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Regional workshop to strengthen health promotion in achieving the sustainable development goals Bangkok, Thailand, 22-24 June 2016
Regional workshop to strengthen health promotion in achieving the sustainable development goals SEA-HE-211 © World Health Organization 2017 Some rights reserved. This work is available under the Creative Commons AttributionNonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for noncommercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. Regional workshop to strengthen health promotion in achieving the sustainable development goals. [New Delhi]: World Health Organization, Regional Office for South-East Asia; 2007. Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris. Sales, rights and licensing. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/about/licensing. Third-party materials. If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user. General disclaimers. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use.
Contents Page 1. 2. 3. 4. 5. 6. Background ................................................................................................. 1 Objectives .................................................................................................... 4 Opening Session ......................................................................................... 4 Introduction of Health Promotion in the new Era from MDGs to SDGs .. 6 Principles and commitments of health promotion from Ottawa Charter to the Helsinki Statement ............................................................. 8 Current situation and needs for health promotion to support disease prevention and promotion of healthy lifestyles ......................................... 9 6.1 Share country experiences and lessons learnt on health promotion infrastructure and system ................................................ 9 6.2 Share tools and approaches on current health promotion initiatives........................................................................................... 13 6.7 Group Discussions ........................................................................... 14 6.4 Discuss SDG targets, indicators, and relevant of health promotion actions to achieve SDGs ................................................ 15 7. Meeting Outputs ....................................................................................... 16 7.1 Strategic Actions and Ways forward............................................... 16 7.2 Strategic Actions for SDG3 (within the health sectors).................. 16 7.3 Strategic Actions to support other SDGs ........................................ 17 7.4 Ways forward for countries ............................................................. 18 7.5 Ways forward for WHO ................................................................... 18
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Annexes 1. 2. Agenda ....................................................................................................... 20 List of participants .................................................................................... 21
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1.
Background Prevention of noncommunicable diseases and addressing health challenges in the upcoming sustainable development goals required both individual and population based approaches for health promotion. Creating healthy environment is an important mission for health promotion along with addressing health determinants and health needs of population within the given contexts. Health promotion plays an important role in reducing NCD risk factors through health education, health literacy, advocacy for healthy public policies, building evidences on health impacts from policies, programmes and actions of different sectors, and social marketing. Health promotion needs to be responsive for prevention of diseases, (communicable and non-communicable), and to promote healthy lifestyles. Skills and capacity of health promotion managers in all countries are critical for effective prevention measures and promoting health across social groups and life-spans. In 2005, some of the SEAR countries participated in health promotion capacity mapping exercise along with countries from WHO Western Pacific Region (WPRO). It was found that SEAR countries had wide gaps between policies and practices. Human resource, sustainable financial mechanism, coordination, and research are the key areas to be strengthened in most countries in South-East Asia Region. Knowledge on health promotion effectiveness, tools and approaches had been far more advanced in other countries beyond the region. The 7th Global Conference on Health Promotion in 2009, the approaches for health promotion has been raised to higher level of global commitments particularly toward advocacy for health in all sectoral policies. The 8th Global Conference on Health Promotion has brought up a concrete approach for Health in all Policies as an outcome of the conference. Many of SEAR representatives participated in the conferences, had expressed the need to strengthen capacities of health promotion in many areas after learning from the conferences. 1
Regional workshop to strengthen health promotion in achieving the sustainable development goals
WHO-SEARO has organized some key workshops in the past to strengthen capacity for member states. HPE has initiated in-country trainings for Bhutan, Nepal, and Indonesia. However, the process was less efficient to strengthen capacity for the whole region and built confidence to take actions in a comprehensive manner. New Tools and approaches need to be shared and discussed with health promotion officers and country focal points to consider appropriate methods in country contexts. For the future action towards the Sustainable Development Goals (SDGs) achievements, health promotion can play an important role in working across sectors and advocate for health at highest level. Thus this meeting can also support Member States to prepare for country strategies to accelerate health promotion in SDGs. Health for all is both precondition and an indicator for sustainable development. Ensuring healthy lives and promoting wellbeing for all at all ages is one of the 17 sustainable development goals. However, most of the 17 goals are established on social, economic, and environmental determinants of health; viz, ending poverty, improving nutrition and food security, ensuring inclusive and quality education, achieving gender equality and female empowerment, ensuring water and sanitation, sustainable economic growth, employment and decent work and creating safe and resilient cities which are to deliver health for all. The broader conceptualization of health within the SDGs framework reflects calls from much of the global health community to break-away from the silo approach. Health promotion concepts, models, practical actions and public policies can not only contribute to achievement of the SDG-3 (health goal), but also to achieving progress across wide range of the 17 goals. Health promotion interventions have been proven to effective in addressing many social, economic and environmental determinants of health. Health promotion approaches such as action across sectors underpinned by health in all policies, and social mobilization underpinned by effective community engagement in health are important strategies for integrated health promotion actions. Public policies developed in other sectors can have profound effect on health and sustainable development. Empowerment and active participations of communities in the settings where they create health, wealth, and 2
