Health education: a case for resuscitation

Health education is the component of health promotion designed to achieve learning related to health or illness. While often described by other names, an educational element features in nearly all health promotion activities. Unlike most other public health actions, it focuses on voluntarism and frequently on the individual. Health education and the resources devoted to it grew rapidly in the latter half of the 20th century. However, in the 1970s, many health educators started to question its value. They criticized it as being excessively concerned with disease, victim blaming, politically naive and increasing health inequalities. While promoting knowledge and skills for health was included as one of the five principles of health promotion in the World Health Organization's Ottawa charter, it received much less attention than the other four principles. Health education was also criticized as being ineffective. Methods for evaluating health education are hotly contested but there is evidence that some education interventions are effective. Current health strategies continue to advocate prevention through health education, and workers in many different settings are expected to ensure that health education is provided. These front-line educators should be able to look to those who specialize in health promotion to support their educational activities. This paper argues that the worth of health education compared with other forms of health promotion has been grossly underestimated and it is time to re-assert its importance.     

The Alberta Health Act: The development of the health charter and the role of the health advocate

The role of the health advocate and the health charter will evolve, but the enactment of the Alberta Health Act is important in establishing the expectations of Albertans and others of the healthcare system. This legislative development is unique in Canada and will be watched closely across the country.     

Auto Action Learning: a tool for policy change. Building capacity across the developing regional system to improve health in the North East of England

Health policy traditionally has tended to focus on health care policy. The World Health Organisation Investment for Health approach aims to influence policy development by locating health as both the outcome of, and an asset for, sustainable economic and social development. The policy context in England offers a range of drivers and opportunities to operationalise the Investment for Health approach through action to improve health and reduce inequalities, nationally and as importantly at a regional and local level. This paper traces developments in the North East of England April 2002-November 2002, from the perspective of an advocate for developing a systemic and systematic approach using an Investment for Health approach. The tool used to track change is based in action learning [M. Pedler, Action Learning for Managers, Lemos and Crane, London, 1996]. The Action Learning Problem Brief identifies why the goal is important, who to, how progress might be identified, difficulties and benefits. Generally, this acts as a starting point for problem solving within an Action Learning Set. This piece of work uses the framework for reflection and tracking, with input from a mentor, at four to eight weekly intervals, 'Auto Action Learning'. The authors pull out key learning points from the process, using a framework 'Towards a model for systematic learning from doing in the North East of England'.     

Urban health: challenges and opportunities

Urban health issues are multidimensional. Some effort has been made to identify their complexities in this presentation. Health providers working with inner-city populations must consider an array of social, health, and environmental factors in their assessments of health problems. Many of the societal issues which negatively impact health, such as poverty, lack of a universal health program, unemployment, violence, drugs, and other factors, can be corrected in our society only if the political will to do so is present. Health workers have a responsibility to advocate for programs and environments in which all citizens can maximize their full potential. Populations in urban areas who are at risk for disease, disability, and premature death make cities special places for focusing on the promotion of health and the prevention of disease. The contributions that can be made by health workers should be directed toward improving the quality of life for urban residents. The challenges to do so are essentially unlimited.     

New CHA head charts assertive future course. Interview by Alan L. Appelbaum.

John E. Curley Jr. is determined that the Catholic Health Association will be a strong advocate in the defense and expansion of the work of Catholic health care institutions.     

School Health Education in the European Community

ABSTRACT: The School Health Education Commission of the European Community is making efforts to improve school health education in the European Community countries. While past efforts have involved single issue causes, current activities emphasize a holistic perception of school health education. Radical education reforms throughout the European Community advocate improved health education. The movement toward quality health education in the European Community countries uses a model called the Health Promoting School, a cooperative effort involving schools, families, and communities. The model is being promoted through three stages: 1) national conferences held in each European Community country, 2) summer schools to provide teacher training, and 3) national projects, supported by the World Health Organization, agreement conducted to determine the efficacy of the Health Promoting School Model.     

Health services waste management: a biosafety issue

The subject of "health services waste" is controversial and widely discussed. Biosafety, the principles of which include safeguarding occupational health, community health, and environmental safety, is directly involved in the issue of medical waste management. There are controversies as to the risks posed by medical waste, as evidenced by diverging opinions among authors: some advocate severe approaches on the basis that medical waste is hazardous, while others contend that the potential for infection from medical waste is nonexistent. The Brazilian National Health Surveillance Agency (ANVISA) has published resolution RDC 33/2003 to standardize medical waste management nationwide. There is an evident need to implement biosafety procedures in this area, including heath care workers' training and provision of information to the general population.     

坚持以人为本,推动卫生职业学校思想教育工作

卫生职业教育是我国职业教育的重要板块,承担着为我国培养实用医技人才的责任。卫生职业院校要本着＂以人为本＂的宗旨,提倡人性化关怀,加强对教师的思想政治教育,引导教师树立正确的世界观、人生观、价值观,促进教学教育及学校发展。     

Core functions and capabilities of state public health laboratories: a report of the Association of Public Health Laboratories.

