HEALTH PROMOTION

PRINCIPLES AND PRACTICE

 OBJECTIVES

1. To describe the principles, different approaches and strategies used in Health Promotion
2. To identify common issues or problem related to Health Promotion like communication
skills, knowledge of culture and social issues.
3. To discuss the dynamic changes occurring in behavior
4. To design, implement and evaluation of an appropriate health promotion program
Health promotion is the process of enabling people to
increase control over, and to improve, their health. It moves
beyond a focus on individual behavior towards a wide range
of social and environmental interventions.

(World Health Organization, WHO)

PRINCIPLES
APPROACHES
STRATEGIES
 EMPOWERMENT

MULTI
PARTICIPATIVE
STRATEGY

7
PRINCIPLES
(WHO)

SUSTAINABLE HOLISTIC

EQUITABLE
 7 PRINCIPLES (WHO)

1) Empowerment - a way of working to enable people to gain greater

control over decisions and actions affecting their health.
2) Participative - where people take an active part in decision making.
3) Holistic - taking account of the separate influences on health and
the interaction of these dimensions.
4) Equitable - ensuring fairness of outcomes for service users.
5) Intersectoral - working in partnership with other relevant
agencies/organisations.
6) Sustainable - ensuring that the outcomes of health promotion
activities are sustainable in the long term.
7) Multi Strategy - working on a number of strategy areas such as
programmes, policy.
The World Health Organisation took a leading role in action for health promotion in the 1980's
with, the Ottawa Charter been published in 1986. It suggested that health promotion happens
at five key levels.

1. DEVELOPING
PERSONAL SKILLS

. RE- ORIENTING 2. CREATING

THE HEALTH SUPPORTIVE
SERVICES ENVIRONMENTS

KEY
LEVELS

3.
4. DEVELOPING STRENGTHENING
PUBLIC POLICY COMMUNITY
ACTION
OTTAWA CHARTER FOR HEALTH PROMOTION
 APPROACHES IN HEALTH PROMOTION

1. Medical
2. Behaviour Change
3. Educational
4. Empowerment
5. Social Change

(Health Education Unit Ministry of Health Malaysia)

 1. MEDICAL APPROACH

Aim
1. To reduce morbidity and premature mortality
2. To ensure freedom from diseases and disability

Methods :
Medical intervention, risk education

Activity: Uses medical intervention to prevent ill-health or premature death.

- Eg. - Immunization, screening, fluoridation.

Evaluation: Reduction in disease rates & associated mortality.

 2) BEHAVIOUR CHANGE
Aim
1. Encourage individuals to adopt healthy behaviors.
2. Views health as the responsibility of individuals.

Methods :

Communication, Education, Persuasion, motivation

Evaluation
Behavior change after the intervention, but
The behavior change is only apparent after a long time.
Difficult to isolate any behavior change as attributable to a health promotion
intervention
 3) EDUCATIONAL APPROACH
Aim
1. To provide knowledge and information.
2. To develop the necessary skills for informed choice.
3. The outcome is clients voluntary choice.
Methods
1. Information-giving through interpersonal channels, small groups and
mass media, so that the clients can make an informed choice.
2. Group discussion for sharing and exploring health attitudes
3. Role play for decision-making and negotiating skills

Evaluation
- Knowledge, attitude and practice.
 4) EMPOWERMENT

Aim
-Helps people to identify their own needs and concerns, and gain the necessary skills and
confidence to act upon them.

Methods
Counselling, problem solving, community development, advocacy, public participation
Two types of empowerment:

1. Self-empowerment
- based on counselling and aimed at increasing peoples control
over their own lives.

2. Community empowerment
- related to community development to create active,
participating communities which are able to change the world
about them through a programme of action.
Evaluation

1. Outcome evaluation - the extent to which specific aims have been met.
2. Process evaluation - the degree to which the individual and community have been
empowered as a result of the intervention.
 5) SOCIAL CHANGE

Aim
1. To bring about changes in physical, social, and economic environment, which enables people
to enjoy better health
2. Radical health promotion - makes the environment supportive of health.
3. To make the healthy choice the easier choice.
4. The focus is on changing society, not on changing the behaviour of individuals.
Methods
- Focus on shaping the health environment
development of healthy public policies and legislation
fiscal measures
creating supportive social and physical environments
lobbying/advocacy
 HEALTH
PROMOTION
STRATEGIES
 The Ottawa Charter identifies three basic strategies for health promotion.

1) Enabling all people to achieve their full health potential

2) Mediating between the different interests in society in the pursuit of health
3) Advocacy for health to create the essential conditions for health
 ADVOCACY

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
 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 nongovernmental and
voluntary organization, by local authorities, by
industry and by the media.
 OTHER STRATEGIES

Counselling and skill development

Education /Health Information
Brochures, newspaper and magazine articles, and television programs may help
people become more knowledgeable about health
Social marketing
Policy development
Process of developing legislative and regulatory measures that protect the health of
communities
 Culture and Communication
religion
-Language barrier,
-not accept poor educational
certain changes status,
in their
lifestyle and
health status.

Problems Poor
Related to compliance
Health
Promotion
Knowledge
-poor
acquisition of Place
knowledge - remote