Ottawa Charter for Health Promotion - Essay Example

Nursing Ottawa charter for health promotion and health is a process of enabling people to increase control and improve their health Introduction Health promotion is the process that enables people to increase the control of over, and to improve their health (Hanson, 2007). Health promotion enables the people to increase control over the determinants of their health and ultimately improve their health (Laverack, 2007). The health encompasses the physical, social wellbeing and metal state and not absence from infirmity or disease. Dixey (2012) outlines that health promotion concept differs from public health since the later is geared at prevention of diseases and prolonging life. In this case, health promotion encompasses certain principles and values that are geared at ensuring effective, efficient, ethical and sustainable approach to achieving good health for the population. This model originated from World Health Organisation in 1986, but currently addresses emerging health challenges and incorporates the environmental, economic and social determinants of health in the society (Sharma & Romas, 2012). Health promotion gathered momentum in the 1980s and several models were proposed including Tannahill’s model that aim at enhancing the positive health and illness prevention. Tannahill model encompasses several conventional public health domains that include the need to have preventive services, preventive health education, preventive health protection, positive health education that is aimed at ensuring positive health protection. The Primary health care (1978) that adopted Health for all is like the Ottawa Charter and is based on acceptable methods and technology that aims at ensuring health care is universally accessible by families and individuals. The Targets for health for All 2000 (1986) concept of the European region WHO entailed a fundamental reorientation of the health systems in European member states in order to attain four targets that include lifestyles,. Risk factors affecting the environment and health, reorientation of the health care systems and adequate infrastructure to support the above three targets (Raeburn & Rootman, 1998). The European Office of WHO sponsored a series of deliberations that culminated in the Ottawa charter that plays a critical role in health promotion across the globe. The Ottawa Charter entails a salutogenic view that aims at strengthening population’s health potential and good health as a means of having enjoyable and productive life (Raeburn & Rootman, 1998). The principles of health promotion considers population as a whole in the context of everyday life rather than concentrating on the risks that lead to specific diseases and such interventions must be geared at addressing the determinants of health (Hanson, 2007). Another critical underlying principle is the use of diversified and complimentary methods and approaches such as communication, legislation, fiscal policies, community development and education in order to improve capacity of the people to take care and control over their health (Funnell and Koutoukidis, 2008). The approach bestows health care professionals a responsibility of nurturing and promoting health especially the primary health care. The prerequisites for health outlined by the model aim at social democratic principles of equity, justice, and access since they are geared at ensuring peace, education, food, shelter and sustainable resources that contribute to equity and social justice in healthcare. In this case, the health promotion is capable of influencing the underlying economic and social environment that determines health and strengthen the basic capacity and skills of individuals to take control over their health (Hanson, 2007). According to Ottawa Charter, one of the action plan is the build healthy public policy that entrenches health agenda in all governmental areas thus making health choices easy. In this case, there should be health research that will guide the review of standards and laws relating the health matters such as avoidance of toxic emissions and pollution of the environment (Sharma & Romas, 2012). The principles aim at creating supportive environments that ensure the working and living conditions are safe and enjoyable (Better health Channel, 2014). There should be smoke-free environments at both local and state level and parks that resemble enjoyable living in the society. The third action plan is strengthening the community action through enabling the communities to gain control of their activities and initiatives. According to Talbot & Verrinder (2010), the health professionals must have new working of working together with the communities rather than imposing solutions to the people. The next guiding principle is developing personal skills through providing information and education that will enable the people to make healthy choices (Australian Health Promotion Association, 2014). The people must acquire life skills such as healthy eating habits, sustainable economic habits and social support skills that will make life more enjoyable. The next guiding principles is reorienting the health services through ensuring that the responsibility is shared among individuals, medical care professionals, community groups and governments. In this case, health sector must move beyond the conventional clinical and curative practices and move towards preventive focus (Tones and Tilford, 2001). The Ottawa Charter perceives health promotion