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Health promotion includes all efforts that
seek to move people closer to optimal well being
or highest levels of wellness. Health promotion
programs and activities include many forms of
health education, for example, teaching the
danger of drug use, demonstrating healthful
practice such as regular exercise and providing
more health promoting options such as selection
of healthy community health promotion.
Definition Of Health Promotion
“Health promotion, as defined by the WHO, is the Process of
enabling people to increase control over, and to improve, their

• Health Promotion Aims to:

Empower individuals and communities towards better health
through supportive environments.

Goals of Health Promotion

• Increase the span of healthy life for all citizens,
• Reduce Health Disparities among population group,
• Achieve access to preventive services for everyone.
Principles of Health Promotion
• Empowerment – A way of working to enable people to gain greater
control over decisions and actions affecting their health.

• Participative - Where people take an active part in decision making.

• Holistic - Taking account of the separate influences on health and the

interaction of these dimensions.

• Equitable - Ensuring fairness of outcomes for service users.

• Intersectoral - Working in partnership with other relevant


• Sustainable - Ensuring that the outcomes of health promotion

activities are sustainable in the long term.

• Multi Strategy - working on a number of strategy areas such as

programmes, policy.
Health promotion Model
Assumptions Of The Health Promotion Model

• Individuals seek to actively regulate their own behaviour.

• Individuals in all their biopsychosocial complexity interact with

the environment, progressively transforming the environment
and being transformed over time.

• Health professionals constitute a part of the interpersonal

environment, which exerts influence on persons throughout
their life span.

• Self-initiated reconfiguration of person-environment interactive

patterns is essential to behaviour change.

• Definition:
“ Primary health care is essential health care & technology based
on practical, scientifically sound & socially acceptable method &
universally accessible to individuals & families in the community by
means acceptable to them, through their full participation & at a cost
that the community & country can afford.”
• Scope of Primary Health Care
Primary health care provides immediate and often continuing
care for children, adults, or families. It is often their first experience
with the formal health care system. In developing countries, public
health posts and health centres often provide this care through
nurses and mid-level health workers. Ideally, doctors are available for
support, training, and referrals. Primary health care serves several
unique and essential.
Principles of Primary Health Care
• Equitable Distribution
• Coverage & Accessibility
• Community Participation
• Multi sectoral Approach
• Appropriate health technology
• Human recourses
• Services by community health workers &
traditional health practitioner
• Referral system
• Logistics of supply
• The physical facility
• Control & Evaluation
Elements of primary health care

• Education of the people concerning prevailing health

problems & methods of preventing & controlling
• Promotion of food supply & proper nutrition.
• Adequate supply of safe water & basic sanitation.
• Maternal & Child health care & family planning.
• Immunisation against the major infectious disease.
• Prevention & control of locally endemic disease.
• Appropriate treatment of common disease & injuries.
• Provision of essential drugs.
Effectiveness of Primary Care

• Reduces the disease burden.

• Produces economic savings.
• Assures greater equity.
• Research.

• Primary health care philosophy

• Primary health care strategies


• 1.Clinical mode
In this model, the absence of signs and
symptoms of disease indicates health. Illness
would be the presence of obvious signs and
symptoms of disease. People who use this
model of health to guide their use of healthcare
services may not seek preventive health
services, or they may wait until they are very ill
to seek care. Clinical model is the predictable
model of the discipline of medicine.
2.Role performance model
• Health is indicated by the ability to perform social roles. Role
performance includes work, family and social roles, with
performance based on societal expectations. Illness would be the
future to perform a person’s roles at the level of others in society.
This model is basis for work and school physical examination and
physician –excused absences. The sick role, in which people can
be excused from performing their social roles while they are ill, is a
vital component of the role performance model.
3.Adaptive model
The ability to adapt positively to social, mental, and
physiological change is indicative of health. Illness occurs when
the person fails to adapt or becomes in adaptive toward these
changes. As the concept of adaptation has entered other aspects
of culture, this model has become widely accepted.

4.Agent-Host-Environmental model (by
Leavell and Clark,1965)
This is useful for examining causes of disease in an individual. The
agent, host and environment interact in ways that create risk factors, and
understanding these is important for the promotion and maintenance of
health. An agent is an environmental factor or stressor that must be
present or absent for an illness to occur. A host is a living organism
capable of being infected or affected by an agent. The host reaction is
influenced by family history, age, and health habits.

