Health Promotion in Primary Health Care & Hospitals: Health Promotion in Primary Health Care & Hospitals By Dr. Deryck D. Pattron, Ph.D. Public Health & Safety Consultant All Rights Reserved © 2008, Dr Deryck D. Pattron


Definition: Definition Primary health care-is the first level of active contact and participation between individuals, groups and communities and health care services


In what ways does primary health care provide:: In what ways does primary health care provide: Availability? Accessibility? Reliability? Capability? Equity?


Why is primary health care a key setting for health promotion?: Why is primary health care a key setting for health promotion? Fulfillment of the declaration of Alma Ata that primary health care as a set of guiding values for health, development, organization of health services, priority needs, and fundamental determinants of health A greater proportion of the population has access to primary health care


Who is responsible for health promotion in primary health care?: Who is responsible for health promotion in primary health care? General practitioner Nurse Health visitor Community midwife Social worker Speech therapist Physiotherapist Chiropodist Optician Dentist Dental hygienist Community pharmacist Optician Councellor


What are the core principles of health promotion in primary health care & hospitals?: What are the core principles of health promotion in primary health care & hospitals? Collaboration means making links within and beyond the hospital Equity means ensuring adequate resourcing and the needs of all groups are met Participation means the involvement of all in making decisions Empowerment means encouraging patients and relatives to share responsibility Sustainability means existence and productivity of the programme over time


Health promotion is all about empowerment: Health promotion is all about empowerment What can health practitioners do to empower their clients?


Case in Point: Case in Point An average of 5 % of smokers will stop smoking after receiving initial advice from their general practitioner Effectiveness can be increased by: Offering supporting literature Negotiating a date to stop smoking Making a self-imposed contract to stop smoking on the proposed date Offering follow-up appointments to deal with problems of stop smoking


Why are hospitals a key setting for health promotion?: Why are hospitals a key setting for health promotion? Many points of contact with health care professionals Heightened awareness about health problems can bring about major lifestyle changes (Health Belief Model) Health care environments can promote and stimulate the adoption of healthy attitudinal and behavioural changes


What are health promotion hospitals?: What are health promotion hospitals? Hospitals in which health promotion is an integral to the values, attitudes and culture of the institution and the way in which it is managed


Objectives of Health Promoting Hospitals: Objectives of Health Promoting Hospitals To make the hospital a healthier working and treatment environment To expand recuperation and rehabilitation programmes To provide information and advice on health issues To shift the role of the hospital from a place of treatment to one of prevention and health gain


Health Promoting Hospital CriteriaBudapest Declaration, WHO 1991: Health Promoting Hospital Criteria Budapest Declaration, WHO 1991 1. Provide opportunities throughout the hospital to develop health-orientated perspectives, objectives and structures 2. Develop a common corporate identity within the hospital which embraces the aims of the Health Promoting Hospital 3. Raise awareness of the impact of the environment of the hospital on the health of patients, staff and community. The physical environment of hospital buildings should support, maintain and improve the healing process 4. Encourage an active and participatory role for patients according to their specific health potentials


Health Promoting Hospital CriteriaBudapest Declaration, WHO 1991 (Cont’d): Health Promoting Hospital Criteria Budapest Declaration, WHO 1991 (Cont’d) 5. Encourage participatory, health-gain orientated procedures throughout the hospital 6. Create healthy working conditions for all hospital staff 7. Strive to make the Health Promoting Hospital a model for healthy services and workplaces 8. Maintain and promote collaboration between community based health promotion initiatives and local governments 9. Improve communication and collaboration with existing social and health services in the community


Health Promoting Hospital CriteriaBudapest Declaration, WHO 1991 (Cont’d): Health Promoting Hospital Criteria Budapest Declaration, WHO 1991 (Cont’d) 10. Improve the range of support given to patients and their relatives by the hospital through community based social and health services and/or volunteer-groups and organizations 11. Identify and acknowledge specific target groups (e.g. age, duration of illness etc.) within the hospital and their specific health needs 12. Acknowledge differences in value sets, needs and cultural conditions for individuals and different population groups 13. Create supportive, humane and stimulating living environments within the hospital especially for long-term and chronic patients


Health Promoting Hospital CriteriaBudapest Declaration, WHO 1991 (Cont’d): Health Promoting Hospital Criteria Budapest Declaration, WHO 1991 (Cont’d) 14. Improve the health promoting quality and the variety of food services in hospitals for patients and personnel 15. Enhance the provision and quality of information, communication and educational programmes and skill training for patients and relatives. 16. Enhance the provision and quality of educational programmes and skill training for staff 17. Develop an epidemiological data base in the hospital specially related to the prevention of illness and injury and communicate this information to public policy makers and to other institutions in the community


Conclusion: Conclusion Primary health care is the first level of contact between individuals and health care services Primary health care should provide; accessibility, availability, reliability, capability and equity Primary health care is the key setting for health promotion through the fulfillment of the Alma Ata Declaration Health promotion hospitals as stated in the Budapest Declaration (WHO, 1991) should be the future vision of hospitals using collaboration, equity, participation, empowerment and sustainability as key health promotion strategies


References: References Naidoo J, Wills J 1998 Practising health promotion: dilemmas and challenges. Bailliere Tindall, London WHO 1985 Targets for health for all. WHO Regional Office for Europe, Copenhagen WHO 1986 Ottawa Charter for health promotion. WHO, Geneva WHO 1991 The Budapest Declaration on Health Promoting Hospitals. WHO, Copenhagen