health of the population in mind. 8 BUILDING HEALTHY PUBLIC POLICY What does it involve? Identifying the influence policy has on health and from this influencing/lobbying for change. AWADZI (MRS) LECTURER: DELPHINA ABBEY- Who is responsible? It requires all sectors to consider health promotion as they develop policies and each level of government to promote laws that improve health outcomes. Examples include: Governments, public bodies, unions, NGO’s, etc. 9  BUILDING HEALTH POLICY CONTD Health promotion policy requires the identification of obstacles to the adoption of healthy public policies in non- health sectors, and ways of removing them. The aim must be to make the healthier choice the easier choice for policy makers as well. AWADZI (MRS) LECTURER: DELPHINA ABBEY- For example: increasing taxes on certain alcoholic drinks which makes participating in unhealthy behaviours more difficult there by reducing exposure to determinants that can cause ill health. Some laws are designed to influence behaviours that is; wearing of seat belts, safety restraints on kids, etc. Some policies and laws are designed to make environment 10 healthier for those who chose not to participate in unhealthy behaviours that is; banning smoking in public areas. CREATING SUPPORTIVE ENVIRONMENT What does it mean? Making the places people live, work and play a major source of good health. It is concerned with our social, physical, economic and political environments. AWADZI (MRS) LECTURER: DELPHINA ABBEY- What is the aim? It aims at increasing people's ability within the community and environment to make health-promoting choices. What does it involve? It involves support networks and community services. It also involves taking care of, protect and support each other, our community and our natural and built environments 11 from threats to health. CREATING SUPPORTIVE ENVIRONMENT Who is responsible? This is a global responsibility that needs to be undertaken by governments, communities, employers, unions and families, support groups (unions), health services, schools AWADZI (MRS) LECTURER: DELPHINA ABBEY- and the media in order to provide supportive environments. Examples of Creating Supportive environments: Creating supportive environments can be achieved through: childcare centers in workplaces safety electrical switches in the home speed ramps, roundabouts and speed limits providing counselors where needed e.g. 12 in schools. STRENGTHENING COMMUNITY ACTION What does it mean? Providing communities the power to identify their own health priorities and take action in collaboration with other agencies. OR Any activity undertaken by a community in AWADZI (MRS) LECTURER: DELPHINA ABBEY- order to effect changes (including voluntary and self-help services). When communities take ownership of the health issues they face and advocate for change, they are more likely to embrace these changes. What is the aim? Empowering communities to take control of their own health needs and decide how they can best work towards 13 meeting these needs. When communities join to take action for their health, we can see positive improvements. STRENGTHENING COMMUNITY ACTION What does it involve? Providing communities with information, allowing for lobby groups to express concerns with all levels of government, learning tools and access to funding. In order for communities AWADZI (MRS) LECTURER: DELPHINA ABBEY- to take action, forming partnerships with health agencies or government or non-government agencies can assist them to implement strategies, access and gain information, and create opportunities to improve their community’s health. Who is responsible? Community and local agencies including schools, government, groups/clubs and planning bodies. 14 STRENGTHENING COMMUNITY ACTION Strengthening community action can be achieved through: Setting up family planning and HIV/AIDS clinics in communities Organizing events such as ‘Clean up every 1st Saturday of AWADZI (MRS) LECTURER: DELPHINA ABBEY- the month in Ghana, community walks, community screening’ Communities lobbying for improvements in their environment, for example, overhead bridges for students to cross busy roads near schools, text messages to young people to remind them to eat healthy and to exercise, etc. 15 DEVELOP PERSONAL SKILLS What does it mean? Supporting the personal and social development of the individual. In order for individuals to achieve good health, they must develop the personal skills and abilities, so they can make the positive behaviour changes to meet the demands of AWADZI (MRS) LECTURER: DELPHINA ABBEY- everyday life. Individuals need to refine and modify poor health behaviours, to improve their health. What is the aim? Aims are to educate, provide individuals with health information and improve decision making, communication and life skills. It also aims in enabling or empowering people to develop skills that will assist them in preventing or treating 16 disease or illness, is a positive step towards individuals achieving good health. DEVELOP PERSONAL SKILLS What does it involve? Developing personal skills such as decision making, problem solving, self-awareness, critiquing information, planning for change, developing time-management skills, AWADZI (MRS) LECTURER: DELPHINA ABBEY- and refining communication and assertiveness skills will assist individuals to make positive health decisions. Who is responsible? Facilitated in schools, home, work and community through educational, professional, commercial and voluntary bodies. 