RHP&EO is the electronic journal of the International
Union for Health Promotion and Education
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RESOURCES THAT HAVE INFLUENCED A LATIN-AMERICAN BEGINNER IN HEALTH PROMOTIONJuan Silva, Bogota- Colombia Silva, J. RESOURCES THAT HAVE INFLUENCED A LATIN-AMERICAN BEGINNER IN HEALTH PROMOTION , Reviews of Health Promotion and Education Online, 2004. URL: 11/index.htm. There are several steps in walking through the health promotion path and always there is a book, publication, movie or just a conversation with a friend or colleague that points at health promotion as not just a professional career but also as a way of thinking. I have being working at the Pan American Health Organization - PAHO - for several years providing technical cooperation in Latin America and the Caribbean assessing the eye care situation and developing policies, plans and programs to increase availability, access, affordability quality and utilization of eye care services. My first exposure to health promotion was in 1992 when the eye care program was incorporated within the PAHO Health Promotion Program that was under the direction of Dr. Helena Restrepo in Washington D.C.; the interactions with my colleagues and the permanent work in concept development in health promotion were a great opportunity to introduce me to the matter. In 1994 my duty station was changed to Bogotá, Colombia, where the need to implement comprehensive health programs encouraged me to become a "beginner in health promotion". There are several good publications but the following five got in my way at the right time helping me to increase my interest, understanding, knowledge and skills. Ottawa Charter for Health PromotionThe Charter published by the end of 1986 is still a resource of inspiration. The short document was produced at the international conference organized in Ottawa on November 1986 by the World Health Organization, Health and Welfare Canada and the Canadian Public Health Association. The Charter combines the philosophy, intellectual work, experience and knowledge in health promotion of many public health practitioners and stakeholders through the years previous to the conference; it builds on the progress made through the Declaration on Primary Health Care at Alma Ata.The Charter describes the prerequisites for health and peace such as shelter, education, food, income, a stable eco-system; it speaks about the role of advocacy in making economic, social, cultural, biological and behavioral factors favorable to health. It gives to health personnel and social groups the responsibility to mediate between differing interests in society for the pursuit of health. Health promotion aims at reducing differences in current health status and ensuring equal opportunities and resources to enable all people to achieve their fullest health potential. In addition, the Charter gives specific action lines for programs development such as building healthy public policy, creating supportive environments, strengthening community action, developing personal skills and reorienting health services. This valuable document provides in two pages the necessary motivation towards and knowledge of the essential aspects of health promotion. Even for those working already for many years in health promotion the Charter is inspiriting non-controversial reading material. Public Health Advocacy: Process and Product This article by Christoffel (2000), published in the American Journal of Public Health, describes advocacy as an assembly line, which produces changes in societal resource allocation for the public health development. Advocacy is presented as a process that includes several stages such as problem identification, research and data gathering, communication of information to stakeholders, publicizing it and utilizing the data to promote regulations and legislation. It uses strategies such as fundraising, tactics, and involvement of policy makers, enforcement of effective policies, crafting regulation and legislation.This article identifies sets of distinguishable activities in a logical sequence; it is concise, applicable, and provides the necessary systematic steps to orient an advocacy program. We have being using this approach to develop policy formulation with good results and believe that it is a good guide to anyone doing advocacy. Health communication: Lessons from family planning and reproductive healthThis book and companion video by Piotrow et al. (1997) is very valuable for a beginner in health promotion. Health communication is an abstract matter especially for those professionals coming from health care careers. The book and video utilize family planning and reproductive health experiences in developing countries to illustrate the strategic communication, planning, design, development of materials, pre-testing, production, monitoring and impact evaluation of the health communication programs.The companion video enables the reader of the book to view some of the videos referred in the text. This includes TV spots, TV drama, radio show, variety shows and others. Depending on the chapter the videos are presented for different purposes such as illustrating communication analysis, audience analysis, audience segmentation, positioning, multi-channel approach, entertainment education, professional marketing, pre-testing and revision of materials, doing campaign launch, building coalitions, and even cost effectiveness. This easy to read and enjoyable publication presents health communication as a valuable tool to achieve results in behavior change of the population. The strategies presented for family planning can be applicable for any behavior change program or intervention. Guidelines for health education and risk reduction activitiesThis is a printed CDC technical program guide (National Center for Preventive Services 1995). This document provides an organized and detailed guideline in how to conduct a health education program through individual and group interventions, community outreach and counseling. It also describes how to conduct a public information campaign describing planning, staff training, channel selection, education materials, using mass media and special events.A beginner in health promotion may use the guidelines to improve the design, implementation and evaluation of the programs or just as a checklist of the different topics that have to be considered. The document is primary oriented to HIV-AIDS programs but is written in a way that can be applicable to any kind of health topic. Promoting Health through Public PolicyThe book by Milio (1986) discusses the concept of "making health" and presents public policy as a tool to affect health, not just health services. It provides a comprehensive view of policy making that takes into account the analytical and political issues as well as the unintended effects of policy. The scope of health making through public policy cuts across policies affecting economy, ecology and other concerns that traditionally are not considered to be health related activities but can best deal with unnecessary disability and death. Public policy can change patterns of behavior by presenting to the people health making opportunities with larger gains at very little "cost". This approach is effective in inducing individuals and organizations to make choices. The concept of costs and gains is very well illustrated in the book.The book is concept-generating and as such can be inspiring reading material for IUHPE members. ConclusionPeople working in health promotion are usually coming from different backgrounds. A life experience, conversation, document, book or any other communication media may trigger our interest for this field. The documents that I just described are those that I found in my way and made me change my orientation in public health or helped me to increase the "know how" in programs development. For each of us the time comes when are ready and open for new visions of life and professional career. Messages coming at that time may change our thinking and future actions. Many other valuable documents are out there to help us to do our work better based on the experience of others. It is our responsibility to keep our mind open to get new views and messages to be able to give a better service.References
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