as a process rather than an end and thus should be done together with the people rather than being imposed on the people. In addition, the process must be directed towards empowering the people and improving their control over the determinants of health (Sharma & Romas, 2012). In this case, the Ottawa Charter has outlined five mechanisms that act as the underlying principles such as need to build healthy public policy, develop personal skills, create supportive environment, strengthen community action and reorient health services. Jakarta Declaration of 1997 aims at enhancing the control of health through partnerships across sectors and implementing multi-sectoral through promoting social responsibility for health, enhancing investments in health, consolidating the partnerships, empowering the communities and building the capacity and securing more infrastructure for the health promotion activities (Sharma & Romas, 2012). Health promotion in the 21st century must be guided by the principle of promoting social responsibility for health since decision-makers must implement policies that avoid harm on the health of the citizens such as ensuring production of safe products and eliminating harmful substances (Hanson, 2007). In addition, the public and private sector must discourage unhealthy product promotion practices and must promote healthy lifestyles such as tobacco avoidance. The health promotion must increase resources for health development including additional resources for the health sector, housing and education so as to attain significant milestones in human development and quality of life. The investments must address the unique needs of certain groups in the society such as indigenous people, elderly, children and marginalised communities (Raeburn & Rootman, 1998). The health promotion activities must consolidate and expand partnerships for health through strengthening the existing partnerships with private sector and non-governmental organisations and going further to expand the scope of such partnerships. The partnerships must be accountable, transparent and must including mutual understanding and sharing of expertise in order to improve the health of the people (Talbot & Verrinder, 2010). MacDonald (2012) asserts that the health promotion principles must increase community capacity and empower the individuals so that individuals and groups can control the determinants of health. In this case, capacity building requires education, training and provision of the necessary resources. The promotion activities must secure an infrastructure that will improve the mechanisms for health funding at the local and national level that will meet the emerging health challenges (O’Hara, Lily, 2007). In this case, attaining complete physical, mental and social wellbeing requires an individual or groups in the society to realise their health aspirations, satisfy their health needs and cope with the changing environment (Talbot & Verrinder, 2010). Health is a everyday life and a positive concept emphasising on the physical, social and personal resources rather than the responsibility of the health care sector since it goes beyond healthy lifestyles to wellbeing (WHO 1986). Contrary to illness prevention that aims at preventing the clients from threats to health, promotion is geared at maintaining the current level of heath, increasing the control over and improving the health of the client (MacDonald, 2012). Numerous health promotion models have been developed to enhance the control and maintain the health of clients that enable nurses to identify the behaviours and beliefs of the clients towards healthcare. According to Tannahill’s model, health promotion entails health prevention, health protection and health education while Beattie’s model advocates for persuasion, counseling, community development and legislative framework (MacDonald, 2012). Ottawa Charter for health promotion (1986) advocates for the need of mediation and enabling the people to gain more control over their lives since good health is the cornerstone of economic, social and personal development and a critical determinant of the quality of life. The Ottawa Charter outlines that actions of health promotion must ensure healthy public policy, create an enabling environment that supports healthy living, strengthen the community action, develop people skills and reorient the health care system (MacDonald, 2012). A key principle of health promotion is enabling equity and reducing differences in health access. In this case, individuals cannot attain fullest health potential unless they are capable of controlling the factors that determine their health and such is expected to apply across gender (Hanson, 2007). Another guiding principle is mediation sine the prospects of health cannot be left to the health sector alone since it is essential to ensure coordinated action by the government agencies, non-profit organisations, media, local authorities and other key economic sectors in the promotion of health (Talbot & Verrinder, 2010). The professionals in health care must mediate between several interest groups in order to adapt the health promotion strategies to the local needs of the society and regions depending on the existing social and cultural systems (MacDonald, 2012). Australia’s Better Health Commission started implementing the Health for all by 2000 goals in 1986 including different groups such as adults, children, women and adolescents. Health promotion recognises the many determinants of health