No abstract

The authors set out to show that the Ottawa Charter of 1986 has not been sufficiently accepted over the past twenty years, even by those who use it as a strategic tool to guide interventions for reducing social inequalities in health. Although some public health policies do emphasize the reduction of social inequalities in health, only the Ottawa Charter appears to possess the status of an international declaration on the matter. Social inequalities in health are the systematic, avoidable, and unjust differences in health that persist between individuals and subgroups of a population. Four examples from the field of health promotion serve to show that forgetting to combat social inequalities in health is not exclusive to the domain of public health. However, taking action against social inequalities in health does not equal tackling poverty. Moreover, intervening on the principle of equality of opportunity, on the basis of an ideology of meritocracy, or for the benefit of the population as a whole, without regard to subgroups , only tends, at best, to reproduce inequalities. Although evidence is insufficient, there are studies that show that reducing social inequalities in health is not an aporia. Three explanations are advanced as to why social inequalities in health have been ignored by health promotion professionals. The Ottawa Charter had the merit of highlighting the struggle against social inequalities in health. Now, moving beyond the declarations, from the strategic framework provided by the Ottawa Charter and in accordance with the Bangkok Charter, it is time to show proof of voluntarism. Several priorities for the future are suggested and the International Union for Health Promotion and Education (IUHPE) should be responsible for advocating for them. (Promotion & Education, 2007, Supplement (2): pp 12-16).

La promotion de la santé (PS) en Afrique subsaharienne reste encore peu développée. L'auteur part de la situation actuelle préoccupante des indicateurs de santé et de développement du continent, comparés au reste de la planète, pour montrer l'intérêt et la place du concept de la PS dans la région africaine. Les efforts déployés dans la région pour le développement des systèmes de santé sont examinés. Un regard est jeté dans l'histoire, à travers l'analyse des facteurs pouvant expliquer « l'absence » actuelle de la PS en Afrique subsaharienne, dans le cadre de ces différents efforts d'améliora-tion des systèmes de santé. La place et le rôle des formes actuelles de partenariat, au niveau international entre les organisations internationales et les pays de la région, dans cette situation actuelle de la PS ont été également analysés. L'auteur explore enfin plusieurs pistes de solutions possibles pouvant aider, dans les meilleurs délais, à une valorisation de la PS dans le cadre des efforts de relance des systèmes de santé et du développement du continent en général. (Promot Educ 2008; Supp(1): 49-53)Mots clés : promotion de la santé, développement des systèmes de santé, Afrique subsaharienne.

Malaria remains a vital concern of child survival in sub-Saharan Africa despite the existence of effective curative and preventive measures. It is known that child malaria is underpinned by factors such as socioeconomic, cultural, environmental, and so forth, that must be considered simultaneously in order to effectively control it. This study applied to a rural community in Benin (West Africa) the Health Promotion concept (community participation and empowerment, contextualism, intersectorality, multistrategy, equity, and sustainability) to develop a program in order to control child malaria and close the gap of unsuccessful programs. The study design was a quasi-experimental pre-post conducted over a period of 27 months. As results, 80% of the community members participated in six of the seven sub-projects planned. The prevalence of fever (malaria) was significantly reduced after the intervention (p = 0.008). The recourse to adequate health care has significantly increased after the intervention (chi2 = 48.07, p = 0.000000). All these contributed to a statistically significant reduction of children deaths due to malaria (p = 0.001) in the village. Health Promotion strategies are likely to contribute to sustainable malaria programs' implementation that reduce malaria incidence and deaths in children under five.

The Ebola virus disease (EVD) epidemic in West Africa, from December 6, 2013 to March 2015, was the largest in history. Neither the virus (pathological cause) nor the host (in terms of biological determinants) is the key to understanding the causes or explaining the magnitude and seriousness of the West Africa EVD epidemic. Such a difference in the manifestation of the EVD epidemic in West Africa invites many questions that we would like to explore under the umbrella of 'the social determinants of emerging infectious diseases in Africa'. The purpose is to consider these root causes that could explain the actual magnitude in order to address them systematically in dealing with EVD epidemics. We explored the international literature and retrieved the essential contextual root causes of West Africa EVD epidemic before concluding with some areas of action to prevent and addressing such a disease.