1. Viseisei Sai Health Centre
Akesa Funaki
S100052
15th May, 2015.

2. Content Page Alma Atta Charter Ottawa Charter for Health Promotion
Sundsvall Statement
Jakarta Declaration
Bangkok Charter for Health Promotion
Healthy Islands Declaration
Rarotonga Review

3. Alma Atta It was the capital of Kazakhstan. Who ? WHO and UNICEF
First International Conference on Primary Health Care.
Why ? expressing the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world.
When? 12th September 1978.
What ? 10 Declarations

4. Health
A state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity
Fundamental human right
Attainment of the highest possible level of health is a world-wide social goal
requires the action of many other social and economic sectors in addition to the health sector.

5. II
The existing gross inequality in the health status of the people particularly between developed and developing countries as well as within countries is politically, socially and economically unacceptable and is a common concern to all countries.
III
reduction of the gap between the health status of the developing and developed countries.
promotion and protection of the health of the people
is essential to sustained economic and social development
contributes to a better quality of life and to world peace. IV
The people have the right and duty to participate individually and collectively in the planning and implementation of their health care

6. V
A main social target by the year 2000 of a level of health that will permit them to lead a socially and economically productive life. Primary health care is the key to attaining this target as part of development in the spirit of social justice.

7. VI Primary health care first level of contact of individuals.
essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self reliance and self-determination.
essential health care based on practical, scientifically sound and
socially acceptable methods and technology made universally accessible to individuals
and families in the community through their full participation and at a cost that the
community and country can afford to maintain at every stage of their development in the
spirit of selfreliance and self-determination.

8. Components of PHC
reflects and evolves from the economic conditions and sociocultural and political characteristics of the country
addresses health problems, provides promotive, preventive, curative and rehabilitative services accordingly
includes:
education and the methods of preventing and controlling them
promotion of food and proper nutrition
adequate supply of safe water and basic sanitation
maternal and child health care FP
Immunization
prevention and control of locally endemic disease
appropriate treatment of common diseases and injuries
provision of essential drugs;
in addition to the health sector, all related sectors and aspects of national and community development
requires and promotes maximum community and individual self-reliance and participation in the planning, organization, operation and control of primary health care
relies, at local and referral levels, on health workers, including physicians, nurses, midwives, auxiliaries and community workers as applicable, as well as traditional practitioners as needed,

9. VIII
All governments should formulate national policies, strategies and plans of action to launch and sustain primary health care as part of a comprehensive national health system and in coordination with other sectors. IX
All countries should cooperate in a spirit of partnership and service to ensure primary health care for all people since the attainment of health by people in any one country directly concerns and benefits every other country.

10. X
An acceptable level of health for all the people of the world by the year 2000 can be attained through a fuller and better use of the world's resources.

11. Selective Primary Health Care
PHC was too idealistic, expensive and unachievable in its goals of achieving total population coverage.
Cheap form of health care
Civil war
natural disasters
HIV affected the ability of PHC to maintain comprehensive services, especially in many sub-Saharan countries.

12. Case Study Location: Gambia, in west Africa.
By: United Kingdom Medical Research Council
Period:
Population: 40 villages
Comparison: compared infant and child mortality between villages with and without PHC.
Extra services to the PHC villages
Community Health Nurse for about every five villages
Village Health Worker
Trained Traditional Birth Attendant.
Maternal and child health services with a vaccination program were accessible to residents in both PHC and non-PHC villages.
There were marked improvements in infant and child (<5 years) mortality in both PHC and non-PHC villages.

13. Results After the establishment of PHC in 1983: 1982–1983: 134/1000
1992–1994 : 69/1000
NON- PHC
155/1000 to 91/1000.
The change in death rates for children aged 1–4 years between the two groups was not as marked.
Supervision of the PHC system weakened after 1994
infant mortality rates in the PHC villages rose to
89/1000 in 1994–1996.
Non-PHC villages fell to 78/1000.
Conclusion:
Mortality rates rose significantly when PHC services were weakened.

14. Ottawa Charter
Ottawa is the capital of Canada. The name "Ottawa" is derived from the Algonquin Odawa, meaning "to trade".

15. First International Conference on Health Promotion, Ottawa, 21 November 1986 .
This conference was primarily a response to growing expectations for a new public health movement around the world.
To achieve Health for All by the year 2000 and beyond.

16. Health Promotion Process of enabling people to :
increase control over,
to improve,
Their health to reach a state of complete physical,
mental and social well-being.
An individual or group must be able to identify
and to realize aspirations, to satisfy needs, and to
change or cope with the environment.

17. Health is seen as a resource for everyday life not the objective of living.
Health is a positive concept emphasizing social and personal resources, as well as physical capacities.
Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being.

