Health Promotion for Early Years Practitioners - Essay Example

? Health Promotion for Early Years Practitioners Concept and definition of heath, & health promotion: Health is a general of well being in a human being, and indicates a condition of being free from any injury of the mind and body, and is achieved as a sum total of the physical, mental and social wellbeing of a person. The first comprehensive definition for health was given by WHO in its Constitution in 1948 where in it stated that health is “A state of complete physical, social and mental well-being and not merely the absence of disease or infirmity”. Later in the Ottawa Charter (1986), it further expanded the scope of the term health, and added that, “Health is a resource for everyday life, not the object of living...It is a positive concept emphasizing social and personal resources as well as physical capabilities (Health Promotion glossary, WHO, 1998). In the 1948 Constitution, WHO further declares that enjoying good health is the basic fundamental right of an individual, and the state must necessarily take measures to fulfil its obligation to this end. In context to child health WHO points out that “Healthy development of the child is of basic importance”, as good health during the formative years forms the foundation for a healthy adulthood. The state must make available to all its citizens the basic resources for medical, psychological well being and all relevant information that aims to achieve good health; and here there must not be any distinctions, based on “race, religion, political belief, economic, or social condition.” However in this context it must be mentioned that health is not only an obligation solely on the state; but there must also be an active cooperation and informed opinion based feedback from the general public that would help the state to function even more effectively. “Health promotion is the process of enabling people to increase control over, and to improve their health” (Health Promotion glossary, WHO, 1998). Health promotion is an ongoing process that reflects the social and political conditions pertinent to health conditions within a country. Promotions are not only aimed at improving individual health but are directed towards transforming the entire social-economic and the physical environmental conditions, so that is an overall improvement in the life qualities of the society as a whole. There are various socioeconomic factors of health, based on the economic and social conditions of different countries. WHO delineates the general factors that are necessary for achieving good health and these are: sufficient economic resources, adequate food and shelter, stable eco-system, sustainable natural resources and their appropriate use., and in the process highlights the important yet complex links that exist between an individual’s socio-economic conditions, his physical environment, his lifestyle, and his health. A UK team of researchers identified the socioeconomic factors of health as: social/class gradient, social support, social exclusion, early life, work, joblessness, stress, food, transport, and addiction (Marmot and Wilkinson, 2005). On the other hand, we find that the US Centers for Disease Control and Prevention identifies socioeconomic factors of health as, social status, housing, transport, easy access to various services, bias on the basis of gender/ race/ or social standing, and various stressors (environmental or social) (Centers for Disease Control and Prevention, 2010). Models and approaches to health promotion: There are various models and approaches to the health promotion plans seen in different countries worldwide. Such variations are owing to the varying socioeconomic factors that are seen worldwide that makes it necessary for each country to adopt a health promotion plan that is made suitable for its social, cultural and economic conditions. In this context we will examine some of the well known approaches to health promotions, commonly seen in practice worldwide. In the Ottawa Charter WHO identifies three basic approaches for creating a health promotion package. These are: advocacy or creating widespread awareness, so that it is possible to remove the harmful factors of health, and create more heath positive conditions; enabling all individuals (including children, as per this topic) within a state to achieve their optimum health levels, by giving full access to the basic facilities needed to improve health, irrespective of caste, creed, religion, or sex; and mediating between the conflicting interests (government, media, health/ social/ and economic sectors, NGOs, voluntary organisations, local authorities, communities, families, and individuals) within a society, in order to achieve good health for all individuals. There are 5 priority action areas to support these approaches which are: Build healthy public policy- here WHO takes the concept of health promotion beyond the narrow concept of health-care, and brings the issue into the agenda of all “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 for health, which is to create an overall structure that would take care of the entire nation as a whole, while also working towards alleviating the life quality and pattern of living, of all individuals. Strengthen community action for health. Health promotion plans work best when a whole community gets its act and resources together to make the plan self sustaining for a long time period. Develop personal skills of each individual, and make him capable to deal with all kinds of health crises, and Re-orient health services to achieve more effective results (Ottawa Charter for Health Promotion, 2-3). Thus WHO gives an approach that takes an overall view of a health programme and also takes into consideration all the possible factors necessary to make a health programme successful. Keeping this basic concept in, mind we will now examine the various child programme frameworks that can be used, especially in the UK context. Fig 1: A holistic Bio-psycho-social framework. In this framework, a child’s (0-8 years) growth and development (that is overall health), is considered with a holistic approach, which takes into consideration various factors of health like social, psychological, and economic, and also includes various harmful factors too like, malnutrition, injuries, or illness. Other threats are also taken into context like economic recession, or increased levels of violence in the society. Here the chid and his parents are kept at the core, and the framework is built around it. So health promotion programmes should be aimed at not only caring for the child but also the caregivers, and must be so created that the health protective forces outdo the harmful factors. (Source: Blair, 2009, 5). Fig 2: The pyramid approach of need. “This is used in many circumstances such as the child health promotion programme, child mental health services, tiered levels of service, speech and language therapy, social services and education, e.g. action plus, statement of special educational needs etc.” this framework is useful when one is trying to analyse the various levels of support a family may require in order have healthy child. Most of the present UK health social services tend to focus more on the pyramid top, as this part requires the maximum skill and specialized interventions. However if the government makes the universal health services stronger, with greater