Health Promotion

Health: WHO constitution of

1948

A state of complete physical,

social and mental well-being,
and not merely the absence
of disease or infirmity.
-health as a resource permits people
to lead an individually, socially and
economically productive life.

Declaration of Alma-Ata
30th World Health Assembly,
Geneva May 1977

-all the people of the world to attain a

level of health that would permit them to
lead a socially and economically

productive life

Health Promotion
Is a process of
enabling
people to take
action to
improve
health

Health Promotion
-participation is essential to
sustain health promotion action
Health is not just a basic human
right.
..it is a self-responsibility

empowerment

Health Promotion
-answer to the emerging public
health problems
-represents a comprehensive
social and political process.
-it not only embraces actions directed at
strengthening the skills and capabilities
of individuals, but also action directed
towards changing social,
environmental and economic
conditions so as to alleviate their impact
on public and individual health.

Health promotion is needed in order to:

1.Build health public policy:

it puts health on the agenda of

policy makers in all sectors

and at all levels, directing them to
be aware of the health
consequences of their decisions
and to accept their responsibilities
for health.

Health promotion is needed in order to:

2. Create supportive
environments:
The links between people and their
environment constitutes the basis for
a socio-ecological approach to
health.

Changing patterns of life,

work and leisure have a
significant impact on health.
Work and leisure should be a source of
health for people.

Health promotion is needed in order to:

3. Strengthen community action:

Health promotion works through concrete
and effective community action in setting
priorities, making decisions, planning
strategies and implementing them to
achieve better health.
The heart of this process is
empowerment of communities: their
ownership
and control of their own endeavors
and destinies.

Health promotion is needed in order to:

4. Develop personal skills:

Health promotion supports personal and
social development by information,
education for health, and enhancing life
skills.
It increases the options available to
people to exercise more control
over their own health, over their
environment, and to make choices
conducive to health

Health promotion is needed in order to:

5. Reorient health services:

The responsibility of health promotion in
health services is shared among
individuals, community groups, health
professionals, health service institutions
and governments.
They must work together towards a
health care system which
contributes to the pursuit of health.

Goals
1. Ensure implementation of major health
promotion strategies such as: changing
living conditions, changing lifestyles
and reorienting health services.
2. Provide leadership in the advocacy for
the adoption of the 5 areas of health
promotion by the health and healthrelated sector.
3. Deliver appropriate and timely health
information/messages to as many
target audiences.

Goals

4. Produce appropriate creative materials

based on acceptable standards set by the
National Center for Health Promotion, DOH.
5. Organize patient/watcher education in all
hospitals.
6. Establish networks with LGUs and partner
agencies.
7. Advocate for local chief executives (LCEs)
to provide funds for their health promotions
facilities and activities.
8. Build health worker capacities at all levels,
on health promotion.

Health Promotion in the 21st century

(Jakarta declaration)

5 priorities:
-promote social responsibility for health
-increase investments for health
development
-expand partnerships for health
promotion
-increase community capacity and
empower
the individual

Major Strategies
1.Changing living conditions
2.Changing lifestyles
3.Reorienting health services

Background and Rationale

One-on-one
communication between
the doctor and the patient
has already been found to

A socio-ecological
approach is now
seen to be
appropriate

WHY PROMOTE HEALTH?

-Prevention is better than cure.

-Studies show that people are becoming

increasingly interested in improving
their health through lifestyle

changes.
-Eliminating a few lifestyle risks could

immediately improve quality of life and

prevent life-threatening diseases.

HEALTH PROMOTION

is the first step

to disease prevention.
It must start with people who are
basically healthy by enhancing
behaviors that promote wellbeing
-and strengthening community
measures
and individual lifestyles for the
maintenance of good health.