Regional workshop to strengthen health promotion in achieving the sustainable development goals
social development are fundamental to the achievement of health and sustainable development. Health literacy means not only understanding individual risk behaviours or knowledge but also understanding of factors determining their health and well-being. Despite of having numbers of global commitments, tools, guidance, and approaches to health promotion, its strategy to response to current challenges were absent in most countries. Technical supports given to develop national health promotion strategy had been on ad hoc basis. Concert effort to strengthen health promotion institutional capacity in the South-East Asia Region is needed especially in response to the SDGs. A series of workshop to strengthen capacity of Member States on health promotion had been conducted with limited numbers of participation from national health promotion managers/focal points, and WHO country offices. Follow-up actions from previous workshops were challenging. There are numbers of new tools, approaches, and issues that required strong and continuous technical supports for WHO country offices and Member States to achieve the global commitments and response to current challenges in addressing NCD as well as communicable diseases. This meeting will bridge the gaps between current global movements on health promotion and current health promotion actions in countries. This meeting will also bring on board WHO country officers and national authorities to follow up on health actions in SDGs. This meeting is also timely to revisit country’s national health promotion strategies for this new development goals. The Year 2016 is also important for health promotion as it is the commencement of the 30th Year of the Ottawa Charter, the 9th Global Conference on Health Promotion 2016, and the 6th International Congress on Physical Activity and Public Health.
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2.
Objectives To identify key strategic actions for health promotion in SEAR countries towards achieving the Sustainable Development Goals Specific objectives (1) To share country experiences, assess capacity, and identify challenges to achieve global commitments and initiatives in areas of health promotion To share tools and approaches on current health promotion initiatives To strengthen coordination of health promotion efforts to promote well-being for all at all ages To support member states to prepare for country strategies to integrate health promotion in actions toward achieving Sustainable Development Goals (SDGs)
(2) (3) (4)
3.
Opening Session Dr Daniel Kertisz WHO Representative to Thailand delivered the message on behalf of Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region. The message highlighted importance of health promotion in disease prevention and actions across sectors for the Millennium Development Goals (MDGs). It also stress that the lessons learnt from the achievements during the MDGs could be valuable for countries to identify contributing factors that were their strength to carry forward and gaps that needed to be addressed. The speech also recalled how important was health promotion in dealing with personal health and hygiene issues that were primary prevention of communicable diseases in the Region. Working across sectors; empowering individuals, families and communities; and promoting healthy public policies are key actions areas for health promotion that should be further strengthened for future implementation to achieve health and sustainable development. Schools, workplaces, communities, and cities are strategic settings to promote health and addressing risk factors for both communicable and noncommunicable
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Regional workshop to strengthen health promotion in achieving the sustainable development goals
diseases. With current global challenges of noncommunicable disease that affect South-East Asian countries, individual- and population-based health promotion interventions are urgently needed to bring direct impacts for overall life-style changes. Health promotion plays an important role in reducing risk factors through health education, health literacy, advocacy for public policies, building evidences on health impacts from policies, programmes, and actions of different sectors, social marketing, and social mobilization. Dr Daniel Kertesz, WHO Representative to Thailand also emphasized the important of health promotion capacities to bring coordinated efforts to address health impacts of development. As appeared in the Regional Director’s speech, health promotion capacities in all countries are critical for effective preventive measures and for promoting health across social groups and lifespans. Both structural and population-based interventions relied very much on generating healthy public policies where health is considered across different sectors. Governance structure of a country is important to support sustainable financial mechanism for health promotion which is a key to successful actions where the whole system of health promotion can be strengthened with sufficient man power and resources for effective contributions to SDGs. Health promotion strategic approaches such as health in all policies, multisectoral actions, social mobilization and empowerment of individuals, families, and communities are vital to support health system and achieving universal health coverage while also contributing to address determinants of health working in collaboration with other sectors. Achieving health for all in the light of sustainable development agendas, health promotion can offer practical solutions to implement public policies. The speech recognized the important of whole-of-government approach or health in all policies (HiAP) approach, and community-based intervention led by health promotion. To address complex transnational threat to health and structural determinants of health, the Regional Director suggested that new forms of global governance through multilateral institutions could be an answer. It required Governments to take leadership to ensure that the supportive conditions to work across sectors are in place to improve health and equity. Highlight for the conclusion of RD’s speech is that the effective application of health promotion concepts, 5
Regional workshop to strengthen health promotion in achieving the sustainable development goals
models, and practical strategies has the potential not only to greatly contribute to the attainment of the SDG-3 Health Goal, but also to achieve progress across wide range of the SDGs and synergize multisectoral actions for mutual health and other development goals. This meeting is an important step towards the development of regional strategic actions for health promotion in the sustainable development era as well as brings SEAR countries in the new ways of thinking and contributing to the upcoming 9th Global Conference on Health Promotion (GCHP) in November 2016 in Shanghai, China where health promotion in SDGs will also be highlighted. Dr Kertesz, WHO Representative to Thailand ended the RD’s speech and declared the meeting open.
