Health promotion in Africa: strategies, players, challenges and prospects.

Abstract

Advocacy for health as a strategy for health promotion is not well established within the health sector in Africa. Advocacy approaches have been used in response to disabilities caused by war and in the anti-female-circumcision movement. Recently the use of this strategy in anti-tobacco action has become visible in some countries. The reason for the limited use of advocacy-related methods stems from the fear governments have about possible spillover into the political arena. At the moment therefore it is only some international NGOs bilateral agencies a few development agencies and even fewer politicians that spearhead most of the advocacy for increased investment in and for health. This situation is likely to change with increasing democratization and related regional development initiatives that encourage more open societies. The recent adoption of a regional health promotion strategy by World Health Organization (WHO) member states in the region provides an opportunity for countries to use advocacy more widely in health development. The strategy document suggests the use of advocacy among other methods to effect comprehensive health promotion action (WHO 2001). On the basis of these advances it can be argued that the foundations for health promotion are well in place in Africa. In order for the grand finale of this development to be reached however a number of challenges still need to be addressed. Addressing such challenges requires the cooperation of health promotion practitioners and a wide range of other actors in particular researchers development workers and the relevant global professional institutions such as the WHO. The remainder of this editorial discusses these challenges further. (excerpt)