Viseisei Sai Health Centre

Akesa FunakiS100052

15th May, 2015.

Content Page

• Alma Atta Charter• Ottawa Charter for Health Promotion• Sundsvall Statement• Jakarta Declaration• Bangkok Charter for Health Promotion• Healthy Islands Declaration• Rarotonga Review

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

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.

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

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.

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.

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,

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.

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.

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.

Case Study• Location: Gambia, in west Africa.• By: United Kingdom Medical Research Council • Period: 1981- 1996• Population: 40 villages • Comparison: compared infant and child mortality between villages with and

without PHC.• Extra services to the PHC villages1. Community Health Nurse for about every five villages2. Village Health Worker 3. 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.

Results• After the establishment of PHC in 1983:• 1982–1983: 134/1000 • 1992–1994 : 69/1000

NON- PHC155/1000 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.

Ottawa Charter

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

trade".

• 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.

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 identifyand to realize aspirations, to satisfy needs, and tochange or cope with the environment.

• 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.

Prerequisites for Health

The fundamental conditions and resources for healthare:• peace,• shelter,• education,• food,• income,• a stable eco-system,• sustainable resources,• social justice, and equity.

Improvement in health requires a secure foundation in thesebasic prerequisites

5 Action Plan

• Build Healthy Public Policy• Create Supportive Environments• Develop Personal Skills• Strengthen Community Actions• Reorient Health Services

Build Healthy Public Policy

Health promotion goes beyond health care. It puts health on theagenda of policy makers in all sectors and at all levels, directingthem to be aware of the health consequences of their decisionsand to accept their responsibilities for health.

Create Supportive EnvironmentsOur 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.

Strengthen Community ActionsHealth promotion works through concrete and effectivecommunity 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 SkillsHealth 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 ownhealth and over their environments, and to make choicesconducive to health.

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.

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 PolicyHealthy public policy is characterized by an explicit concern for health and equity in all areas of policy and by an accountability for health impact

4 Key Areas

• Supporting the health of women• Food and Nutrition• Tobacco and Alcohol• Creating Supporting Environment

Sundsvall Statement on Supportive Environments for Health

Third International Conference on Health Promotion.

Location: Sundsvall, Sweden.When: 9-15 June 1991.Participants: 81 countries

Calls upon people in all parts of the world to actively engage in

making environments more supportive to health.

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.

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.

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

Jakarta Declaration on Leading Health Promotion into the 21st Century

Fourth International Conference on HealthPromotion: New Players for a New Era - Leading Health Promotion into the 21st Century.

Location: Jakarta On: 21 to 25 July 1997

Priorities for health promotion in the 21st Century

1. Promote social responsibility for health2. Increase investments for health development3. Consolidate and expand partnerships for

health.4. Increase community capacity and empower

the individual5. Secure an infrastructure for health promotion

The Bangkok Charter for Health Promotion in a Globalized World On: 7-11 August 2005.

PurposeThe 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.

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.

Four key commitments

For the Promotion of Health

1. central to the global development agenda 2. a core responsibility for all of government 3. a key focus of communities and civil society4. a requirement for good corporate practice

Global Pledge to Make it happen

• All for health• Closing the implementation gap• Call for action• Worldwide partnership• Commitment to improve health

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.

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.’

References

• WHO, Milestone in Health Promotion.• WHO, Yanuca Island Declaration.• The Ottawa and Bangkok Charters: from principles to action", SIASS, Firenze, 21-23.11.2006