Health Promotion Thinking, Interpretation and Implementation in Iran: Capacities, and the Way Forward

Abstract

Copyright © 2013, Health Promotion Research Center. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Reviewing the history of public health in the past 60 years indicates evidence of significant changes and adaptive developmental shifts in public health focuses and approaches to health. Our collective understanding about health and its determinants has changed from non-scientific approaches to the scientific approaches including medical, psychological, ecological, social and more recently systems approaches (1). The concept of “health promotion” coined in Ottawa Charter in 1986 (2), was a revolutionary shift from reductionist individualistic perspective to holistic population perspective to health which values the role of the context and its political, economic, environmental and social dimensions. The Ottawa charter advocates for five key actions including building healthy policies, creating supportive environments , strengthening community actions , developing individual skills and re-orienting health systems. Since emergence of health promotion approach to health the required capacity for implementing health promotion values, principles and concepts were developed in many countries Especially developed countries. Health promotion capacity can include essential knowledge, skills, commitment, structures, systems and leadership (3) policies, institutions, programs and practices (4) to enable effective health promotion and mainstreaming health promotion for strengthening national health systems and promote population health. However, these complementary and adaptive changes did not happen in all regions and countries in a similar ways. While the uptake of health promotion in developed countries led to significant change in their capacities such as policy, infrastructure and practice and hence improved their population health, many developing countries lagged behind. Although the dialogue of health promotion has been diffused in many developing countries such as Iran, the research shows differences in the understanding of key concepts of health promotion and lack of a functional health promotion infrastructure in the majority of developing countries around the world (5).