4.
Introduction of Health Promotion in the new Era from MDGs to SDGs Dr Suvajee Good presented meeting objectives and introduced participants. She provided background of the meeting and linkage this activity to the regional and global commitments and the 9th Global Conference on Health Promotion in November 2016. Dr Good then invited Dr Thaksaphon Thamarangsi, Director, Noncommunicable Disease and Environmental Health Department (NDE), WHO-SEARO to give his view on the new era of health promotion. Dr Thamarangsi presented the differences between the millennium development goals (MDGs) and sustainable development goals (SDGs), in terms of targets, approaches and the way the goals would be operationalized. The MDGs were technically driven by developed countries and donor to support the less developed countries to achieved the development goals, while the SDGs are for all countries regardless of their development stage. The SDGs also require global community process that inclusive and universally apply to all. The MDGs and targets are comparatively less comprehensive than the SDGs. The development of setting the goals and targets are from multiple partners across countries and regions rather than as direct top down goal settings from experts and donors. The goals of sustainable development thus had combinations of interrelated issues
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Regional workshop to strengthen health promotion in achieving the sustainable development goals
that are intertwined. The principles of sustainable development are based on the three pillars namely equitable economic, viable environment, and bearable (inclusive) society. Health sector is no longer accountable to only one or two development agendas as in the past MDGs. In the SDG-3: Ensure healthy lives and promote well-being for all at all ages has a mixed of the unfinished business of the MDGs, and the new health targets that include broader determinants of health, and other targets that are means of implementation. As WHO have presented the wheel of relevant of health in other sectors, all of the 17 targets have health and health determinants issues. The set of targets proposed in the SDGs, require health and other sectors to work together. Dr Thamarangsi articulated that health is in transition with this new development agenda. SDGs reflected that health needs to be considered as well-being, as security, as human rights, as a matter of economic, and as a political scheme. Health system today is in a neoliberalized world that people needs/demand are to be considered, and choices needed to be available. Commercialized health care is influenced by the consumer world we live in. Health promotion to advocate for healthy life-styles and behaviour becomes priority especially when it uses multi-disciplinary approach to promote health and address health determinants. Dr Thamarangsi demonstrated complexity of health determinants and multiple factors that influence population health from individual lifestyle, behavior, belief, genetics, and spirits; to environment both man-made and physical environment. Health service system today needs to address this complexity to ensure that all types of needs and all people are being met at all levels of the services with quality and efficiency. Public health services exist in both public and private sectors. In order to deliver effective health promotion interventions or services, health professions and counterparts need to understand this complexity. SDGs Era is a window of opportunity to revisit health promotion that had been going on in each country. This forum would facilitate our member states to reexamine how effective or sufficient is our health education, health literacy; or how did we promote health among work forces both formal and informal sector, professional and non-professional occupations; how successful we are in promote healthy environments; or whether we have firm health promotion system and infrastructure, 7
Regional workshop to strengthen health promotion in achieving the sustainable development goals
as well as sufficient investment for health promotion in our respected countries.
5.
