To Effectively Utilize Health Promotion For Disease Prevention;
Multi-sectoral Stakeholders Approach is Key
The ability of Sierra Leone to defeat Ebola and sustain a resilient Ebola free in 2015 was widely commendable. This laudable achievement could not have been possible without the aggressive and well-coordinated use of Health Promotion through Social Mobilization, Community Engagements and the media during and after the Ebola epidemic. The aftermath of the Ebola surge precipitated the need for Health Promotion/Health Education and Social Mobilization for disease prevention to be on top of the health agenda, which seems to be an illusion, not to talk of a dream. (Photo: Ibrahim Sorie Koroma, author)
However, the Health Education Division which is a support programme to all the technical programmes and units in the Ministry of Health and Sanitation is constraint with multisectoral and public private partnership to have a comprehensive national approach of actualizing a positive healthy outcomes and the undeniable fact is health promotion goes beyond the health sector itself.
Health promotion is more relevant today than ever in addressing public health problems. The health scenario is positioned at unique crossroads as the world is facing a ‘triple burden of diseases’ constituted by the unfinished agenda of communicable diseases, newly emerging and re-emerging diseases as well as the unprecedented rise of non-communicable chronic diseases. The factors which aid progress and development in today’s world such as globalization of trade, urbanization, ease of global travel, advanced technologies and more act as a double-edged sword as they lead to positive health outcomes on one hand and increase the vulnerability to poor health on the other hand as these contribute to sedentary lifestyles and unhealthy dietary patterns.
There is a high prevalence of tobacco use along with increase in unhealthy dietary practices and decrease in physical activity contributing to increase in biological risk factors which in turn leads to increase in non-communicable diseases in the world, Sierra Leone to be specific. This is the more reason a strong multisectoral partnership is needed to address the burning issues of tobacco and alcohol regulation in the country. They are two of the most lucrative industries in the country and the world over. So, regulating the sale and advertising of tobacco and alcohol products in the country goes beyond the Ministry of Health and Sanitation
Health education and health promotion are two terms which are sometimes used interchangeably. Even, health professionals often consider Health Promotion and Health Education as one and the same. Health Education is about providing health information and knowledge to individuals and communities and providing skills to enable individuals to adopt healthy behaviors voluntarily. It is a combination of learning experiences designed to help individuals and communities improve their health, by increasing their knowledge or influencing their attitudes, whereas Health Promotion takes a more comprehensive approach to promoting health by involving various players and focusing on multisectoral approaches. Health promotion has a much broader perspective and it is tuned to respond to developments which have a direct or indirect bearing on health such as inequities, changes in the patterns of consumption, environments, cultural beliefs, etc.
The rowing expectations in public health around the world led the World Health Organization (WHO) to organize the Otawa international conference on Health Promotion in Canada in 1986. This conference produced not only the “Ottawa Charter for Health Promotion” but also served as the conduit for subsequent international conferences on Health Promotion. The Ottawa Charter defined Health Promotion as the process of enabling people to increase control over and 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. Health is, therefore, seen as a resource for everyday life, not the objective of living.
The fundamental conditions and resources for health are: peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice and equity. Health promotion thus is not just the responsibility of the health sector, but goes beyond healthy lifestyles to well being.
The Charter calls for advocacy for health actions for bringing about favorable political, economic, social, cultural, environmental, behavioral and biological factors for health; thereby enabling people to take control of the factors influencing their health and mediation for multi sectoral action.
The Charter also defined Health Promotion action as one, which builds up healthy public policy that combines diverse but complementary approaches including legislation, fiscal measures, taxation and organizational change to build policies which foster equity, create supportive environments, support community action through empowerment of communities; their ownership and control of their own endeavors and destinies, develop personal skills by providing information, education for health, and enhancing life skills and reorienting health services towards health promotion from just providing clinical and curative services.
This benchmark conference led to a series of conferences on health promotion, notable Adelaide (1988), Sundsvall (1991), Jakarta (1997), Mexico-City (2000), Bangkok (2005) and Nairobi (2009). In Adelaide, the member states acknowledged that government sectors such as agriculture, trade, education, industry and communication had to consider health as an essential factor when formulating healthy public policy.
The Sundsvall statement highlighted that poverty and deprivation affecting millions of people who were living in extremely degraded environment prone to deplorable ill health conditions. In Jakarta too poverty, low status of women, civil and domestic violence were listed as the major threats to health.
The Mexico statement called upon the international community to address the social determinants of health to facilitate achievement of health-related millennium development goals. The Bangkok charter identified four commitments to make health promotion (a) central to the global development agenda; (b) a core responsibility for all governments (c) a key focus of communities and civil society; and (d) a requirement for good corporate practice. The last conference in October 2009 in Nairobi called for urgent need to strengthen leadership and workforce, mainstream health promotion, empower communities and individuals, enhance participatory processes and build and apply knowledge for health promotion.
Finally, one would see that from the Otawa Charter on to the Nairobi conference call for multisectoral stakeholders approach, where government ministries, public and private sector institutions, civil society, the media, Religious bodies, traditional leaders and community structures is pivotal in actualizing improved wellbeing. Wellbeing are determined by many factors outside the health system which include socioeconomic conditions, patterns of consumption associated with food and communication, demographic patterns, learning environments, family patterns, the cultural and social fabric of societies; sociopolitical and economic changes, including commercialization, trade and global environmental change.
In situation like that, health issues can be effectively addressed by adopting a holistic approach by empowering individuals and communities to take action for their health, fostering leadership for public health, promoting intersectoral / multi sectoral action to build healthy public policies in all sectors and creating sustainable health systems.
This writer firmly agrees that, Health Promotion through the effective use of awareness raising and information dissemination for a specific disease prevention backed with actions from individuals, communities with strong multi sectoral partnership can lead to improved health thereby reducing the high indices of maternal and child deaths in Sierra Leone.
It is also note worthy that Health Promotion does not occur in vacuum/ isolation; it takes place in an enabling environment. First, the right structures for health promotion to take place in schools, hospitals, workplaces, residential areas etc. should be put in place. For instance, health promotion targeting school going pupils will not complete without partnering with the Ministry of Education and other institutions and agencies working on child education. Similarly, health promotion on hand washing in schools cannot complete without providing hand washing materials like veronica bucket and soap. So, so it takes strong partnership for health promotion to be achieved.
It is obvious that the Ministry of Health and Sanitation and the Ministry of Education Science and Technology cannot at all times be able to provide the required materials in schools for proper hand washing for disease prevention; his is where strong Public-Private Partnership comes. The enjoyment of the highest attainable standard of health is considered as one of the fundamental rights of every human being.
With that being said, it is now ripe to state that, Health Promotion is pivotal in disease prevention to enhance improved health. So, we are calling for both human and financial investment in Health Promotion not only to create demand but to enable people/communities and institutions to take actions for their own health; there by changing behaviours to prevent diseases and ill health conditions. Health Promotion is not only a Ministry of Health Affair. It takes all of us to effectively utilize Health Promotion to ensure disease prevention for improved health on Environmental Sanitation, Maternal and Child Health, Animal Health, Social Health Related Issues, Malaria, HIV/AIDS, TB, Mental Health, Child Education, Teenage Pregnancy to name but a few.
By Ibrahim Sorie Koroma, Health Education Officer-HED/MoHS
About the Author:
Ibrahim Sorie Koroma is a graduate in Mass Communication and works with the Health Education Division, Ministry of Health and Sanitation, New England Ville, Central Medical Stores, Freetown.
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