1. Presented by Dr/Amira Yahia
HEALTH PROMOTION
Presented by Dr/Amira Yahia

2. Learning outcomes To define health promotion
To identify the Principles of Health Promotion
To discus the Concerns of health promotion
To describe the Health Promotion Values
To enlist the Components of Health Promotion
To identify the basic charactristics of health promotion
To enoumrate the Health Promotion Triad
To discuss the health promotion program
To apply the community health nurses roles

3. What is Health Promotion all about?
It is the process of enabling people to increase control over and improve their health. (Ottawa H.P. Charter).
It is a process which empowers families and communities to improve their quality of life, and achieve and maintain health and wellness.
It emphasizes not only prevention of disease but the promotion of positive good health.

4. What is Health Promotion all about?
It is a positive concept emphasizing personal, social, political and institutional resources, as well as physical capacities.
Health promotion is any combination of health, education, economic, political, spiritual or organizational initiative designed to bring about positive attitudinal, behavioral, social or environmental changes conducive to improving the health of populations.

5. What is Health Promotion all about?
Health promotion is directed towards action on the determinants or causes of health
Health promotion, therefore, requires a close co-operation of sectors beyond health services, reflecting the diversity of conditions which influence health.
Government at both local and national levels has a unique responsibility to act appropriately and in a timely way to ensure that the ‘total’ environment, which is beyond the control of individuals and groups, is conducive to health.

6. Definitions of health promotion
“Any combination of health education and related organizational, economic and political interventions designed to facilitate behavioral and environmental changes conductive to health”. (Green LW 1979)
"Health promotion is the science and art of helping people change their lifestyle to move toward a state of optimal health. 

7. Definitions of health promotion (cont.)
“the process of enabling people to increase control over, and to improve, their health: (WHO, 1984, 1986; Epp, 1986)
“the process of enabling [individuals and communities] to increase control over [the determinants of health] and [thereby] improve their health” (Nutbeam, 1985) 7

8. Definitions of health promotion (cont.)
“the maintenance and enhancement of existing levels of health through the implementation of effective programs, services, and policies” (Goodstadt, et al.,1987)
“the advancement of wellbeing and the avoidance of health risks by achieving optimal levels of the behavioral, societal, environmental and biomedicial determinants of health” (Kar, 1987) 8

9. Cont…
Optimal health is defined as a balance of physical, emotional, social, spiritual, and intellectual health.  Lifestyle change can be facilitated through a combination of efforts to enhance awareness, change behavior and create environments that support good health practices.  Of the three, supportive environments will probably have the greatest impact in producing lasting change".  (American Journal of Health Promotion, 1989,3,3,5)

10. Health Promotion
Process enabling individually acollectivelly increase control over determinants of their health, and improve health status. (WHO, 1998)
It does not mean only responsibility of the health care system, but also individual responsibility for health expressed via life style. (Kebza, 2005)

11. Principles of Health Promotion
Involves population as a whole
Acts on the determinants of health
Combines diverse approaches
Aims at public participation
Health professionals have enabling role 11

12. Concerns of health promotion
Health education programmes - to raise awareness of health risk and to encourage behaviour change
Primary health education - to prevent ill health developing (e.g. diet, hygiene, social skills, etc)

13. Concerns of health promotion
Preventive health services - e.g. family planning, immunisation and well person clinics
Community-based work - local communities identify health problems and address them
Healthy public policies - housing, employment, transport, etc

14. Concerns of health promotion
Environmental health issues - making the physical environment safer - e.g. tackling pollution.
Economic and regulatory activities - e.g. trying to get the government to raise tax on tobacco, etc

15. Health Promotion Values
Empowerment
Participation
Social Justice/Equity
Respect
Priority to common good
Choice
Positive health 15

16. Components of Health Promotion
Health protection implemented by public health policy
Health education
Intervention programmes

17. BASIC CHARACTERISTICS OF HEALTH PROMOTION
Enabling people to take control over, and responsibility for, their health as an important component of everyday life.
Requiring the close cooperation of sectors beyond the health services.
Combining diverse, but complimentary, methods or approaches.
Encouraging effective and concrete public participation.
Media, newspapers, for a
Participation from day 1 17

18. THE TRIAD OF HEALTH PROMOTION
HEALTH EDUCATION
HEALTH PROTECTION
DISEASE PREVENTION
Define
Which is more difficult 18

19. The Health Promotion Triad
Health Education
Health Protection
Prevention

20. Health Promotion Programs – Priorities
Life style
Nutrition
Physical activity
Tobacco
Alcohol
Accidents
HIV/AIDS
Noncommunicable diseases (NCD)
Prevention of CVD
Prevention of cancer diseases
Prevention of metabolic diseases (obesity, diabetes)

21. Health Promotion includes …
Promoting healthy lifestyles.
Getting people involved in their own health care.
Creating an environment that makes it possible to live a healthy life.
Recognition of lifestyle diseases as major causes of illness and death.
Strengthening community participation.