Principles and commitments of health promotion from Ottawa Charter to the Helsinki Statement Dr Suvajee Good, programme coordinator for health promotion and social determinants of health (HPE), WHO-SEARO, presented the key principles of health promotion from the Ottawa charter to Helsinki, especially what considered as new public health. Health for all was the goal for public health and health promotion to build strategic approach to address determinants of health that lie outside health sectors. Setting approach is a strategic entry point for health promotion to take action towards effective and sustainable public health settings that influence everyday life of the population from birth to death. Setting approach allows multisectoral action plan, political commitments, visibility of health issues in development, institutional change, and create space for innovative health actions. Dr Good also demonstrated the third wave of public health actions that required health promotion to reassess the ways it take actions to promote health when double and triple of diseases (communicable, noncommunicable, and combination of health risks and challenges from broader determinants of health). The current phase of public health, health promotion needs to address the global health policies and determinants of health that affected collective lifestyles and public policies causing broad range of risks for negative health outcomes. Recognizing major shifts in social, political, economic, culture, and environmental determinants of health, current health promotion strategic framework for South-East Asia needs to be reframed towards sustainable development. New strategic actions for health promotion may include strengthening the key mechanisms (settings), tools for behavioral changes and risk reduction, multisectoral actions at programme level to create enabling environment that have greater impacts on health outcome. Member States need appropriate tools and approach such as health impact assessment, health in all policies, to address health inequities, improve equitable access to health
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Regional workshop to strengthen health promotion in achieving the sustainable development goals
services for all types of population, and engage with policies of other sectors to consider population health/well-being as priority and outcome of the development. Current capacity of health promotion in the new sustainable development agenda needs to be assessed. Health in all policies is an optimal action to support sustainable development through promotion of health across sectors, ensuring health throughout the life-course and supporting partnerships in development. This approach fosters multisectoral actions linking health and development in a way that concerted efforts are made and synergized for health and well-being of population.
6.
Current situation and needs for health promotion to support disease prevention and promotion of healthy lifestyles Dr Manoj Fernando presented an analysis of how health promotion contributed in the millennium development goals (MDGs) especially in supporting reduction of under-five and maternal mortality, malaria morbidity, HIV infection, TB and overall sanitation. It was important for health promotion to tackle broader determinants of health especially in supporting vulnerable population, providing services to empowering communities, and advocate for actions across sectors for well-being of population. Countries in SEA Region need to have transformation in approaches to promote health and well-being.
6.1
Share country experiences and lessons learnt on health promotion infrastructure and system In this session, the countries highlighted the governing structure of Health Promotion, staffing and capacity, financial support, policy framework for Health Promotion, monitoring and accountability, partnership, role of Health Promotion in national development, champions, and skills and capacity needs for SDGs. National health promotion system and structure need to be in place with effective capacities to support the complexity of promoting health and development. Selected countries presented the national
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capacity, structure and system delivering health promotion in the respected countries. Indonesia: The National Center of Health Promotion is under the Secretary General, Ministry of Health with the governing structure at the Directorate of Health Promotion and Community Empowerment. Health promotion functions rely heavily on local level personnel. Various regulations exist to ensure access to health for maternal, child, adolescent and elderly population, improving community nutrition, disease control and environmental health. Indonesia is establishing the national social security and basic quality of primary health care and referral system, ensuring availability of health workers, pharmacy and health equipment, medicines. Health promotion monitoring system is integrated in community health and health promotion information system. Since 2005, the health promotion has become a mainstream in the national health development, and explicitly included in the National Development Plans. Healthy city initiative is one of the core functions of health promotion with a system of maintaining intersectoral coordination. Health promotion team in Indonesia plays an important role in achieving MDGs through intensive coordination with other sectors at the central level and advocacy with decision makers at provincial and district levels along with numbers of core activities to achieve MDGs. Health promotion also plays important roles to develop partnership with civil society organization with focus on community-based integrated services such as sanitation, clean water, maternal and child health, dengue, NCDs, HIV AIDS, TB and asthma disease control, drugs, education of drug use, nutrition, family planning, alert village, adolescent health, health of the elderly, training of health human resources, and healthy lifestyle. Maldives: The apex body of health promotion is at the Health Protection Agency (HPA), under Director General of Public Health. Health promotion works are delivered through different programmes supported by government budget and the United Nation Agencies. National policy and legislation place health promotion as a mandate of health protection agency (HPA), under the Public Health Protection Act. Some of the health promotion activities are carried out by other sectors such as education-school health programme, the NGOs in collaboration with health sectors, or the United National and international agencies. Health promotion has played an important 10
Regional workshop to strengthen health promotion in achieving the sustainable development goals
