L-4, Health Education and

Health Promotion
Health Promotion, Health Education
WHO Definitions of Health Promotion and
Health Education
• Health promotion is the process of enabling
people to increase control over, and to improve,
their health.
• Health Education as comprising of
consciously constructed opportunities for
learning involving some form of
communication designed to improve health
literacy, including improving knowledge,
and developing life skills which are
Relationship between HP & HE
Approaches for Health Promotion

Healthy Population
Healthy Lifestyle
Health Environment
 Who Promote Health?

 Individual Role  Governmental Role

 H. Consciousness  Legislation
 Life Style  Env. Health
 Genetic  Health Services
 Beliefs  Other Ministries
 Occupation AND  Policy and Budget
 International Organizations
 Health Authorities
 NGOs
 Primary Health Care Team
 Private Physician
 Other Health Professions: nurses, profession allied to
medicine
 Religious organizations
 3 key strategies of
health promoters

1.Advocate: through advocacy making the

following factors favorable for health: Political,
economic, social, cultural, environmental,
behavioral and biological factors
2.Enable: supportive environment, access to
information, life skills and opportunities for
making healthy choices
3.Mediate: between governments, health and
other social and economic sectors, NGO’s and
voluntary organization, local authorities,
industry and the media.
 The Ottawa Charter for
Health Promotion:
 First International Conference on Health Promotion, Ottawa, 21
November 1986.
 According to the Ottawa Charter, 5 key health promotion action
means:
1. Build Healthy Public Policies: legislation, fiscal measures, taxation and
organizational change
2. Create Supportive Environments: to take care of each other, our
communities and our natural environment. Technology, work, energy
production and urbanization should generate living and working conditions that
are safe, stimulating, satisfying and enjoyable.
3. Strengthen Community Actions: empowerment of communities -their
ownership and control over their health issues, such as, self-help groups, social
support systems.
4. Develop Personal Skills: through providing information, education for
health, and enhancing life skills. Preparing people for all of its stages and to
cope with chronic illness and injuries
5. Reorient Health Services: The role of the health sector must move
increasingly in a health promotion direction, beyond its responsibility for
 Jakarta Declaration

The 1997 Jakarta Declaration set Priorities

for Health Promotion in the 21st Century
• Promote social responsibility for health
• Increases investments for health
development
• Consolidate and expand partnerships for
health
• Increase community capacity and
empower the individual
• Secure an infrastructure for health
promotion
Five key areas of action for a
healthier world…
1. Partner and build alliances:
with private, non-private, non-
governmental or international
organizations to create
sustainable actions
2. Invest in sustainable
policies: actions and
infrastructure to address the
determinants of health
3. Build capacity: for policy
development, health
promotion practice and health
literacy
4. Regulate and legislate: to
ensure a high level of
protection from harm and
enable equal opportunity for
health and well being
5. Advocate: health based on
human rights and solidarity
 2009 in Nairobi. Health Promotion

 Community
empowerment
 Health literacy and
health behavior
 Strengthening health
systems
 Partnerships and
intersectoral action
 Building capacity for
health promotion
Models of influenced Health Promotion.
 Over the past 30 years, three key models of health have
influenced health promotion.
 The biomedical model of health (pre-1970s):
 focuses on risk behaviors and healthy lifestyles
 emphasizes health education – changing knowledge,
attitudes and skills
 focuses on individual responsibility
 treats people in isolation of their environments
 The social model of health (from 1970s onwards):
 addresses the broader determinants of health
 involves inter-sectoral collaboration
 acts to reduce social inequities
 empowers individuals and communities
 Models of influenced health
promotion….continue
The ecological model of health (from late 1970s
onwards):
 acknowledges the reciprocal relationship between
health-related behaviors and the environments in
which people live, work and play
 considers the *environment is made up of different
subsystems – Micro, Meso, Exo and Macro
 emphasizes the relationships and dependencies
between these subsystems
 is comprehensive and multi-faceted, using a shared
framework for change at individual and
environmental levels
 *Environment is made up of different
subsystems….
• Urie Bronfenbrenner's Micro, Meso, Exo and Macro
system….
 of
Approaches
Health Promotion
 Ewles and Simnett distinguish five
approaches to health promotion.
These approaches are:
1. Medical
2. Behavioral Change
3. Educational
4. Client-centred
5. Societal Change
1. Medical Approach

• -Interventionist
-Seeks to use medical
treatment and/or screening
to reduce ill health (also
called preventive model)
-Seeks to influence health
through advice,
instructions, persuasion
-Focuses on medical view
of health and assumes health
professionals are best
judges of a person’s needs
Advantages and Disadvantages of
the Medical Approach?
Advantages
-People sometimes want to be told what to do
-Health experts do have relevant knowledge
and expertise
Disadvantages:
-Ignores root cause of ill- health
-Risk of victim blaming
-Top-down approach
 2. Behavior Change Approach

 --Aims to change the behavior of individuals

through persuasion and education
--Tends to work well with middle class
groups and less well with working class people
 --Healthy lifestyle is dictated by the health
promoter
Advantages and Disadvantages
of the Behavior Change Model
Advantages:
• Aims to change behavior
and encourage healthier
lifestyle
Disadvantages:
• -May be seen as too
‘health promoter led’
-People may feel they are
being told what to do
-May increase health
gap between social
classes
 3. Educational Approach
--Seeks to provide people with accurate
information so they can make informed
decisions about their own health
--Closely linked with behavior change
approach
--Gives individuals the right to choose
--Health promoter provides the information the
client needs
Advantages and Disadvantages of
the Educational Approach
 Advantages:
-Provides individuals with knowledge to make
informed decisions
-Explores attitudes and values
-Freedom to choose advantages of educational
approach
 Disadvantages:
-May not result in a change of behavior
-Person may not have the skills to use the
information given
 4. Client-centred Approach
• Involves working with an individual client and helps
them identify any changes they wish to make to
their lifestyles
• Support is then given to help the client to make the
changes
• Clients are treated as equals
• Self-empowerment is key
Advantages and Disadvantages of
the Client-centred Approach
 Advantages:
-Empowers clients
-Clients have the right to set the agenda
-Ethical approach, valuing the right to choose
-Individuals identify their own priorities
-More likely to respond if they set the agenda
 Disadvantages:
-Ignores obstacles that prevent free and
informed decision making
-Issues are only considered if the client
5. Societal Change Approach
--Seeksto change the
physical and social
environment
and/or the law
e.g. banning tobacco
advertising; banning
smoking in public
places
--Relies on changing
the environment to
enable healthier living
 Advantages and Disadvantages
of the Societal Change Approach
 Advantages:
-Addresses real causes of ill health
-Raises awareness
-Previous Public Health successes indicate
effectiveness of the approach
 Disadvantages:
-May reduce individual freedom and choice
through social regulation
-May discourage individuals from taking
responsibility
Tannahill’s Model of
Health Promotion
 Beatties' model of health of
promotion- 1991
Health persuasion Personal
factors counseling
--Advice factors
--Education --Counseling
--Behavior Change --Education
--Mass Media --Group Work
Campaign
 Beatties' model of health of
promotion- 1991..continue
Legislative • Community
Action: Development
--Policy making --Lobbying
and --Action research
implementation --Skills sharing
--Legislation and training
--Health --Group work
surveillance
 Effective Health Promotion

• You may need a combination of

approaches.
• Adapt your approach/models to fit
with the aim of your health
promotion.
• Also, select the method of
promoting health that best suits your
aims
 How?

04/16/2024 SzP 29
Thank you
