Year : 2014 | Volume
: 39 | Issue : 1 | Page : 1--2
Health in post 2015 development agenda: Deliver on health promotion
National Programme Officer (Reproductive Health), UNFPA, New Delhi, India
National Programme Officer (Reproductive Health), UNFPA, EP-16/17, Chandragupta Marg, Chanakyapuri, New Delhi - 110 021
|How to cite this article:|
Agarwal D. Health in post 2015 development agenda: Deliver on health promotion.Indian J Community Med 2014;39:1-2
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Agarwal D. Health in post 2015 development agenda: Deliver on health promotion. Indian J Community Med [serial online] 2014 [cited 2021 Jan 26 ];39:1-2
Available from: https://www.ijcm.org.in/text.asp?2014/39/1/1/126338
As global deliberations on scale and scope of post 2015 development agenda are taking shape and transition from present set of millennium development goals (MDGs) to a new set of sustainable development goals are being deliberated, public health advocates are increasingly articulating views on outcomes, contents and modalities to achieve the same within larger frame of transformational shifts. The high level panel constituted by the Secretary General of United Nations in its report has listed ensuring healthy lives as one of the illustrative goals. 1 It is really good to note that all health related outcomes are clubbed in one (welcome departure from earlier three health MDGs). Also inclusion of neglected tropical diseases and priority non-communicable diseases is also very much timely. Universal Health Coverage and all that goes within its rubric is seen as a major delivery framework to achieve goals.
There is consensus about health MDGs targets that would be missed by many countries although there are undeniable signs of progress across countries. Sub Saharan African countries, having 11 percent of world population, bear 24 percent burden of the global diseases and less than one percent of global health expenditure. These and countries in SE Asia are largely off the track in achieving these goals.
One of the criticisms of health MDGs was absence of any specific target and related indicator on health promotion. As members of public health fraternity, we understand criticality of investing in health promotion as a central piece in health programmes, be it communicable disease, nutritional diseases and common maternal and child health problems. Take example of non-communicable diseases; risk behavior modifications are expected to make a significant dent in non-communicable diseases. Much of the policy related interventions for instance reducing intake of unhealthy food through trade agreements and enforcing domestic food standards would also fall within realm of health promotion.
World Health Organization (WHO) defines health promotion as a process to enable people to take control over and to improve their health. Individuals play key role in terms of changing their behaviors for which they need to be empowered. Here vast number of personnel in health sector right from community health workers to counselors, nursing staff and doctors, super specialists need to be fully clued about empowerment framework so as to help people gain power to make healthy decisions.
The National Rural Health Mission implementation framework does not provide due emphasis on health promotion. Focus is largely on working on the supply side so as to increase coverage with evidence based technical interventions for achieving improved health outcomes. Even much talked about American speech language hearing association (ASHA) intervention though designed to work strongly on demand side (remember activist role !) has been reduced to extended arm of poor performing and weak health system. Multitude of capacity building interventions for vast army of health personnel does not include people centric approaches within its scope and practice, signifying opportunity lost. BCC programmes have come under lot of criticism due to normative messaging and lack of imagination. Programme monitoring largely include coverage with interventions and no effort made to capture progress on delivery of health promotion interventions, if any.
It is in this context, public health advocates globally are articulating strong need to focus on health promotion in new paradigm. Lower income countries are beginning to epidemiological, demographic and risk factor transition. Intersectoral nature of sustainable development goals (SDGs) require engagement of multiple stakeholders and offers right "fit" for health promotion. At the 2011, UN high level meeting on NCDs, 2 participants agreed that no one factor could fully address burden of NCDs and called for collaboration with "non-health actors and key stakeholders including private sector and civil society to promote health and reduce non-communicable disease risk factors. "Family Planning 2020, 3 a global partnership developed post London Family Planning Summit, aims to enable 120 million women and girls in need of contraception to use FP methods. Partnerships have a sub group on rights and empowerment to develop approaches that address barriers preventing women and girls making reproductive choices decisions and ability to act. Clearly International community would be failing in its obligations towards ensuring healthy lives, if we once again fail to give rightful place to health promotion in post 2015 development agenda.
1 Report of High Level Panel of SG on post 2015 Development Agenda. www.post2015hlp.org
2 UN high level meeting on NCD. Summary Report Sept 2011 who.int