role in achieving MDGs through community health workers and in areas of school health. Highly achieve health promotion actions at national level is the tobacco-free Maldives initiative. Sri Lanka: Implementation of health promotion activities has been decentralized to provincial and districts since 1987. Ministry of Health and Ministry of Higher Education are the key agencies to train human resource for health promotion. Health Policy has recently been submitted for cabinet approval. Each district has approximately 25 health education officers. The approach used for health promotion in Sri Lanka is strongly emphasis on preventive medicine to reduce morbidity and mortality and increase immunization and screening. Behavioral change communication is employed to encourage people to adopt healthy lifestyles, while heath education is used to provide knowledge and skills. Community empowerment is applied to development of skills and support social change to create healthy environment. Sri Lanka has a long history of investment in health, education and poverty alleviation programmes. Health promotion plays important roles in MDGs especially when enabling factors exists such as literacy rate, means of years in schools, gender equity index and increase of employment. Health promotion in Sri Lank is progressing with multisectoral partnerships and community workers. However, capacity of health promotion in advocacy skills, risk communication, communication, and health economic negotiation skills are needed for sustainable development era. Thailand: Ministry of Public Health has designated health promotion cluster and other departments that contributed to health promotion. Collaboration among health care professionals, civil society groups, and politicians was highlighted as the strategic movement called “triangle that move the mountain”. The strategy was to take actions with the foundation of knowledge-based actions/advocacy, political linkages, and social mobilization. The Thai Health Promotion Foundation is an important mechanism for Thailand to sustain collaborative actions to promote health with broader term of physical, mental, and social health and well-beings. Thailand has developed numbers of innovations in health promotion in partnerships with several actors such as NCD alliances, tobacco control groups, school networks, road traffic accident networks, academics, civil societies, communities, national and global organizations including World Health Organization. Sustainable 11
Regional workshop to strengthen health promotion in achieving the sustainable development goals
financial mechanism for health promotion is through taxation of tobacco, called sin tax. Timor Leste: The National Health Sector Strategic Plan 20112030 and the National Strategy for Health Promotion are the key frameworks for health promotion in Timor Leste. Governing structure of health promotion lies under the Director General Pres. Saude. Health promotion is strategically integrated into annual national and municipality health plan. The health promotion department collaborates with other departments in the Ministry of Health and other ministries, as well as development partners and the United Nation Agencies. Most of the accomplishments of health promotion to achieve MDGs includes nutrition programme, primary health care package (family health). Strength of health promotion in the country lies in health volunteers and sisca (community health forum) outreach activities, comprehensive primary health care package, iliga inan programme (which is SMS/calls programme to follow up on maternal care). Visible activities are in areas of promotion of healthy diets, anti-smoking initiatives (in all health facilities and public places), promotion of physical activity (poco-poco, Zumba, walking); diabetes, and reduce open defecation. Scaling up of health education for maternal and child health, nutrition, non-communicable diseases would be considered for the SDG era. Capacity and skilled of health staffs in coordination, advocacy, planning are needed. Discussion: Participants reflected that the whole concept of health promotion needed to be further understood by governments to make political commitments as example in Thailand. Effective infrastructure and system for health promotion would need to be further advocated. Participants discussed that school is the most important setting for health promotion and to invest resources. Public health inspectors should play an important role in ensuring good monitoring of the activities. Legislative framework for intersectoral and multisectoral coordination will optimize the benefits of policies, strategies, and guidelines of all related sectors.
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6.2
Share tools and approaches on current health promotion initiatives In order to introduce participants for future of health promotion and in response to the sustainable development, the current health promotion approaches and tools have been used by countries like Thailand, Singapore, and Australia. These countries have advance initiatives on health promotion. Tools and approaches on current health promotion initiatives Dr Ling Li Foo, from the Health Promotion Board of Singapore, presented strategic actions for health promotion in Singapore using the healthy settings approach and taking actions across sectors as main function of health promotion. She highlighted that the Health Promotion Board in Singapore use 2% of public health expenditure for health promotion and chronic disease prevention. The five years health promotion strategic plan focused on physical activities and healthy diet strategy, with healthy workplace, healthy school and communities where health promotion board does active outreach to all the settings. Public campaign and social marketing techniques were used to engage with public to promote healthy lifestyles in Singapore. Professor Richard Osborn, Head of Public Health Innovation, Deakin University, Australia presented health literacy and health equity for the SDG. First, he shared WHO/SEARO, the Health Literacy Toolkit for low- and middle-income countries. He pointed out that Health literacy is best thought of as a problem solving tool to assess and meet the needs of those who do not access or benefit from existing services. It is deeply linked to the concept of equity. He also mentioned about the relationship of health literacy and SDG1,2 and 3. Dr Pairoj Saonaum, Director of Healthy Lifestyle Promotion Section, The Thai Health Promotion Foundation presented tools and methods to promote physical activities and healthy diets in Thailand. He shared Thaihealth’s 15 master plan-Tri-power Strategy, a calculation of social returns on investment, and 10 years review of Thai Health.
