Health Promotion

1. Health Promotion Introduction dr. Harun Al Rasyid, MPH

2. Influences on health • Lifestyle and behaviour • Knowledge • Beliefs • Culture • Social influences • Environment • Housing/building • Water/sanitation • Hazardous waste • Pollution • Climate

3. Influences on health • Health Care • Preventative services • Treatment services • Traditional medicine • Health policy • Primary health care • Heredity • Genetic attributes

4. So what is health promotion?What does it aim to do? How does it do it? Who does it?

5. What is health promotion? • Lalonde, 1974 Suatustrategi yang ditujukanuntukmemberikaninformasi, mempengaruhi, danmembantuindividu-individuataukelompok agar merekabisamemenrimatanggungjawabdanlebihaktifpadahal-hal yang mempengarhuikesehatanfisikdan mental • A strategy “aimed at informing, influencing and assisting both individuals and organizations so that they will accept more responsibility and be more active in matters affecting mental and physical health”

6. What is health promotion? • Green, 1980 Kombinasiantarapendidikankesehatan (penyuluhan) danintervensi-intervensi yang bersifatorganisasi, politikdanekonomi yang didesainuntukmemfasilitasiperubahanperilakudanlingkunganuntukmeningkatkan (status) kesehatan • Any combination of health education and related organizational, political and economic interventions designed to facilitate behavioral and environmental changes that will improve health

7. What is health promotion? • Ottawa Charter for Health Promotion, 1986 The process of enabling people to increase control over, and to improve, their health

8. What is health promotion? • Howatt et al., 2003 Combination of educational, organisational, economic, social and political actions designed with meaningfulparticipation, to enable individuals, groups and whole communities to increase control over, and to improve their health through attitudinal, behavioural, social and environmental changes

9. Combination of actions • Educational • Organizational • Economic • Social • Political

10. With Meaningful participation (what is this?) To • Enable • Individuals • Groups • Whole communities

11. To to increase control over, and to improve their health Through • attitudinal, • behavioural, • social and • environmental changes.

12. Ottawa Charter for Health Promotion • Building healthy public policy • Kesehatanbelumtentumenjadi agenda parapengambilkebijakan • Banyakpermasalahankesehatan yang bisadiatasimelaluiintervensikebijakan Key: Legislative Action Organizational change

13. Ottawa Charter for Health Promotion • Creating supportive environments • Menciptakankondisitempattinggaldantempatkerja yang amandankondusifuntukperilakusehat Key: Facilitate healthy behaviours Reduce barriers

14. Ottawa Charter for Health Promotion • Strengthening community action • Pemberdayaanmasyarakat (community empowerment) • Memilikikemampuanuntukmenjagadanmeningkatkan status kesehatan Key: empowerment, ownership, control

15. Ottawa Charter for Health Promotion • Developing personal skill • Biasanyaaktivitaspromosikesehatanlebihbanyakfokuskepadaaktivitaspenyuluhankesehatan (KIE)  peningkatanpengetahuan • Selainpengetahuanjugadiperlukansikap yang positifdanlatihanketerampilan Key: educate for health enhance life skills

16. Ottawa Charter for Health Promotion • Re-orienting health services • Lebihmenekankanpadaaktivitaspencegahan • Lebihmemperhatikan (sensitif) padabudayalokal setiapdaerahmemilikikeunikantersendirisehinggabisamembutuhkanpendekatan yang berbeda Key: increase emphasis in prevention sensitive to cultural needs

17. Health Promotion health education - behavioural - structural ------------------------- organisational actions ------------------------- economic actions ------------------------- political actions Including advocacy attitudinal behavioural environmental and social changes conducive to health Improved Health status

18. Settings of Health Promotion • Health promotion intervention can be applied at: • Family level • School • Workplace • Public places

19. Theories used in Health Promotion • Maslow • Health Believe Model • Social Cognitive Theory • Diffusion of Innovation Theory

20. Abraham Maslow (humanistic theory) • Basis: We attend to fundamental human needs first self Actualization needs self esteem needs lovely belonging needs safety needs physiological needs

21. Health Belief Model Perceived susceptibility to problem Perceivedthreat Perceived seriousness of consequences of problem Self-efficacy (perceived ability to carry out recommended action) Perceived benefits of specified action Perceivedexpectations Perceived barriers to taking actions Cues to action

22. Social Cognitive Theory(Albert Bandura 1977) • Individual, environment and behaviour continuously interact and influence each other (reciprocal determinism) • Key components: self- efficacy, learning though observation, reinforcement, reciprocal determinism, expectations, behavioural capability • This theory is useful for individual, group, and population program development

23. Reciprocal determinism Environmental factors (e.g. Social norms, access to community) Cognitive factors (e.g. Expectations, attitudes) Behavioural factors, skills, practice

24. Diffusion of Innovation Theory(Everett Rogers) • Some individuals and groups in society tend to be quicker to pick up new ideas than others. • Others in the community tend to be more suspicious of change and slow to respond to ‘new-fangled’ idea (new idea but seems complicated/unnecessary)

25. Classification of adopters: • Innovators (2-3%) quickest adopt new ideas, less-likely to be trusted by the majority of the community • Early adopters (10-15%) More mainstream within community, amenable to change, have personal, social and financial resources to adopt the innovation • Early majority (30-35%) amenable to change, have become persuaded of the benefits of adopting the innovation • Late majority (30-35%) sceptics, reluctant to adopt ideas until the benefits have been clearly established • Laggards (10-20%) the most conservative, actively resistant to new ideas

26. Thank You!