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Health promotion
Introduction
Health promotion nursing involves the nurse becoming personally engaged with the client to facilitate the promotion of health. This personal engagement requires the nurse to have a caring presence, appreciate multiple realities, respect diversity and value each person. The origins of the concept of health promotion
In 1986, the World Health Organization (WHO) published the Ottawa Charter for Health Promotion, which subsequently became a widely disseminated and much referenced document. The charter was produced following the first International Conference on Health Promotion held at Ottawa, Canada. The conference was held against the background of slow implementation of the primary health care strategy outlined in the AlmaAta Declaration, published by the World Health Organization in 1978, and increasingly complex patterns and disparities in the health of peoples within and between nations. At that time, socio-economic influences on health were becoming more noticeable with the publication of research addressing quality of life as well as quantitative measurements of mortality (death) and morbidity (illness) (Pool, 1994). In developed nations, as communicable diseases became less prevalent through improvements in hygiene, immunisation regimes and drug treatment strategies, people were living longer and illnesses associated with longevity and lifestyle were becoming more prevalent. In developing countries, improving hygiene and access to adequate food and clean water were still the highest priorities for achievement of health gains. The disparities that occurred within and between nations were described by Omran's epidemiological transition theory in 1971 (Pool, 1994; Trlin, 1994; Beaglehole & Bonita, 1997; WHO, 1998).
As the theory of epidemiological transition illuminated the causes of ill health (health determinants), it was recognised that health education in isolation from other measures had not resulted in the expected health gains (WHO, 1998). Lifestyle-related ill health and the need to reassess the concepts of preventative medicine and health education became the driving forces for the support of health promotion as an entity (Parish, 1995).
Health promotion as defined by the World Health Organization is the process of enabling people to increase control over, and to improve, their health.. In the USA, health promotion is much more narrowly conceived as "the science and art of helping people change their lifestyle to move toward a state of optimal health.
Prerequisites for health The fundamental conditions and resources for health are peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice and equity. Improvement in health requires a secure foundation in these basic prerequisites.
Advocate Good health is a major resource for social, economic and personal development and an important dimension of quality of life. Political, economic, social, cultural, environmental, behavioural 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.
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. 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.
Mediate The prerequisites and prospects for health cannot be ensured by the health sector alone. More importantly, health promotion demands coordinated action by all concerned: by governments, by health and other social and economic sectors, by nongoverwnental and voluntary organizations, 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.
Health Promotion Action Means: 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.
Health promotion policy combines diverse but complementary approaches including legislation, fiscal measures, taxation and organizational change. It is coordinated action that leads to health, income and social policies that foster greater equity. 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 the easier choice for policy-makers as well.
Create supportive environments Our societies are complex and interrelated. Health cannot be separated from other goals. The inextricable links between people and their environment constitute the basis for a socioecological approach to health. The overall guiding principle for the world, nations, regions and communities alike is the need to encourage reciprocal maintenance - to take care of each other, our communities and our natural environment. The conservation of natural resources throughout the world should be emphasized as a global responsibility.
Changing patterns of life, work and leisure have a significant impact on health. Work and leisure should be a source of health for people. 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 - particularly in areas of technology, work, energy production and urbanization 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 action 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 and direction of health matters. This requires full and continuous access to information, learning opportunities for health, as well as funding support.
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. This has to be facilitated in school, home, work and community settings. Action is required through educational, professional, commercial and voluntary bodies, and within the institutions themselves.
Reorient health services The responsibility for health promotion in health services is shared among individuals, community groups, health professionals, health service institutions and governments. They must work together towards a health care system which contributes to the pursuit of health.
The role of the health sector 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 between the health sector and broader social, political, economic and physical environmental components.
Reorienting health services also requires stronger attention to health research as well as changes in professional education and training. This must lead to a change of attitude and organization of health services, which refocuses on the total needs of the individual as a whole person.
Health education
Health education is defined as the process by which individuals and groups of people learn to behave in a manner conducive to the promotion, maintenance or restoration of health.
Education for health begins with people as they are, with whatever interests they may have in improving their living conditions. Its aim is to develop in them a sense of responsibility for health conditions, as individuals and as members of families and communities. In communicable disease control, health education commonly includes an appraisal of what is known by a population about a disease, an assessment of habits and attitudes of the people as they relate to spread and frequency of the disease, and the presentation of specific means to remedy observed deficiencies.
Health education is included in the curriculum of most schools. In the United States, some forty states require the teaching of health education. A comprehensive health education curriculum consists of planned learning experiences which will assist students to achieve desirable understandings, attitudes and practices related to critical health issues including, but not limited to, the following: emotional health and a positive self image; appreciation, respect for, and care of the human body and its vital organs; physical fitness; health issues of alcohol, tobacco and drug use and abuse; health misconceptions and quackery; effects of exercise on the body systems and on general well being; nutrition and weight control; sexual relationships, the scientific, social and economic aspects of community and ecological health; communicable and degenerative diseases including sexually transmitted diseases; disaster preparedness; safety and driver education; choosing professional medical and health services; and choices of health careers.
