Global Health Promotion recent issues

Knowledge transfer and the university system's functioning: need for change

Ridde, V. — 2009-09-22

Work life and mental well-being: single and coupled employed mothers in Southern Europe and Scandinavia

Bull, T. — 2009-09-22

Many European mothers, single and coupled, combine work outside the home and family life. The effects of this on their mental well-being may vary depending on the level of support available from the State’s welfare system, since welfare may buffer working mothers from some of the stress that can arise from trying to manage significant responsibilities on the job and at home. Welfare may be especially important for single working mothers, for whom the burden of multiple roles may be even heavier. The present study assessed levels and predictors of well-being of single and coupled employed mothers in Greece, Portugal and Spain, where welfare support is relatively limited. Results were compared to a parallel study with data from Denmark, Norway and Sweden, where welfare support is relatively comprehensive. Coupled mothers in Scandinavia had significantly lower financial hardship, longer education, higher life satisfaction, more enriching jobs, practical support, financial support and social participation than coupled mothers in the Southern European sample. On the other hand, the Scandinavian coupled mothers had higher levels of work family conflict than coupled mothers in Southern Europe. Single mothers in Scandinavia, compared to single mothers in Southern Europe, had significantly longer education, higher life satisfaction and positive affect, more enriching jobs, confidant support, practical support, financial support and social participation. Level of job stress was the same for all mother groups. All groups differed significantly from each other in level of financial hardship, with Scandinavian coupled mothers being best off, followed by Scandinavian single mothers, Southern European coupled mothers, and Southern European single mothers. The regional differences suggest that single motherhood per se need not be a risk factor for poorer well-being, and that welfare policies may have a protective effect for the mental well-being of single mothers. (Global Health Promotion, 2009; 16(3): pp. 06—16)

The impact of an international health study abroad program on university students from the United States

Fennell, R. — 2009-09-22

Objective: International experience is paramount in society today. However, many US citizens have little understanding of the world beyond US borders. The purpose of this qualitative study was to (i) assess the impact of a study abroad program on students and (ii) the impact on the career goals of students who completed the program. Participants and Methods: Fall 2005 alumni (N = 68) of an international health study abroad program were sent a mail survey. Results: Twenty-seven of the students who responded to the survey (61%) were currently in medical school, nursing school, or a master’s program. Conclusions: All students indicated the program influenced their global view of the world. Participants indicated the experience continues to have an impact on how they critically think about the world, including US politics. (Global Health Promotion, 2009; 16(3): pp. 17—23)

Pedagogical competence and value clarification among health educators

Wistoft, K. — 2009-09-22

Individual and social values are increasingly important in health education. This article examines how health educators in Greenland and Denmark engage in value clarification as part of their educational practices. It presents the results of a study of health professionals in a variety of settings, focusing in particular on how development work and experimentation can strengthen their pedagogical competences. The study focuses on belief, reasoning, interpretation and reflection, rather than routines, skills, or ethical rules, and takes a participatory approach that oscillates between dialogical and qualitative empirical methodologies. It observes pedagogical practice in selected settings in Greenland and the municipality of Copenhagen. Within the framework provided by four discourses that appear to organize communication about health, it shows how values became important to the progress of two research-based development projects. On this basis, the article argues that health education can be effectively grounde d in the values, perceptions, and experiences of a given population, while being guided by the health educators’ biomedical knowledge and educational values. (Global Health Promotion, 2009; 16(3): pp. 24—34)

Development of a student health questionnaire: the necessity of a symbiosis of science and practice

Boot, C. R. L., Donders, N. C. G. M., Vonk, P., Meijman, F. J. — 2009-09-22

Rationale, aims and objectives: University students report more health complaints than their working peers, but do not appear to seek help for these problems. This stresses the importance of early detection. The aim of this study was to obtain information on indicators of health associated with academic functioning to develop a preliminary health surveillance questionnaire. In addition, we aimed to gain insight in the additional value of adding experience-based information from the priority population, and individuals in their direct environment, to the knowledge gained from the scientific literature. Method: First, a review of literature on indicators of health associated with academic functioning was conducted. Next, interviews were held with students (n = 11) and two groups of significant others with professional experience in student health care: general practitioners (n = 9) and practice assistants (n = 8). Results and conclusions: A health surveillance questionnaire to detect students with health problems associated with academic functioning should consist of questions on social support, general health, physical health, psychological health, study-related issues and health, help-seeking behaviour and life events in the past. Experiences from practice should be integrated when developing a questionnaire. (Global Health Promotion, 2009; 16(3): pp. 35-44)

Exploring the effects of government funding on community-based organizations: 'top-down' or 'bottom-up' approaches to health promotion?

