Health Promotion
WCHM bases our work on the Ottawa Charter for Health Promotion which was developed at the first World Health Organisation (WHO) International Conference on Health Promotion held in Ottawa, Canada, in 1986. The Charter was developed as a clear statement of action for health promotion, aiming to increase the relevance of the primary health care philosophy for industrialised countries.
Health promotion refers to the process of enabling people to increase control over and improve their health (WHO 1986), by creating opportunities for individuals, communities and populations to understand the determinants (influences) of their health and wellbeing and what they can do to improve them. It emphasises inclusion by working with members of marginalised groups in the community who face barriers to good health - this ensures that everyone has access to the resources needed to maintain good health as well as a voice in the decisions affecting their health.
The Ottawa Charter identified three basic strategies for health promotion: advocacy for health to create the essential conditions for health; enabling all people to achieve their full health potential; and mediating between the different interests in society in the pursuit of health.
- Build healthy public policy
- Create supportive environments for health
- Strengthen community action for health
- Develop personal skills, and
- Re-orient health services
- the participation of women in making decisions about health issues, their health care, and health service delivery, policy, planning and evaluation
- the requirement for good accessible information for informed decisions to be made about health and health care which is appropriately targeted for different socioeconomic, educational and cultural groups of women
- using existing data, conducting social research, and including women’s views about their health and the best ways to address their health needs.
The Ottawa Charter Action Areas
The following information about the Ottawa Charter action areas are direct quotes from the World Health Organisation (WHO, 2006).
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 organisational 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 constitutes the basis for a socio-ecological approach to health.
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 organises 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 urbanisation - 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 in 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 organisation of health services which refocuses on the total needs of the individual as a whole person.