17 DEVELOP PERSONAL SKILLS Examples of Developing Personal Skills include: Enabling people to make positive behaviour changes can be achieved through: compulsory basic lessons in schools from kindergarten to SHS on skill development AWADZI (MRS) LECTURER: DELPHINA ABBEY- television and radio commercials that encourage individuals to adopt positive healthy choices making sure brochures on accessing health services are provided in a variety of languages and made free to cater for the diversity of communities time-management seminars to develop skills around organizing time to look after one’s health 18 REORIENT HEALTH SERVICES Health personnel, institutions and the government must work together towards a health care system that contributes to pursuit of health. They must work together towards a health care system which contributes to the pursuit of health. The role of the health sector AWADZI (MRS) LECTURER: DELPHINA ABBEY- must move increasingly in a health promotion direction, beyond its responsibility for providing clinical and curative services. Health services need to embrace an expanded mandate which is sensitive and respects cultural needs. This mandate should support the needs of individuals and communities for a healthier life, and open channels 19 between the health sector and broader social, political, economic and physical environmental components. REORIENT HEALTH SERVICES What does it mean? Adjusting the direction of health promotion approaches from traditional ‘curative’ approaches to a more ‘preventative’ approach. Health care system must be equitable and client- centered. AWADZI (MRS) LECTURER: DELPHINA ABBEY- What is the aim? The reorientation of health services aim at the well-being of the whole person: promoting health, preventing ill health and supporting well-being. 20 REORIENT HEALTH SERVICES What does it involve? This requires a change in attitude and identifying the range of health services in an area, improving the access to such services and moving towards a preventative approach. Eg; AWADZI (MRS) LECTURER: DELPHINA ABBEY- lifestyle modification. Who is responsible? Individuals, community groups, health professionals, health services and governments. 21 REORIENT HEALTH SERVICES Examples include: Health professionals working with and supporting schools in health promotion initiatives such as fruit day, dental hygiene, healthy eating for students. AWADZI (MRS) LECTURER: DELPHINA ABBEY- Police / security forces working in schools to support road safety education Cardiovascular surgeons giving presentations on the risks of smoking Educating nurses in health care promotion practices 22 OTTAWA CHARTER ACTION AREAS IN PRACTICE AWADZI (MRS) LECTURER: DELPHINA ABBEY- 23 OTTAWA CHARTER ACTION AREAS IN PRACTICE AWADZI (MRS) LECTURER: DELPHINA ABBEY- 24 HEALTH PROMOTION STRATEGIES The Ottawa Charter proposes a framework of three strategies: Advocacy- for favorable conditions for health Enabling- all people to reach their full health potential. Emphasizes on the goal of equity. AWADZI (MRS) LECTURER: DELPHINA ABBEY- Mediating- between different interests in society for the pursuit of health 25  LECTURER: DELPHINA ABBEY- 26 AWADZI (MRS) ADVOCATE Advocacy is ‘an organized systematic intentional process of influencing matters of public interest to improve the life of others.’ Political, economic, social, cultural, environmental, behavioural and biological factors can all favour health or AWADZI (MRS) LECTURER: DELPHINA ABBEY- be harmful to it. Advocacy can take many forms including the use of the mass media and multi-media, direct political lobbying, and community mobilization to ensure the creation of conditions conducive to healthy lifestyles. Health professionals have a major responsibility to act as advocates for health at all levels in society.” 27 ADVOCATE Advocacy is speaking up, or drawing a community’s attention to an important issue, and directing decision– makers towards a solution. Advocacy is working with other people and organizations to make a difference. ▪ The building of support for a cause, influence others to support it, and trying to influence or change legislation that affect it. Concerns for Advocacy ▪ Representing the interests of people who cannot speak up for themselves because of the illness, handicap, poverty, or other deficiencies or limitations (disempowered). ▪ Assisting people to become independent and fight for themselves. It is the method of mobilizing resources or changing policies and legislation. ▪ Mobilising support and goodwill to formulate or change policies for the benefit of the people. ▪ Promote and protect the interests of the client or community members in the provision of health care Advocate in health and social care ▪ The role of an advocate in health and social care is to support a vulnerable or disadvantaged person and ensure that their rights are being upheld in a healthcare context. ▪ Ensure client’s voice, views and experiences are heard and treated with appropriate respect ▪ client is receiving equal and fair treatment and is not on the receiving end