DEPARTMENT OF PREVENTIVE DENTISTRY UNIVERSITY OF BENIN TEACHING
HOSPITAL BENIN CITY
LIST THE VARIOUS FRAMEWORK OF HEALTH PROMOTION DISCUSS ORAL
HEALTH PROMOTION USING THE OTTAWA CHARTER
BY
DR. AMAECHI UCHE ANDERS
FEBRUARY, 2014CERTIFICATIONI hereby certify that the department
seminar presentation on THE VARIOUS FRAMEWORK OF HEALTH PROMOTION
DISCUSS ORAL HEALTH PROMOTION USING THE OTTAWA CHARTER was
presented by DR. AMAECHI UCHE ANDERS in the month of February 2014
and was accordingly approved
.....DR AGHIMIEN AODR. IZE-IYAMUChief Resident Head of
Department
OUTLINE Introduction Rationale for Health Promotion Historic
perspectives Frameworks of health Promotion Ottawa charter Health
Promotion Action in Ottawa charter Oral health promotion Rationale
for oral health promotion Oral Health Promotion action using Ottawa
charter framework Conclusion Reference
16 | Page
INTRODUCTION Health is the extent to which an individual or
group is able on the one hand to realize aspirations and satisfy
needs and on the other hand to change or cope with the
environment.Health is a basic human right and is essential for
social and economic development. Health promotion is the process of
enabling people to increase control over, and to improve, their
health.(WHO, 1986) . Health promotion is any planned combination of
educational, political, regulatory, and organizational supports for
actions and conditions conducive to the health of individuals,
groups, or communities.(Harris,2004)Rationale for Health Promotion
In the past, healthy behavioral change was considered likely to
occur by health education. Practiced as a one way process with the
health professional transmitting information and advice produced
from ready-made packages of ideas and plans based on the
preconceived notions of the health staff. This rather simplistic
approach was not effective because it failed to acknowledge the
complexities of human behaviour and the importance of the broader
social, economic, and environmental factors determining behaviour
change. Hence the emergence of the modern health promotion movement
which is based on Prevention of disease at a primary level and the
promotion of health. Application of the above concepts to
developing environments which promote healthier choices for people
in coping with their lives, in a manner that encourages those
choices to be the easiest choicesHISTORIC PERSPECTIVES Growth of
cities and poor health practices led to the development of epidemic
diseases. Failure of the curative approach to reduce impact Lalonde
(1974) recognised that biomedical interventions not primarily
responsible for improvement in health Primary Health Care adoption
at Alma-Ata in 1978. McKeown (1979) demonstrated convincingly that
improvements in health over about two centuries was the result of
rising standards of living.
INTERNATIONAL CONFERENCES ON HEALTH PROMOTIONi. 1st Global
Conference on Health Promotion: Ottawa 1986ii. 2nd Global
Conference on Health Promotion: Adelaide 1988iii. 3rd Global
Conference on Health Promotion: Sundsvall 1991iv. 4th Global
Conference on Health Promotion: Jakarta 1997v. 5th Global
Conference on Health Promotion: Mexico 2000 vi. 6th Global
Conference on Health Promotion: Bangkok 2005 vii. 7th Global
Conference on Health Promotion: Nairobi 2009viii. 8th Global
Conference on Health Promotion will be held in Helsinki, 10-14 June
2013 FRAMEWORKS OF HEALTH PROMOTIONBase action upon a comprehensive
needs assessment using both normative and lay measures of
need.Develop a range of clearly stated and challenging goals
Preventive rather than curative approachespromote public health
measures to the public and public authorities. Be based upon
contemporary theories of individual and organizational changeA
re-orientation from prescription to supportive health promotion
methodsredress the balance of influence and make healthier choices
easier. Promote self-esteem and facilitate decision-making skills
rather than be prescriptive. Combat the influence of those
interests which produce and profit from ill health. This involves
controls on industry sponsored educational materials in schools,
advertising, and campaigns to reduce barriers to good health.Public
health rather than individually focussed programmes.Focus on the
social causes of ill health rather than a victim-blaming.
Approachacknowledging the limited real choices available to any
individual.Address the underlying determinants of health.Tackle
causes that are common to a number of chronic diseasesSupportive
rather than authoritarian styles of action. A commitment to
distribute success equitably. Ensure actions are evidence
based.Community participation rather than professionally dominated
activities.Working in partnership with key groups and
agencies.OTTAWA CHARTERThe principles of social justice - equity,
diversity and supportive environments - are an essential part of
effective health promotion. The Ottawa Charter promotes social
justice as it is designed to provide access to health opportunities
for all members of a community and aims to reduce the level of
health inequalitiesPrerequisites for Healthi. Peaceii. Shelteriii.