such as stress, early development experience, employment, social support services and food. Accordingly, the social security, education, stable ecosystem, human rights, equity and availability of sustainable resources will either hinder or facilitate the health and the impact on the people (Talbot & Verrinder, 2010). The primary health promotion practices include accessing immunizations, maintaining the right body weight, and minimising exposure to health hazards through wearing sunscreens. There are secondary health promotion activities that enhance the control of helath such as performing monthly breast examinations and regular glaucoma testing activities that aim at illness prevention. The active promotion activities entail participating in specific health programs such as tobacco cessation programs and passive activities such as fluoridation of drinking water. According to the WHO declaration of Alma-Ata in 1978, health promotion must enhance equity, fundamental human rights, use of socially and safe technology, community participation and health promotion. Strengths of Ottawa Charter health promotion model The model addresses the determinants of health such as food since it advocates for healthy eating habits and empowers the people to engage in sustainable employment activities that improve the wellbeing and personal satisfaction (Raeburn & Rootman, 1998). Accordingly, social wellbeing is essential for enjoyable life and individuals have access to social support through friendships, supportive family networks and good social relations. The model addresses social exclusion such as discrimination and poverty and all situations that may make an individual feel stressful and anxious (Wise & Signal, 2000, p 246). Another strength of the model is the empowerment since individuals and local communities are capable of attaining more personal ad economic power thus controlling the factors that affect their health (Hanson, 2007). In addition, the more requires community participation in all stages of planning and implementation of the action plans. The model takes a holistic approach since it fosters the spiritual, mental, physical and social health and ensures multi-sectoral partnerships that involve collaboration of various agencies in enabling people take control over their health (Oldenburg, French, & Owen, 1997, p 128). The model is a multi-strategy approach since it involves combination of numerous approaches such as policy legislation, community empowerment and capacity building, education, and education thus improving all aspects of health and wellbeing (Swerissen & Crisp, 2004, p 127). The model is also action oriented and combines complimentary methods of promoting the control and maintaining the quality of health of the individual. The model aims at addressing the social justice issues such as structural and economic disadvantages, human rights and limited empowerment in the control of health (Hanson, 2007). The model caters for the local needs and aims at improving the knowledge, skills and processes through consciously raising the awareness and improving cooperation in the promotion of health in the community (McQueen, p 263). Murphy advocates for health promotion action that entails building collaborative partnership and advocacy that leads to more engagement while Raeburn and Rootman claim that health promotion must be concerned on the real living people (Hawe, Noort, King & Jordens, 1997, p 36). The health promotion principles must focus on the positive life enhancing matters rather than concentrating on the symptoms or social problems that hinder the quality of health (Nutbeam, 2000, p 264). In addition, the promotion methods must take advantage of the strengths and not dwell on the weaknesses and should be well organised and systematic. The model is based on evidence of needs and sound theoretical underpinnings since it incorporates all stakeholders and uses the best practices in health promotion. The model promotes governance and decision-making that is democratic and outlines the professional roles of health care practitioners must be geared at enabling the people control the determinants of their health (Green & Tones, 2010). The model has the potential of reducing the disease rates in the society since it discourages unhealthy lifestyle behaviours and caters for the needs of the high-risk populations such as marginalised groups. Limitations of the theory that underpin this model One of the limitations of health promotion theory is the lack of guidance on how to apply the principles and values since Ottawa Charter for health promotion articulates equity, empowerment and participation as the core principles of health promotion. Although previous declarations such as Jakarta Declaration on health promotion in the 21st century and Bangkok Charter on health promotion in the current globalised world have stressed the need to follow such principles, there are gaps in the guidance on how such principles must be incorporated in health promotion (Leddy, 2006). The models stress the needs assessments and outcomes and ignore the values thus offering only technical guidance and general descriptions on health promotion. Another limitation is the different interpretations and practitioners have failed to find a model that explicitly relies on the principles and values in systematic manner. Another common limitation is the existing gap between the modern and traditional health promotion principles since holistic models incorporate the physical, social, mental and