Carey, G. E., Braunack-Mayer, A. J. — 2009-09-22

Community-based organizations hold an increasingly central role in the representation and advocacy of marginalized groups and individuals. In these capacities, such organizations make significant contributions to the areas of health and health services. In particular, they are considered well-positioned to operationalize ‘bottom-up’ approaches to health promotion. In this article we use a case study to illuminate unforeseen consequences of government funding of community-based organizations involved in health promotion and health service work. Previous research has found that many health promotion practitioners are engaged in a shift towards ‘bottom-up’ approaches to health promotion (1). In contrast, our findings suggest that due to government funding, those best positioned to promote community participation and empowerment may be experiencing a converse shift away from ‘bottom-up’ approaches. (Global Health Promotion, 2009; 16(3): pp. 45—52)

Reports from the field: Engaging learners as interpreters for developing health messages -- designing the 'Familias Sin Plomo' English as a Second Language curriculum project

Handley, M. A., Santos, M. G., McClelland, J. — 2009-09-22

California has a recently documented problem of trans-national environmental lead exposures in imported foods from Mexico but there is limited health information available in immigrant communities about this problem. This report highlights collaborative work with English as a Second Language (ESL) learners to critically review research data on lead exposures and reframe prevention messages about lead contamination of imported foods. These messages are now integrated into ESL curricula for dissemination to Spanish-speaking populations that are disproportionately affected by lead poisoning. This ‘learners as interpreters’ approach is a participatory method that can be applied across a wide range of public health activities. ESL learners emerged as ideal partners in developing curriculum for lead poisoning prevention for several reasons: the parents expressed strong interest in lead poisoning prevention, several have children under age 6 when lead screenings are recommended, and many have emigrated from regions in Mexico where lead hazards were identified. (Global Health Promotion, 2009; 16(3): pp. 53—58)

The contribution of social work in promoting rural health: a case from the grassroots

Nanjunda, D.C. — 2009-09-22

Promotion of rural health has become a high priority of policy makers in many third world countries. Numerous NGOs are working to improve health quality in rural India. By describing a rural health promotion project in which a social worker played a key role, this article illustrates how social work practitioners can bring their many skills to bear in efforts to promote health. This commentary seeks to share the experience of an NGO in specific health promotion project in Rural Karnataka State (India). (Global Health Promotion, 2009; 16(3): pp. 59—62)

Flow and sense of coherence: two aspects of the same dynamic?

Lutz, J. — 2009-09-22

Antonovsky’s sense of coherence (SOC) and Csikszentmihalyi’s concept of flow appeared approximately 20 years ago and have received widespread recognition as resource-oriented approaches within the fields of health and psychology, respectively. Both focus on the dynamics of engagement with life, flow on one’s level of engagement in the present and SOC on one’s global orientation — one’s self-perceived capacity for engagement over time. While the two constructs are very similar, even collinear, no attempt seems to have been made to integrate them. This article proposes that flow and sense of coherence are not only complementary but actually two aspects of the same dynamic: flow is sense of coherence made visible in the present, while sense of coherence is a product of flow over time. It is suggested that this hypothesis could be tested using existing or new empirical methods. If evidence is found to support the hypothesis, this could lead to a more useful, integrated model of the dynamics of engagement.

Abstracts

2009-09-22

Le transfert de connaissances et les regles de fonctionnement du systeme universitaire: besoin de changementsi

Ridde, V. — 2009-09-22

Equite et determinants sociaux de la sante: de l'urgence d'agir

Begin, M. — 2009-09-22

Accompagner les familles pour promouvoir leur participation dans la trajectoire medicale de leur enfant

Gisquet, E. — 2009-09-22

Le sujet traité est celui de la participation des familles dans les services hospitaliers. A travers l’exemple de deux services de réanimation néonatale, il apparaît que les modalités d’accueil et d’encadrement influencent le mode de participation des parents à la trajectoire médicale de leur enfant. Ces résultats mettent en évidence qu’une forte intégration des parents dans l’univers médical leur procure une plus grande marge de manœuvre, favorise une relation égalitaire entre usagers et professionnels et diminue les différences de départ liées à la catégorie socioprofessionnelle. Il est ainsi souligné la nécessité d’une première phase d’initiation et de formation des familles pour l’installation d’une certaine parité de participation dans la décision. (Global Health Promotion, 2009; 16(3): pp. 76—84)

Rencontre francophone internationale sur les inegalites sociales de sante: Etat de situation, moyens entrevus et referentiels pour l'action en sante publique visant a reduire les inegalites sociales de sante