Health Promotion is
exclusively

not

IEC

Health Promotion is multi-

faceted
It combines diverse but complementary
methods including:

IEC,
LEGISLATION,
FISCAL MEASURES,
ORGANIZATIONAL CHANGE,
COMMUNITY DEVELOPMENT
and LOCAL ACTIVITIES
against health hazards.

and GOVERNMENT CANNOT DO IT

Why invest in health promotion

1. Leading causes of diseases and deaths

are highly preventable.
Health promotion approaches are
essential.
2. High economic burden of diseases,
to the individual, family, community
and governments
3. Health promotion can be effectively
applied to complement treatment
services.

Why invest in health promotion

4. Public demand and support.

People consider prevention is preferable
to cure.
5. Opportunity for shared investment by
others and shared responsibilities
(government and private)
6. Return on investment: invest on
health. ..economically
productive people

Health
promotio
n

Health
y
people

Socially
Economical
ly
productive

STAGES IN THE PREVENTION

PRIMARY
OF DISEASES SECONDARY

DISEASE

PATHWAY OF
HEALTH

PATHWA

Immunization
Chemoprophylaxis
Nutrition
Personal hygiene,
child spacing

Environmental control
water and food
hygiene

excreta and rubbish

disposal,

disinfection and
sterilization,

vector and reservoir

control,

Living and working

conditions

Screening

Surveillance

The pathway
of

ll

Fu ery

ov
c

Re

Permanent

Disability

t
ea
D
h

S
EA
IS

HEALTH

ELO
PM
ENT
OF

DIS
EAS
E

PREVENTION

F
O

DEV

PREVENTION

TERTIARY
PREVENTION

Diagnosis
Treatment
Management
Rehabilitation

Health Education is an integral

part of all the health services.

All health workers are health

What is Health
Education?

As a process:

-it is the provision of learning

experiences for the purpose of
influencing knowledge, attitudes or
conduct, relating to individual or
community health

As an end:
-the growth of individuals by means
of which he alters his behavior or
change his attitude towards health
practices as a result of a new

The aim of Health Education

1. To help people to achieve health by
their actions and efforts.
2. To develop the interest of people in
improving their conditions of living.
3. To develop a sense of responsibility for
their own health betterment as
individuals, and as members of
families, communities and government.

Criteria to be considered in order to effect

changes in people and the community

1. Culture or way of life of people

including beliefs, traditions, values,
systems, religious practices, etc
2. Community leaders and leadership
patterns
3. Problems that the people recognize and
have an interest in doing something
about
4. Socio-economic level of the community
5. Channel of communication in which the

Criteria to be considered in order to effect

changes in people and the community

6. Community resources: human,

financial, institutional and/or technical
7. Past experiences of people with respect
to health and illness with public health
workers, hilots etc
8. Educational methods and media and
their effectiveness
9. Motivation of people why they do
things they do
10 principles of learning and barriers to

I hear and I
forget
I see and I
remember
I do and I
understand

Health Education
-leading out what people already know and believe
and do about their health
-modifying those that are undesirable, and
developing desirable behaviors that are conducive
to health.
-it is a process of providing learning experiences to
people in order that they may be able to define their
health problems- personal, family and community,
and to take needed action in solving these problems
-Health education is a process that bridges

the gap between health information and

health practice.

Improving knowledge and

understanding of health is an
indispensable step in promoting
health-supportive action.
Creating social, economic and
environmental conditions that are
conducive to health is also essential.a
reality only when there is
heightened awareness of
health matters among policy-makers,
politicians, economic planners and the
public, and when this awareness is
transformed into .. policies,

Health education is a process that bridges the gap

between health information and health practice.

Health
informati
on

Health
educati
on

Health
practice

Health information
Health practice

Some rules to remember when

teaching
1.
Be simple: make one or two points
clear. Dont confuse adult learners with
too much information.

2. Be seen: use visual aids

3. Be heard: speak loud and clear to
capture the interest of the
audience.
4. Be remembered: smile

5. Be humble: learn from your

audience.

Why not teach

everything?

