Promoting Public health – Ottawa Charter 1986

Promoting Public health – Ottawa Charter 1986

In order to understand what public health means we need to begin with what health means.

We will use the definition of health that was adopted by the World Health Organization (WHO).

The definition of health originated in the Alma Ata Declaration which was signed by participants at a WHO international conference in 1978 on Primary Health Care.

By defining what health means, we will be able to get a firm foundation for then by identifying what differentiate public health from other arenas.


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Definition of health

According to Alma Ata Declaration, it states that health is a state of complete physical, social and mental wellbeing and not just the absence of disease or infirmity.

Apart from providing the definition of health, The Alma-Ata Declaration also said some important things about health that PHANZ also endorses.

Health is characterized as a fundamental human right as well as attaining the highest possible level of health that is an important social goal worldwide.


Promoting Public health – Ottawa Charter 1986 essay


Alma-Ata Declaration also said some important things about health that PHANZ also endorses.

Apart from providing the definition of health, health is characterized as a fundamental human right as well as attaining the highest possible level of health that is an important social goal worldwide.

The Alma-Ata Declaration recognizes that by realizing the goal, it also required the actions of other social and economic sectors apart from the health sectors.


Our own Public Health Advisory Committee further emphasized the importance of recognizing the breadth of the determinants of health. According to the research of the committee, they revealed that the strongest influences on the health of individuals normally comes from the factors that are outside the health system.

They include the social, physical, cultural, and economic environment in which we live

Public Health

It is a science and art of promoting health preventing disease as well as prolonging life through education, research as well as promotion of healthy lifestyle.

Public health focuses on health promotion as well as disease or injury prevention which contrast to the medical model of care.

Medical model of care focuses more on diagnosis and treating illnesses as well as conditions after they occur.

How to differentiate Public health from other health care?

Based on the definition of public health, there are a number of key things that differentiate it from personal health and public health interventions from person health services. These include;

Public health is all about keeping people well instead of treating their diseases, disorders as well as disabilities after they emerged hence this is why the definition of public health emphasizes more on promoting health, prolonging life as well as preventing disease.

Public health focuses more on populations and not individuals hence it is often described as being for protecting people instead of treating the few who fall off.

The adjective public that is used in “public health has two meaning thus they are all important. The first meaning means that the health of the public while the second meaning means the organized efforts of society.

In a simpler way, public health is more concern in improving the health outcome of population through intervention that requires a collective effort which is normally organized by the public institutions. Public institutions mean “the government”. Other key aspect of public health that is worth noting are that public health;

Is community-focused and defined Is evidenced-based and not anecdotally based.

Therefore, public health is all about using evidence-based prevention as well as intervention strategies to enable communities grow their own ability so as to address the issues that are affecting the population.


The five core disciplines of public health are:

Behavioral science or health education

Environmental health


Health services administration


Factors contributing to public health and community wellbeing

the natural and physical/built environment,

the social, economic and cultural environment

individual behaviors

And lastly, health diseases across physical, mental. Family as well as spiritual dimension.

International Milestones in Public Health

Apart from the Alma-Ata Declaration in 1978, individuals who have a background of public health generally cite other major landmarks as well in international thinking about public health as being;

Ottawa Charter of health promotion in 1986.

Bangkok Charter for Health promotion in a Globalized World in 2005

And lastly, The WHO Commission on Social Determinants of Health in 2008.

With the insights gained at these international gathering enables us to craft effective public health actions in our own communities.

These international gatherings provide us with some conceptual frameworks as well as checklists that are relevance despite where an individual is working at such as in national, regional local or in an organizational level.


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The Ottawa Charter

The United Nations World Health Organization sponsored the first international conference on health promotion in 1986 in Ottawa, Canada.

The experts who attended the conference developed the Ottawa Charter for health promotion; this was an international framework for promoting health as well as achieving health for all.

According to Ottawa Charter, they define health promotion as the process of enabling people to increase control over as well as improve their health.

