Health Promoting Settings for Moldava

8/2/2019 Health Promoting Settings for Moldava

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Health Promoting Settings

Milka Donchin MD, MPH

Braun School of Public Health& community MedicineJerusalem


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Main activities in Health Promotion

Settings

programs

training


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The setting-based approach

A setting is a social system in which people live,

work, learn, love and play

Characterized by a particular organizational culture,

structure, functions, norms and values.


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A setting is the context

within which and through which

health occur


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A holistic and socio-ecological model of health

Focus on populations, policy and environments

Protect human rights, equity and social justice

sustainability

Community participation

Enablement and empowerment

Cooperation


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Key elements:

A healthy working and living environments

Integrating health promotion into the daily

activities of the setting

Reaching out into the community


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Underpinned by:

Health for all

Ottawa Charter

Agenda 21


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Sustainable Development

'development which meets the needs

of the present without compromising

the ability of future generations to

meet their own needs'


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Principles for Sustainable Development in Israel

(partly)

Agenda 21 Integrated Resource

Management

Inter-generational andIntra-generational

Equity

Environmental andSocial Justice

Accountability and

Transparency

Eco-Efficiency

Polluter Pays

User Pays

SustainableConsumption


10/51Source: European Sustainable Development and Health Series:1


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The first

health promoting settingHealthy cities


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One in which residents, business, non-

governmental organizations and the

municipal government work together to

ensure a viable and livable city.

A Healthy City


13/51Healthy cities networks


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Israel network of healthy cities

Established in 1990 with 4 cities

In 2012 50 cities & local authorities,

& 4 regional authorities

Covers >50% of the population in Israel


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Israel Network of Healthy CitiesIn operation since 1990

A unit of theUnion of Local Authorities

Ministries

Health

Education

Environment

Welfare

Sports

Cities

Local councils

Regional councils

Institutions

School of Public Health, Jerusalem

Israel cancer Association

Nature protection society

Community centers association

4 HMOs

Beterm

Enosh

Milenium

Association of cardiologistsIMA

Individuals

A member of the European Network

of National Healthy Cities Networks , lead by WHO

Members of the Network


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Membership Criteriafor cities

A formal decision of the city council to adopt HFA principles

Nominate a multi-sectoral steering committee

Nominate a city health coordinator

A commitment to prepare a city health profile

A commitment to prepare a strategic health development

plan based on the profile

A commitment to cooperate with the networks activities.


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The Healthy City mode of action

Steering

committee

City profile

Strategic planning for health& sustainable development

Health

promotionprojects

Action plans in city settings

Sustainable

development

projects


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Identify needs of the population

Determine inequalities in health

Identify desires and aspiration of the citizens

City health profile


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All Healthy Cities are committed to preparing a City

Health Profile as a basis for their strategic planning

for Health for All and Sustainable Development

The profile includes:

data on the state of health of the population

socio-economic and environmental determinants

Identification of social and health inequalities

Mapping of the services in the city and their usage

City Health Profiles


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A toolkit for preparing city profile

Enable standardization

Has operational

definitions

Forms for extracting

information

A questionnaire

A CITY PROFILE

A basis for strategic planning for

health and sustainable

developmentsGUIDELINES

Updated version 2010


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The profile a joint effort

Expert

network team

collect data

from nationalsources

facilitators and

consultants to thecity coordinators

and their teams

City

coordinator &local team

collect data

from municipalsources

Define determinants

for inequalities andvulnerable groups

CBS

provide population

random samples and

weights for populationestimates


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Selected results


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Selected characteristics

AshP-TN-Z

567Socio-economic cluster

303331Median age

16.28.85.6% of families with 4+children

55.961.370.2% entitled tomatriculation certificate

of 12th graders

49.625.715.7% elderly receiving

supplement income


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Participated in the surveys aged 22+

