STRATEGI

PROMOSI KESEHATAN

Muji Sulistyowati
Bagian Promosi Kesehatan & Ilmu Perilaku
KONSEP (I)
 SEHAT (WHO)
 SEHAT (UU KESEHATAN RI, 1992)

 William Griffith, 1972 :

Pendidikan kesehatan tidak hanya
menitikberatkan pada pendidikan individu &
keluarga tetapi juga pada institusi dan
lingkungan sosial yang akan mempengaruhi
(memfasilitasi) individu mencapai kesehatan
optimal
KONSEP (II)

 HEALTH PROMOTION (WHO, 1984)

The process of enabling people to control
over and improve their health..

 HP (Green et al, 1980)

Kombinasi/ gabungan antara pendidikan
kesehatan dengan dukungan organisasi/
institusi, ekonomi & lingkungan yang kondusif
bagi kesehatan individu, kelompok &
masyarakat
KONSEP (III)

 HP (De Leeuw, 1989; Taylor, 1991)

Sebuah proses yang memungkinkan pada individu dan
masyarakat untuk meningkatkan kontrol tentang determinan-
determinan kesehatan, sehingga kesehatannya dapat diperbaiki

 WHO, 1984 :
“Health Promotion has come to represent a unifying concept for
those who recognize the need for change in the ways and
conditions of living in order to promote health. Health promotion
represents a mediating strategy between people and their
environments, synthesizing personal choice and social
responsibility in health to create a healthier future”
KONSEP (IV)
 WHO does distinguish between health promotion and
prevention.
Health education is seen as an integral part of
health promotion in conjunction with the field of prevention.
 Dennis et al, 1982 :
the term health promotion and health education are not
interchangeable. Health promotion covers all aspects of those
activities which seek to improve the health status of individuals
and communities. It therefore includes both health education
and all attempts to produce environmental and legislative
change conducive to good health. Put another way, health
promotion is concerned with making healthier choices easier
choices
Approaches to Health Promotion
(Jennie Naidoo, Jane Wills, 1994)

The Medical Approach

 focuses on activity which aims to reduce
morbidity and premature mortality
 Target are whole populations or high-risk
groups
 Ex : immunization, screening
 It is popular, because :
1)It uses scientific methods, such as epidemiology
2)Prevention and the early detection of disease is much
cheaper than treatment and care of people who have
ill
3)It is an expert-led, or top-down
4)There have been successes, ex : eradication of
smallpox by vaccination program

 Behavior Change
 Aims : to encourage individuals to adopt healthy
behaviors, to improved health
 Behavior-change approaches have much in common
with the free-market philosophy (make lifestyle choice)
 The Educational Approach
The purpose is to provide knowledge and
information, and to develop the necessary
skills, so that a person can make an informed
choice about their health behavior
It is based on a set of assumptions about the
relationship between knowledge and
behavior: that by increasing knowledge, there
will be a change in attitudes which may lead
to changed behavior
 Empowerment
 This approach helps people to identify their own
concerns and gain the skills and confidence to act
upon them.
 It is a “bottom-up” strategy, which health promoter
becomes a facilitator
 It is needed to distinguish self-empowerment and
community empowerment
 Self-empowerment is based on counseling and which
use non-directive client-centre approaches aimed at
increasing people’s control over their own lives
 Social Change
Its focus is at the policy or environmental level
The aim is to bring about changes in the
physical, social and economic environment
which will have the effect of promoting health.
“to make the healthy choice the easier choice”
A healthy choice is available, but to make it
realistic option for most people requires
changes in its cost, availability or accessibility
The social change or radical approach is
targeted towards groups and populations, and
involves a top-down method of working
A threefold strategy to Health
Promotion (WHO, 1994)
 Advocacy for Health
 The aim is to generate public demand, place health issues
high on the public agenda and effectively convince those who
are influential : policy-makers, elected representatives,
professionals, political & religious leaders, and interest groups,
to act in support of health
 Advocacy directed at policy makers and decision makers :
to help them recognize that health is an economic and political
asset, by :
-strengthening political commitment to health
-promoting social policies conducive to positive action for
health
-supporting systems that are responsive to people’s needs
and aspirations
 Advocacy directed at professionals, public
figures and service providers :
should seek to make them sensitive to people’s
needs and demands, but without adequate
support systems are not enough to lead people
to action
 Advocacy directed at the public : should help to
create interest and support for positive health
action
 Advocacy directed at academic leaders: should
aim to stimulate interest in study of the aspects
of policy and other factors that facilitate progress
in health
 Social support for health
There are 2 important targets :
1) consists of community organizations and
institutions that encourage healthy lifestyles
as a social norm and foster community
actions for health
2) comprises systems that provide the
infrastructure for health care services and
related development activities that have an
influence on health
 Empowerment for health
 This strategy equip individuals, families and
communities with the knowledge and skills that will
enable them to take positive action for health and
make sound health choices
 It should help people to learn how specific choices of
behavior can affect their own health, their families and
communities
 It should also enable people to participate fully in
national and community health actions
 Empowerment strategies should complement
strategies for advocacy and social support in
encouraging people to take control of their own health
and become partner in the systems that can help
them to lead healthy lives
References