It also recognize that in order to reach a state of complete physical, mental as well as social well being a person/ groups has to be able to identify, realize aspirations, satisfy neesa and also change or either cope with the environment.

Therefore, in order to achieve this, we need the basic pre-requisites individuals as well as groups hence they require peace, education, income, food, shelter, a stable eco-system, social justice, sustainable as well as equity.


The four key themes for health promotion action in the Ottawa Charter

The four key themes for health promotion action in the Ottawa Charter includes:

To advocate for good health. This is because good health is the major resource for social, economic and personal development as well as an important dimension of quality of life

To enable both men and women to take control of those things that determine their health and also reduce health inequities for the purpose of enabling all people to achieve their fullest health potential.

To mediate between central and local government agencies, voluntary organization, and professional groups. This was aimed at promoting the health individuals, families as well as communities since the health sector alone cannot ensure the prerequisites and prospects for health

A one size fits all approach is not feasible in health promotion. In order to be successful, strategies as well as the programmes should be adopted to local needs and possibilities having in mind the differing social, cultural and economic system

Components of the framework for health promotion

The framework for health promotion action that was advocated in the Ottawa Charter has five key components which are;

Build healthy public policy

Strengthen community actions

Create supportive environments

Reorient health services

Develop personal skills

Move into the Future

The Bangkok Charter.

Promoting Public health – Ottawa Charter 1986 essay

After the adoption of Ottawa Chatter in 1986, the WHO member states signed certain number of resolutions at both national and global level in support of health promotion but these actions where not followed hence in 2005, WHO called gain experts from its member states to examine as well as advise on how they would close this implementation gap so that they can move to policies and also partnerships for action. The result is known as the Bangkok Charter for Health Promotion worldwide.


According to Bangkok Charter, in order to further make advances in implementing these strategies, it recommends that all sectors and settings must act to:

Advocate for health based on human rights and solidarity

Partner and build alliances with public, private, nongovernmental and international organizations and civil society in order to create sustainable actions.

Invest in sustainable policies, actions and infrastructure to address the determinants of health

Build capacity for policy development, health promotion practice, leadership, knowledge transfer and research, as well as health literacy

Regulate and legislate to ensure a high level of protection from harm and enable equal opportunity for health and well-being for all people

Key commitments

The four key commitments of the Bangkok Charter are to make the promotion of health:

central to the global development agenda

a requirement for good corporate practice.

a key focus of communities and civil society

a core responsibility for all of government

WHO Commission on Social Determinants of Health

The current and the latest international landmark publication on action to improve public health is the 2008 report of the WHO Commission on Social Determinants of Health.

According to the Commission, they found out that social injustice is killing people on a grand scale hence concluded that the poor health of the poor, the marked health inequities between countries and the social gradient of health within countries are facilitated by;

the unequal distribution of power, goods and services, income both globally and nationally

the consequent unfairness in access to health care, conditions of work and leisure, schools and education, homes, communities, towns/ cities, this diminish the chance of the poor and ill individuals hence leading a flourishing life.

According to the Commission, this unequal experience of health-damaging experiences is as a result of;

a toxic combination of poor social policies and programme,

unfair economic arrangements,

And bad politics.

We can close the health gap in a generation by using the knowledge that exists to make the huge as well as achievable differences in people’s life chances hence resulting to remarkable improvements in health equity.

Based on the conclusion of the Commission, we can reduce the inequalities as well as identify what must be done to achieve each principle of action by;

1. Improve daily living conditions by:

Fair employment and decent working conditions

Investing in equity in the early years

Social protection across the life course

Universal health care

Developing healthy places, and healthy people

2. Tackling the inequitable distribution of power, money and resources by:

Market responsibility

Health equity being a focus for all policies, systems and programmes

Political empowerment, inclusion and voice

Fair financing

Gender equity empowerment, inclusion and voice

Good global governance

3. Measuring and Understanding the Problem and Assessing the Impact of Action by:

Creating organizational space and capacity to act effectively on health inequities

Setting up national and global health equity surveillance systems

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