De Koninck, M., Hebert, C. — 2009-09-22

Les 17 et 18 novembre 2008, se tenait à Québec la Rencontre francophone internationale sur les inégalités sociales de santé . Nous présentons ici un bref état de la situation élaboré sur la base de constats dégagés des différentes activités de la Rencontre. Après un détour par l’histoire des luttes sociales, l’accent a été mis sur l’urgence d’agir pour réduire les inégalités sociales de santé. Plusieurs illustrations de l’existence de ces inégalités qui s’observent selon un gradient plus ou moins prononcé entre groupes sociaux étaient présentées. Le caractère multifactoriel des inégalités sociales de santé est apparu comme un défi, mais un défi qui n’est pas insurmontable. Des moyens et repères d’action proposés par les experts invités à Québec sont ici rapportés, soit des approches adaptées en recherche et des moyens qui font appel aux communautés et à l’engagement citoyen sans négliger la mobilisation des acteurs de santé publique pour l’équité en santé. (Global Health Promotion, 2009; 16(3): pp. 85—88)

Resumes

2009-09-22

La transferencia de conocimientos y las normas de funcionamiento del sistema universitario: necesidad de cambiosi

Ridde, V. — 2009-09-22

Evaluacion de las Escuelas Promotoras de Salud en Asturias (Espana)

2009-09-22

n: Objetivo: Evaluar la situación de las escuelas en relación a la Promoción de la Salud, sus fortalezas y debilidades, a través de la incorporación de los principios de la Red Europea de Escuelas Promotoras de Salud y de las opiniones de alumnado y profesorado. Metodología: La población de estudio fueron 29 centros educativos. Se realizó una visita a cada centro y se recogió información por observación directa y entrevistas a equipo directivo, persona coordinadora del proyecto de salud y alumnado. Los criterios evaluados fueron: experiencia, compromiso, implicación del profesorado, metodología con alumnado, participación comunitaria, mejora del entorno, democracia y equidad, y otras acciones promotoras de salud. Cada criterio se valoró con una o varias variables. A cada criterio, se le dio 1 punto, de manera que cada centro podía obtener un total de 8 puntos. Juntos con éstas se recogieron otras variables cualitativas en relación a las fortalezas y debilidades de los centros en Promoción de la Salud. Resultados: La puntuación media de los centros fue 5,19 (DE: 1,16). Mayoritariamente, los centros tenían experiencia previa, incluía la Promoción en la Programación General Anual y en el Proyecto Educativo, y contaban con profesorado implicado, organizado y formado. Aproximadamente la mitad tenía una estética agradable y realizaba incorporación curricular, acciones de coeducación, de mejora del entorno, de alimentación saludable y actividades con comunidad. La participación del alumnado, de las familias y el uso organizado de espacios se dio en un porcentaje minoritario de centros. Conclusiones: Se constató un esfuerzo importante por incorporar la Promoción de la Salud, pero numerosas dificultades para ello. La principal limitación tiene que ver con la voluntariedad de estas acciones y la ausencia de políticas públicas para transformar los centros educativos. Destacar la aportación novedosa de esta investigación, en relación a la creación de un indicador global que permite evaluar la incorporación de la Promoción de la Salud en las escuelas utilizando los criterios de la Red Europea de Escuelas Promotoras de Salud. (Global Health Promotion, 2009; 16(3): pp. 96—106)

Resumenes

2009-09-22

The Galway Consensus

McQueen, D. V. — 2009-05-22

The Galway Consensus Conference: international collaboration on the development of core competencies for health promotion and health education

Barry, M. M., Allegrante, J. P., Lamarre, M.-C., Auld, M. E., Taub, A. — 2009-05-22

Developing a competent health promotion workforce is a key component of capacity building for the future and is critical to delivering on the vision, values and commitments of global health promotion. This paper reports on an international consensus meeting to identify core competencies, jointly organized by the International Union for Health Promotion and Education (IUHPE), the Society for Public Health Education (SOPHE) and the US Centers for Disease Control (CDC), with participation from international leaders in the field, that took place at the National University of Ireland, Galway, in June 2008. The purpose of the meeting is outlined and the outcomes in terms of strengthening global exchange, collaboration and common approaches to capacity building and workforce development are discussed. The Consensus Statement, based on the proceedings of the meeting, outlines core values and principles, a common definition and eight domains of core competency that are required to engage in effective health promotion practice. The core domains of competency agreed to at the meeting are: catalysing change, leadership, assessment, planning, impementation, evaluation, advocacy and partnerships. A summary of the Consensus Statement is presented and further dialogue and discussion are invited in order to continue the process of building international consensus with regard to health promotion core competencies. (Global Health Promotion, 2009; 16 (2): pp. 5—11)

A review of the international literature on health promotion competencies: identifying frameworks and core competencies

Battel-Kirk, B., Barry, M. M., Taub, A., Lysoby, L. — 2009-05-22

Building a competent health promotion workforce with the necessary knowledge and skills to develop, implement and evaluate health promotion policies and practice is fundamental to mainstreaming and sustaining health promotion action. This paper reviews the international literature on competencies in health promotion, examines the competencies developed to date, identifies the methods used in their development and considers what can be learned from the experience of others when establishing international core competencies. The paper considers the advantages and disadvantages of employing a competency approach and the extent to which the competencies identified to date can enhance the quality of practice and update the skill set required to work within changing social, cultural and political contexts.

