Ottawa Charter for Health Promotion-International Conference Case Study

The first International Conference on Health Promotion, meeting in Ottawa this 21st day ofNovember 1986, hereby presents this CHARTER for action to achieve Health for All by theyear 2000 and beyond.
This conference was primarily a response to growing expectations for a new public healthmovement around the world. Discussions focused on the needs in industrialized countries, buttook into account similar concerns in all other regions. It built on the progress made throughthe Declaration on Primary Health Care at Alma-Ata, the World Health Organization'sTargets for Health for All document, and the recent debate at the World Health Assembly on
intersectoral action for health.

Health Promotion
Health promotion is the process of enabling people to increase control over, and to improve,their health. To reach a state of complete physical, mental and social well-being, an individualor group must be able to identify and to realize aspirations, to satisfy needs, and to change orcope with the environment. Health is, therefore, seen as a resource for everyday life, not theobjective of living. Health is a positive concept emphasizing social and personal resources, aswell as physical capacities. Therefore, health promotion is not just the responsibility of thehealth sector, but goes beyond healthy life-styles to well-being.

Prerequisites for Health
The fundamental conditions and resources for health are:

• peace,
• shelter,
• education,
• food,
• income,
• a stable eco-system,
• sustainable resources,
• social justice, and equity.

Improvement in health requires a secure foundation in these basic prerequisites.
Advocate
Good health is a major resource for social, economic and personal development and animportant dimension of quality of life. Political, economic, social, cultural, environmental,behavioural and biological factors can all favour health or be harmful to it. Health promotionaction aims at making these conditions favourable through advocacy for health.
Enable
Health promotion focuses on achieving equity in health. Health promotion action aims atreducing differences in current health status and ensuring equal opportunities and resources toenable all people to achieve their fullest health potential. This includes a secure foundation ina supportive environment, access to information, life skills and opportunities for makinghealthy choices. People cannot achieve their fullest health potential unless they are able totake control of those things which determine their health. This must apply equally to womenand men.

Mediate
The prerequisites and prospects for health cannot be ensured by the health sector alone. Moreimportantly, health promotion demands coordinated action by all concerned: by governments,by health and other social and economic sectors, by nongovernmental and voluntaryorganization, by local authorities, by industry and by the media. People in all walks of life areinvolved as individuals, families and communities. Professional and social groups and healthpersonnel have a major responsibility to mediate between differing interests in society for thepursuit of health .Health promotion strategies and programmes should be adapted to the local needs and
possibilities of individual countries and regions to take into account differing social, culturaland economic systems.

Health Promotion Action Means:
Build Healthy Public Policy
Health promotion goes beyond health care. It puts health on the agenda of policy makers in allsectors and at all levels, directing them to be aware of the health consequences of theirdecisions and to accept their responsibilities for health.Health promotion policy combines diverse but complementary approaches includinglegislation, fiscal measures, taxation and organizational change. It is coordinated action thatleads to health, income and social policies that foster greater equity. Joint action contributes toensuring safer and healthier goods and services, healthier public services, and cleaner, moreenjoyable environments.Health promotion policy requires the identification of obstacles to the adoption of healthypublic policies in non-health sectors, and ways of removing them. The aim must be to makethe healthier choice the easier choice for policy makers as well.
Create Supportive Environments
Our societies are complex and interrelated. Health cannot be separated from other goals. Theinextricable links between people and their environment constitutes the basis for a socio-ecological approach to health. The overall guiding principle for the world, nations, regionsand communities alike, is the need to encourage reciprocal maintenance - to take care of eachother, our communities and our natural environment. The conservation of natural resourcesthroughout the world should be emphasized as a global responsibility.Changing patterns of life, work and leisure have a significant impact on health. Work andleisure should be a source of health for people. The way society organizes work should helpcreate a healthy society. Health promotion generates living and working conditions that aresafe, stimulating, satisfying and enjoyable.Systematic assessment of the health impact of a rapidly changing environment - particularlyin areas of technology, work, energy production and urbanization - is essential and must befollowed by action to ensure positive benefit to the health of the public. The protection of the
natural and built environments and the conservation of natural resources must be addressed inany health promotion strategy.
Strengthen Community Actions
Health promotion works through concrete and effective community action in setting priorities,making decisions, planning strategies and implementing them to achieve better health. At theheart of this process is the empowerment of communities - their ownership and control oftheir own endeavours and destinies.Community development draws on existing human and material resources in the communityto enhance self-help and social support, and to develop flexible systems for strengtheningpublic participation in and direction of health matters. This requires full and continuousaccess to information, learning opportunities for health, as well as funding support.
Develop Personal Skills
Health promotion supports personal and social development through providing information,education for health, and enhancing life skills. By so doing, it increases the options availableto people to exercise more control over their own health and over their environments, and tomake choices conducive to health.Enabling people to learn, throughout life, to prepare themselves for all of its stages and tocope with chronic illness and injuries is essential. This has to be facilitated in school, home,work and community settings. Action is required through educational, professional,commercial and voluntary bodies, and within the institutions themselves.
Reorient Health Services
The responsibility for health promotion in health services is shared among individuals,community groups, health professionals, health service institutions and governments. Theymust work together towards a health care system which contributes to the pursuit of health.The role of the health sector must move increasingly in a health promotion direction, beyondits responsibility for providing clinical and curative services. Health services need to embrace
an expanded mandate which is sensitive and respects cultural needs. This mandate shouldsupport the needs of individuals and communities for a healthier life, and open channelsbetween the health sector and broader social, political, economic and physical environmentalcomponents.
Reorienting health services also requires stronger attention to health research as well aschanges in professional education and training. This must lead to a change of attitude andorganization of health services which refocuses on the total needs of the individual as a wholeperson.
Moving into the Future
Health is created and lived by people within the settings of their everyday life; where theylearn, work, play and love. Health is created by caring for oneself and others, by being able totake decisions and have control over one's life circumstances, and by ensuring that the societyone lives in creates conditions that allow the attainment of health by all its members.Caring, holism and ecology are essential issues in developing strategies for health promotion.Therefore, those involved should take as a guiding principle that, in each phase of planning,implementation and evaluation of health promotion activities, women and men should
become equal partners.