Health Promotion 2

(PUB 205)

Session 1: Concepts of health, health promotion and health education

 Learning objectives

By the end of the session, participants should be able to:

•Define health
•List different dimensions of health
•Define health education
•Define health promotion
•List the activities conducted in health promotion
What is ‘HEALTH’ ?
Health and being healthy mean different to
different people.
 Health is…
‘…a state of complete physical, mental and
social well-being, not merely the absence of
disease or infirmity’

(World Health Organization,1948)

The Health FIELD Model
Application of Health Field Model to Diarrhea
 Dimensions of Health
Health is holistic and includes different dimensions

Aggleton & Homans (1987 & Elwes & Simnett, (1999), cited in
Naidoo & Wills, (2000)
 Dimensions of Health

• Physical Health
– Most obvious dimension of health, and is concerned with the
mechanistic functioning of the body.
• E.g. keeping fit, being free of disease, being able to function
physically

• Social Health
– The ability to make and maintain relationships with other people.
• E.g. able to relate to others, being part of social networks
and relationships.
 Dimensions of Health
• Mental / Emotional Health
– The ability to think clearly and logically. We distinguish this from
emotional and social health, although there is a close association
between the three.

• E.g. able to think clearly, make judgments and decisions

The ability to recognize emotions such as fear, grief and anger and to
express such emotions appropriately. Emotional or ‘effective’ health
also means coping with stress, tension, depression and anxiety.
 Dimensions of Health

• Spiritual Health
Some people are connected with religious beliefs and practices; for
other people it is to do with personal belief, principles of behaviour
and way of achieving peace of mind and being at peace with
oneself.

• Intellectual
The ability to learn and grow in a variety of situations, express
creativity and innovation, the ability to think critically, and the engage
in lifelong learning.
 Dimensions of Health
• Environmental Health
The physical environments like housing, sanitation, fresh water,
flooding etc…

• Occupational
Engaging in meaningful work that reflects personal values and
beliefs, finding balance between work and leisure.
 Class Activity
• Discuss the holistic link or connection in different dimension of health
with one another
What is Health Education?
 Health education
The definition and scope of health education have evolved since the
1950s, particularly in relation to improved understanding of behavioral
and socio-ecological influences on health. The early definition of health
education in primarily emphasized the provision of learning experiences
to promote voluntary changes to individual health (Griffiths 1972).

The profession of educating people about health. It is the process of

providing people opportunities to learn about health and to undertake
voluntary changes in their health.

It can be defined as the principle by which individuals and groups of

people learn to behave in a manner conducive to the promotion,
maintenance, or restoration of health.
.
What is Health Promotion?
 Health promotion

Improving Health: advancing, supporting, encouraging and placing it

higher on personal and public agenda.

‘…the process of enabling people to increase control over, and

improve, their health’
(From the Ottawa Charter on Health Promotion, 1986)
 Health Promotion

Health Promotion can be regarded as a combination of educational,

organizational, economic, social and political actions designed with
meaningful participation, to enable individuals, groups and whole
communities to increase control over, and to improve their health
through attitudinal, behavioral, social and environmental changes.
Health Education
Vs
Health Promotion
 Scope of Health Promotion
• The scope of health promotion is very wide.

• Activities which may be included in health promotion are:-

– Mass media advertising,
– Campaigning on health issues,
– Patient education,
– Environmental safety measures,
– Public policy issues,
– Health education about physical health,
– Preventive and curative medical procedures,
– Codes of practice on health issues,
– Workplace health policies,
– Social education for young people, etc.
Activities which aim to improve people’s health
 Class activity

Write down the list of activities under each and

every services.
 Illness and Disability Services

• Personal and social service:

All those social services which aim to address the needs of sick or
disabled members of society whose health is improved by those
services. E.g. the community care for the elderly, home care for the
sick, mental health services for those who are mentally ill, etc.

• Health Care services:

Includes treatment, cure and care in primary care and hospital
settings. In the case of the Maldives this includes the health services
such as medical care services provided by IGMH, the Regional
Hospital, Health Centers and the Health Posts.
 Positive Health Activities

• Health Education Programs:

Planned activities that provide information and learning activities for people so
that they are able to undertake voluntary changes in their behavior.
• Programs may include providing information, exploring values and attitudes,
making health decisions and acquiring skills to enable behavior change to
take place.
• These programs can be implemented on a personal level, one to one such as
in the case of family health workers who do home visits to give health
education.
• In a school setting where a teacher or a health worker conducts classes on
nutrition, exercise etc.
• Targeted to large audience through mass media, health fairs and exhibitions.
 Positive Health Activities

• Health Education Programs: can be directed at three different

levels:

1- Primary Health Education

– Directed at healthy people and is aimed to help them to stay
healthy and therefore to prevent ill health arising in the first
place.
– For example teaching mothers and children about personal
hygiene and sanitation can help in preventing them from
getting diarrhea and other water-borne diseases.
– Primary health education not only helps prevent illness, but
also helps in positively improving quality of health and quality
of life.
 Positive Health Activities

2- Secondary Health Education

– Targeted to ill people to help prevent the development of further

complications or the ill health condition leading to chronic or
irreversible stages.

