HEALTH PROMOTION

GINA F. PARDILLA, M.D.M.P.H.

1945: HENRY E. SIGERIST, medical
historian defined the 4 major tasks of
medicine as
2. promotion of health
3. Prevention of illness
4. Restoration of the sick
5. rehabilitation

CONCEPTS AND DEFINITIONS

HEALTH IS MULTIDIMENSIONAL,
COMPOSED OF DIFFERENT BUT
INTERRELATED DIMENSIONS.

DEFINITION OF HEALTH
PHYSICAL- body shape, size , function
MENTAL- ability to think clearly abd coherently
EMOTIONAL- affective health
SOCIAL- ability to make and sustain
relationships with people
SPIRITUAL- refers to personal beliefs and
behavior
SOCIETAL- everything surrounding a person in
immediate or wider environment

SIX DIMENSIONS OF HEALTH

I’m ill ( Not at all healthy, impaired
function, symptoms present, illness
present)
or I’m not ill( perfect or optimal health,
high level of well being)
The continuum allows for movement along
the line, reflecting the dynamic nature of
health which varies over time with age,
stage of development and changing
circumstances

The continuum of health

HEALTH IS A STATE OF COMPLETE
PHYSICAL, MENTAL AND SOCIAL WELL
BEING AND NOT MERELY THE ABSENCE OF
DISEASE OR INFIRMITY

WHO DEFINITION ( 1946)

“ health is promoted by a decent standard
of living, good labor conditions, education,
physical culture, means of rest and
recreation”
1986: WHO, Health and Welfare Canada
and the Canadian Public Health Association
organized an International Conference on
Health Promotion which was adopted by
212 participants from 38 countries
HEALTH IS AN EXTENT TO WHICH AN
INDIVIDUAL OR GROUP IS ABLE TO REALIZE
ASPIRATIONS, TO SATISFY NEEDS, AND TO
CHANGE OR COPE WITH ENVIRONMENT.
HEALTH IS THEREFORE SEEN AS A
RESOURCE FOR EVERYDAY LIFE, NOT THE
OBJECTIVE OF LIVING. HEALTH IS A
POSITIVE CONCEPT, EMPHASIZING SOCIAL
AND PERSONAL RESOURCES, AS WELL AS
PHYSICAL CAPACITIES.

WHO AMENDED DEFINITION

BASED ON OTTAWA CHARTER
1. Build healthy public policy
2. Create supportive environments
3. Strengthen community action
4. Develop personal skills
5. Reorient health services

Ottawa Charter recommended the

following action areas:
Defines health as “the process of enabling
people to increase control over and to
improve their health”
Health is seen as a resource for everyday
life, not the objective for living
Therefore, health promotion is not just
responsibility of the health sector but goes
beyond health lifestyles to well-being

OTTAWA CHARTER FOR HEALTH

PROMOTION
1. THE MEDICAL MODEL- the intention is
to remove the identifiable cause of the
problem, returning the patient to a normal
state.
2. THE SOCIAL MODEL – Improved health
comes from improved environmental and
living conditions
3. THE PATIENT CENTERED MODEL
Patient’s perception of their physical and
psychological health is important for more
holistic assessment

MODELS OF HEALTH AND ILLNESS

1. Peace
2. Shelter
3. Education
4. Food
5. Income
6. Stable eco-system
7. Sustainable resources
8. Social justice
9. equity

Fundamental conditions and

resources for health
1. Involves population as a whole rather than
focusing on people at risk from specific
diseases
2. Directed towards action on the determinants
of health
3. Combines diverse but complimentary
approaches against health hazards
4. Aims particularly at effective and concrete
public participation
5. Primarily a societal and political venture, not
a medical service

WHO PRINCIPLES OF HEALTH

PROMOTION
Nurses need to have an informed
understanding of the diversity of health
beliefs because of their significant position
as “intermediaries” between medical and
lay belief systems
Have sensitivity to people’s subjective
experience of illness and open-mindedness
regarding limitations of medical approach

HEALTH BELIEFS
INDIVIDUAL LEVEL THEORIES-
EMPHASIZE MALFUNCTION WITHIN THE
BODY
NATURAL WORLD THEORIES- SEEKS
EXPLANATION IN CLIMACTIC CONDITIONS
SOCIAL WORLD THEORIES- TEND TO
BLAME OTHER PEOPLE LIKE INTERPERSONAL
CONFLICT, WITCHCRAFT, SPELLS, ETC
SUPERNATURAL WORLD THEORIES-
SEEKS EXPLANATION IN GODS, ANCESTORS
OR SPIRITS

LAY BELIEFS ABOUT THE CAUSES

OF ILLNESS
HBM explain how people behave in relation to
their health. Participation in preventive
health behavior which should decrease the
risk of illness, is predicted on the basis of the
ffg: HOW THE INDIVIDUAL PERCEIVES:
Susceptibility to a given disorder
Seriousness or severity of disorder
Benefits of taking action
Barriers to action
Individual’s experiences of cues to action
Health motivation- how highly a person
values health.

Becker’s health belief model

Nurses should offer factual, balanced
health information that clearly indicated
individual susceptibility or risk. Language
and images used are important
considerations, especially in children and
people with learning disability.
Shock tactics, moral judgments or
emotive language unhelpful and may
alienate patients.

NURSES ROLE AND APPLICATION

OF HBM
“Any combination of learning experience
designed to facilitate voluntary adoptions
of behaviors conducive to health”(Green et
al 1980)
Covers the continuum of the levels of
prevention
Activities: health information,
communication, social marketing,etc.

HEALTH EDUCATION
Primary: health promotion and specific
protection
Secondary: early diagnosis and prompt
treatment
Tertiary: disability limitation and
rehabilitation

LEVELS OF PREVENTION
1. Pender’s Health Promotion Theory
2. Bandura’s Self Efficacy Theory
3. Health Belief Model

THEORIES OF HEALTH PROMOTION

WHO: essential health care made
universally accessible to individuals and
families in the community by means
acceptable to them through their full
participation at a cost the community and
country can afford at every stage of
development
Declared during the first International
Conference on PHC in Alma Ata, USSR on
September 6-12, 1978

PRIMARY HEALTH CARE

GOAL: “Health for all by the year 2000”
Adopted in the Philippines through LOI 949
signed by Pres. Marcos on October 19,
1979
And has an underlying theme “Health in the
Hands of the people”

PRIMARY HEALTH CARE

1. Environmental sanitation
2. Control of communicable diseases
3. Immunization
4. Health Education
5. Maternal and Child Health and Family
Planning
6. Adequate Food and Proper Nutrition
7. Provision of Medical Care and Emergency
Treatment
8. Treatment of Locally Endemic Diseases
9. Provision of Essential Drugs

ELEMENTS /COMPONENTS OF PHC

FOUR CORNERSTONES/PILLARS IN
PHC
1. Reorientation and organization of the national
health care system with the establishment of
functional support mechanism
2. Effective preparation and enabling process for
health action at all levels
3. Mobilization of the people to know their
communities and identifying their basic health
needs
4. Development and utilization of appropriate
technology on local indigenous resources
available in and acceptable to the community

STRATEGIES IN PHC
5. Organization of communities arising
from their expressed needs which they
have decided to address
6. Increased opportunities for community
participation in local level planning,
management, monitoring, and evaluation
within the context of local regional and
national objectives

STRATEGIES OF PHC
7. Development of intra-sectoral linkages
with other government and private
agencies
8. Emphasizing partnership so that health
workers and community view each other
as partners rather than merely as
providers and receivers of health care

strategies
THE PHILIPPINE PUBLIC
HEALTH SYSTEM