18. Prerequisites for Health
The fundamental conditions and resources for health
are:
peace,
shelter,
education,
food,
income,
a stable eco-system,
sustainable resources,
social justice, and equity.
Improvement in health requires a secure foundation in these
basic prerequisites

19. 5 Action Plan Build Healthy Public Policy
Create Supportive Environments
Develop Personal Skills
Strengthen Community Actions
Reorient Health Services

20. Build Healthy Public Policy
Health promotion goes beyond health care. 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.
Create Supportive Environments Our societies are complex and interrelated. The overall guiding principle for the world, nations, regions and communities alike, is the need to encourage reciprocal maintenance - to take care of each other, our communities and our natural environment.

21. Strengthen Community Actions
Health promotion works through concrete and effective
community action in setting priorities, making decisions,
planning strategies and implementing them to achieve better
health. At the heart of this process is the empowerment of
communities - their ownership and control of their own
endeavours and destinies.
Develop Personal Skills
Health promotion supports personal and social development
through providing information, education for health, and
enhancing life skills. By so doing, it increases the options
available to people to exercise more control over their own
health and over their environments, and to make choices
conducive to health.

22. Reorient Health Services
The responsibility for 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.

23. Adelaide Recommendations on Healthy Public Policy
Second International Conference on Health Promotion.
Location: Adelaide, South Australia, 5-9 April 1988.
Participants: Two hundred and twenty participants from forty-two countries shared experiences in formulating and implementing healthy public policy.
Healthy Public Policy
Healthy public policy is characterized by an explicit concern for health and
equity in all areas of policy and by an accountability for health impact

24. 4 Key Areas Supporting the health of women Food and Nutrition
Tobacco and Alcohol
Creating Supporting Environment

25. Sundsvall Statement on Supportive Environments for Health
Third International Conference on Health Promotion.
Location: Sundsvall, Sweden.
When: June 1991.
Participants: 81 countries
Calls upon people in all parts of the world to actively engage in making environments more supportive to health.

26. The way forward lies in making the environment
Conference points people living in extreme poverty and
deprivation live in an increasingly degraded environment
that threatens their health.
The way forward lies in making the environment
- the physical environment
- the social
- economic environment
- the political environment
Supportive to health rather than damaging to it.

27. Proposals for Action
1. Equity must be a basic priority in creating supportive environments for health, releasing energy and creative power by including all human beings in this unique endeavour. 2. Public action for supportive environments for health must recognize the interdependence of all living beings, and must manage all natural resources, taking into account the needs of future generations.

28. 1. Strengthening advocacy through community action
2. Enabling communities and individuals to take control over their health .
3. Building alliances for health and supportive environments in order to strengthen the cooperation between health and environmental campaigns and strategies.
4. Mediating between conflicting interests in society in order to ensure equitable access to supportive environments for health

29. Jakarta Declaration on Leading Health Promotion into the 21st Century
Fourth International Conference on Health Promotion: New Players for a New Era - Leading Health Promotion into the 21st Century. Location: Jakarta On: 21 to 25 July 1997
First to be held in a developing country

30. Priorities for health promotion in the 21st Century
1. Promote social responsibility for health 2. Increase investments for health development 3. Consolidate and expand partnerships for health. 4. Increase community capacity and empower the individual 5. Secure an infrastructure for health promotion

31. The Bangkok Charter for Health Promotion in a Globalized World On: 7-11 August Purpose The Bangkok Charter affirms that policies and partnerships to empower communities, and to improve health and health equality, should be at the centre of global and national development.

32. Addressing the determinants of health
Changing context since the Ottawa charter.
Critical factors
increasing inequalities within and between countries
new patterns of consumption and communication
commercialization
global environmental change
urbanisation.

33. Four key commitments For the Promotion of Health
1. central to the global development agenda
a core responsibility for all of government
a key focus of communities and civil society
4. a requirement for good corporate practice

34. Global Pledge to Make it happen
All for health
Closing the implementation gap
Call for action
Worldwide partnership
Commitment to improve health

35. PROMOTING HEALTHY SETTING
Yanuca Declaration
1995 – 2015
Healthy islands should be places where:
children are nurtured in body and mind;
environments invite learning and leisure;
people work and age with dignity;
ecological balance is a source of pride.

36. The Healthy Islands concept involves continuously:
identifying and
resolving priority issues related to health and
well-being
by advocating,
facilitating and enabling these issues to be addressed in partnerships among communities, organizations and agencies at local, national and regional levels.’

37. References WHO, Milestone in Health Promotion.
WHO, Yanuca Island Declaration.
The Ottawa and Bangkok Charters: from principles to action", SIASS, Firenze,