CURRENT ISSUES AND CHALLENGES OF

HEALTH
PROMOTION

Presented by Shristi Khattri

(NAMS College)
 Introduction

Health promotion is the process of enabling people to increase control over the
determinants of health and thereby improve their health.
- The Ottawa Charter for Health Promotion 1986
• Health promotion is the science of aiming at reaching optimal health of individual,
society or community.
• All activities aiming at increasing well-being, prevention of disease and health hazards,
or control of disease are included under health promotion.
• Health promotion is carried out through acts of advocacy, empowerment of people and
building social support systems that enable people to make healthy choices and live
healthy lives.
 Why we need Health
Promotion?

 Promotes quality of life

 Reduce inequalities in health
 Reduce pressure in services
 Health promotion is concerned with making healthier
choices and easier choices
 It is cost effective and efficient
 Adds life to year ,Adds year to life
THE DEVELOPMENT OF HEALTH PROMOTION
-Ottawa (Canada) 1986:
First international health promotion conference as an extended application for the
Alma Atta declaration 1978 on primary health care.
-Australia 1988:
Concept of healthy public policy being a human right gender dimension was given
specific attention.
-Sweden 1991:
Concept of supportive environments for Health Promotion.
-Jakarta, Indonesia 1997:
Issues related to globalization infrastructure and funding.
-Mexico city, Mexico 2000
High level political commitment to health promotion.
Positioning health promotion higher on the political agenda and recognizing it is a
priority in local , reginal, national , and international programs.

-Nairobi ,Kenya 2009

Building capacity for health promotion, strengthening health systems, partnerships
and inter-sectoral action, community empowerment and health literacy and health
behaviors.

-Helsinki 2013
Every policies should focus on health, it’s improvement in every sectors (Health in
All Policies).

-Shanghai, China 2016

Promoting health through action on all the SDGs. (All for Health, Health for All )
CHALLENGES AND ISSUES FACING HEALTH PROMOTION
IN DEVELOPING COUNTRIES
Poverty: Poverty and consequently the poor conditions (e.g. poor nutrition, poor sanitation,
poor housing , environmental degradation) associated with it are the major obstacle for improving
health of people in developing countries like Nepal, Bangladesh ,etc. Unless fundamental
changes are made to this wider context it will be difficult to make major advances in health
promotion. The challenges of reducing poverty cannot be underestimated. According to report of
Nepal Multidimensional Poverty Index 2021(UNICEF) , the poverty rate was still 17.4% in 2019.

Economic status: Most developing countries have limited resources and many competing
demands for these resources. They are seeking to achieve rapid economic gains and development
by industrialization and food production that gives priority to foreign markets for earning foreign
exchange.
Insufficient attention is given to the needs of local citizens leading to low wages and poverty,
poor nutrition and worse environmental condition, all of which have serious consequences.
International donors tend to encourage activities that promote economic development and have
quick and visible outcomes.
The challenges for health promotion is to convince policy makers that good health is an economic
asset rather than a cost and it is essential component of social and economic empowerment.
 Education: Low levels of literacy specially health promotion approach. This can be an
obvious problem when we trying to promote better health behavior among people. Poor
levels of knowledge is the factor that contribute to almost all diseases. Efforts done to
improve illiteracy actually impact in health promotion.

 Political instability: When there is political instability, internal conflict and war, it
extremely difficult to develop health-promoting environments. Not only are the
economic resources and priorities of government is something else and also the
environment to create health supportive is lacking.

 Inter sectoral co-operation: Decision-makers in all sectors (even in areas that are
indirectly related to health as agriculture , commerce, education, industry , etc ) must
focus on the health implications of their policies , in fact their competing priorities may
lead them to disregard the health implications of their decisions.

 The double burden of disease: One of the particular challenges that face developing
countries is that the epidemic of non-communicable disease is developing before the
burden of communicable disease. The difficulty faced by developing nations is to deal
with these dual sources of disease without adequate economic resources.

 Rapid population growth : The population growth rate in the developing countries ( like
Nepal is increased by 1.8%) and developed countries (like UK is only increased by
0.4% ).It is much easier for countries adjust gradual population transitions than to these
rapid changes. The change in population growth in developing countries , it nearly
impossible to provide all the needs and services to citizens.

 Gender inequality: Gender inequalities can give rise to inequities between men and
women in health status and access to health care. Recognizing the root cause of gender
inequities in health is crucial therefore when designing health system. Health promotion as
well as disease prevention needs to address these differences women and men in an
equitable manner in order to be effective.

 Lack of community participation : Community participation is very important for health

promotion but the empowerment of the community to take charge of its own health is
lacking.
 Lack of proper research for proper development of healthy public policies involving
all agencies, private sector, and NGOs is difficult also lack knowledge and research in
policy analysis and impact assessment. Difficulty in putting health on the agenda of
others ministers and sectors.

 Programs support to the educational campaign is still weak e.g. provision of screening
facilities, services for fitness and health /medical examination.

 Commercial interest : Ambiguity in government policies. E.g. indirect advertising

of alcohol, tobacco in sponsorship of sports/ events. Marketing does not consider
health of citizens of developing countries. The taxes gained from unhealthy products
and used as an important source of governmental funds. Poor governments can find it
difficult to resist this source of revenue.

 Others challenges like in traffic , infrastructure, natural disaster management ,

new borne disease due to changing climate ,lack of nearby medical facilities, etc.
SOLUTIONS
• Strengthening of research for evidence based health promotion and evaluation of
programmes.

• Intensify empowerment of individuals and the community through public education , skill
development, leadership training, provision of resources, providing guidance and
facilitation.

• Intensify and strengthen implementation of “settings approach” to address the

determinants of health and create supportive environments.

• Improve cooperation and collaboration with NGOs –working towards common health
objectives.

• Raising awareness about healthy behaviors for general public. Examples of

communication strategies include public service announcements, health fairs, etc.
• Empowering behavior change and actions through increased knowledge. Examples of
health education strategies include courses, training, and support groups.

• Making systematic changes –through improved laws, rules, and regulations, functional
organizational components and economic, social, or physical environment – to courage ,
make available and enable healthy choices.

Reference:
S. El. Amany ,Jun 27 (2015), ‘’ HEALTH PROMOTION’’ , Slide share
https://www.slideshare.net/amanyhoda/health-promotion-49904260

P. Mara ,Mar 11, (2019), “PROBLEMS/ ISSUES IN HEALTH PROMOTION” ,Slide serve
https://www.slideserve.com/mara-peters/problems-issues-in-health-promotion-powerpoint-
ppt-presentation
The Greatest Medicine of all is to teach people how not
to need it.

Thank you!