– This may be related to educating people on the importance of taking

treatment and changing lifestyle so that no further complications may
develop.

– In the case of a person who has high blood pressure, secondary

health education programs will provide information, communication
and skills to help people to exercise more, adopt healthy eating habits
and stop smoking in order to prevent the high blood pressure leading
to a stroke or heart attack.
 Positive Health Activities

3- Tertiary Health Education

– Concerned with educating patients & relatives about how to make

the most of the remaining potential for healthy living & how to avoid
unnecessary complications.

– For example in the case of people who have food allergies, with
tertiary education the person may be taught how to avoid food
allergies & what to do in the case of a food allergy occurring.

– Rehabilitation training following accident that has caused a

permanent disability such as loss of a limb.
 Positive Health Activities
• Preventive Health Services

– Include medical services which aim to prevent ill health such as

immunization, family planning and personal health checks.

– Wider preventive health services such as child protection

services for children at risk of child abuse.
 Positive Health Activities

• Community Based Work:

–This includes working with communities for improving health.
–This may include community development which is essentially
about communities identifying their own health needs and taking
action to address them.
–It can include local campaigns for better facilities. In the Maldives it
may mean health workers working together with island
development committee to set up a community drug store, to
establish a fund for transporting women with complicated
pregnancies to the regional hospital, etc.
–It may also mean working with women's committee to set up home
gardens and establish a meal program at school.
 Positive Health Activities

• Organizational Development:

– This is about developing and implementing policies within

organizations which promote the health of staff and customers.

– For example- a staff canteen providing healthy food choices,

having exercise facilities for staff, offering annual medical
checkups of staff, etc.
 Positive Health Activities
• Healthy Public Policies:

– This involves legal and voluntary agencies, professionals and the

public working together to develop changes in the conditions of
living.

– Example providing better housing facilities, leisure activities,

creating employment opportunities etc.

– Development of good public transport in order to minimize the

number of cars on the road, lessening pollution, etc - will also
contribute to a healthier life.
 Positive Health Activities
• Environmental Health Measures
– This is about making the physical environment conducive to health.
– This applies not only to the environment at large, but includes the
home environment, the work environment, public places etc.
– It includes traditional public health measures such as providing
clean food and water and controlling pollution as well as working
on newer issues such as smoke free areas in restaurants and
controlling the use of environmentally damaging CFCs.
– It includes setting up proper waste disposal system and eliminating
both indoor and out door air pollution.
 Positive Health Activities

• Economic and Regulatory Activities:

– This is a political and educational activity directed at politicians,

policy makers and planners.
– It involves lobbying/promoting for and implementing legislative
changes.
– For example to regulations to ensure that all food imported in to
the country has labels bearing the expiry date and nutritional
information, or banning of advertisements of cigarettes and
breast milk substitutes.
– It also improves setting up economic measures which will make
preventive health care costs such as cost of nutritional food
affordable to people.
 The Ottawa Charter on Health Promotion (1986)
• The Ottawa Charter in health promotion was drawn up in a meeting
held in Canada in 1986. The Charter emphasizes that promoting
health is more than just providing health services.

• To promote health people need:

– Peace, housing, education, food, income, a sustainable
environment, social justice and equity
The 9 ‘prerequisites for health’ stated in the Charter
1. Peace
2. Shelter
3. Education
4. Food
5. Income
6. Stable ecosystem
7. Sustainable resources
8. Social justice
9. Equity

Are all these available in our country?

Factors that can favour health or be harmful to it,
according to the Charter
• Political
• Economic
• Social
• Cultural
• Environmental
• Biological
• Behavioural

Health promotion action aims at making these conditions favourable

through advocacy for health.
 Stakeholders in health promotion
• Governments
• Health and other social and economic sectors
• Non-governmental and voluntary organisations
• Local authorities
• Industry
• Media
• Individuals, families, communities
• Professional and social groups
• Health personnel
 Health actions’ described in the Charter
1. Build healthy public policy

2. Create supportive environments

3. Strengthen community actions

4. Develop personal skills

5. Reorient health services

6. ‘Moving into the future’

Referencing
● Aggleton & Homans (1987 & Elwes & Simnett, (1999), cited in Naidoo & Wills, (2000).