Ottawa Charter Research Articles

Empowerment: a key to promote the health of people with disabilities

Abstract In France, health public policies for people with disabilities are based on specific laws, recommendations and systems of reference. This population is under the responsibility of the medico-social sector, which governs specialized institutions and services. These services favor a medical approach to health focused on access to care. Their main missions are to take care of disabled people with kindness on a daily basis and to adapt the care to each person’s special needs, whatever the disability. They create links with families, organize the services offered and the living environments, administer their staff and collaborate with health professionals. As they ensure safety and health at all levels, from every individual project to collective life, they have a real opportunity to act on a set of health determinants. The Ottawa Charter for Health Promotion refers to the empowerment and participation of the population as fundamental principles; this is also true as far as people with disabilities are concerned. With the principal stakeholders on a national level, we wrote a handbook in order to support the implementation of these principles in medico-social institutions and services: ’Promoting health and well-being in the medico-social field in cooperation with people with disabilities” and their families. In this presentation, based on concrete examples, we will outline how the five intervention strategies of the Ottawa Charter can apply to people with disabilities, their families and their communities, especially inside specialized institutions and services. We will pay particular attention to the intervention methods and pedagogical tools which can be used to initiate or to improve the participation of disabled people in decisions, through the valuing of their experiential expertise, the development of their social skills, the strengthening of their health literacy, family-professional co-education, and cooperative strategies. Key messages Specialized institutions and services can promote the health of the people with disabilities they care for, by acting on the determinants of their health and by mobilizing participatory strategies. To strengthen disabled people’s participation, using their experiential expertise, developing their social skills and health literacy, and mobilizing co-education, are the best strategies.

A public health approach to imprisonment

Abstract This presentation explores the contested meaning of “prison public health”. European Public Health aligns itself with legal, ethical, political and economic principles that govern human rights, the rule of law and social justice. The UN Universal Declaration of Human Rights and the WHO Commission on the Social Determinants of Health infer an egalitarian approach towards social justice that supports rights of all citizens to have their basic needs met, unnecessary threats to wellbeing minimised, and social competence maximised. In the spirit of the WHO Ottawa Charter for Health Promotion, this means operationalising agency of individuals and communities and of the broad structural determinants of health: economic, political, legal and institutional. In contrast, the law conventionally positions criminal responsibility with the individual perpetrator who is held responsible for their ‘offending’ behaviour. In parallel, arguments surrounding responsibility for health have abounded for many decades, with the principle of collective responsibility for health forming the ethos of the Ottawa Charter. Only recently has it been acknowledged that criminogenic and pathogenic ‘determinants’ intersect, criminal risk behaviours and health risk behaviours sharing common aetiologies. This presentation will reinforce that a public health approach towards imprisonment is fundamentally egalitarian and commitment to social justice, recognising that structure and agency intersect and that the health of the prison is as important as that of the prisoner. It will argue that it is short-sighted to attend only to prisoner behaviour if the system surrounding the prisoner is failing in its duty of care and capacity to serve society. Most prison populations represent the most vulnerable or disadvantaged sectors of society. Governments must proactively facilitate sustainable human development and protection and empowerment of vulnerable groups including those in custody.