AshP-TN-Zcity

539414489N

86.266.277.9Response rate

2006-72007-82008Year of conducting

the survey


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Selected characteristics of the

population in geographical areasP-T Ash

S i l it l


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Social capital

Trust people Mutual support


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lifestyles

AshP-TN-Z

27.520.020.8Rate of smokers

12.733.440.3Rate of physically

3+/w

46.268.662.150+ womenperformed

mammography


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Women aged 50+ performed

screening mammography (%)


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Self assessment of health by areas in cities and age

P di f i h l h d d


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Predictors of assessing health as good-very good

Logistic regressionin P-T -PC.IOR


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Predictors of assessing health as good-very good

Logistic regressionin N-Z-

PC.IOR


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Environmental and social nuisances

P-TN-Z


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conclusions

Variation in population composition exists within and

between cities

Inequalities between geographical areas in each city

are determined by the population mix as well as bytheir physical and social environments

Predictors of self assessment of health are not

identical in different cities.

A city health profile should be performed in each city

as a basis for identifying and prioritizing needs and as

a basis for evaluating the implementation of a health

equity policy.


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Strategic health development plan

Based on needs assessment

Integrates public desires and aspirations

Has a participatory planning process

Is integrated in the city action plans


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Haifa


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Schools &kindergartensCommunitycentersWorkplaces

Healthservices

Deprived

neighborhoods

municipality

Narrowing gaps, answer needs,

improving quality of servicesReduce

injuries

Improve theenvironment

Awareness

Reduce

smoking

Physical

activity

Haifa - a healthy city


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Towards an active city

The Haifa forum for healthy & active living

Steering committee

Sharing knowledge and experience

Mapping needs & assets

Political commitment

Participatory planning process

Determinants of physical activity


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Determinants of physical activity


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multi-component interventions that are adapted to the

local context were found to be the most successful.

What works?

Effective interventions invariably involved participants

in the planning and implementation stages, such as

involving the workers themselves in workplace

interventions, and community leaders in community

and..

WHO, 2009


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Evaluation framework

WHO global strategy on diet, physical activity and health: a framework tomonitor and evaluate implementation, 2008


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Health promoting hospitals

The health promoting hospitals (HPH) project and

network facilitates change to promote total quality

management of the hospital.

It produces evidence to help hospitals achieve their

health mission and to support cooperation and

exchanges of experience between participating

hospitals.

http://www.euro.who.int/healthpromohosp
http://www.euro.who.int/healthpromohosphttp://www.euro.who.int/healthpromohosp


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objectives:

To change the culture of hospital care towardsinterdisciplinary working, transparent decision-making and with active involvement of patientsand partners.

To evaluate health promotion activities in thehealth care setting and build an evidence-base inthis area.

To incorporate standards and indicators for healthpromotion in existing quality managementsystems at hospital and at national levels.


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Health promoting hospital-hospitals

promote human dignity, equity and solidarity,and professional ethics, acknowledgingdifferences in the needs, values and cultures

of different population groups; be oriented towards quality improvement, the

well-being of patients, relatives and staff,protection of the environment and realization

of the potential to become learningorganizations;

The Vienna Recommendations, adopted at the 3rd Workshop of National/Regional HealthPromoting Hospitals Network Coordinators, Vienna, 16 April 1997


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Standards of a HPH

1. A hospital has a written policy for health

promotion. This policy must beimplemented as

part of the overall organization quality system

and is aiming to improve healthoutcomes. It is stated that the policy is aimed at

patients, relatives and staff.

2. describes the organizations' obligation to ensurethe assessment of the patients' needs for health

promotion, disease prevention and rehabilitation.

3 h i i id h i i h


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3. the organization must provide the patient withinformation on significant factors concerningtheir disease or health condition and health

promotion interventions should be

established in all patients' pathways.

4. gives the management the responsibility to

establish conditions for the development ofthe hospital as a healthy workplace.

5. deals with continuity and cooperation,

demanding a planned approach to collaborationwith other health service sectors andinstitutions.


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Universities

Teaching health promotion in all schools of

public health

Health promotion university


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J. Orme and M. Dooris, HEALTH EDUCATION RESEARCH, 2010, 25: 425437


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thanks

Documents

Health Promoting Settings for Moldava