Perspectives on health promotion competencies and accreditation in Europe

2009-05-22

There is a growing and diverse health promotion workforce in Europe; however, no overall body has responsibility for quality assuring standards of training and professional practice at the European level. This paper provides an overview of recent developments in Europe, including initiatives led by the International Union for Health Promotion and Education, in the context of developing a pan-European accreditation system. Specific developments on establishing national-level accreditation processes in the UK, Estonia and The Netherlands are examined. While there is limited experience in this field across Europe, lessons can be learned from those countries with established systems. This paper focuses on those countries which have developed competencies, standards and accreditation systems, and the implications for developing a pan-European accreditation system are discussed. Differences between countries in the formats, content and processes of developing accreditation, coupled with the different educational, practice, political and resource situations, reflect the complexity of developing a pan-European system that is flexible, relevant and comprehensive. The development of competencies, standards and accreditation is not intended to be directed at health promotion specialists alone but aims to assure quality in performance of all those who contribute to health promotion, from whatever background or area of professional practice. It is likely that there will be a need to develop a robust system that will accommodate different levels of accreditation for different levels and fields of practice. Developing a pan-European accreditation system poses a significant challenge but also presents a unique opportunity to form a solid basis for building capacity and assuring quality for health promotion practice, research and training across the European region.

Development and utilization of professional standards in health education and promotion: US and UK experiences

Speller, V., Smith, B. J., Lysoby, L. — 2009-05-22

This article defines standards, discusses the components of standards development, and provides an overview of the use of standards in the credentialing processes of health promotion and education specialists. Credentialing or registering agencies related to health promotion and education in the US and UK are identified and their role in credentialing processes is discussed. Examples outlining the development and application of professional standards in both the UK and US are presented. In order to advance the development of international competencies in health promotion, and move towards agreement between different country accrediting systems, there needs to be additional clarification and/or standardization of health promotion terminology at the global level, and further in-depth work to review the implementation of different systems on the ground to enhance our common understanding of the standards employed and competencies required in order to assist the development and utilization of standards for health promotion and education specialists in various countries/regions. (Global Health Promotion, 2009; 16 (2): pp. 32—41)

Health promotion competencies: providing a road map for health promotion to assume a prominent role in global health

Shilton, T. — 2009-05-22

Understanding of health and its determinants is rapidly expanding and changing. The emergence of chronic diseases as the leading cause of global disease burden and improved understanding of social determinants of health has brought greater focus to the role of prevention in health. The IUHPE has shown outstanding leadership through the Galway Consensus Statement. Its three recommendations appropriately focus on stimulating dialogue, developing global consensus and communicating the results to key stakeholders. The IUHPE can further enhance progress of the statement by developing participative processes to ensure engagement and ownership by its members. The Galway Consensus Statement can be used to advance professional standards in global health promotion by: (1) providing a common language by which health promotion and its meaning can be communicated to others; (2) providing a framework for building capacity in the health promotion workforce and in the health workforce in general; (3) providing international consensus for consistency in university health promotion courses; (4) providing a framework for credentialing in health promotion; (5) better informing health promotion engagement with other significant workforce sectors and advancing partnership as a key way of working. A vital further application of the Galway Consensus Statement is to inform advocacy. Advocacy is vital to ensure health promotion is better resourced and prioritized by policy makers. Advocacy and communication are vital tools to highlight the evidence, establish the policy fit and infrastructure requirements of health promotion, and present health promotion solutions based on evidence of effectiveness.

Health promotion competency building in Africa: a call for action

Onya, H. E. — 2009-05-22

The 26 leading authorities in competency-based and accreditation movements in global health promotion, health education, and public health identified eight domains of core competency that are required to engage in effective health promotion practice. The conference held in Galway, Ireland, issued a statement on building competency of health education and health promotion practitioners. Almost all the countries in the African region have structures for health education and/or health promotion that will benefit from the outcome of this conference, a first of its kind. Countries such as South Africa, Botswana and Nigeria have policies that support health education and health promotion development, and capacity building will be encouraged by the Consensus Statement to concentrate on identifying and building capacity within existing infrastructures across government and community sectors. South Africa attempted to establish a Standard Generating Board (SGB) for Health Promotion that envisaged the development of standards and qualifications for part of the second learner category, who hold the National Qualification Framework (NQF) level 5 certificate in health promotion. The author of this commentary joins other colleagues in congratulating the Galway conference participants for identifying the eight domains of core competency that are necessary if health promotion and health education are to develop into a distinct discipline, particularly in the African region.