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Regional workshop to strengthen health promotion in achieving the sustainable development goals
Discussion: The participants were interested in numbers of issues from the participants’ ranging from how to create healthier choice symbols (HCS) products to how to measure social return of investment, methods of monitoring, developing country guidelines, and implementation of health literacy at hospital. The session continued after a healthy break with two presentations from WHO regional advisor Dr Angela Padmini De Silva and Dr Suvajee Good. Dr Angela Padmini De Silva presented the regional strategic plan on ending childhood obesity (ECHO) and healthy diets in line with SDGs. She further highlighted importance of health promotion advocacy, campaign, and building up capacity on health literacy for people to recognize healthy food items and make good decision for healthier choices. Dr Suvajee Good shared both the health in all policies (HiAP) approach for multisectoral actions and health impact assessment (HIA) for healthy public policies as important tools for future response and achievement for SDGs.
6.7
Group Discussions Two group discussions were organized to facilitate countries to (a) identify strengths and challenges in health promotion capacity in achieving development goals from MDGs and SDGs, and (b) identify strategic actions to accelerate health promotion in the sustainable development goals Most countries acknowledged the values of having health promotion in coordination with multisectoral partners and advocacy for health in development. However, the past experiences suggested that the capacity for broader health promotion actions is needed in almost all countries. Some countries had integrated health education and health promotion in the primary health care package for maternal and child health including some specific disease controls. Life-style related diseases are very much needed health promotion works to create supportive environment which is yet to be strengthened. Health promotion in a disaster management was discussed and emphasized especially for countries that needed to have preparation for disaster. Intersectoral collaboration were conducted with numbers of ministries especially on tobacco control and water and sanitation intervention.
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Regional workshop to strengthen health promotion in achieving the sustainable development goals
The participants echoed the opinion that actual practices of health promotion were beyond Noncommunicable Diseases, as health promotion were about the prevention and control of communicable and noncommunicable diseases with healthy behavior, healthy lifestyle, healthy environment. Dr Thamarangsi, NDE, provided inputs that strength of health promotion team will be on collaboration with multisectoral partners and ministries at different levels from policies to operations. Member States should consider building capacity for technical arears such as school health programmes that are easy to reach and high return of investment and clearly less political complexities. The school health programme has high population coverage to promote healthy life-styles and response to SDGs.
6.4
Discuss SDG targets, indicators, and relevant of health promotion actions to achieve SDGs Dr Good briefed on the role of health promotion in the SDGs and led the discussion on the targets, indicators, and relevance of health promotion actions in achieving SDGs. Key targets of SDG-3 ensuring healthy life and promote wellbeing for all at all ages reflects health promotion strategies in South-East Asia. However, one of the new challenges to achieve SDGs is how to create joint-policies, jointprogrammes, and joint-planning for cross-sectoral targets when countries are custom to working in silos. WHO proposed for the 8th Global Conference on Health Promotion to take strategic actions on healthy cities/communities, health literacy, health in all policies calling “all for health”, with good governance in public policies, and social mobilization and protection. Each of these actions can support almost all SDGs target and place health in the center of the developments. Participants deliberated upon the issues on the introduced strategic actions for SDGs with experts who facilitated group discussions. The result was collected and presented in the meeting outcomes.
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7. 7.1
Meeting Outputs Strategic Actions and Ways forward Rationale: Individual’s health and well-being are determined by social, environment and economic policies beyond control of the health sector. Universal health care is a good entry point to reach population’s health needs, and embrace the whole spectrum of promotion and prevention. Understanding of broader and more comprehensive and systematic health promotion is needed in the region. Addressing health through all the SDGs will create healthier living conditions. “Health in all Goals” approach could indirectly channel financial contributions of sectors other than health by influencing other policies to take into account the health concerns. Promotion of collaboration among different sectors across the SDGs is the key to maximizing health benefits and reducing health inequity. This offers win-wins situation. Health promotion strategic actions go beyond health sectors to achieve “health for all” and encourage active citizens/governments to achieve “all for health” Promoting health in all goals is important for all countries.