Measuring health promotion in a sports club setting: a modified Delphi study

Abstract Background The settings-based approach has become an increasing focus in health promotion since the World Health Organization’s 1986 Ottawa Charter. Schools and cities have implemented this approach, but development within sports clubs is limited. Thus, an internationally validated measurement of health promotion within this setting is lacking. Methods A modified Delphi study was completed to develop an international evaluation tool grounded in the settings-based approach. Expert panelists from academia, sports and health sectors were invited to participate in 3 online rounds. Items were generated or selected based on 3 prior Delphi-based studies and 2 nationally validated scales. Round one created a collaborative list of items, round two validated items based on relevance, importance and feasibility and the final round classified items into one of four determinants: cultural, social, environmental or economic. Results Panelists (69) from 13 countries participated in creating a final list of 62 items at 3 organizational levels. The sports club level included; 5 cultural, 6 social, 6 environmental and 5 economic items. The management level included; 5 cultural, 5 social, 5 environmental and 3 economic items. The coaching level included; 5 cultural, 5 social, 4 environmental and 4 economic items. Conclusions This study provides three important innovations; 1- it is rooted in theory through the settings-based approach, 2- the measurement tool includes three levels within sports clubs, capturing a whole club dynamic and 3- all items included in the tool have been validated by an international panel of experts. Key messages This 62-item measurement tool allows the comparison of perceptions from participants, coaches and management regarding how health is promoted within their sports club. This information offers insight on the capacity of sports clubs to implement and monitor policies and practices on the promotion of health beyond sports performance within their organization.

Addressing equity in eHealth interventions for healthcare system users & patients, literature review

Abstract Objective eHealth has great potential to improve access to health information and care but important barriers to equity still exist and a real digital divide threatens its use. It is therefore necessary to build a conceptual framework on digital health interventions aiming at promoting equity and to analyse the strategies and recommendations that arise through the literature. Such a conceptual framework has not been identified in the literature yet. Methods We carried out a scoping literature review of the scientific literature since 2000 in Western countries, in Scopus, PubMed, PsycArticles, SocIndex and PBSC. Results Strategies that take into account equity in eHealth for healthcare system users and patients can be presented in light of the five key action areas of the Ottawa Charter for Health Promotion. They deal with the policy level, the individual one, aim at creating supportive environments, at using the community level for eHealth promotion and focus on health services. Individuals-oriented interventions are the most reported, thus revealing a lack of systematic thinking and certainly a lack of understanding of the whole spectrum of health determinants. Conclusions Following Gibbons’ expression of “compunetics” (Information and Communication Technologies & ethics), interventions that truly consider the unintended consequences of eHealth on social and geographic health inequalities are absolutely necessary. The conceptual model analysing the whole literature on this interaction makes it easy to understand the types of interventions that are or could be carried out to tackle equity issues in digital health interventions. Its recommendations become easy to implement in the field and can be extremely helpful for decision-making. Key messages Strategies that take into account equity in eHealth for healthcare system users and patients can be presented in light of the five key action areas of the Ottawa Charter for Health Promotion. The conceptual model we elaborated makes it easy to understand the types of interventions that could be carried out to tackle equity issues in digital health interventions.

The Power of Recognition: A Qualitative Study of Social Connectedness and Wellbeing through LGBT Sporting, Creative and Social Groups in Ireland.

The broad research consensus suggesting substantial vulnerabilities among lesbian, gay, bisexual and transgender (LGBT) communities may fail to recognize the protective factors available to these populations. The sparse literature on mental health promotion highlights the importance of understanding strengths-based community approaches that promote LGBT wellbeing. Informed by the Ottawa Charter for Health Promotion, underpinned by Honneth’s Theory of Recognition, this paper outlines the findings of a qualitative Irish study on LGBT social connectedness through a diverse range of sporting, creative and social interests. Ten in-depth interviews were conducted with 11 people (including one couple) who self-identified as lesbian (5), gay (4), bisexual (1) and transgender (1) aged between 22 and 56 years. A university Research Ethics Committee granted approval. The data were transcribed and coded using thematic analysis, enhanced through a memo-writing approach to reflexivity. The theme of ‘connecting’ emphasized the shared nature of activities, with like-minded others through groups established by, and for, LGBT communities. Messages from the study reinforce the central role of LGBT communities in the promotion of mental health and social wellbeing, with important policy and practice implications. This requires the contextualization of the contribution of LGBT communities within understandings of social justice, identity and recognition.