spiritual dimensions of health (Hanson, 2007). In this case, many nursing practitioners still focus on the proximal behavioural risk factors such as disease conditions without addressing more pertinent issues such as social determinants of quality of health (Fleming, 2006). The conventional principles are non-participatory while the modern methods of health promotion go further to support good health, happiness and include empowerment and participation of the community in health promotion (Nutbeam, 2000, p 265). Health promotion suffers from the limited partnerships in some countries due to lack of shared goals and values among different players in the health sector such as public agencies and non-governmental organisations (Tones and Tilford, 2001). In addition, the state agencies play more roles in determining the health policies of certain countries thus limiting the participation of the general population and control of their health in those countries (Fleming, 2006). Another challenge is poor leadership and sustainable health promotion infrastructure. Political will and administrative leadership is essential in capacity building that enables the population to have access to highly qualified health professionals and information on different health promotion matters (Hanson, 2007). There is a limitation posed by the unsustainable funding and investments in health since the investments in the health sector are insufficient to contribute to economic and social development (Leddy, 2006). In most cases, the relevant authorities regard health promotion investments as a cost to taxpayers and not a long-term investment geared at contributing to general wellbeing of the society. Conclusion Health promotion must aim at enabling the people to gain more control of their health and improve their wellbeing thus leading to enjoyable life. A good model of health promotion must promote equity, multi-sectoral partnerships, supportive environment and development of personal skills. Ottawa charter of health ensures that people control the determinants of health such as the natural environment, economic factors, social environment and spiritual welfare thus leading to high quality life. The model supports the development of public policies, creation of supporting environments, strengthening community capacity, development of people skills and reorientation of the services towards primary health care and good lifestyles. The model is based on the values of equity, social justice, empowerment and multi-sectoral partnerships in peole take control over their health and enjoy good health. References: Australian Health Promotion Association. ‘Health promotion’, Retrieved on 18th May, 2014 from (web): http://www.healthpromotion.org.au/component/content/article/191-ahpa. Better health Channel. 2014. ‘Ottawa Charter for Health Promotion’, Retrieved on 18th May, 2014 from http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Ottawa_Charter_for_Hea lth_Promotion. Dixey, R. (2012). Health promotion: global principles and practice. Wallingford: CABL. Fleming, M.L. (2006). Health promotion: principles and practice in Australian context. Sydney: Allen & Unwin. Funnell, R and Koutoukidis, G. (2008). Tabbner’s nursing care: theory and practice. Sydney: Elsevier. Green, J & Tones, K. (2010). Health promotion: planning and strategies. New York: Sage Publications. Hanson, A. (2007). Workplace health promotion: a salutogenic approach. Bloomington: AuthorHouse. Hawe, P., Noort, M., King, L & Jordens, C. (1997). “multiplying health gains: the critical role of capacity-building within health promotion programs”, special issue; health outcomes and policy making, Volume 39, Issue 1, January 1997, pp 29-42. Laverack, G. (2007). Health promotion practice: building empowered communities. Maidenhead: Open University Press. Leddy, S. (2006). Integrative health promotion: conceptual bases for nursing practice. Sudbury: Jones and Bartlett Publishers. MacDonald, T.H. (2012). Rethinking health promotion: a global approach. New York: Routledge. McQueen, D.V. (2001). “Strengthening the evidence base for health promotion”, Health promotion international, Vol 16 (3): pp 261-268. Nutbeam, D. (2000). “Health literacy as a public health goal: a critical challenge for contemporary health education and communication in to the 21st century”, Health promotion international, 2000, 15(3): pp 259-267. O’Hara, Lily. (2007). ‘Values and principles evident in current health promotion practice’, health promotion journal of Australia 2007: 18 (1), pp 7-11. Oldenburg, B., French, M.L & Owen, N. (1997). “Health promotion research and the diffusion and institutionalization of interventions”, Health promotion international, Vol 14 (1): pp 121-130. Raeburn, J & Rootman, I. (1998). People-centred health promotion. New York: John Wiley & sons. Sharma, M & Romas, J.A. (2012). Theoretical foundations of health education and health promotion. Sudbury: Jones & Bartlett Learning. Swerissen, H & Crisp, B.R. (2004). “ The sustainability of health promotion interventions for different levels of social organization”, Health promotion international, Vol 19(1): pp 123-130. Talbot, L & Verrinder, G. (2010). Promoting health: the primary health care approach. Chatswood: Elsevier. Tones, K and Tilford, S. (2001). Health promotion: effectiveness, efficiency, and equity. Cheltenham: Nelson Thornes. Wise, M & Signal, L. (2000). “Health promotion development in Australia and New Zealand”, Health promotion international, Vol 15 (3): pp 237-247. Read More