Date 27 January
By Samia Khan
This report aims to assess health promotion initiatives from the global to national level to understand how they feed into public health strategies.
Developing health promoton
In 1986, the First International Conference on Health Promotion was held in Ottawa, Canada to promote a new global public health movement. With 200 participants across 38 countries, international organisations, and local communities were encouraged to Advocate – to boost factors that encourage health, Enable – to allow all people to achieve health equity, and Mediate – through collaboration across all sectors. (WHO, 2012)
“Health does not begin in a hospital or clinic. It begins in our homes and communities, with the food we eat and the water we drink, the air we breathe, in our schools and our workplaces.”
Dr Tedros Adhanom Ghebreyesus
As a result, the World Health Organization (WHO) established and developed global principles and action areas for health promotion. In 2016, the 9th Global Conference on Health Promotion in Shanghai concluded with a framework for governments to harness the transformational potential of global health promotion. (WHO, 2018) The Shanghai Declaration on Health Promotion stressed links between health and wellbeing and the United Nations 2030 Agenda for Sustainable Development and its Sustainable Development Goals. (WHO, 2016) In addition, the 10th Global Conference on Health Promotion in 2021 chartered a path for creating ‘well-being societies.’ As WHO Director-General stated, “Health does not begin in a hospital or clinic. It begins in our homes and communities, with the food we eat and the water we drink, the air we breathe, in our schools and our workplaces.” (2021)
Health promotion is essential in the public health realm. As a start, the following logo, which outlines the approach toward health promotion as outlined in the Ottawa Charter, can be used to create a foundation for a health promotion tool (pictured).
It is important to consider developing a methodological strategy to combat misinformation, increase access to health information, and make health equitable. As a multi-layered approach, making health information a part of public space and using evidence-based approaches to create health promotion strategies is key.
We discuss evidence-based interventions across three themes: global disease history, song and community design.
Global disease history
The Global Burden of Disease (GBD), established in 2010, was a cross-sectoral effort to understand trends in disease, injuries, and risk. It aims to enable countries to compare and analyse the health of their populations. GBD 2010 proved important for health policies in a global context. For example, in 2019, GBD provided an independent estimation of the population for 204 countries and territories. It was also used to provide a comprehensive update on migration and fertility. (IHME, 2019) GBD provides a platform for medical speciality to understand research priorities. Following assessments conducted in the UK and after addressing weaknesses found in certain geographic and speciality areas, GBD 2010 will be used to conduct a rigorous analysis of health in middle- to low-income countries. (Spencer, 2018)
National strategy through song
In Ghana, interventions include songs and music to combat misinformation and promote health equity. Analysis by frontiers in public health revealed at least 28 songs were produced from the start of the COVID-19 pandemic to early 2021, with lyrics in local languages to communicate important messages. (Thompson, et al, 2021)
‘Songs inspired hope, informed the population about public health’
The songs inspired hope, informed the population about public health guidelines, and invoked emotional reactions to curb the spread of the virus. They encouraged community efforts and called for unity. At the same time, in Uganda, music and songs that address key health issues are considered more effective than lectures or seminars. (ibid)
Community-designed obesity intervention
A successful community-designed intervention in Australia –‘be active, eat well’ – is a health-promotion program that encourages physical activity and healthy eating in children aged 4 to 12 years. Using a quasi-experimental design, the program was used to collect anthropometric data in four intervention schools. (Economos et al, 2011)
‘Be active, eat well’
The intervention aimed to build the community’s capacity to create their own health promotion strategy and solution to obesity-related behaviour. This resulted in changes in community behaviour such as improved school nutrition policies, the establishment of a community garden, and other measures to target health inequalities. (ibid)
As the case studies suggest, tools such as global disease history song(s) as a national health promotion tool and community design for intervention can be used to formulate health promotion interventions on a global, national, and community level.
The coronavirus outbreak has highlighted the significance of addressing gaps and needs in the public health realm. Health promotion can feed into a cohesive global public health strategy to promote health equity and increase preparedness for future disease outbreaks.
Global health promotion frameworks established by credible international public health institutions such as the WHO can be fundamental in the process. Further, cross-sectoral collaboration in creating and delivering these interventions is key to capacity building and identifying health priorities.
“We cannot go back to exploiting our environments and overlooking what sustains all life. Looking forward past COVID-19 to pathways that lead to ‘well-being societies’, we need resilience and system-wide approaches at local, national and global levels,” says Public Health Pathways CEO Theo Richardson-Gool. “Our charity uses health promotion strategies to bridge understanding and capacity across communities.”
Health for all-all for health by Dr Halfdan Mahler
Promoting health: guide to national implementation of the Shanghai Declaration
The London Health Inequalities Strategy