Emerging natural and man-made threats to the health of the nations population require development of a seamless laboratory network to address preventable health risks; this can be achieved only by defining the role of public health laboratories in public and private laboratory service delivery. Establishing defined core functions and capabilities for state public health laboratories will provide a basis for assessing and improving quality laboratory activities. Defining public health laboratory functions in support of public health programs is the beginning of the process of developing performance standards for laboratories, against which state public health laboratories, and eventually local public health and clinical laboratories, will establish and implement best laboratory practices. Public health is changing, and as apart of that change, public health laboratories must advocate for and implement improvements for public health testing and surveillance. These changes are outlined also in the Association of Public Health Laboratories consensus report (Association of Public Health Laboratories. Core functions and capabilities of state public health laboratories: a white paper for use in understanding the role and value of public health laboratories in protecting our nation's health. Washington, DC: Association of Public Health Laboratories, 2000).     

Abogacía por la salud de la población gitana: capacitación de profesionales del Distrito Sanitario Sevilla

This article describes a workshop whose objective was to build Roma health advocacy capacity among a group of health professionals. Health advocacy is recommended by international organizations and public health experts to overcome the health inequities that Roma populations suffer. Sixteen professionals from three health centres located in neighbourhoods with a high Roma population participated. The workshop was organized in three sessions aimed at raising awareness, sharing an advocacy framework and methodology and designing an advocacy plan. We highlight the utility of spaces for reflection and analysis, the need to advocate for Roma health with Roma leaders and community sectors, identification of opportunities and utilization of community resources. Future research should strengthen the development of intersectoral advocacy plans, disseminate them and facilitate their implementation in other contexts with similar characteristics.     

论媒体与健康教育材料在全民健康促进行动中的作用

媒体与健康教育材料是向公众传播健康知识、技能和服务的常用手段。杭州市余杭区在开展"全民健康促进行动"(以下简称"行动")中,坚持"政府主导、部门合作、社会支持、群众参与"的原则,充分发挥媒体与健康教育材料在"行动"的应用,传播健康信息,提高全民健康意识和自我保健,倡导健康行为和生活方式,营造有益的健康环境,促进全民健康素质和生活品质的提高。     

To achieve "health for all" we must shift the world's paradigm to "primary care access for all".

Since the early 1950s, the World Health Organization has proposed programs to promote primary health care around the world. From the 1978 Alma-Ata Declaration to the current promulgation of the Millennium Development Goals, the World Health Organization has tried to improve health in developing countries through a focus on disease-oriented (vertical) programs. The World Health Organization and other organizations have not focused on the horizontal role of primary care. The expectations created by these programs have not been met. Evidence demonstrates that the advent of health care through a base of primary care improves health better than through the traditional vertical disease-oriented health programs used around the globe. The global "family" of family medicine must advocate for a shift from the current solutions to one in which the family doctor is part of a well-trained health care team that can function in networks that incorporate the vertical programs into a broad horizontal approach for better access to primary care. Perhaps in this way "health for all" can be achieved.     

Health promoting schools

Promoting the health of children through schools has long been an important task of the WHO. Guided by the recommendations of the Expert Committee on Comprehensive School Health Education and Promotion, the Initiative seeks to strengthen health promotion and education activities at the local, national, regional, and global levels. It aims to increase the number of schools that can truly be called "Health-Promoting Schools". The four strategies undertaken by WHO in creating Health-Promoting Schools are: 1) strengthening the ability to advocate for improved school health programs, 2) creating networks and alliances for the development of Health-Promoting Schools, 3) strengthening national capacities, and 4) research to improve school health program. Finally, WHO recognizes that the success of the Global School Health Initiative lies on the extent to which partnerships can be formed at local, national, and international levels.     

Role of trade unions in workplace health promotion.

Since the 19th century, workers have organized in trade unions and parties to strengthen their efforts at improving workplace health and safety, job conditions, working hours, wages, job contracts, and social security. Cooperation between workers and their organizations and professionals has been instrumental in improving regulation and legislation affecting workers' health. The authors give examples of participatory research in occupational health in Denmark and Finland. The social context of workplace health promotion, particularly the role of unions and workers' safety representatives, is described in an international feasibility study. Health promotion is rife with fundamental political, socioeconomic, philosophical, ethical, gender- and ethnicity-related, psychological, and biological problems. Analysis of power and context is crucial, focusing on political systems nationally, regionally, and globally. The authors advocate defending and supporting workers and their trade unions and strengthening their influence on workplace health promotion. In the face of rapid capitalist globalization, unions represent a barricade in defense of workers' health and safety. Health promoters and related professionals are encouraged to support trade unions in their efforts to promote health for workers and other less privileged groups.     

