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Health promotion is a means of increasing individual and collective participation in health

action and strengthening programs through the integrative use of various methods. This
approach recognizes that health is affected by a broad range of determinants (physical,
socio-economic, biological, lifestyle and environmental), all of which must be addressed
in order to improve the long term health and development of communities.1 Given that
good health promotion activities address such a wide range of issues, it follows that
successful strategies require the involvement of all segments of society. In fact, health
promotion often demands that people who are not health care professionals participate
in improving the health of the community.
Health promotion outcomes include positive changes and enhancements of personal
behavior, skills and norms; as well as community actions, organizational practices and
public policies.2 It can be used to address a broad range of illnesses and health
problems, both communicable and non-communicable. The health of the community is
improved by the increase in individual knowledge, the strengthening of community
action, the creation of environments that are protective and supportive of health, and the
development of public policies that encourage health.3 These goals are achieved via the
various components of health promotion strategy. These will be defined and briefly
discussed below.
While discussing the various components of successful health promotion it is essential to
remember that while health and social services play an essential role in this domain,
their work is most effective when complemented by other sectors of the society.
Examples are: education, recreation, environment, central and local government,
commerce, industry, and the voluntary sector.

Health Education

WHO AFRO. Regional Strategy

WHO AFRO. Regional Guidelines
WHO AFRO. Regional Strategy

Health education is the process of assisting individuals acting separately or collectively

to make informed decisions on matters affecting their health as individuals, families and
communities. It is not only concerned with the communication of information, but also
with fostering the motivation, skills and confidence necessary to take action to improve
health. Given the acknowledgment of the broad determinants of health, good health
education must address the underlying social, economic and environmental conditions
impacting on health, as well as individual risk factors and risk behaviors.4 It is the
continuum of learning that enables people to voluntarily make decisions to modify those
behaviors and conditions in ways that are health enhancing.

Communication for Behavior Change

Communication is a critical component of health promotion. Communication for
Behavior Change (CBC) refers to strategic communication designed to achieve specific
behavior changes. Its goal is to foster behavior change actions in the home, community
or health facility that will promote healthy living and prevent health problems. In that
regard, CBC overlaps with other methods of health education. However, it is distinct in
its systematic use of principles and methods of community based research, mass
communication, social marketing, behavior analysis and even anthropology.5 While
communication alone may not produce or sustain behavior change, it serves as a
powerful tool when it is used in tandem with other program activities and viewed as an
integral part of broad behavior change strategies.6

Social Marketing
Social Marketing is one component of CBC. It is a consumer oriented approach of
defining, promoting and making accessible practices or products that are socially
beneficial. Based on the success of commercial marketing, social marketing campaigns
for health combine education and the provision of health products and services. These
are often branded, attractively packaged and widely marketed to selected target groups.

WHO, Geneva. Health Promotion Strategy

USAID. Communication for Child Survival

World Bank document

This is accomplished with the help of the private sector and at affordable prices. Over
the last 25 years social marketing has become an important way to advertise and deliver
needed health products and services to lower income people, and to motivate the use of
those products and services. One of the key premises of social marketing is that
recipients do not equally value products that are given away for free. When charging an
affordable fee, the commercial infrastructure is more likely to stock and distribute the
item, and the customer is more likely to use it. Obviously, applying social marketing
methods usually demands high level of collaboration between public and private

Information Education Communication

Information Education Communication (IEC) refers to comprehensive programming
interventions that aim at achieving behavior changes in designated audiences using a
combination of communication technologies. This most often includes the use of some
mass media or smaller scale material distribution (posters, pamphlets) to inform or
establish positive norms among the general population. In some cases targeted
interpersonal communication is used to help those at particular risk evaluate their own
behavior and develop new skills. The aim of IEC is to measurably change behavior and
attitudes within specific audiences based on a study of their needs and perceptions.
This often includes research on what kind of information would be most useful and the
most effective way of delivering it.8

Social Mobilization
Social mobilization is a planned process or operational strategy that count on the
support and active involvement of many sectors within a society that can play a role in
achieving an agreed objective. It the health context, it describes the vast cooperative
efforts of public and private organizations that are often necessary to make large health
promotion actions successful. Social mobilization brings together those who are

World Bank document

UNFPA document

affected by the problem and those who can contribute to the solution, through linking,
networking and organizing. Such efforts include (among other things) publicity
campaigns, logistical support, transportation and transmission of information.

In health promotion, mediation is the process through which the different interests
(personal, social and economic) of individuals and communities as well as different
sectors (public and private) are reconciled in ways that promote and protect health.
Producing change in peoples lifestyles and living conditions often produces conflicts
between the different sectors and interests in a population. Such conflicts may arise, for
example, from concerns about access to, use and distribution of resources. Or perhaps
regarding constraints on individual or organizational practices. Reconciling such
conflicts in ways that promote health may require considerable input from health
promotion practitioners, including the application of skills in advocacy for health.9

Advocacy and Lobbying

Advocacy means to speak up, to plead the case of another, or to champion a cause. It
is a word used to capture a broad set of skills used to create a shift in public opinion and
mobilize the necessary resources and forces to support an issue, policy or constituency.
Advocacy for health refers to a combination of individual and social actions designed to
gain political commitment, policy support, social acceptance, and systems support for a
particular health program or goal.10 Advocacy may be carried out through lobbying,
social marketing, IEC, social mobilization, and other approaches.
Lobbying is the communication of ones interests to a carefully chosen person, with the
aim of influencing decision making. Lobbying always involves advocacy, but advocacy
does not always include lobbying. The objective of lobbying is to have the legislation
one supports passed, or the legislation one opposes defeated or modified. In order to

Health Promotion Glossary

WHO AFRO. Guidelines


lobby effectively, health promoters must have knowledge of who the decision makers
are, and how the legislative process works.

Above all, it is essential to remember as health promoters that health promotion
assumes certain things: that health status can be changed, that prevention strategies
can resolve many identified health problems, that changes in individual and societal
behaviors can affect health status, and that individual motivation and readiness for
change can lead to permanent health behavior change. The components of health
promotion defined above are a means to the end suggested by these assumptions. The
end or goal is to enable people to increase control over and to improve their own health.
In practice, there is quite a bit of overlap between the components of health promotion
defined above. In some cases, for example, CBC, IEC and health education will not be
completely distinct. More important than the differences is that strategies be adapted to
the particular context, and that the ultimate goal always remain the same.