only ▪ client is fully aware of their rights under current legislation and can make informed decisions based on the advice provided An advocate in health and social care will provide practical assistance with: ▪ Accessing necessary social services, including those provided by social workers ▪ Registering formal complaints regarding the conduct of health and social care professionals ▪ Discussing changes in health and social care, including on-going care and discharge from hospitals and other institutions ▪ Providing support during Community Care Assessments and Care Programme Approach (CPA) meetings ADVOCATE Health professionals must: identify the issues set realistic goals/objectives identify the target audience AWADZI (MRS) LECTURER: DELPHINA ABBEY- collect data evaluate. For instance, you want to tackle an issue on indiscriminate disposal of refuse, galamsay, etc. The goal is the positive results you want to achieve. 32 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. AWADZI (MRS) LECTURER: DELPHINA ABBEY- Enabling, has been interpreted frequently as ‘empowering’ people and communities to act on their own behalf to improve their health and to create more supportive environments. 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 33 and men.  MEDIATE The prerequisites and prospects for health cannot be ensured by the health sector alone. Health promotion demands coordinated action from all concerned that is: the government, the health and other social and economic sectors, non-governmental organizations, voluntary AWADZI (MRS) LECTURER: DELPHINA ABBEY- organizations, industry and the media. People from all walks of life are involved; individuals, families, communities, etc. Professionals, social groups and health personnel have a major responsibility to mediate between interests in society for pursuit of health. 34 Other skills in health promotion ❑ Negotiation: is a dialogue between two or more people or parties intended to reach a beneficial outcome over one or more issues where a conflict exists with respect to at least one of these issues. ▪ A discussion set up or intended to produce a settlement or agreement. The health worker talks or works with others to achieve a transaction or an agreement. ▪ An interaction and process between entities who compromise to agree on matters of mutual interest, while optimizing their individual utilities. Aims ▪ resolve points of difference to achieve an agreement ▪ gain advantage for an individual or collective ▪ craft outcomes to satisfy various interests ▪ Avoid conflicts The process of negotiation ▪ Preparation ▪ Discussion ▪ Clarification of goals ▪ Negotiate towards a Win-Win outcome ▪ Agreement ▪ Implementation of a course of action ❑ Lobbying: ▪ It is the process of seeking to influence legislation, or persuading, or supporting one’s cause ▪ Persuading authority or people of concern to give in by doing what the you want. How to Lobby ▪ Establish your agenda and goals ▪ Listen well ▪ Do not behave and feel like an expert ▪ Do not stay too long ▪ build a relationship ▪ Follow-up  Categories of Attitudes towards Lobbying There are five categories of attitudes that the lobbyist or community health nurse can meet, each of which requires its own special strategies to use in convincing them. 1. Champions: These are dedicated and committed advocates, who have adequate information on the issue, very vocal, and can present their case to colleagues, higher authority and the ordinary people to convince them to support the issue at stake. 2. Allies: These are a set of advocates who have convincing facts and can push authority to side them to support the issue. 3. Fence Sitters: The advocate must be mindful of the fact that there are those in authority and people who do not commit themselves to issues. These when pressed with little persuasion can be won over. They are people who can easily be swayed; one must therefore be tactful and careful when dealing with them. 4. Mellow Opponents: In terms of voting, these isolated groups are in opposition and can influence members to oppose. The health promoter must identify and persuade them to win them on his side. 5. Hard Core Opponents: These are very strong opposes who can easily persuade others and prevent them from supporting the issue. There is the need for the health promoter to notice them and even assign them responsibility. ❑ Mediation ▪ The process of alternative dispute resolution in which a neutral party assists two or more parties to help them reach an agreement with concrete effects on a matter of common interest. ▪ A process of facilitating an agreement on any matter in the common interest of the parties involved. Process of Mediation ▪ An introduction by the mediator that includes establishing ground rules suggested by the mediator and the parties involved in the issue. ▪ The parties telling their stories in an uninterrupted manner ▪ The mediator asking questions to clarify issues ▪ The mediator discovers the parties’ underlying interests and concerns related to the issues ▪ The party’s generation of options, that may resolve the dispute. ▪ The reality testing of the options leading to one option that best resolves the issues for all the parties.  LECTURER: DELPHINA ABBEY- 42 AWADZI (MRS)  LECTURER: DELPHINA ABBEY- 43 AWADZI (MRS)