RHP&EO is the electronic journal of the International
Union for Health Promotion and Education
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Resources that have recently influenced a Health Promoter in Africaby David Nyamwaya Phd, Brazzaville, Republic of Congo Nyamwaya, D., Resources that have recently influenced a Health Promoter in Africa, Reviews of Health Promotion and Education Online, 2002. URL: reviews/2002/5/index.htm. Since several influences have impacted on my health promotion career, the resources reviewed in this article are those that I have encountered during the last seven years or so. I have chosen these resources because of their direct, and continuing, relevance to my day-to-day work in supporting national health promotion policy as well as institutional programme development. I am a health promotion practitioner, researcher and teacher. Two decades ago, I got interested in general health development and especially research into ways of accelerating health improvement through education. A few years as a research fellow in a university institute soon led to frustration. The frustration was due to the lack of opportunities for applying research findings to health action. My next job was as a project officer focusing on water and sanitation programmes in a UN agency. I had a chance to do research whose findings were used to improve health education interventions. During this period I learned that health education then presupposed that major barriers to health development lay primarily in cultural beliefs and practices. It became evident that in order to assist people improve their health, there was need for a good understanding of their cultural, physical, economic, and political environments. The next decade was spent in a regional health non-governmental organization. During this period I lead a multidisciplinary team in a health behavior and education department. It was at this stage that my attention turned to the underlying determinants of health. School health programmes were of particular interest since they represented a setting where knowledge, skills, the physical environment, policies and advocacy for health could be addressed through comprehensive health interventions. After difficult and lengthy debate, a health promotion programme replaced the health behavior department. I thus had the good fortune to lead the first health promotion proramme in Africa, immediately after the fourth global conference on health promotion in Jakarta, (1997). At the moment I work with the African Regional Office of the World Health Organization focusing on health promotion policy, human resource development and programming. Health and culture: Beyond the western paradigm
A book , "Health and culture: Beyond the Western paradigm" (Airhihenbuwa , 1995) is capable of jostling health promotion practitioners who have fallen into cultural slumber. The book argues forcibly that culture can exert a positive, negative or existential influence on health. Those trying to contribute to health promotion should therefore take care not to overemphasize the role of culture as a barrier to health development; the focus should be on recognizing the cultural dimension in health. Once this dimension is recognized, practitioners are forced to identify ways of facilitating effective use of public health interventions based on the western paradigm in nonwestern societies. The book is valuable because it enables health promotion practitioners to be critical of the values and paradigms that underlie their knowledge and approaches. It cautions that health promoters should avoid equating health development with westernization. When this equation exists, the author argues, much time and effort and energy are wasted in trying to change people in order to achieve health status defined according to the western paradigm. The book makes many suggestions on how to go about health development without assuming inferiority of non-western indigenous health ideas and practices, while not taking for granted cultural elements that are inimical to health. Creating Supportive Environments for Health
"Creating Supportive Environments" (Haglund et al, 1996) is a publication that takes its title from the third Global Conference on Health Promotion (Sundsvall, 1991). The book briefly presents the theory and principles that usually constitute the basis for actions aimed at creating environments supportive of health. Several examples of health promotion interventions are described to illustrate a wide range of health promotion issues, approaches and methods. The Jakarta Declaration
The "Jakarta Declaration" exists in printed form as well as on the WHO Website. The declaration states plainly and authoritatively, that health promotion is a key investment essential for socioeconomic development. It also states emphatically that health is a basic human right. The notion of determinants of health is elucidated; echoing the Ottawa Charter, but going beyond, peace, shelter, education, social security, social relations, food, income, the environment, empowerment of women, a stable eco-system, sustainable resource use, social justice, respect for human rights, and equity are listed as the prerequisites for health. Local Action: Creating Health Promoting Schools
"Local Action: Creating Health Promoting Schools" (WHO, 2000) is a how-to-do-it manual for teachers, health workers, parents and pupils who wish to make the school a setting for health promotion. Heart 2 Heart (Heart-to-Heart)
"Heart-2-Heart" (Heart Foundation of South Africa, Vol. 1 Issue 2) is an in-house Magazine focusing on cardiovascular health. It comes in colorful, easy to read format in ordinary people's language. On the front page of volume one, issue two for example, there is a picture of a heart shaped red sweet paper, and headings such as like: 'A change of heart takes a week', 'Growing healthy children', 'Do vitamins complex you?' 'Obesity, a heavy burden on the heart'. This is a user-friendly product that is copiously illustrated with real life pictures and is especially relevant for the non- specialist in heart matters. ConclusionHealth promotion is rapidly getting established in Africa but locally produced resources are still few. A regional strategy has recently been endorsed by all countries in the region and will be soon reviewed in this series. It is my hope that you too have or will benefit by reading the resources reviewed. References
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