Health literacy in health systems: perspectives on patient self-management in Israel

Health systems will face new challenges in this millennium. Striking the balance between the best quality of care and optimal use of dwindling resources will challenge health policy makers, managers and practitioners. Increasingly, improvements in the outcomes of interventions for both acute and chronic patients will depend on partnerships between health service providers, the individual and their family. Patient education that incorporates self-management and empowerment has proven to be cost-effective. It is essential that health care providers promote informed decision making, and facilitate actions designed to improve personal capacity to exert control over factors that determine health and improve health outcomes. It is for these reasons that promoting health literacy is a central strategy for improving self-management in health. The different types of health literacy--functional, interactive and critical health literacy--are considered. The potential to improve health literacy at each of these levels has been demonstrated in practice among diabetics and other chronic disease patients in Clalit Health Services (CHS) in Israel is used as an example to demonstrate possibilities. The application of all three types of health literacy is expressed in: (i) developing appropriate health information tools for the public to be applied in primary, secondary and tertiary care settings, and in online and media information accessibility and appropriateness using culturally relevant participatory methods; (ii) training of health professionals at all levels, including undergraduate and in-service training; and (iii) developing and applying appropriate assessment and monitoring tools which include public/patient participatory methods. Health care providers need to consider where their patients are getting information on disease and self-management, whether or not that information is reliable, and inform their patients of the best sources of information and its use. The improved collaboration with patient and consumer groups, whose goals are to promote rights and self-management capabilities and advocate for improved health services, can be very beneficial.     

Food scares and sustainability: A consumer perspective

Health campaigns have focused on lifestyle decisions such as physical inactivity, diet and smoking to minimise health risks. The links between health, environmental sustainability and consumer food choices have less prominence. Reported here are Australian consumer perceptions of environmental health issues related to the food system. Interviews with 26 participants explored the environmental implications of food choices. Concerns included conflicting information, related health risks, and the blaming of individuals for ‘poor’ choices. Participants recognised that focussing on the individual overlooked the structural context of food production. They requested information about food production processes to assist decision-making and identified the need for an influential body to advocate for their interests in food production decisions. The results indicate a need for government, industry and consumer collaboration to develop and implement practical communication strategies about food production for communities.     

Health Promotion Dreaming: 6th Eberhard Wenzel Memorial Oration

The Eberhard Wenzel Memorial Oration was established in honour of the memory of Eberhard Wenzel (1950–2001), an inspiring Australian advocate for health promotion for more than 20 years. The oration has become an annual event in conferences held by the Australian Health Promotion Association for the past seven years. Just before he died, Eberhard was nominated for an award and the following is a quote from the nomination: “Eberhard has maintained the best public health website in the world and has supported, through his email list, communications between many different parts of the public health community around the world. He has sifted and sorted through a drift of chaff and sieved out the critical and relevant and passed it on through multiple mixed networks. He has editorialised with insight, kindness and the occasional blowtorch. Eberhard has contributed to warmer, firmer, closer forms of solidarity between different members of the human family, in particular, through his work with indigenous people. His work is characterised by a passion for justice and a fair go and intolerance for hypocrisy and guile.” The Virtual Library: Public Health established by Eberhard is now maintained by the School of Public Health and Community Medicine at the University of New South Wales and can be viewed at http://vph.sphcm.med.unsw.edu.au     

Regulating India's health services: To what end? What future?

India has a comprehensive legal and regulatory framework and large public health delivery system which are disconnected from the realities of health care delivery and financing for most Indians. In reviewing the current bureaucratic approach to regulation, we find an extensive set of rules and procedures, though we argue it has failed in three critical ways, namely to (1) protect the interests of vulnerable groups; (2) demonstrate how health financing meets the public interests; (3) generate the trust of providers and the public. The paper reviews the state of alternative approaches to regulation of health services in India, using consumer and market based approaches, as well as multi-actor and collaborative approaches. We argue that poor regulation is a symptom of poor governance and that simply creating and enforcing the rules will continue to have limited effects. Rather than advocate for better implementation and expansion of the current bureaucratic approach, where Ministries of Health focus on their roles as inspectorate and provider, we propose that India's future health system is more likely to achieve its goals through greater attention to consumer and other market oriented approaches, and through collaborative mechanisms that enhance accountability. Civil society organizations, the media, and provider organizations can play more active parts in disclosing and using information on the use of health resources and the performance of public and private providers. The overview of the health sector would be more effective, if Indian Ministries of Health were to actively facilitate participation of these key stakeholders and the use of information.     

Objectives and activities of the German Federal Working Group on migration and public health

The 53rd scientific congress of the Federal association of physicians and dentists in the public health services addressed the interdependence of migration and health under the motto "health unlimited" in May, 2003. Manifold interactions between migration and health contribute to the public health services' everyday experiences. Immigrants often encounter manifold obstacles to their access to health services in Germany. These barriers are often of communicative or administrative nature. The system of public health administration and services has, by its very nature, opportunities and assignment a special obligation to support the immigrant population. The public health services will increasingly become guarantors of equal health opportunities in times of cumulative migration and social inequalities. In cooperation with the German Federal Commissioner for Migration, Refugees and Integration the German Federal Working Group on Migration and Public Health acts as facilitator and advocate for health of immigrants to Germany since 1994. A very close co-operation with the public health services and an interdisciplinary, intercultural, population-oriented and health-promoting approach are core elements of the working group that is lobbying the health of a multinational population within the borders of Germany.