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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. 2. 3. 4. 5.

Build healthy public policy Create supportive environments Strengthen community action Develop personal skills 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. 2. 3. 4. 5. 6. 7. 8. 9.

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

Environmental sanitation Control of communicable diseases Immunization Health Education Maternal and Child Health and Family Planning Adequate Food and Proper Nutrition Provision of Medical Care and Emergency Treatment Treatment of Locally Endemic Diseases 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