support from other organisations, there may be no need to move into the higher levels of the pyramid. Owing to various factors, UK does have a large number of vulnerable children which makes it imperative for the government to have a health promotion approach that is both universal and targeted in nature (source: ibid). The religious and cultural beliefs of UK children need to be taken into consideration when planning health promotion: The twenty-first century is a globalised world, and UK like any other modern industrialised country of the world, has families from almost all parts of the world residing within its borders. Thus it is imperative that the government develops a health promotion plan that takes into account the varying religious and cultural traditions of UK children while planning for a health promotion. To bring about uniformity in health programmes (5 A- Day, safety) one will have to take into consideration certain factors: Language barrier factor: One of the strongest barriers in accessing complete health-care programmes for a child, are the lack of an effective communication. This owes to the language mismatch between the provider and the receiver. Many families do not speak or comprehend the English language very well, in such cases the government will have to arrange for other language services, especially for the community groups that have a large presence within UK. Health Systems Factors: an important measure to remove barriers at this end would be to make available for the health-care providers, various trainings for cultural competency, which may help to improve the quality of primary care for minority children. It would also be beneficial, if the health programme allows for an ‘open access’ to the parents of the minority children (fixing appointments for health checkups for such children whenever their parents find time). It has been observed that parents’ perspectives on some areas of the health of their children vary on basis of their cultural upbringing, and while planning health programmes, one will have to take into account these factors. Health programmes must also take into account various health financing (health savings accounts) for culturally deviant children, in order to promote their overall well being. Cultural Factors: Cultural factors also tend to affect the health programme results. experience. “For example, Asian Americans have higher expectations for receiving timely care and as a consequence may perceive this aspect of care more negatively. [one can assist by] incorporating elements of cultural competency—such as provider knowledge of the health belief of different ethnicities—into the delivery of primary care will significantly reduce racial and ethnic health disparities” (Bergman, Plsek, and Saunders, 2006, 10). Often food guides seen in such health programmes have a very general approach. A look at the health programme 5-a day, at the section “5 a day and yr family,” where a dietician Govindji advises on eating 5 types vegetables and fruits in a day. The advice given is detailed, but extremely generalised, to more or less suit all families. Here one has to keep in mind the varying religious and cultural traditions that have certain dietary restrictions, like some religious group may not eat meat, while some groups may eat only one particular type of meat some at vegetarian but will eat eggs, etc. Since it is almost impossible to keep all minority groups in focus, the government must try to at least include dietary habits of the groups that have a major presence in UK, while also creating an ‘open access’ for the ready availability of health facilities, as already mentioned. “It is important that early years workers discuss the dietary needs of the child with the parent(s) as some children may have medical conditions that might affect their diet, others may have dietary restrictions due to religious or cultural beliefs”(Scottish Further Education Unit, 2005, 22). However the 5-a day programme does include a section for the vegan babies, which is a welcome move, since many religious groups tend to be vegetarian in their dietary habits. In contrast the safety programme is a much generalised health programme, without much specific details on the proper growth and development of a child. A health programme for children within the age group of 0-8 years must necessarily take into account the basic needs for the healthy development of a child, like physical needs, cognitive needs, social needs and emotional needs. All these needs are very dependent on the cultural and religious practices of his parents, and a holistic child care programme must take this into account. The 5 A-day and also Health and Safety, both the public health programmes give a much generalised view on these areas, without taking into account some of the conservative societies that exist in large numbers within UK. These aspects are extremely sensitive areas, and the government will have to tread very cautiously, so that the boundaries can slowly break and the child is allowed access an overall development programme. Conclusion: Both the public programmes 5 A-day and especially the Health and Safety, have a much generalised approach to the heath and development of a child. For holistic development of a child, one must necessarily take into account the various religious and cultural groups that reside without our society. The government cannot be complacent and present a general perspective on this important issue of child development. A child happens to be our future, so investing in a complete child care is actually investing in our own future, and the government must walk that extra mile to integrate all the diverse cultural and religious groups that have become an integral part of UK’s society. Bibliography Bergman, D., Plsek, P., and Saunders, M. 2006. A High-Performing System for Well- Child Care: A Vision for the Future, 10. Retrieved from, http://www.commonwealthfund.org/usr_doc/Bergman_high-performsyswell-childcare_959.pdf. Blair, M. 2009. Optimising Health in the Early Years. British Association of Community Child Health (BACCH); Child Public Health Interest Group (CPHIG); Community Practitioners and Health Visitors Association (CPHVA); Early Childhood Forum, National Children’s Bureau, London. Retrieved from,  http://www.bacch.org.uk/publications/documents/HealthandEarlyyearsUK.pdf. Centers for Disease Control and Prevention. (2010). Social Determinants of Health. Retrieved from, http://www.cdc.gov/socialdeterminants/docs/SDH-White-Paper-2010.pdf Constitution of the World Health Organization. October 2006. Basic Documents, Forty- fifth edition, Supplement, 1. Retrieved from,  http://www.who.int/governance/eb/who_constitution_en.pdf. Health Promotion Glossary, WHO. 1998. Section 1: list of basic terms, 1. Retrieved from, http://www.who.int/hpr/NPH/docs/hp_glossary_en.pdf  Marmot, M., and Wilkinson, R. (Eds.). 2005. Social Determinants of Health, (2nd ed.). Oxford, UK: Oxford University Press, 224-237. Ottawa Charter for Health Promotion, First International Conference on Health Promotion.1986. Retrieved from,  http://www.who.int/hpr/NPH/docs/ottawa_charter_hp.pdf. Scottish Further Education Unit, 2005. Holistic Approaches to Child Health. Retrieved from, http://www.scotlandscolleges.ac.uk/component/option,com_docman/Itemid,78/gid,1431/task,doc_download/. 5 A Day. 2011. NHS. Retrieved from, http://www.nhs.uk/livewell/5aday/pages/5adayhome.aspx/ . Read More