7.2
Strategic Actions for SDG3 (within the health sectors) Mainstreaming health promotion in all programmes Build capacity within health workforce to be able to take proactive actions within health and across sectors
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Build capacity for multidisciplinary expertise to create effective tools, interventions, and research for evidencebased health promotion Build strategic partnership for engagement, and social mobilization health, community
Create conducive and inclusive environments for health promotion enabling healthy behavior within health sector (become role models) Scale-up health information systems to collect and build evidence relevant to health promotion Strengthen health literacy, community empowerment, and innovative health promotion
7.3
Strategic Actions to support other SDGs Positioning health and well-being at the core of the development process and putting people’s health at the center of sustainable development Advocacy for health and partnership with other sectors to create win-win situation Engage multisectoral partners to secure high political commitments and leverage national agendas as entry points to achieve buy-in for partnership such as SDGs Select high leverage areas/settings such as school/workplaces/ communities that have high return of investment in partnership Develop strategic actions for health in all policies and health impact assessment to build momentum for coordination and collaboration Social mobilization and partnership across multi-sectors (with effective communications) Develop sets of targets and indicators for joint-actions to promote health
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Utilize legislative framework and legal measures (such as FCTC, social protection act, etc.)
7.4
Ways forward for countries Linking their National Health Promotion strategy with SDGs Develop comprehensive health promotion strategic plan and mainstreaming HP in SDGs and with other strategies Make comprehensive health promotion implementation and plans throughout life-course Revise communication strategic plans and reorient those plans to achieve SDGs Empower all existing health promotion in mainstreaming health promotion and select the high leverage healthy settings (schools and hospitals). Increase political advocacy for health promotion in achieving SDGs and reporting directly to main responsible person for SDGs Communicate the result of workshop (strategic actions) with the MOH to be in line with other movements. Revise the HP plans to coordinate with other SDGs. Revisit the other priority programs. Develop health impact assessment as a tool to aligning sustainable development and healthy public policies through health promotion actions Establish national steering committee for monitoring, evaluation and development Capacity building and multisectoral partners
7.5
Ways forward for WHO Create community of practices, pool of experts
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Regional workshop to strengthen health promotion in achieving the sustainable development goals
Country office to facilitate the process with the regional office Advocacy for resources for health promotion through strengthening country’s capacity to create sustainable financial mechanism To provide technical assistance to develop strategic plans (country, regional, HQ) Conduct follow-up WHO regional meetings on health promotion strategies in achieving SDGs Advocate for high-level adoption of health promotion strategies for SDGs Scholarship from WHO for training/ fellowship Expert meeting on strategic plan and invite high level officers for technical consultation after the 9th GCHP Support and coordinate with WHO country office to have follow-up meetings and planning with in-country multisectoral partners WHO-HQ should develop guidance for technical support such as Global plans of actions on HP, indicators and targets for health promotion to achieve within the next 5-10 years.
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Annex 1
Agenda (1) (2) (3) (4) (5) (6) (7) Inauguration Introduction of Health Promotion in the new Era from MDGs to SDGs Principles and commitments of health promotion from Ottawa Charter to the Helsinki Statement Current situation and needs for health promotion to support disease prevention and promotion of healthy lifestyles Share country experiences and lessons learnt on health promotion infrastructure and system Share tools and approaches on current health promotion initiatives Identify strength and challenges in health promotion capacity addressing equity, determinants of health, and achieving development goals (from MDG to SDGs) Discuss SDG targets, indicators, and relevant of health promotion actions to achieve SDGs Identify roles of health promotion in global and country development agendas.