Towards the development of skills-based health promotion competencies: the Canadian experience

Hyndman, B. — 2009-05-22

The health promotion competencies presented in the Galway Consensus Conference Statement build on an emerging international literature that includes a proposed set of Canadian competencies developed for health promotion practitioners. In Canada, the creation of draft health promotion competencies by Health Promotion Ontario (HPO) was fueled by increased concerns about the potential marginalization of health promotion as well as a national public health renewal process that placed increased emphasis on competency development as a means of strengthening the public health workforce. This commentary presents the proposed Canadian competencies and provides an overview of the process utilized to develop them. Key similarities and differences between the proposed Canadian competencies and the competencies outlined in the Consensus Statement are also explored. The Canadian experience illustrates the way in which national health promotion competencies can be shaped by cultural and political factors unique to a specific jurisdiction.

Abstract

2009-05-22

Le Consensus de Galway

McQueen, D. V. — 2009-05-22

Resumes

2009-05-22

El Consenso de Galway

McQueen, D. V. — 2009-05-22

La formacion de recursos humanos y el desarrollo de competencias para la capacitacion en promocion de la salud en America Latina

Arroyo, H. V. — 2009-05-22

El tema de la formación de recursos humanos en promoción de la salud ha generado gran interés en los ámbitos universitarios, en las organizaciones profesionales y en el sector de servicios de salud a nivel global y regional. Algunos de los asuntos que han motivado discusiones y acciones a nivel regional han sido los siguientes: interés en el desarrollo de guías curriculares y propuestas de competencias profesionales para los programas académicos de especialización en promoción de la salud; definición de competencias y saberes para orientar otras iniciativas de capacitación en promoción de la salud principalmente para el personal de salud pública en servicio directo; fortalecimiento y expansión de las redes académicas y profesionales en promoción de la salud a nivel Iberoamericano; desarrollo de reuniones, eventos académicos y publicaciones sobre el tema. Durante los años académicos 2006 al 2008 el Consorcio Interamericano de Universidades y Centros de Formación de Personal en Educación para la Salud y Promoción de la Salud (CIUEPS) ha estado analizando información acerca de los enfoques, las competencias y las características de los programas de formación de recursos humanos en promoción de la salud y educación para la salud en Iberoamérica. Como parte del análisis se observan diferencias de enfoques curriculares en las modalidades de pregrado, postgrado y otras ofertas académicas con diferentes tipos de certificación académica-profesional. Tanto el CIUEPS como otras entidades de América Latina han reiterado los desafíos en el ámbito de la formación de recursos humanos en promoción de la salud en la región. Entre ellos se destacan los siguientes: mantener un foro activo para la afinación de las competencias profesionales; ampliar las ofertas curriculares en diversas modalidades en el ámbito de la promoción de la salud; desarrollar cursos de promoción de la salud en otras disciplinas relacionadas; incrementar las redes y las acciones de intercambio académico entre las instituciones formadoras en la región Latinoamericana e Iberoamericana; fomentar el desarrollo de cursos internacionales sobre promoción de la salud; aumentar la producción teórica-conceptual sobre promoción de la salud y sus aplicaciones y variantes en el contexto de América Latina; mejorar las acciones de difusión de experiencias a través de publicaciones, conferencias y redes electrónicas de intercambio de información.

Resumenes

2009-05-22

An inspirational conference

O'Brien, U. — 2009-04-08

Closing the gap in a generation: health equity through action on the social determinants of health. An international conference based on the work of the Commission on Social Determinants of Health, 6--7 November 2008, London

Davies, M., Adshead, F. — 2009-04-08

Calling all Don Quixotes and Sancho Panzas: achieving the dream of global health equity through practical action on the social determinants of health

Friel, S., Bell, R., Houweling, T., Marmot, M. — 2009-04-08

Overview of content

Mittelmark, M. B. — 2009-04-08

Address from the Prime Minister

Brown MP, R. H. G. — 2009-04-08

Opening address by the Secretary of State for Health

Johnson MP, R. H. A. — 2009-04-08

Closing the health gap in a generation: the work of the Commission on Social Determinants of Health and its recommendations

Marmot, S. M. — 2009-04-08

Crossing cultures: the European regional approach to addressing the social determinants and health equity

Danzon, M. — 2009-04-08

Social determinants of health -- a country perspective: issues, priorities and action

Mugo MP, Hon. B. W. — 2009-04-08

Global partners: addressing the social determinants of health through international development

Lewis, I. — 2009-04-08

Missed opportunities: human rights and the Commission on Social Determinants of Health

Hunt, P. — 2009-04-08

The environmental determinants of health

Benn MP, R. H. H. — 2009-04-08

A regional perspective on the Commission on Social Determinants of Health report

Siddiqi, S. — 2009-04-08

The Brazilian Commission on Social Determinants of Health: next steps

Gomes Temporao, J. — 2009-04-08

Equity, justice and the social determinants of health

Robinson, M. — 2009-04-08

The experiences of the Islamic Republic of Iran on tackling health inequities

Kamran Bagheri Lankanari, — 2009-04-08

Farewell address on visionary pragmatism

Adshead, F. — 2009-04-08

Interview

Wilensky, G. — 2009-04-08

Interview

Madelin, R. — 2009-04-08

Interview

Chatterjee, M. — 2009-04-08

Interview

Berlinguer, G. — 2009-04-08

Equity through development: a panel discussion on balancing the demands of social and economic development

