OTTAWA DECLARATION AND HEALTH PROMOTIN PRINCIPLE by Dr Ojeremi Taiwo Tosin OUTLINE.
Introduction
Health Promotion
Elements and Components
Guiding Principles
Consumer Rights and Health
Conclusion
INTRODUCTION The concept of HEALTH PROMOTION is broader than health education. There was a growing realization that health education can influence knowledge, but on its own may not result in behaviour change. Hence the concept of Health Promotion was defined at the landmark Global Conference on Health promotion.

HEALTH PROMOTION
Health promotion is the process of enabling people to increase control over their health and it’s determinants, and thereby improve their health.

A planned combination of educational, political, regulatory and organizational supports for actions and conditions of living conducive to the health of individuals, groups or communities (Green and kreuter,1999.) It is a core function of public health and contributes to the work of tackling communicable and non communicable diseases and other threats to health. Health promotion therefore involves a multidisciplinary application of skills in psychology,anthropology,economic,political theory, consumer rights/law,communication,media design,epidemiology,management,community mobilization and the application of resaerch,planning and evaluation skills.

Who does Health Promotion?

Health Promotion is part of the role of a wide range of field staff within health and other services. e.g nurses, doctors, teachers, agricultural workers etc
PREREQUISITES FOR HEALTH Improvement in health requires a secure foundation in these basic prerequisites. They are fundamental conditions and resources for health.They are:
Peace
Shelter
Education
Food
Income
A stable eco-system
Sustainable resources
Social justice and equity

ELEMENTS AND COMPONENTS. The Ottawa Charter defined Health Promotion as consisting of five elements. These five elements can also be simplified into 3 basic components.
The 5 elements are:
Development of health public policy
Creation of supportive environments for health
Strengthening of community action
Development of personal skills
Reorientation of health services

The 3 basic components are:
Health education with individuals and communities.
Reorientation of health services to improve their accessibility, acceptability and appropriateness.
Advocacy to influence policy makers to adopt healthy public policies and enforce laws that promote health and consumer rights

Health Education Communication is directed at families and communities to influence:
Awareness/Knowledge
Decision-making
Beliefs/attitudes
Employment
Individual and community
Action/behaviour change
Community participation

Health services improvement
Improvement in quality and quantity of services:
Accessibility
Case Management
Counseling
Patient education
Outreach
Social marketing

Advocacy Agenda setting and individuals, advocacy for healthy public policy:
Policies for health
Income generation
Removal of obstacles
Discrimination
Inequalities
Gender barriers
Health Promotion Specialists These are persons who have received specialist training in Health Promotion, whose task is to act as resource persons for the planning,evaluation,training and support of Health Promotion
KEY PRINCIPLES GUIDING HEALTH PROMOTION
Context Driven: Promoting health requires advanced knowledge about the interface between health and its determinants, social epidemiological skills for analyzing socio-economic, gender and ethnic gaps in health and diseases patterns in populations, as well as effective mechanisms to maintain and improve good health for all ,taking into account different historical, religious and societal values and practices.
Integrates the three Dimensions of the WHO Health Definition: Promoting health means addressing the multi-dimensional nature of health,its physical,social,and mental dimensions. For many countries and communities it has also been evident to include a fourth dimension, spiritual health, given their cultural context

Underpins the Overall Responsibility of the state in promoting health: All levels of government have a responsibility and accountability for protecting, maintaining and improving the health of its citizens, and need to include health as a major

Champions good health as public good: Good health is beneficial to the society as a whole, its social and its economic development. In this view health becomes a public good and a key component of modern citizenship.

Participation and core principle in promoting health: The participation of people and their communities in improving and controlling the conditions of health is a core principle in promoting health
CONSUMER RIGHTS AND HEALTH
The community has both rights and responsibilities for health. Consumers have the responsibility to take the best possible action to ensure their health, that of their family and community. In return they have the right to expect the health system to provide the services and enabling environment that will allow them to take those actions.

Improving consumer awareness and community involvement is one of the thrusts of the Health Sector Reform Programme in Nigeria. This includes both the rights of the public to have access to quality health care services as well as the right to healthy environments.

Measures set out include establishing guidelines to ensure quality of care, treatment of patients and enforcement through law of health protection measures.E.g enforcement of food hygiene, water quality measures, control of fake and sub-standard drugs, monitoring of unsafe working conditions etc.

PRIORITIES FOR HEALTH PROMOTION
Priorities for health promotion in the 21st century are:
Promote social responsibility for health: Decision makers must be firmly committed to social responsibility. Both the public and private sectors should promote health by pursuing policies and practices that; avoid harming the health of individuals, protect the environment and ensure sustainable use of resources, and safeguard both the citizen in the market place and the individual in the workplace.

Increase investments for health development: In many countries, current investment in health is inadequate and often ineffective. Increasing investment for health development requires a truly multi-sectoral approach ,eg additional resources for education and housing as well as for health sector. Greater investment for health and reorientation of existing investment, both within and among countries, has the potential to achieve significant advances in human development, health and quality of life.

Consolidate and expand partnerships for health: Health promotion requires partnership for health and social development between the different sectors at all levels of governance and society. Existing partnerships need to be strengthened and the potential for new partnerships must be explored .Partnerships offer mutual benefit for health through the sharing of expertise, skills and resources. Each partnership must be transparent and accountable and be based on agreed ethical principles ,mutual understanding and respect. WHO guidelines should be adhered to.

Increase community capacity and empower the individual: This is done by educating them, training them and making resources available and accessible. Secure an infrastructure for health promotion: Incentives should be developed to influence the actions of governments, non-governmental organizations, educational institutions and the private sector to make sure that resource mobilization for health promotion is maximized

CONCLUSION.
The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. In light of these realities, promoting health requires that we focus our efforts and prioritise our actions
REFERENCE
Dr caleb Adegbenro. Health Promotion/Education
Federal ministry of health. National Promotion Health policy. 2006.5-12.
Ewles L, Simnett I (2005) Promoting Health - a practical guide Balliere Tindall: Edinburgh
WHO Europe (1999) Health 21 - Health for all in the 21st Century WHO Europe: Copenhagen
WHO (1999) Reducing health inequalities - proposals for health promotion and actions WHO: Copenhagen.