Beyond the bench and bedside: Health literacy is fundamental to sustainable health and development

Thirty years after the Ottawa Charter for Health Promotion, the 2030 Agenda for Sustainable Development - predicated on seventeen Sustainable Development Goals (SDGs) - were unveiled to the global community. Health literacy is an essential preconditi

Predictors of Tuberculosis outcomes amongst drug sensitive patients in Boteti sub-district, Botswana, 2015–2017

IntroductionThe. Boteti sub-district in Botswana has a high TB notification rate of 356 per 100 000 population in 2013, a Treatment completion rate of 55%, 13% cure rate, and 4% defaulter rate in 2014. The high TB notification and defaulter rates with lower cure and treatment success rates in this sub-district relative to the country, are indicative of certain determinants that may be hampering TB control. The aim of this study was to determine the factors associated drug sensitive TB treatment outcomes. MethodsA retrospective cohort study was conducted amongst all the new-smear positive adult pulmonary TB patients who registered and/or completed the treatment period at the six selected health-care centres in Boteti sub-district, between 1 January 2015 and 31 January 2017. An interviewer-administered questionnaire in the patient's language of choice- Setswana or English was utilised for data collection. Adjusted risk ratios (ARR) and their respective 95% confidence intervals (95% CI) were used for expressing associations. ResultsFifty-eight (56.9%) patients were successfully cured compared to 44 (43.1%) who successfully completed treatment. Patients that attended the clinics by foot (ARR 3.38) (P < 0.05), females (ARR: 1.25) and HIV negative patients (ARR: 1.20) were more likely to achieve TB cure. Patients that attended the facility with a vehicle were 2.12 (P < 0.000), a primary school and above education (ARR: 1.59), travelled less than 5 km (ARR: 1.05) and less than 38 years of age (ARR:1.02) were more likely to complete TB treatment. ConclusionA comprehensive health promotion approach based on the Ottawa charter principles to should be developed and implemented.

Language and framing as determinants of the predominance of behavioural health promotion: an Australian view.

The language used in health promotion warrants attention as it shapes how health promotion is understood, constraining or opening up possibilities for action. The 2016 Shanghai Declaration and the 1986 Ottawa Charter for Health Promotion call for comprehensive approaches which include policy and environmental changes. Yet many health promotion programmes in Australia continue to focus on informational and/or behavioural strategies, and there is a contemporary tendency for such programmes to be described as 'sending messages'. This paper uses frame analysis to discuss the role of language, and specifically language that frames health promotion as sending messages, in contributing to and reinforcing the predominance of informational and/or behavioural strategies. It argues such 'message' language helps to set a pattern in which informational and/or behavioural strategies are assumed to be the primary goal and extent of health promotion; rather than one component of a comprehensive, multi-strategic approach. It discusses how frames can be 'taken for granted' and ways in which such frames can be challenged and broadened. It argues that the message frame and associated behavioural framings set narrow boundaries for health promotion, contributing to the continuation of health inequities. These frames can also displace the language of the Ottawa Charter, which has capacity to reframe health issues socio-ecologically and include collective strategies. The paper concludes that a first step (of the many needed) towards applying the Charter's approach and multi-level, multi-strategic framework is to use the innovative vocabulary it offers. The words matter.

Health promotion at the workplace setting: a protocol for a systematic review of effectiveness and sustainability of current practice in low-income and middle-income countries

IntroductionLow-income and middle-income countries (LMICs) are experiencing a growing disease burden due to non-communicable diseases (NCDs). Changing behavioural practices, such as diets high in saturated fat, salt and sugar and...

Connecting Health and Peacebuilding in Theory and Practice

Peace and health have long been connected through significant social structures such as violent conflict and social/economic inequalities and oppression. Peace and health have also been connected through research and action as war and interpersonal violence are recognized as threats to public health and individual welfare. In 1986, the Ottawa Charter for Health Promotion laid out the dependence of health on the presence of “peace, shelter, education, food, income, a stable eco-system, sustainable resources, social justice, and equity.”Scholars of peace building and community health (including “peace through health”) share an interest in the marriage between theoretical and applied aspects of the discipline, but we lack interdisciplinary thinking through collaborative projects and the development of transdisciplinary theoretical and methodological insights. The opportunity for interprofessional and intellectual exchange can benefit scholars and practitioners focused on each topic. The following outlines the similarities and differences in the fields and identifies where opportunities for symbiosis and support exist.

