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Health promotion: A critical tool for improving public health in Africa

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Health promotion enables people to increase their control over their own health. It covers a wide range of social and environmental interventions that are designed to benefit and protect individual people’s health and quality of life by addressing and preventing the root causes of ill health, not just focusing on treatment and cure (WHO, 2016).

It focuses on creating awareness of health issues, engendering behaviour modification consistent with prevention and attitudes toward ill health, and motivating increased usage of available health facilities.

In the pursuit of good health (physical, mental, and social well-being), individuals and groups are enabled through health promotion to identify and realise aspirations, satisfy needs, and change or cope with the environment in manners consistent with complete good health.

Health promotion is essentially about engendering a context in which the health and well-being of whole populations or groups are owned mainly by the people concerned, i.e., enabling citizens of local communities to achieve political control and determination of their health.

Therefore, health promotion goes beyond mere healthcare and puts health on the policymaking agenda in all sectors and at all levels, directing policymakers to be cognisant or conscious of the health consequences of their decisions and accept responsibilities for health.

Health promotion in Africa

Health promotion can play a leading role in the drive for sustainable and effective public health delivery in Africa. Africa continues to experience a disproportionately high burden of communicable and noncommunicable diseases, maternal and child mortality, and new and re-emerging threats to health, all of which require health promotion interventions.

According to the WHO Health Promotion Strategy for the African Region, the contributions of health promotion to the achievement of health objectives include increasing individual knowledge and skills, especially through information, education, and communication (IEC); strengthening community action through the use of social mobilisation; and enabling the emergence of environments supportive and protective of health by making optimal use of mediation and negotiation.

Effective health promotion strategies enable the development of public policies, legislation, and fiscal controls which enhance and support health and overall development through advocacy and lobbying and make prevention and consumer needs the core focus of health service delivery.

Health promotion can also improve the overall effectiveness and sustainability of priority health programmes in Africa. Programmes such as the Global Fund, Immunization, and Mental Health, among others can have more deliberate and impactful health promotion components embedded in them.

Challenges to health promotion in Africa

Generally, health promotion in Africa suffers from some of the debilitating challenges that confront the practice of health promotion in many countries on the continent. These challenges include:

(a) inadequate leadership of ministries of health in coordinating activities across sectors; (b) limited involvement of various players such as community-based groups, civil society, academia, and development partners in advocacy actions and regulation and legislation for good health governance; (c) paucity of human resources to carry out health promotion activities at community level; (d) limited application of both qualitative and quantitative health promotion research to monitor implementation progress and to evaluate the effectiveness of programme interventions; and (e) lack of sustainable financing mechanisms for health promotion.

Concerted efforts are required to address the above gaps and challenges, which have implications for research in health promotion on the continent.

There is no denying the need for health promotion to be evidence-based because, essentially, it is the only way to make it responsive to the health needs and interests of the people.

Strengthening health promotion in Africa

Effective health promotion interventions require a multisectoral approach that combines varied but complementary indicators like legislation, health finance, including fiscal measures and taxation, gender inclusiveness, mapping of priorities, and organisational change. The following are key strategies to improve health promotion in Africa.

African governments should:

· Establish structures in the Ministries of Health at national and subnational levels with adequate human and financial resources to coordinate and manage the implementation of multisectoral and multi-disciplinary health promotion actions across programmes and sectors;

· Build the capacity of both health and non-health professionals to plan, implement, monitor, and evaluate health promotion interventions at national and subnational levels and to advocate for legislative frameworks, policies, and strategic plans of action to promote health;

· Establish/strengthen health promotion partnerships, networks, and alliances in order to harness technical and financial resources for health promotion;

· Strengthen IEC processes and actions for better social mobilisation, community empowerment, and advocacy to promote health among the population;

· Allocate adequate financial resources for health promotion activities from the national budget and consider changes in financing options, including legislating the use of earmarked dedicated special levies from tobacco, alcohol, or other sources;

· Monitor progress in the implementation of the health promotion priority interventions, including documentation and dissemination of lessons learned through case studies, surveys, and research.

Read also: Emotional intelligence and your health

In conclusion

The successful implementation of effective multisectoral and priority health promotion interventions requires strong political action, broad participation, and sustained advocacy. This calls for the involvement of various players, including the government, the private sector, civil society, the media, and communities.

However, African governments must take the lead in coordinating social dialogue, facilitating community participation, and fostering partnerships.