Health Prom

COMPILED BY YAMBASU DAVID BSN SET-8
SUMMARY NOTES
ON
HEALTH PROMOTION
FOR
BSc. Hon. Nursing
Compiled by:
Yambasu David
(BSN SET-8)
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HEALTH PROMOTION
1. The Broad Definition of Health Promotion:
Health promotion enables people to increase control over their own health. It covers a wide range
of social and environmental interventions that are designed to benefit and protect individual
people’s health and qualities of life by addressing and preventing the root of causes of ill-health,
not just focusing on treatment and cure.
2. The First/Early Definition of Health Promotion:
The early definition of health promotion states that; it was “any combination of health education
and related organisational, politically and economic interventions designed to facilitate
behavioural, environmental adaptations that will improve or protect health.” (United States
Department of Health and Human Services (USDHHS) 1980, PAGE 1).
• In the aforementioned definition “Interventions” refers to; “systematically planned health
promotion programme.”
3. The Second/The More Recent Definition of Health Promotion:

A more recent definition of health promotion was offered by GREEN & KREUTER (1991, page
4). They simplified the early definition to read; “Health Promotion is any combination of education
and environmental support for action and condition of living conducive to life.” In this definition
“educational” refers to “health education,” and “environmental” refers to “social, political,
organizational, policy economic and regulatory circumstances bearing on health.”
4. The Third Definition of Health Promotion:

The third definition of health promotion was provided in the Joint Committee on Health
Education Terminology Report. (1991, page 102). The committee defined health promotion and
disease prevention as “The aggregate of all purposeful activities designed to improve personal and
public health through the combination of strategies of health promotion, health protection
measures, health education, risk factor education, health enhancement, and health maintenance.”
KEY ELEMENTS OF HEALTH PROMOTION

There are three (3) key elements of health promotion include;
• Good governance for health.
• Health literacy, and
• Health cities.
1. Good governance for health:

• Here, health promotion requires policy makers across all government departments to make
health a central line of government policy.
• This means they must factor health implications into all the decisions they take, and prioritize
policies that prevent people from becoming ill and protect them from injuries.
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2. Health literacy:
• This involves the need for people to acquire the knowledge, skills and information to make
healthy choices.
• For example; people need to acquire health education about the food they eat and healthcare
services that they need.
• They need to have opportunities to make those choices. And they need to be assured of an
environment in which they can demand further policy actions to further improve their health.
3. Health cities:
Cities have a key role to play in promoting good health. Strong leadership and commitment at
the municipal level is essential to healthy urban planning and to build up preventive measures
in communities and primary health care facilities. From healthy cities evolve healthy countries
and ultimately, a healthier world.
CONCEPT OF NEEDS IN HEALTH PROMOTION

• Normative Need:
• It is a need defined by experts or professionals according to their own standards; falling short
of those standards means that there is a need.
• Comparative Need:
• It is defined by comparison between similar groups of clients, some in receipt of health
promotion and some not. Those who are not are then defined as being in need.
TYPICAL ACTIVITIES FOR HEALTH PROMOTION, DISEASE PREVENTION, AND

WELLNESS PROGRAMS
• Communication:
• Involves raising awareness about healthy behaviors for the general public.
• Examples of communication strategies include public service announcements, health fairs,
mass media campaigns, and newsletters.
• Education:
• Involves empowering behavior change and actions through increased knowledge.
• Examples of health education strategies include courses, trainings, and support groups.
• Policy, Systems, and Environment:
• Involves making systematic changes – through improved laws, rules, and regulations (policy),
functional organizational components (systems), and economic, social, or physical
environment – to encourage, make available, and enable healthy choices.
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MODELS OF HEALTH PROMOTION

There are three (3) keys models of health that have influence health promotion, they include:
1. The biomedical model of health (Pre 1970s):
• Focuses on the risk behavior and healthy lifestyles.
• Emphasises on health education- changing knowledge, attitudes and skills.
• Focuses on individual responsibility.
• Treats people in isolation of their environment.
2. The social model of health (from 1970s onwards):

• Addresses the broader determinants of health.
• Involve inter-sectoral collaboration.
• Acts to reduce social inequalities.
• Empowers individuals and communities.
• Acts to enable access to health care.
3. The ecological model of health (from late 1970s onwards):

• Acknowledges the reciprocal relationship between health-related behaviours and the
environment in which people live, work and play (behaviour does not occur in a vacuum).
• Considers the environment in made up of different sub systems- micro, meso, exo and macro.
• Emphasises on the relationships and dependencies between these sub systems are
comprehensive and multi- faceted, using a shared framework for change at individual and
environmental levels.
BRIEF HISTORY OF HEALTH PROMOTION

The first International Conference on Health Promotion was held in Ottawa in 1996, and primarily
a response to growing expectations for a new public health movement around the world. It
launched a series of actions among international organisations, 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 Ottawa Charter were: Advocate (to boost the factors
which encourage health), enable (allow all people to achieve high equity of health), and mediate
(through collaboration across all sectors).
Since then, WHO Global Health Promotion Conferences have established and developed the global
principles and action areas for health promotion. Most recently, the 9 th global conference
(Shanghai 2016), titled ‘Promoting health in the Sustainable development Goals: Health for All
and All for health,’ highlighted the critical links between promoting health and the 2030 agenda
for sustainable development. Whilst calling for bold political interventions to accelerate country
action on the SDGs, the Shanghai Declaration provides a framework through which governments
can utilize the transformational potential of health promotion.
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HEALTH LITERACY:
• Health Literacy is the cognitive and social skills which determine the motivation and ability of
individuals to gain access to, understand and use information in ways which promote and
maintain good health.
• Health Literacy means more than being able to read pamphlets and successfully make
appointments.
HEALTHY CITIES:
• A healthy city is one that continually creates and improves its physical and social environments
and expands the community resources that enable people to mutually support each other in
performing all the functions of life and developing to their maximum potential.
Aims of Healthy City

