What remains for the future: strengthening community actions to become an integral part of health promotion practice

Abstract

To mark the 25th anniversary of the Ottawa Charter, this paper will discuss what remains to be achieved in strengthening community actions as an integral part of health promotion practice. To do this, the paper discusses four key elements for the future of health promotion programmes: (1) engage communities to share priorities; (2) build community capacity; (3) mechanisms for flexible and transparent funding; and (4) being creative in order to expand or replicate successful local initiatives. The paper uses a number of international case study examples of how these key elements can be achieved in health promotion programmes. A major challenge for the future is how health promotion agencies can develop and maintain the trust of communities, especially socially marginalized communities in society. The paper concludes by identifying a number of short and longer term challenges to achieve these goals and offers a way forward for a brighter future direction of health promotion practice.

Spirituality in the occupational therapy community fieldwork process: A qualitative study in the South African context

“…The health promotion perspective is used in occupational therapy to promote empowerment of community members through education and skills development 24,25 . This concurs with Micallef's 26 and Laverack and Mohammadi's 27 explanation of empowerment, namely the process by which community members gain greater control over decisions and actions affecting their health. The Ottawa Charter of Health Promotion promotes the use of five strategies, including building healthy public policies; creating supportive environments (culture, social, economic, political, physical and spiritual); developing personal skills; strengthening community actions and reorienting health service 28 .…”

Health Promotion in Ecuador: A Solution for a Failing System

“…Therefore, the health promoters would need to receive continual training, support, and supplies from the MOH. However, to insure sustainability and community control, reliance on the government should be slowly minimized as the community builds its capacity to take greater responsibility and action carrying out healthcare plans [32].…”

Are we there yet? Use of the Ottawa Charter action areas in the perspective of European health promotion professionals

“…As the next most common area, 41% of participants rated "Strengthening community action" as often used, with significant differences between regions showing the highest ratings for Northern Europeans (53%) and the least for Eastern Europeans (11%). The struggle in using this domain can be in part due to its complexity, which may focus on a different purpose or require engagement in various stages at different times such as participation, or becoming concerned with building on competencies and capacities, and is directed toward specific goals and actions (Laverack and Mohammadi 2011). At another stage, strengthening community action may be assisting communities to solve issues related to their lack of power and locating or using their voice to be more politically active.…”

“…This has been considered to be the catalyst for empowerment (Laverack and Mohammadi 2011), a term which, though explored in this domain, is often elusive with its absence of concrete methodologies and strong evidence in diverse settings and cultural environments (Laverack and Wallerstein 2001). Furthermore, it is possible that its reliance on reorientation of health services and professional practice as well as the political climate that influences practitioners, communities, approaches, and agendas (Laverack and Mohammadi 2011) can further complicate the use and feasibility of this action area.…”

“…The Ottawa Charter for Health Promotion, sub-titled "The Move Towards a New Public Health," has been identified as an influential and guiding document and tool (IUHPE and CCHPR 2008;Baum and Sanders 2011) responsible for laying a foundation for health promotion theory and practice (IUHPE and CCHPR 2008;Nutbeam 2008) and broadening its outcomes beyond the absence of disease (Laverack and Mohammadi 2011). Since its inception at the First International WHO Conference on Health promotion in Ottawa, Canada, in November 1986, it has sparked the conceptualization, development, discourse, and integration of health promotion while inspiring professionals, politicians, and citizens worldwide (Dooris 2013), giving health promoters a sense of identity (Pettersson 2011) and taking on a 'Holy Grail' status (McPhail-Bell, Fredericks and Brough 2013).…”