Scherer, P. — 2009-04-08

UNICEF's contribution to address the social determinants of health

George, A. — 2009-04-08

Health systems

Ndiaye, N. — 2009-04-08

The global impacts of climate change on human health

Odingo, R. S. — 2009-04-08

Envisioning a healthy and sustainable future: essential to closing the gap in a generation

Baum, F. — 2009-04-08

Climate change and social determinants of health: two interlinked agendas

Galvao, L. A. C., Edwards, S., Corvalan, C., Fortune, K., Akerman, M. — 2009-04-08

Priorities and actions to move health care beyond its comfort zone and move the nation to better health

Lavizzo-Mourey, R. — 2009-04-08

Health systems' impact on social determinants of health

Aasrud, R. — 2009-04-08

IUHPE and social determinants of health: setting an action agenda

De Castro Freire, S. B., Manoncourt, E., Mukhopadhyay, A. — 2009-04-08

This commentary introduces the recently created IUHPE Global Working Group (GWG) on Social Determinants of Health, which provides a unique opportunity to bring a global health promotion response to the social inequalities that result from the unequal distribution of the social determinants of health.

The two launch meetings of the GWG, which were held in the context of the conference `Closing the gap in a generation', enabled direct discussion and reaction with respect to the implementation of the WHO Commission on Social Determinants of Health's (CSDH) recommendations. Over the course of these meetings the group identified five main areas of work to specifically focus on over the next 18 months, leading to the 20th IUHPE World Conference on `Health, equity and sustainable development'. The discussions also facilitated the revision of the GWG's terms of reference, as presented in this commentary (Global Health Promotion, 2009; Supp (1): pp. 89—92)

Une conference inspiratrice

O'Brien, U. — 2009-04-08

Combler le fosse en une generation : instaurer l'equite en sante en agissant sur les determinants sociaux de la sante. Une conference internationale fondee sur le travail de la Commission des Determinants sociaux de la Sante, les 6 et 7 novembre 2008, a Londres

Davies, M., Adshead, F. — 2009-04-08

Faire appel a tous les Don Quichotte et a tous les Sancho Panza : realiser le reve de l'equite en sante dans le monde en agissant concretement sur les determinants sociaux de la sante

Friel, S., Bell, R., Houweling, T., Marmot, M. — 2009-04-08

Un apercu du contenu

Mittelmark, M. B. — 2009-04-08

Resume

2009-04-08

Una conferencia inspiradora

O'Brien, U. — 2009-04-08

Subsanar las desigualdades en una generacion: alcanzar la equidad sanitaria actuando sobre los determinantes sociales de la salud. Conferencia internacional en torno al trabajo de la Comision sobre determinantes sociales de la salud, 6--7 Noviembre 2008, Londres

Davies, M., Adshead, F. — 2009-04-08

Llamamiento a todos los Don Quijotes y Sancho Panzas: hacer realidad el sueno de la equidad sanitaria a escala mundial a traves de medidas practicas que incidan en los determinantes sociales de la salud

Friel, S., Bell, R., Houweling, T., Marmot, M. — 2009-04-08

Una mirada al contenido

Mittelmark, M. B. — 2009-04-08

Resumen

2009-04-08

Views of Health Promotion Online (VHPO) is alive and kicking at www.vhpo.net!

Mittelmark, M. B. — 2009-03-10

What we mean by social determinants of health

Navarro, V. — 2009-03-10

The salutogenic approach to the making of HiAP/healthy public policy: illustrated by a case study

Lindstrom, B., Eriksson, M. — 2009-03-10

Twenty years have passed since the central document of health promotion, the Ottawa Charter, was constituted. Health was seen as the process enabling individuals and communities to increase control over their determinants of health, thereby improving their health and enabling an active and productive life, that is, a good quality of life. One main strategy was the making of a healthy public policy. At the same time Aaron Antonovsky developed the salutogenic theory and its core concepts the sense of coherence and the generalized resistance resources. This paper integrates Antonovsky's salutogenic theory and a salutogenic model of quality of life into the core principles of the Ottawa Charter and exemplifies how to make healthy public policy the salutogenic way. A process-oriented coherent health promotion research model integrating an ecological, a salutogenic and a resilient approach is shown. The objective of this theoretical model is to bring together the whole spectrum of risk factors, protective factors and promotion factors in one model. Further, individual, group and society level are considered. The model suggested aims to contribute to the creation of sense of coherence. This is exemplified in practice in a case study of a Nation, that is, on a national level. The case study of the "Nation" is partly masked. The principles behind these processes are explained in detail while the case study of the "Nation" only includes parts of the process explaining some core issues. The overall aim of this paper is to stimulate health promotion activities along the lines presented and invite the readers to comment and continue the discussion. (Global Health Promotion, 2009; 16 (1): pp. 17—28)

