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Track 3: Strengthening health systems

7th Global Conference on Health Promotion: track themes

Health promotion requires a well functioning health system – a system that has universal reach, adequate workforce, mechanisms for community participation, is well-financed, and has leadership and power. Strengthening health systems is therefore a key strategy and priority for health promotion.

Health promotion closely aligns with and reinforces efforts in bringing in health systems reforms based on the Primary Health Care renewal as laid out in the World Health Report 2008. With increasing inequities between and within countries, it supports reforms that ensure universal coverage and thereby equitable access to health services for all people. Service delivery reforms that ensure health care is people-centred and based on expectations and needs of people are vital for effective health promotion, just as much as are healthy public policies, and inclusive and participatory leadership.

In a world threatened by emerging crises such as climate change, financial crises and the growth of non-communicable conditions, and where global human security is considered compromised by new strains of infectious diseases with pandemic potential, health systems have tended to lurch from priority to priority.

This track at the Conference will focus on practical linkages between Health Promotion and health systems. It will showcase efforts such as those that achieve universal coverage especially in low income countries, in reaching hard-to-reach groups and/or financing primary health care. How can primary prevention and a social determinants approach be executed at scale? How can accessibility and reduced inequities in health systems be made integral to reporting systems? How can health systems play a catalytic role in achieving health and development goals? These are some of the questions that will be discussed.

Thailand's health successes

Vinai Dithajohn/OnAsia.com/WHO

Thailand’s adoption of a primary health care approach – in which health promotion and disease prevention are key – has had considerable success over the past three decades, with mortality in children aged under five dropping from around 75 such deaths per 1000 in 1975 to 8 in 2006.

Medical advances cannot take all of the credit for this success. Much of it is due to the efforts of community health volunteers working among Thailand’s 64 million people, health officials say. Buddhist monks and temples, for example, have been strongly involved in health promotion and education, working hard to prevent people getting sick in the first place, particularly in remote, rural communities.

There are more than 800 000 health volunteers across the country. They have played a crucial role in controlling many communicable diseases. They were, for example, instrumental in the dramatic decline of protein-calorie malnutrition in preschool children.

The central role for community work was placed firmly on the international health agenda by the World Health Organization and its Member States in the Declaration of Alma-Ata in 1978. The goal these countries set themselves was to achieve ‘health for all’ by the year 2000 through a primary health care approach.

(Source: Abridged from Primary Health Care in action: country examples)

Sources

1. WHO World Health Report, 2008, Primary Health Care: Now more than ever
2. WHO, 2009, Mainstreaming Health Promotion, draft of technical document in development for the Global conference on health promotion