Concept of Health Promotion

Over the past three decades, the field of health promotion has emerged as a new way of thinking about the root causes of health and wellness. This thinking has sparked the development of new approaches to improving the health of individuals and communities. What is Health Promotion Health promotion is the process of enabling people to increase control over, and to improve, their health.

Ref: Ottawa Charter for Health Promotion (WHO 1986)

What is Health Promotion

• Health promotion represents a comprehensive social and political process, it not only embraces actions directed at strengthening the skills and capabilities of individuals, but also action directed towards changing social, environmental and economic conditions so as to alleviatetheir impact on public and individual health. Health promotion is theprocess of enabling people to increase control over the determinantsof health and thereby improve their health. (WHO 1998)
• Every one’s Participation is essential to sustain health promotion action.
• Health promotion practice is influenced by beliefs and assumptions we hold
Ottawa Charter for Health Promotion has
identified 3 strategies and 5 priority actions
for Health Promotion.

Strategies for Health Promotion

• Advocacy for Health to create essential conditions for health

– Political, economic, social, cultural, environmental, behavioral and biological factors can all favour health or be harmful to it. Health promotion action aims at making these conditions favourable through advocacy for health.

• Enabling all people to achieve their full health potential

– 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. This includes a secure foundation in a supportive environment, access to information, life skills and opportunities for making healthy choices. 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 and men.

• Mediating between the different interests in society in the pursuit of health

– 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.
– People in all walks of life are involved as individuals, families and communities. Professional and social groups and health personnel have a major responsibility to mediate between differing interests in society for the pursuit of health.

• Health promotion strategies and programmes should be adapted to the local needs and possibilities of individual countries and regions to take into account differing social, cultural and economic systems.

• Build Healthy Public Policy

– Health promotion goes beyond health care. It puts health on the agenda of policy makers in all sectors and at all levels, directing them to be aware of the health consequences of their decisions and to accept their responsibilities for health.
– Joint action contributes to ensuring safer and healthier goods and services, healthier public services, and cleaner, more enjoyable environments.
– 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

• Create Supportive Environments for Health

– The inextricable links between people and their environment constitutes the basis for a socioecological approach to health.
– There is a need to encourage reciprocal maintenance to take care of each other, our communities and our natural environment.
– The way society organizes work should help create a healthy society. Health promotion generates living and working conditions that are safe, stimulating, satisfying and enjoyable.
– Systematic assessment of the health impact of a rapidly changing environment is essential and must be followed by action to ensure positive benefit to the health of the public.
– The protection of the natural and built environments and the conservation of natural resources must be addressed in any health promotion strategy.

• Strengthen Community Actions

– Health promotion works through concrete and effective community action in setting priorities, making decisions, planning strategies and implementing them to achieve better health. At the heart of this process is the empowerment of communities-their ownership and control of their own endeavours and destinies.
– Community development draws on existing human and material resources in the community to enhance self-help and social support, and to develop flexible systems for strengthening public participation in and direction of health matters.

• Develop Personal Skills

– Health promotion supports personal and social development through providing information, education for health, and enhancing life skills. By so doing, it increases the options available to people to exercise more control over their own health and over their environments, and to make choices conducive to health.
– Enabling people to learn, throughout life, to prepare themselves for all of its stages and to cope with chronic illness and injuries is essential.

• Reorient Health Services

– The responsibility for health promotion in health services is shared among individuals, community groups, health professionals, health service institutions and governments.
– The role of the health sector must move increasingly in a health promotion direction, beyond its responsibility for providing clinical and curative services.
– Reorienting health services also requires stronger attention to health research as well as changes in professional education and training.

• Issue based:

– Health promotion efforts can be directed toward priority healthconditions involving a large population and promoting multiple interventions.
– Issue-based approach will work best if complemented by settings based designs.

• Setting based:

– The settings-based designs can be implemented in schools, workplaces, markets, residential areas, etc to address priority health problems by taking into account the complex health determinants
such as behaviors, cultural beliefs, practices, etc that operate in the places people live and work.
– Settings-based design also facilitates integration of health promotion actions into the social activities with consideration for existing local situations.


Examples of Health Promotion

• Example from Communicable disease –
Malaria Elimination Programme
• Example from Non-communicable DiseasesExamples of Health Promotion Health Promoting School
• Fosters health and learning with all the measures at its disposal.
• Engages health and education officials, teachers, teachers' unions, students, parents, health providers and community leaders in efforts to make the school a healthy place.
• Strives to provide a healthy environment, school health education, and school health services along with school/community projects and outreach, health promotion programmes for staff, nutrition and food safety programmes, opportunities for physical education and recreation, and programmes for counselling, social support and mental health promotion.
• Implements policies and practices that respect an individual's well being and dignity, provide multiple opportunities for success, and acknowledge good efforts and intentions as well as personal achievements.
• Strives to improve the health of school personnel, families and community members as well as pupils; and works with community leaders to help them understand how the community contributes to, or undermines, health and education.

Examples of Health Promotion
• Healthy Workplace Health Promotion in India
• Health promotion is strongly built into the concept of all the national health programs with implementation envisaged through the primary health care system based on the principles on equitable distribution, community participation, intersectoral coordination and appropriate technology.
• The National RuralHealth Mission (NRHM)called for a synergistic approach by relating health to determinants of good health such as segments of nutrition, sanitation, hygiene and safe drinking water and by revitalizing local traditions and mainstreaming the Ayurvedic, Unani, Siddha and Homeopathic systems of medicine to facilitate health care.
• Emphasis is also given on Yoga and medicine

To conclude:
• In view of the changing scenarios such as demographic and epidemiological transition, urbanization, climate change, food insecurity, financial crisis, etc. the role of health promotion
cannot be understated.
• A multi-sectoral, adequately funded, evidence-based health promotion program with community participation, targeting the complex socio-economic and cultural changes at family and
community levels is the need of the hour to positively modify the complex socio-economic determinants of health.