5.High Level Wellness Model (by Dunn,1961)

This model recognizes health as an ongoing process toward a
person’s highest potential of functioning. This process involves the person,
family and the community. He describes high-level wellness as “the
experience of a person alive with the glow of good health, alive to the tips
of their fingers with energy to burn, tingling with vitality – at times like this
the world is a glorious place”. High level wellness is a lifestyle focused
approach which you design for the purpose of pursuing the highest level of
health within your capability.

6.Holistic Health Model (by Edelman and
Mandle, 2002)
• Holism acknowledges and respects the interaction of a person’s mind,
body and spirit within the environment. Holism is an antidote to the
atomistic approach of contemporary science. An atomistic approach
takes things apart, examining the person piece by piece in an attempt
to understand the larger picture.
• In this model, nurses using the nursing process consider clients the
ultimate experts regarding their own health and respect client’s
subjective experience as relevant in maintaining health or assisting in
healing. In holistic model of health, clients are involved in their healing
process, thereby assuming some responsibility for health
• Nurses using the holistic nursing model recognize the natural healing
abilities of the body and incorporate complementary and alternative
interventions, such as music therapy, reminiscence, relaxation
therapy, therapeutic touch, and guided imagery because they are
effective, economical, non-invasive, non-pharmacological
complements to traditional medical care.
7.Levels of Prevention Model

• This model, advocated by Leavell and Clark in 1975, has

influenced both public health practice and ambulatory care
delivery worldwide. This model suggests that the natural history
of any disease exists on a variety, with health at one end and
advanced disease at the other. The model delineates three levels
of the application of preventive measures that can be used to
promote health and arrest the disease process at different points
along the continuum. The goal is to maintain a healthy state and
to prevent disease or injury. It has been defined in terms of four
Primordial prevention
Primary prevention
Secondary prevention
Tertiary prevention
8.The Health Belief Model

• The Health Belief Model (HBM) was one of the first models that
adapted theory from the behavioural sciences to health problems,
and it remains one of the most widely recognized conceptual
frameworks of health behaviour.
• Purpose of the Model.
Method to explain and predict preventive health behaviour.
• The model in action: an example
• A parent will organize immunization for a child if he/she.
• Believes there is a danger of the child contracting the disease
(perceived susceptibility)
• Believes that immunization is effective in eliminating the danger
(perceived benefits)
• Trusts that the method is safe and has an acceptable level of risk
(possibly through education and media information)
• Has the means to access the vaccination service (no barriers to
behaviour change)
9.The Social Model
• A social health model, that is, one aimed at incorporating the
social and economic, as well as biophysical context of health
status, is now acknowledged as having greater impact on the
determinants and generation of health. However, the political will
and theoretical framework must also be present for the change
to a social health model to occur. It is:
• Based on knowledge of the experience, views and practices of
people with disabilities.
• Locates the problem within society, rather than within the
individual with a disability
• Rules are determined within a framework of choice and
independent living with strong support from organized disability
• The biases of the social model include: limiting the causes
of disability either exclusively or mainly to social and
environmental policies and practices, or advancing perceptions
of disability.
10.The Social-Ecological Model
• The ultimate goal is to stop violence before it begins. Prevention requires
understanding the factors that influence violence. This model takes into
consideration the complex interplay between individual, relationship,
community and societal factors. It allows us to address the factors that put
people at risk for experiencing or perpetrating-violence.
11.Mental Health Promotion Model
• Purpose of mental health promotion for people with mental illness is to
ensure that individuals with mental illness have power, choice, and control
over their lives and mental health, and that their communities have the
strength and capacity to support individual empowerment and recovery.
• The person with mental illness is the central focus: participating in her/his
community, involved in decision-making about mental health services, and
choosing which supports are most appropriate.
• There are four key resources which should be available to the person to
support their mental health: a) mental health services; b) family and
friends; c) consumer groups and organizations; and d) generic community
services and groups.
12.AIDS Risk Reduction Model
• It believes change is a process. Individuals must go through with
different factors affecting movement. This model proposes that the further
an intervention helps clients to progress on the stage continuum, the
more likely they are to exhibit change. Individuals must pass through
three stages;
• Knowledge about how HIV is transmitted and prevented,
• Perceiving themselves as susceptible for HIV and
• Believing HIV is undesirable.
• This decision-making stage may result in one of several outcomes
• Making a firm commitment to deal with the problem
• Remaining undecided,
• Waiting for the problem to solve itself, or
• Resigning to the problem: Weigh cost and benefits.
• Giving up pleasure (high risk) for less pleasure (low risk)
• Seeking information
• Obtaining remedies and solution.