(8) (9)
(10) Identify strategic actions to accelerate health promotion in the sustainable development goals (11) SEAR contribution to the 9th Global Conference on Health Promotion (12) Way forwards and conclusion
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Regional workshop to strengthen health promotion in achieving the sustainable development goals
Annex 2
List of participants Member States Bangladesh Mr Md Anowar Hossain Joint Secretary Ministry of Health & Family Welfare Dhaka, Bangladesh Ms Sharifa Begum Chief Health Education Bureo & Line Director, (Health Education & Promotion), Director General Health Services Mohakhali, Dhaka, Bangladesh Bhutan Mr Dorji Phub Chief Programme Officer Health Promotion Division Department of Public Health Ministry of Health Thimphu, Bhutan Mr Tshering Gyeltshen Senior Communication Officer Health Promotion Division Department of Public Health Ministry of Health Thimphu, Bhutan Indonesia Dr Ni Made Diah Permata Laksmi D. Head of Section School Health Program Sub Directorate School Age and Adolescent Health, Directorate of Family Health Ministry of Health, Jakarta, Indonesia Ms Riza Afriani Margaresa Staff, Directorate Health Promotion and Community Empowerment Ministry of Health, Jakarta, Indonesia India Dr Niraj Kulshrestha Director Central Health Education Bureau Directorate General of Health Services Ministry of Health & Family Welfare New Delhi Mr Raman Prasad Programme Officer (AV) Ministry of Health & Family Welfare New Delhi Maldives Mr Ahmed Zahid Community Health Officer Sh. Funadhoo Atoll Hospital Male, Maldives Ms Hawwa Shamaa Hassan Rasheed Public Health Programme Officer Health Protection Agency Male, Maldives Myanmar Dr Yin Thandar Lwin Deputy Director General Public Health Department of Public Health Nayphitaw, Myanmar Dr Sandar Director, School Health Department of Public Health, Ministry of Health Sports Nayphitaw, Myanmar Nepal
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Regional workshop to strengthen health promotion in achieving the sustainable development goals
Mr Badri Bahadur Khadka Director National Health Education, Information and Communication Centre (NHEICC) Department of Health Services Ministry of Health Teku Kathmandu, Nepal Dr Ram Bahadur K.C. Senior Integrated Medical Officer Chief, District Health Office Khotang, Nepal Sri Lanka Dr MAAP Alagiyawanne Consultant Community Physician Health Education Bureau Colombo 10, Sri Lanka Dr BKR Batuwanthudawa Consultant Community Physician Health Education Bureau Colombo 10, Sri Lanka Thailand Dr Sanchai Chasombat Ag. Director, Bureau of NCD Department of Disease Control Ministry of Public Health, Thailand Mr Pramote Sepsuk Public Health Technical Officer Practitioner Level Bureau of Environmental Health Department of Health Ministry of Public Health, Thailand Dr Jureephon Khongprasert Deputy Director, Bureau of NCD Department of Disease Control Ministry of Public Health, Thailand Dr Thitikorn Topothai Medical Physician (Professional Level) Division of Physical Activity and Health
Department of Health Ministry of Public Health, Thailand Timor-Leste Ms Misliza Vital Head of Health Promotion Department Ministry of Health Dili, Timor-Leste Mr Marcelo Amaral Mali Regional KSP Koordenator Ministry of Health Dili, Timor-Leste Temporary Advisers Dr Ling Li Foo Deputy Director Strategic Initiatives Department Research & Strategic Planning Division Singapore Health Promotion Board Singapore Professor Richard Osborn Head of Public Health Innovation Deakin University, Australia Dr Manoj Sanjeeva Fernando Lecturer in Health Promotion Faculty of Applied Sciences Rajarata University of Sri Lanka Mhintale, Sri Lanka Partners Mr Hom Nath Subedi Senior Manager, Programme Management Health Research and Social Development Forum Thapathali, Kathmandu Nepal Dr Supreda Adulyanon Chief Executive Officer The Thai Health Promotion Foundation ThaiHealth Centre
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Regional workshop to strengthen health promotion in achieving the sustainable development goals
Sathorn, Bangkok 10120 Thailand Dr Pairoj Saonaum Director of Healthy Lifestyle Promotion Section The Thai Health Promotion Foundation ThaiHealth Centre Sathorn, Bangkok 10120 Thailand Dr.May Myat cho Program manager SEATCA Dr Chris Hirabayashi Regional Adviser Young Child Survival and Development UNICEF East Asia and Pacific Regional Office, 19 Phra Atit Road Chanasongkram, Phra Nakorn Bangkok 10200, Thailand WHO/HQ Dr Shi Qi Technical Officer/HPR WHO HQ, Geneva WHO Country Office Dr Nima Wangchuk NPO WCO, Bhutan Dr Atreyi Ganguli NPO WCO, India Dr Theingi Myint TO-RMNCAH WCO, Indonesia Dr Chamaiparn Santikarn MO, IVP WCO, Myanmar Dr Nilmini Hemachandra NPO, RMNCAH & Nutrition WHO country Office, Sri Lanka
Dr Nima Asgari-Jirhandeh Public Health Administrator Thailand WHO Secretariat Dr Thaksaphon Thamarangsi Director Noncommunicable Diseases and Environmental Health Dr Suvajee Good Programme Coordinator - Health Promotion Dr Padmini Angela De Silva Regional Adviser – Nutrition for Health and Development Mr Jatinder Pal Singh Executive Assistant
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