Educationiv. Foodv. Incomevi. Stable eco-systemvii. Sustainable
resourcesviii. Social justice and equity The Ottawa Charter
incorporates three basic health promotion strategies: i.
Advocateii. Enableiii. Mediate
ADVOCACYAt making political, economic, social, cultural,
environmental, behavioural and biological conditions favourable
ENABLEAll people to achieve their fullest health potential
through reducing inequity in health by; a supportive environment
access to information Life skills and opportunities for making
healthy choices.MEDIATEProfessional and social groups and health
personnel have a major responsibility to mediate between differing
interests in society for the pursuit of health
HEALTH PROMOTION ACTION/OTTAWA CHARTER Promoting health through
public policy Creating a supportive environment Strengthening
community action Developing personal skills Reorienting health
services
Oral health promotion Any planned effort to Build public
policies Create supportive environments Strengthen community action
Develop personal skills Reorient health services in ways that will
influence these factors. Oral Health promotion activity has 3
elements which may overlap. They arei. Oral disease Preventionii.
Oral Health Educationiii. Oral Health Protection
Rationale for oral health promotion The most common oral
diseases/abnormalies of public health interest because i. High
prevalenceii. Preventableiii. Availability of means of
preventioniv. Under utilization of these means of preventionv.
Financial implication in management and quality of life
Oral Health Promotion Action/Ottawa charter
Possible approaches for building healthy public policy Laws to
control non milk extrinsic sugars (NMES) in foods produced in the
country. Subsidies in agriculture, low tax regimes to healthy food
industries Stiff penalty for overspeeding, non-use of seat belts
and helmets, use of alcohol and other hard drugs during driving
Possible approaches for building healthy public policy Inclusion of
oral care services in children, pregnant women and the aged health
schemes policies Supporting the creation of policies for smoke and
pollution free environments. product labelling/ advertisement to
expose risks with using unwholesome products like tobacco
CREATING SUPPORTIVE ENVIRONMENTS21Provides people with
encouragement, opportunity, and rewards for healthy oral lifestyles
This is addressed under Physical Social Psychological Economic
Political
POSSIBLE APPROACHES Establishing community water flouridation
systems Availability of non-propriety flouride toothpaste and cheap
toothbrush Easy accessibility of oral health-care centers Provision
of safe play areas, restriction of NMES snacks in schools Creation
of smoke free areas Campaigns to raise oral health awareness.
Strengthening community action Enable concrete and effective
community action in achieving better oral health by Setting
priorities Making decision Planning strategies Implementation
Evalution and monitoring Strengthening community action This
requires full and continuous access to information, learning
opportunities for oral health, as well as funding support. The key
themes here are partnership, participation and engagement.
POSSIBLE APPROACHES Advocacy for oral health- care clubs and
oral health in health curriculum in schools Joint funding for
community water flouridation, school flouride mouthrinses , tooth
brushing or fissure sealing programmes Rewards for oral health
promoting communities and schools Inter- school competitions in
oral health Funding of community centers promoting health
lifestyles and offering counseling services Developing personal
skills Supports personal and social development of the individual
through providing information, education and enhancing oral health
skills. This can be facilitated in school, home, work and community
settings. Developing personal skills Compliments oral health public
initiatives. Success here depends on paying attention to the 3 Ps
patients characteristics patient-oral health professional
relationship predictive characteristics
Information and education on Drug , Alcohol and Tobacco use Use
of safety equipment (e.g., seat belts, helmets, mouthguard, broad
rimed caps) Lifestyles (exercise, sexual behaviors) Nutrition and
oral hygiene
Oral health skills like;I. ToothbrushingII. Use interdental
cleaning aidsIII. Pre-hospital care for orofacial, dental traumaIV.
Reorient Health ServiceV. Responsibility of all groupsVI. Focus on
preventive and oral-outreach care service than clinical and
curative services. VII. Research, education and training of
professionalsVIII. Cooperation by the health and other sectorsIX.
Design an effective oral health program that is cultural sensitive
and substainable with the community participationX. Developing
professionally applied fluoride/ sealant programmes for high-need
groups to be delivered by primary health care professionalsXI. Oral
care outreach services to the underserved.XII. Collaboration with
non-governmental organization, other sectors (transport,
entertainment, media, financial), political groups, interested
individuals to raise awareness and sustain outreach programs
CONCLUSIONHealth promotion through the Ottawa charter framework
has proven to be effective because it acknowledges the challenges
posed by determinants of health ..
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