1. ECOSOC Annual Ministerial Review Regional Ministerial Meeting for Asia and the Pacific Promoting Health Literacy, Promoting Multisectoral Actions Dr Fiona Adshead Director, Chronic Diseases and Health Promotion World Health Organization 29-30 April 2009 Beijing, China

2. ECOSOC Annual Ministerial Review Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009 2 |2 | Health literacy: a whole of society approach Health literacy involves: –People using information at key decision points, delivered through different media, –An enabling environment promoting healthy choices, –Cross-sectoral, whole-of-society action, –Empowering people to make healthy choices.

3. ECOSOC Annual Ministerial Review Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009 3 |3 | MULTISTAKEHOLDER, CROSS-SECTORAL APPROACH Government – civil society – private sector – media BEHAVIOUR CHANGE ENABLINGENVIRONMENT HEALTH LITERACY Empowerment HEALTHOUTCOME Access to information, knowledge reinforcement, and opportunity to act Feedback and policy change GOVERNMENT leadership

4. ECOSOC Annual Ministerial Review Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009 4 |4 | Multisectoral action: enabling breastfeeding in the workplace Enabling workplace conditions for breastfeeding are important for the health of mother and child. The ILO Maternity Protection Convention 183 (2000) provides for 14 weeks paid maternity leave and paid breastfeeding breaks. The Philippines example of multisectoral action: –Key stakeholders involved: Department of Labour and Employment and DoH Trade Union Congress of the Philippines (TUCP) Employers Confederation of the Philippines (ECOP) NGOs WHO support –Benefits health benefits for mother and child, lower cost of infant feeding, improved bonding, lower absenteeism and higher productivity, enhancement of employer–employee relationship.

5. ECOSOC Annual Ministerial Review Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009 5 |5 | Counseling (health literacy) empowers mothers to practice exclusive breastfeeding All differences between intervention and control groups are significant at p<0.001. Source: CAH/WHO. Age: 5 months (Haider) 3 months ( Albernaz) 3 months ( Morrow) 2 weeks after diarrhoea (Haider)

6. ECOSOC Annual Ministerial Review Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009 6 |6 | Reducing salt consumption: a health literacy approach Government role: –Leadership across society, –Creating enabling environments, –Building capacity in consumers, –Working in partnership with industry and NGOs, –Measuring outcomes and ensuring it works.

7. ECOSOC Annual Ministerial Review Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009 7 |7 | The UK health literacy journey on salt

8. ECOSOC Annual Ministerial Review Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009 8 |8 | The Value of Partnerships Project Neptune REGIONAL NETWORKS European Salt Action Network PAHO Observatory on Chronic Noncommunicable Disease Policies

9. ECOSOC Annual Ministerial Review Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009 9 |9 | Successful Intervention programs NaCl g/d Salt intake in Finland 1977-2007 Source: National Public Health Institute, Helsinki, Finland

10. ECOSOC Annual Ministerial Review Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009 10 | Empowered Citizen Health Literacy Health Promotion Self care Chronic disease self-management Patient and citizen involvement The Self Care Circle © Harry Cayton Health literacy and self care: co-producing health in chronic disease Self care: A great example of partnership between public and health service. $100 spent on self care = $150 worth of benefits delivered in return. A sense of control over one's destiny = PRICELESS.

11. ECOSOC Annual Ministerial Review Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009 11 | Health literacy: at the centre of public health delivery Improving people's health literacy capability needs to be coupled with a cross-sectoral, multistakeholder approach, creating enabling environments. Examples of breastfeeding and reduction in salt consumption shows that it can work. The lessons learned can be applied to broader public health delivery including achievement of the MDGs.