• To create a health-supportive environment.
• To achieve a good quality of life.
• To provide basic sanitation and hygiene needs.
• To supply access to health care.
• Being a healthy city depends not on the current health infrastructure, rather upon a commitment
to improve a city's environs and a willingness to forge the necessary connection in political,
economic, and social arenas.
Social Mobilization:
Social Mobilization is the process of bringing together all societal and personal influences to raise
awareness of and demand for health care, assist in the delivery of resources and services, and
cultivate sustainable individual and community involvement.
GOOD GOVERNANCE
Good governance requires the use of appropriate bodies of high-quality evidence to inform policy
and promotes decisions- making processes that are transparent, accountable, and open to
contestation by the population they govern.
It is a key approach of health promotion that seeks to mainstream health in all policies tackling
difference in socioeconomic status, gender, ethnicity, disability status and sexuality, which may
deepen health inequalities, if not
Health promotion requires policy makers across all government departments to make health a
central line of government policy. This means they must factor health implications into all the
decisions they take, and prioritize policies that prevent people from becoming I'll and protect them
from injuries.
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HOW CAN WE ACHIEVE GOOD GOVERNANCE?

To achieve good governance, various sectors/stakeholders have to play vital roles, in promoting
action across sectors for health, health equity and the SDGs and these sectors include:
• Government:
- Government develops policies and plans on health literacy promotion, including sustained
funding, systemic intervention and surveillance; work across sectors and meet obligations to
provide people with accurate, update information.
• Civil society:
- They work together to bring different CSO expertise, experiences and capacities for community-
based mobilization, communication, sensitization and efforts in all kinds of settings throughout
the life course.
• Media (including social media):

- The media serves as a platform for messaging, and sending out vital information on health.
• Organizations of the UN system:

- Support multisectoral action with a mirrored interagency response, providing mainstreaming,
acceleration and policy support, including to demonstrate the SDGs in line with national targets
and objectives, as requested.
• Community Leaders:
- Advocate for greater policy coherence and coordination at the local level to address issues of
local concern efficiently, and to advance sustainable human development.
• Research and academic institutions

Expand the evidence base for promoting action across sectors, help to fill key information gaps
and promote evidence-based win-win practices.
• Transparency.
• Accountability.
• Participation.
• Responsiveness.
• Health Promotion in schools:
- This helps to strengthening the capacity of schools to be healthy settings for living, learning and
working.
• EMPOWERNMENT:
- It is a process through which people gain greater control over decisions and actions affecting their
health.
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PAST GLOBAL CONFERENCE ON HEALTH PROMOTION

1st Global Conference on Health promotion- Ottawa, 1986
2nd Global Conference on Health promotion-Adelaide, 1988
3rd Global Conference on Health promotion- Sundsvall, 1991
4th Global Conference on Health promotion- Jakarta, 1997
5th Global Conference on Health promotion-Mexico, 2000
6th Global Conference on Health promotion-Bangkok, 2005
7th Global Conference on Health promotion- Nairobi, 2009 8th
Global Conference on Health promotion-Helsinki, 2013
9th Global Conference on Health promotion-Shanghai, 2016
HEALTH DETERMINANTS, INDICATORS AND RISK FACTORS

Health determinants: are generally defined as the underlying social, economic and environmental
factors that are responsible for health and disease. Most of which are outside the health sector
Health indicators: is a variable that can be measured directly to reflect on stain of health of
population within the community. It can also be used as components in the calculation of a broad
social development index.
Risk factors: reflect to an aspect of personal habit or environmental exposures that are associated
to an increase in probability of occurrence of disease. Since the risk factors can usually be
modified, intervening after them in a favourable direction can reduce the probability of occurrence
of disease. Risk factors include: tobacco use, alcohol use. Indiscriminate sexual activities, diet,
obesity, blood pressure activity.
The three (3) classes or factors that have the potential to affect health are:
- Predisposing factors: include many traits, personal attitude, values, beliefs and perception.
These are the factors that can facilitate or hinder a person’s motivation to change.
- Enabling factor: refers to barriers created mainly by societal forces or system. These barriers
include limited access to health care facilities, inadequate resources, income, health insurance
and restrictive laws, rules, regulations and policies.
- Re-enforcing factors: including the different types of feedback that those in the target
population receives which may rather encourage or discourage them for changing their
behaviour.
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COMPILED BY YAMBASU DAVID BSN SET-8

3. The Second/The More Recent Definition of Health Promotion:

4. The Third Definition of Health Promotion:

KEY ELEMENTS OF HEALTH PROMOTION

1. Good governance for health:

CONCEPT OF NEEDS IN HEALTH PROMOTION

TYPICAL ACTIVITIES FOR HEALTH PROMOTION, DISEASE PREVENTION, AND

MODELS OF HEALTH PROMOTION

2. The social model of health (from 1970s onwards):

3. The ecological model of health (from late 1970s onwards):

BRIEF HISTORY OF HEALTH PROMOTION

Aims of Healthy City

HOW CAN WE ACHIEVE GOOD GOVERNANCE?

• Media (including social media):

• Organizations of the UN system:

• Research and academic institutions

PAST GLOBAL CONFERENCE ON HEALTH PROMOTION

HEALTH DETERMINANTS, INDICATORS AND RISK FACTORS

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