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Health Promotion Conference

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Now I’d like to move on to the second part. It is about partnership in health promotion from a historical perspective. Primary health care, or PHC, is the foundation of health promotion. the Alma-Ata declaration was issued for primary health care in 1978, and it has been considered a revolutionary approach to achieve health for all. You may know PHC as health services but PHC is not only health services or other health related services like water and nutrition. This primary rescue approach includes three key pillars. There are participation, intersectoral collaboration, and equity. Among them, intersectoral collaboration involves addressing the broader determinants of health through multi-sectoral policy and action.
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It suggests that health cannot be achieved only by health sector and this is known from long long time ago. Then in 1986, Ottawa Charter for health promotion identified three roles of health promoters. There are to advocate, enable, and mediate. Among these mediation, Among three, the last one, mediation is a term which emphasizes the importance of partnership. Partnership is not only about the presence of two or more partners or parties. It is not a simple anatomy. More than two parties must function well by mediation. And by mediation, health promotion can make coordinate reduction by all concerned, by the government, by health and other sectors, by NGOs, voluntary organizations, local authorities, industry, and by the media.
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Health promoters have a major responsibility to mediate between on different different…interests in society to achieve shared health goals. In these three roles were considered revolutionary, before the tower charter, the typical attitude of health professionals were like this, instruct, comply and control all paternalistic. Then in the Ottawa Charter, they emphasized advocate, enable, and mediate. And even nearly 35 years after the Ottawa Charter, these three roles remain still challenged among many health workers in several countries. In the original document of the Ottawa Charter, mediate was explained like this.
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It emphasizes the importance of collaboration of all sectors.
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Through these collaborations, health promotion become possible. 25 years after the Ottawa Charter, a historical review was made on these three roles. And the authors tried to know what happened in the last 25 years. These are the major ones. Health agenda became a global issue ,so no need to advocate much about health issues. New viruses, infections have arisen and gone in the last 25 years. Then modern technology of internet and social media have rapidly advanced. Last three, people started to travel a lot around the world and see, hear current news from everywhere. So the situation has been changed in the last 25 years. Then what happened to mediate? Now we know how important it is to establish and maintain well-connected partnerships.
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So we know more and more the importance of partnerships. We seem to know how important it is but we don’t know how we can make it better in a real world setting. Mediation is useful in revolving conflicts but we need more efforts to do it well in health promotion. As I mentioned so far in the Alma-Ata declaration and in the Ottawa Charter, we have seen the word intersectional collaboration. In the history of his motion, another time partnership, has been getting more common since 1997. It was the fourth international conference on health promotion held in Jakarta.
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The fourth international conference on health promotion was held in 1997 and its main theme was “New players for a New Era-Leading Health Promotion into the 21st century”. Because it was held three years before the 21st century. And I personally attended this conference as a representative not from Japan but from Nepal In those days, I was working in Nepal as a public health expert for Japan international cooperation agency. And as I had a good contact with WHO headquarters and yielded permission to attend it. And in this title, “New Players”. They used the term “New Players”. And “New Players” meant public sectors. And there was a surprising change for his promotion.
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This is because policy and the environment are keys to health promotion, and the role of public sectors has been considered more important for his promotion. And we tend to think the role of private sector is limited but now it’s changing. So private sector is important now. But when it was introduced in the conference in Jakarta, one person stood up. The one, the person in this picture. Here’s the previous health minister of Nepal, Dr. Machila Shiresta. He raised his hand and he said, “It may be true in high-income countries to involve or to work with the private sector but it is too early in a low-income country like Nepal.
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This is because the private sector is not mature, not reliable, and not easy to work with them ,so we need to be very very careful in Nepal and other low-income countries.” More than 20 years have passed since the Jakarta conference, the quality of private sector has been improved even in low-income countries. But we need to keep an eye on these ethical principles. Money is important for the private sector but we have to be careful about environment safety, payment issues, equity, and human rights. The Jakarta conference prioritized five issues in this conference, and one of them in the middle is “Consolidate and expand partnership for health”. More details for specific points about partnership. This declaration encourages having more partnership.
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It also emphasizes the importance of transparency and accountability.

Dr. Jimba will explain partnership in health promotion from a historical perspective.

Primary health care, or PHC, is the foundation of health promotion. The Alma-Ata declaration was issued for primary health care in 1978, and it has been considered a revolutionary approach to achieve health for all.

Then in 1986, Ottawa Charter for health promotion identified three roles of health promoters. There are to advocate, enable, and mediate. Mediation is a term that emphasizes the importance of partnership. Dr. Jimba will explain mediation and partnerships in more detail.

In the Ottawa Charter, they emphasized advocate, enable, and mediate. And even nearly 35 years after the Ottawa Charter, these three roles remain still challenged among many health workers in several countries. In the original document of the Ottawa Charter, mediate was explained like this:

  • It emphasizes the importance of collaboration in all sectors.

In 1997, the fourth international conference on health promotion held in Jakarta. The main theme was “New players for a New Era-Leading Health Promotion into the 21st century”. Dr. Jimba will share his personal experience attending this conference.

The Jakarta conference prioritized five issues in this conference, and one of them in the middle is “Consolidate and expand partnership for health”. This declaration encourages having more partnerships. Please check the slides for more information.

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