22. The Phases of Prevention in relation to natural history of disease
Primary
Prevention
Secondary
Prevention
Tertiary
Prevention
Cure
Chronic
disease
Healthy
individual
Biological
onset of
disease
Clinical
Course of
disease
Disability
Death
Functional
Status
Risk
Factors
Asymptomatic
signs
Symptoms and
signs
Predisposition/susceptibility
Preclinical/presymptomatic
Clinical/symptomatic
Outcome- cure, permanent/temporary-partial disability/death
Rehabilitation
Support
Immunization Health Education
Prophylaxis
Screening
Surveillance
Diagnosis
Treatment
Compliance
Adherence
The Phases of Prevention in relation to
natural history of disease 22

23. Examples of preventable health problems related to lifestyle
Chronic non-communicable diseases such as diabetes and hypertension. These are major causes of illness and death. They are related to…
Overweight and obesity.
Unhealthy diet.
Insufficient physical activity.
HIV/AIDS is related to unsafe sexual lifestyle, and causes many deaths.

24. - Action taken to avert the occurrence of disease
PRIMARY PREVENTION
- Action taken to avert the
occurrence of disease
Interventions:
o Medical
o Legislative
o Societal
o Educational
o Individual efforts
Nip in the bud 24

25. PRIMARY PREVENTION
- The more directly a behavior is
linked to a health problem as a
risk factor, the better
candidate it is for primary
prevention efforts

26. SECONDARY PREVENTION
Action taken to identify
diseases at their earliest stages
and to apply appropriate
treatments to limit their
consequences and severity.

27. TERTIARY PREVENTION
Specific interventions to assist
diseased or disabled persons in
limiting the effects of their
diseases or disabilities; also may
include activities to prevent
recurrences of a disease.

28. HEALTH EDUCATION
Planned process,
Combines a variety of educational
experiences, and
Facilitates voluntary adaptations
or establishment of behaviour
conducive to health

29. HEALTH EDUCATION
Aims primarily at the voluntary
actions people can take on their
own part, individually or
collectively, for their own health
or the health of others and the
common good of the community

30. Learning Domains Health Education Cognitive Psychomotor Affective
Each learning domains are related and cannot be separated from one another.
Example: Management of Diarrhea
Cognitive: Acquired due lack of proper sanitation, causes dehydration
Psychomotor: fluid and salt replacement
Affective: hand washing 30

31. Cognitive Domain
Aspect of health education that comprises information and knowledge
Information gained from health education can be
A new information
A reinforcement

32. Psychomotor Domain
Aspect of health education that deals with skill acquisition and reinforcement

33. Affective Domain
Aspect of health education that is mainly concerned in
Habit formation
Behavior change
New practice

34. THREE MAIN PURPOSES OF HEALTH PROMOTION/EDUCATION IN TERMS APPLICABLE TO THE THREE LEVELS OF PREVENTION
Promotion of health and illness
prevention
Restoration of health when one
becomes ill
Maintenance of health while
coping with chronic, long-term
conditions

35. Intersectoral approach
Health Promotion brings together many sectors to work towards the achievement and maintenance of health and wellness.
The Health sector alone cannot achieve a healthy society.
All sectors, both government and non-government, need to work together.
Health Promotion can provide the link between the various sectors.
Within Health the various disciplines also need to work together towards wellness.

36. Some non-health sectors with an input into Health Promotion…
Education/ schools
Agriculture
Community Services
Sport
Media
Non-Governmental Organizations (NGO’s)
Community groups
Youth
Private sector

37. Health sectors with an input into Health Promotion
Environmental Health
Nutrition
Community nursing
Mental Health
Dental
Epidemiology
Hospital (secondary) care
School of Nursing
Occupational therapy

38. Formulating healthy public policy
Promotes healthy policies in all sectors , eg healthy workplaces, schools, homes, buildings, villages and communities.
Health aspect should be thought of and included in the policies of the various sectors.
Health Policies should also emphasize the prevention and promotion.

39. Reorienting health services
Since lifestyle is linked to many of today’s health problems, prevention and promotion should decrease the burden on secondary (curative) health care.
Greater emphasis and resources placed on health promotion and primary health care.
Less emphasis on purchase of high tech equipment for secondary health care.
Equity in health care.

40. Empowering communities to achieve well-being
Involvement of the community in health decisions, a multisectoral and participatory approach.
Provide communities with the information and tools to take actions to improve health and well-being.

41. Creating supportive environments
Healthy physical, social and economic environment.
All development activities should aim for a healthy environment – healthy buildings, roads, workplaces, homes, surroundings and schools.

42. Developing /increasing personal health skills
Information and education for personal and family health.
Take account of values, beliefs and customs of the community.
Continuous process at all stages of life.
Guided and supported in developing skills (not imposed on them).
Build on existing knowledge and attitudes.

43. Building alliances with special emphasis on the media
Media key players, influence on health of people.
Partnership with media ensures their collaboration and that correct information is passed on.
Free flow of information both ways, on matters vital to health.

44. CHN roles
The role of nurses has included clinical nursing practices, consultation, follow-up treatment, patient education and illness prevention. This has improved the availability of health-care services, reduced symptoms of chronic diseases, increased cost-effectiveness and enhanced customers' experiences of health-care services.

45. Cont….
Health promotion by nurses can lead to many positive health outcomes including adherence, quality of life, patients' knowledge of their illness and self-management

46. THANK YOU VERY MUCH