Priorities for mental health promotion during pregnancy and infancy in primary health care

2009-03-10

The perinatal period (shortly before and after birth) is a particularly significant stage, providing a sound base for healthy development. Primary health care should accompany the individual through the entire life cycle, and mental health problems constitute a public health threat that calls for the development of mental health promotion initiatives in primary health care. Responding, in 2004 our team initiated an action research project with the aim of reorganising primary health care during pregnancy and the first year of life. The aim is to enable health professionals to support families in the transition to parenthood, thereby promoting children's mental health.

In order to plan this reorganisation, we developed a two-step decision-making process: 1. assessment of antenatal health care; 2. joint reflection concerning the priorities for change. The study goal was to assess the particular characteristics and needs of families during the perinatal period as well as the kind of care they were actually receiving. We designed a cross-sectional quantitative—qualitative study that collected data from users and health professionals using questionnaires and semi-structured interviews. The reflection step took place during a workshop that aimed to analyse the results and discuss priorities. The study confirmed the need to search for mental health problems during pregnancy, particularly to prevent a disturbed mother/child bonding process, and the importance of emphasising issues such as communication, information provision and the adequate availability of health professionals for antenatal care.

The findings led to the following conclusions: 1. risk and needs assessment regarding mental health and options for family support should be included in the protocols of antenatal care; 2. primary health care professionals should be enabled to undertake diagnostic work and problem solving related to mental health; 3. collaboration between different levels of health care and between health sector and community resources should be increased.

The highly participative decision-making process used led to a selection of priorities and strategies that was meaningful to users and health professionals and should contribute to the implementation and sustainability of changes for mental health promotion. (Global Health Promotion, 2009; 1 (1): pp. 29—38)

Elaborating on systems thinking in health promotion practice

2009-03-10

Health and well-being are the result of a series of complex processes in which an individual interacts with other people and the environment. A systematic approach ensures incorporation of individual, ecological, social and political factors. However, interactions between these factors can be overlooked within a systematical approach. A systemic approach can provide additional information by incorporating interactions and communication. The opportunities of a systems thinking perspective for health promotion were investigated for this paper. Although others have also made attempts to explore systems thinking in the field of health promotion, the implications of systems thinking in practice need attention. Other fields such as agricultural extension studies, organizational studies and development studies provide useful experiences with the use of a systems thinking perspective in practice. Building on experiences from these fields, we give a theoretical background in which processes of social learning and innovation play an important role. From this background, we derive an overview of important concepts for the practical application of a systems thinking perspective. These concepts are the structure of the system, meanings attached to actions, and power relations between actors. To make these concepts more explicit and reduce the theoretical character of systems thinking, we use an illustration to elaborate on these concepts in practice. For this purpose, we describe a health promotion partnership in The Netherlands using the concepts structure, meaning and power relations. We show how a systems perspective increases insight in the functioning of a partnership and how this can facilitate processes of social learning and innovation. This article concludes by identifying future opportunities and challenges in adopting systems thinking for health promotion practice. A systems perspective towards health promotion can help projects reaching a more integral and sustainable approach in which the complex nature of health promotion processes is supported. Practical applications of systems thinking are necessary to adapt this perspective. (Global Health Promotion, 2009; 16 (1): pp. 39—47)

Abstract

2009-03-10

Health promotion, environmental psychology and sustainable development -- a successful "menage-a-trois"

Annerstedt, M. — 2009-03-10

Our society is facing a crisis with escalating mental health disorders, long-term sick leaves and a health care system not provided with the appropriate healing tools. Combined with the global environmental degradation this could be a very depressive scenario.

I suggest a new and dynamic thinking in order to create a more positive atmosphere, both literally and conceptually, into which diverse disciplines work together to reach a mutual goal — global health and environmental justice. It is time to accept that science cannot be dispensed from the dynamics of living, culture and nature, but on the contrary those belong together. Only by working with this premise as a point of departure, can former criteria and old traditions in science be challenged and subsequently ameliorated. (Global Health Promotion, 2009; 16 (1): pp. 49—52)

Social determinants of health in very poor ruralities

Bull, T. — 2009-03-10

Globally, research on social determinants of health has built a considerable knowledge base over the last decade. Still, not much of this research has been carried out in the extremely poor areas of the world, like for instance Africa south of the Sahara. In very poor ruralities, classic indicators of socioeconomic status are not well suited. Few people have any education, monetary income is not a good measure of material standing and people cannot be classified by occupation as they make their livelihood from a variety of activities. For efforts towards health equity to benefit the poorest of the poor, more suitable indicators of social health determinants must be identified. Health research might benefit from knowledge developed in neighbouring fields like development research, anthropology and sociology. (Global Health Promotion, 2009; 16 (1): pp. 53—56)