Nice to learn
Useful to
learn
Must
learn

Task and responsibility of health workers

Health
workers

Technical task

-to solve health

problems
technically:
-physically
-chemically
-biologically

Improved

Educational
task

-to solve health

problems
through
changing in
health related
behavior:
-values
-belief
-knowledge
-feeling
community
-emotion

Adult learning
-a process by which an individual
invests energy in making use of
available resources to acquire
-new knowledge,
-skills or
-attitudes that are seen as
relevant to personal needs and
goals.

Assumptions about adult learners vs

child learners

Child

Adult

-dependent

-self-directed

-little experience

-experience as
knowledge

-learning for grades -learning for practical

use

-postponed
application

-immediate
application

Ako ang
tama
Alam ko

Wala kang
alam

Patient education in a hospital setting

patie
consultati
nt
on
confineme
nt
Patient needs to know
many things about his
illness

Task and responsibility of all health workers:

technical/educational

In the hospital, usually

the nurse

Client: -patient and

-significant
others

From
admission to

Educational task:
-to help solve
problems through
changing in
health-related
behavior:
-values
-belief
-knowledge
-feeling
-emotion

Objectives of health teachings:

1. To enable patient to freely participate

in and integrate the illness in order to
prevent regression
2. Help individual find meaning in his
illness as well as in measures he
must take to conserve health. Help
master his disease and assume
responsibility for his own care.
3. help patient strengthen themselves
thru strengthening of role performance
4. Guide the patient in making
optimum adjustment to his

More specific goals of health teaching:

1. Follow thru on treatment and rehab

2. Directions after discharge
3. Cooperation with treatment relieving
tension of illness by means of learning
4. Acceptance of diagnosis and
prognosis which may have
emotional, mental, spiritual and social,
economic and physical implication and
may create problem for the individual
which may affect his relationship with
his family and community

More specific goals of health teaching:

5. Preparation for hospitalization so that the
patient will have lesser difficulty in
adjustment.
6. Follow thru carean instruction upon
discharge
7. Practicing healthful living techniques such as
anticipatory guidance for healthful living
as dietary advices, personal hygiene
measures, mental health principles, safety
rules, periodic physical exam
8. Utilization of community services thru
referrals

Factors that may affect effective

health education
1. Physical atmosphere
2. Attitude displayed and approach used
by the health worker
3. Knowledge and understanding of the
patho-physiology of the disease
4. Communication ability of the health
worker

Restrictions upon communication

1. Information given should be related clearly,

slowly in simple familiar way.
2. Avoid too many subjects, long words and
medial terminologies.
3. Avoid indiscreet remarks about patients
illness which may produce emotional
trauma.
4. Avoid authoritative statements and
superior pronouncements.
5. Family and significant others should be
accorded with respect.
6. Avoid sarcasm or evasion.

Suggestions for effective patient teaching

(on

set rules)

1. Be trustworthy and consistent.

2. Have self esteem and enthusiasm.
Generate a sense that what you teach
will benefit the learner.
3. Do not discuss your personal
problems.
4. Be knowledgeable about your subject.
Organize and present your material so
that the patient will feel you really
know what you are talking about.
5. Review/evaluate your teaching

Suggestions for effective patient teaching

(on

set rules)

6. Accept good and bad days.

Results may not always be favorable.
7. Respect the patient as more important than
procedure.
8. Always explain the reasons if u ask the patient
to do something.
9. Appropriate timing is essential in teaching.
10. Do not allow racial bias to control your
attitude.
11. Do not reinforce destructive thinking when
patient say, my mother died of cancer.-dont
say its a real killer, my aunt died from it too.

Follow up teaching and referral

Often, patient teaching from

hospitals/health centers/clinics to home
has no continuity.
Ideally, health teaching should include the
patients family which can be done by a
visiting health worker.
..or the patient may be referred to an
agency or a community based health
worker.

Health is not just a basic human

right
it is a self
responsibility

empowerment