Introduction
Health promotion nursing involves the nurse becoming personally engaged with the client to facilitate the promotion of health. This personal engagement requires the nurse to have a caring presence, appreciate multiple realities, respect diversity and value each person. The origins of the concept of health promotion
In 1986, the World Health Organization (WHO) published the Ottawa Charter for Health Promotion, which subsequently became a widely disseminated and much referenced document. The charter was produced following the first International Conference on Health Promotion held at Ottawa, Canada. The conference was held against the background of slow implementation of the primary health care strategy outlined in the AlmaAta Declaration, published by the World Health Organization in 1978, and increasingly complex patterns and disparities in the health of peoples within and between nations. At that time, socio-economic influences on health were becoming more noticeable with the publication of research addressing quality of life as well as quantitative measurements of mortality (death) and morbidity (illness) (Pool, 1994). In developed nations, as communicable diseases became less prevalent through improvements in hygiene, immunisation regimes and drug treatment strategies, people were living longer and illnesses associated with longevity and lifestyle were becoming more prevalent. In developing countries, improving hygiene and access to adequate food and clean water were still the highest priorities for achievement of health gains. The disparities that occurred within and between nations were described by Omran's epidemiological transition theory in 1971 (Pool, 1994; Trlin, 1994; Beaglehole & Bonita, 1997; WHO, 1998).
As the theory of epidemiological transition illuminated the causes of ill health (health determinants), it was recognised that health education in isolation from other measures had not resulted in the expected health gains (WHO, 1998). Lifestyle-related ill health and the need to reassess the concepts of preventative medicine and health education became the driving forces for the support of health promotion as an entity (Parish, 1995).
Health promotion as defined by the World Health Organization is the process of enabling people to increase control over, and to improve, their health.. In the USA, health promotion is much more narrowly conceived as "the science and art of helping people change their lifestyle to move toward a state of optimal health.
Prerequisites for health The fundamental conditions and resources for health are peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice and equity. Improvement in health requires a secure foundation in these basic prerequisites.
Advocate Good health is a major resource for social, economic and personal development and an important dimension of quality of life. Political, economic, social, cultural, environmental, behavioural 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.
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. 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.
Mediate The prerequisites and prospects for health cannot be ensured by the health sector alone. More importantly, health promotion demands coordinated action by all concerned: by governments, by health and other social and economic sectors, by nongoverwnental and voluntary organizations, 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.
Health Promotion Action Means: 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.
Health promotion policy combines diverse but complementary approaches including legislation, fiscal measures, taxation and organizational change. It is coordinated action that leads to health, income and social policies that foster greater equity. 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 the easier choice for policy-makers as well.
Create supportive environments Our societies are complex and interrelated. Health cannot be separated from other goals. The inextricable links between people and their environment constitute the basis for a socioecological approach to health. The overall guiding principle for the world, nations, regions and communities alike is the need to encourage reciprocal maintenance - to take care of each other, our communities and our natural environment. The conservation of natural resources throughout the world should be emphasized as a global responsibility.
Changing patterns of life, work and leisure have a significant impact on health. Work and leisure should be a source of health for people. 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 - particularly in areas of technology, work, energy production and urbanization 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 action 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 and direction of health matters. This requires full and continuous access to information, learning opportunities for health, as well as funding support.
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. This has to be facilitated in school, home, work and community settings. Action is required through educational, professional, commercial and voluntary bodies, and within the institutions themselves.
Reorient health services The responsibility for health promotion in health services is shared among individuals, community groups, health professionals, health service institutions and governments. They must work together towards a health care system which contributes to the pursuit of health.
The role of the health sector 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 between the health sector and broader social, political, economic and physical environmental components.
Reorienting health services also requires stronger attention to health research as well as changes in professional education and training. This must lead to a change of attitude and organization of health services, which refocuses on the total needs of the individual as a whole person.
Health education
Health education is defined as the process by which individuals and groups of people learn to behave in a manner conducive to the promotion, maintenance or restoration of health.
Education for health begins with people as they are, with whatever interests they may have in improving their living conditions. Its aim is to develop in them a sense of responsibility for health conditions, as individuals and as members of families and communities. In communicable disease control, health education commonly includes an appraisal of what is known by a population about a disease, an assessment of habits and attitudes of the people as they relate to spread and frequency of the disease, and the presentation of specific means to remedy observed deficiencies.
Health education is included in the curriculum of most schools. In the United States, some forty states require the teaching of health education. A comprehensive health education curriculum consists of planned learning experiences which will assist students to achieve desirable understandings, attitudes and practices related to critical health issues including, but not limited to, the following: emotional health and a positive self image; appreciation, respect for, and care of the human body and its vital organs; physical fitness; health issues of alcohol, tobacco and drug use and abuse; health misconceptions and quackery; effects of exercise on the body systems and on general well being; nutrition and weight control; sexual relationships, the scientific, social and economic aspects of community and ecological health; communicable and degenerative diseases including sexually transmitted diseases; disaster preparedness; safety and driver education; choosing professional medical and health services; and choices of health careers.
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