RHP&EO is the electronic journal of the International
Union for Health Promotion and Education
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Five Resources that Shaped My View as a Health Promoter in the British Virgin Islands.by Ivy George George, I. Five Resources that Shaped My View as a Health Promoter in the British Virgin Islands, Reviews of Health Promotion and Education Online, 2004. URL: 3/index.htm. Introduction This paper reviews five resources that have strongly influenced my work in health promotion. My interest in promoting health started during the time I was working as a student nurse in Peebles Hospital, British Virgin Islands, shortly after graduation from high school. Due to social and economic improvement in the territory, morbidity and mortality from communicable diseases were on the declined. However, complications and disabilities due to untreated and uncontrolled chronic non-communicable diseases such as diabetes and high blood pressure were common. My desire to conduct research to try to understand the causes and means of prevention of these increasingly prevalent conditions led to my career in health education and health promotion. I will discuss my five resources chronologically. The Alma-Ata Declaration My professional career in health education began in 1979, one year after the renowned international conference on Primary Health Care held in Alma Ata, USSR. It was from this conference that the call went out internationally for a united effort by health workers and professionals in other sectors, including community members, to protect and promote the health of all people of the world. The desires of the participants of this milestone conference were recorded in ten recommendations and enshrined in the "Alma Ata Declaration on Primary Health Care"(WHO and UNCF, 1978) . This Declaration would later influence the renowned "Health for All by the Year 2000 Strategy." The Alma Ata Declaration became one of the main resources to guide my work during the early years of my career. A Canadian Professional Journal Another publication which was instrumental in influencing my early career was a professional Canadian journal, published by Health and Welfare Canada for health educators called "Health Education" renamed "Health Promotion" in 1986 and finally renamed "Health Promotion Canada" before it sadly disappeared in the mid 1990's. This publication was one of the first professional publications in the health promotion arena that I was able to access during the period 1980-1995. It was through it that I was introduced to the term health promotion, and later was kept abreast of developments in the field. For example, this publication reported on key papers and documents that have shaped health promotion, including the "Lalonde Report" of 1974, as well as two major documents released in Ottawa in 1986 during the first International Conference on Health Promotion: the "Ottawa Charter on Health Promotion" and "Achieving Health for all: A Framework for Health Promotion", by Jake Epp (1986). It also featured reports on exciting and innovative interventions that were being pioneered across Canada. PAHO Anthology on Health Promotion "Health Promotion: An Anthology" is a book published in 1995 by the Pan American Health Organization. It is a comprehensive collection of international articles and papers on health promotion written from a holistic view of health. This was the first full text that I read on health promotion. It provides an in-depth coverage of the range of issues being addressed under the banner of health promotion. This book helped me to put health promotion into perspective, and to better articulate how the holistic approach differs from traditional health education. The book also provided insight into the complex and major challenges with which health professions using this approach must grapple. This document became one of my main references on health promotion during most of the 90's. Two IUHPE related documents The two resources that most influence my career currently are published by International Union of Health Promotion and Education (IUHPE). The first document is "The Evidence of Health Promotion Effectiveness: Shaping Public Health in a New Europe" (IUHPE, 1999). The report seeks to assess the effectiveness of health promotion over the past twenty years, internationally. It also seeks to examine the political, social, economic and health impacts of interventions carried out under the label of health promotion. The report is presented in two parts. Part One, which is designed for decision makers, presents the evidence and makes recommendations for action by decision makers. By contrast, Part Two gives a more in-depth analysis of the evidence and is targeted toward public policy advisers and academics. A practitioner advocating health promotion is often bombarded with requests for evidence of the effectiveness of its interventions. Hence, discovering this report provided me with a useful resource for making the case for health promotion as an effective public health strategy. It is an accepted fact that most of the broader determinants of health are outside the direct control of the health sector, and while working intersectorally is one of the core principles of health promotion, it is easier said than done. The article entitled "Principles, Methodology and Practices of Investment for Health" published by Erio Ziglio et al. (2000) in IUHPE's journal Promotion and Education introduced me to the work being done by the European Office of WHO through the Verona Initiative (1997). This article directly explored some of the issues that were of concern to me, and I was excited to learn about the work being done in the WHO/EURO Office. It is my opinion that the Investment for Health approach makes a good case for focusing more on the social, economic and environmental interventions that are needed, in addition to the traditional health focus, for a drastic improvement in population health. This approach can play a major role in putting health on national developmental agendas. It presents a "win/win" situation. As pointed out by Spencer Hagard (2000) in the same issue of Promotion and Education, investing for health is an approach to health promotion which is directed at enabling sectors to work more effectively together to improve health gains, without compromising their own agendas. Conclusions The resources discussed here span a long period of time, and come from different types of publications. Being a pioneer in health education/health promotion in my small country, resources such as articles, books and reports have played a major role in my career development. Hence, the opportunity to pause and reflect on the resources that have influenced my career has been a challenging but enjoyable exercise. References
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