The struggle for abandonment of Female Genital Mutilation/Cutting (FGM/C) in Egypt

Molleman, G., Franse, L. — 2009-03-10

This commentary describes a visit to the Female Genital Mutilation/Cutting project in Cairo. FGM/C is a very serious problem in Egypt and other countries in the North of Africa. Among girls between the age of 15—17, 77% have been cut, with very serious health consequences. In Egypt, there is a comprehensive strategy led by very enthusiastic employees of the National Council for Childhood and Motherhood with support of UNICEF. At a national level a broad coalition is being built that tries to mobilise the legal, medical and media communities to overcome the practice of FGM/C and realising adequate laws that criminalise FGM/C.

At a local level two community projects were started in 160 villages in Upper and Lower Egypt for raising community awareness and dialogue on FGM/C. That is the only way to create a growing social movement that can collectively abandon the practice of FGM/C. (Global Health Promotion, 2009; 16 (1): pp. 57—60)

A rights-based approach to accessing health determinants

Perkins, F. — 2009-03-10

This commentary summarizes the experience and learnings from a site visit in May 2008 to a drop-in centre for vulnerable women in downtown Cairo run by El-Shehab Institution for Comprehensive Development, which provides street outreach for the prevention of Sexually Transmitted Infection (STI). The Centre successfully provides services and support for women, many of who are displaced or refugees and are from the most marginalized areas in Cairo. Through a rights-based approach to the work, the Centre helps people living in the slums fight and win the right to access clean water, sewerage and electrical power in their communities. An individual-based approach to human rights is also used. In the last year El-Shehab have helped 67 women go to court and win their marriage rights from husbands who have abandoned them. Their approach is an example of a successful way to achieve access to basic health determinants. (Global Health Promotion, 2009; 16 (1): pp. 61—64)

New horizons for social development

2009-03-10

This commentary follows up on a field visit made by the authors to a community development programme in Cairo supported by a local non-governmental organization called New Horizon Association for Social Development (NHASD). The people who comprise NHASD are dedicated to improving the conditions and quality of life of the most marginalized and underdeveloped communities. The paper describes the overall approach that community members, social workers and leaders use to tackle the underlying causes of poverty and the skills, resources and services they build using a rights-based and participatory community development approach. It also addresses ideas for IUHPE concrete action, which came from discussions stimulated by the visit, to support such community initiatives out of isolation. It ranges from complimentary membership of the NHASD to the organization of a specific health promotion network of extremely socio-economically vulnerable communities in urban areas worldwide, connected to the IUHPE Group on Settings-based Health Promotion, as well as sessions at the forthcoming IUHPE 20th World Conference on Health Promotion on the theme "Health, Equity and Sustainable Development". (Global Health Promotion, 2009; 16 (1): pp. 65—68)

Views of Health Promotion Online (VHPO) est lance et operationnel sur www.vhpo.net !

Mittelmark, M. B. — 2009-03-10

Approche socio-anthropologique de la dynamisation du reseau d'acteurs de prise en charge des malades tuberculeux au Burkina Faso

2009-03-10

La tuberculose est une maladie chronique dont la prise en charge nécessite une approche multisectorielle: le social et le biomédical. Une étude socio-anthropologique retraçant les itinéraires thérapeutiques des malades a permis d'identifier les détenteurs d'enjeux dans la gestion de la maladie pour élaborer une « carte des acteurs » et encourager une interaction dynamique entre les membres. L'identification des acteurs clés et leur mise en réseau a permis d'entreprendre des actions contribuant à renforcer l'efficacité et l'efficience de la prise en charge des malades au Burkina Faso, par des actions collectives. Nous identifions ainsi des acteurs sociaux, alliés et confidents des malades; des acteurs biomédicaux, directement concernés par la prise en charge médicale de la maladie. A travers ces liens entre les acteurs, nous remarquons que les systèmes de santé sont caractérisés par des interactions sur fond d'incompréhension qui influence négativement la qualité des soins. La dynamisation du réseau d'acteurs a permis d'éprouver un mode de collaboration axé sur l'analyse collective des problèmes rencontrés par les prestataires de soins et les malades tuberculeux. Celle-ci a permis la mise en œuvre d'actions visant à améliorer la qualité de vie des malades. La dynamique de collaboration entre acteurs concernés par l'accès aux soins de santé a eu raison sur les situations problématiques qui entament les succès thérapeutiques et la qualité de vie des malades tuberculeux. (Global Health Promotion, 2009; 16 (1): pp. 72—80)

Resumes

2009-03-10

{inverted exclamation}Views of Health Promotion Online (VHPO) esta viva y coleando en www.vhpo.net!

Mittelmark, M. B. — 2009-03-10

Resumenes

2009-03-10