Is the oral health reform in Israel optimally distributed? - A commentary

A traditional and ethical principle recognizes a country’s primary general welfare responsibility to the young and the old. However, the middle, adult, age group cannot and should not be disregarded. The current dental component of the National Health Insurance Law (NHIL), in Israel, only includes children and the elderly. The present commentary focuses on the large group of adults, age 19–74, which are currently excluded.The cumulative incidence of disease increases over the lifetime of a person. We believe that a NHIL commitment with a major age gap in coverage is unacceptable. The recent manuscript, published by Natapov et al., in this journal, has documented the overall dental health of the older Israeli population, with emphasis on nutritional aspects. This contribution to the literature is commendable. However, we aim to follow in the steps of the Alma Ata Declaration and Ottawa Charter of the World Health Organization (WHO) and to clarify that the government’s responsibility should cover all residents regardless of their age. In addition, a dental health epidemiological data base, currently nonexistent for adults, is called for.

Ottawa charter framework as a guide for type 2 diabetes prevention and control in Iran.

The growth of T2DM in Iran is predicted to be even greater than the global trend. So a new public health movement to effectively prevent and manage T2DM is required more than ever. The solution has lain in the heart of the Ottawa Charter, the first international conference on health promotion more than 30years ago. The charter contains five useful actions to facilitate the process of diseases prevention and control: 1) building healthy public policy, 2) creating supportive environments, 3) strengthening community action, 4) developing personal skills, and 5) reorienting health care services toward promotion of health. The charter articulates health in all policies and their frameworks. The aim of this review is to examine how the five actions have been implemented in Iran and can serve as a guide to prevent and control diabetes. Several national case studies will be examined to illustrate the challenges facing Iran's health system. It enables the identification and sharing of best practice between countries.

Mental Health Navigation - a Model.

The need for mental health care services is a growing concern around the world. This article proposes a conceptual model for the role a mental health care navigator to meet the growing needs of consumers who are seeking greater access to fragmented and confusing mental health care services. This conceptual model proposes integrating mental health into primary care with a more patient-centered approach to the care of the whole person. This approach is congruent with The Ottawa Charter for Health Promotion Charter calling for the reorienting of health services focusing on the total needs of the individual as a whole person. Although USA focused, the model has potential for sharing across countries to build capacity for mental health care in other countries around the world. The conceptual model focuses on matching consumer mental health care needs with the correct mental health care services. This would ensure that patients get the appropriate mental health care services while allowing the primary care physician to maintain the role of coordinator of care for all of the patient's health care needs. The main intent of the model is to stimulate discussion and exploration around the role of a proposed mental health care navigator that can lead to creating models reflecting local need and adaptation. Successful models can lead to collaborative discussion encouraging capacity building in other countries. The authors maintain that coordination of health care, including mental, medical and surgical care, is the best approach to controlling costs and ensuring the health of the whole person.

ASSESSMENT OF LEVEL OF KNOWLEDGE, ATTITUDE AND PRACTISE IN PROMOTING HEALTHCARE AMONG HEALTH CLINIC ADVISORY PANEL IN KUALA SELANGOR

In 1978, in Alma Ata Declaration and Ottawa Charter (1986), World Health Organization has highlighted their vision in health promotion is about principles of participation and empowerment. In 1994, HCAP has been introducing by Malaysia Ministry of Health as a channel to help the community to get an information regarding health and also to get health services such as health screening program, defaulter tracing program and home medical assessment review program. A cross-sectional survey of a random 36 Health Clinic Advisory Panel has been selected has been conducted in 2017. Questionnaire from Individual-Community Related Empowerment has been used to assess the level of knowledge, attitude, and practice regarding healthcare. All the data has been analysed used SPSS Statistics 21. On the demographic data, sample gender stat higher on a male with 52.8% (n:19) meanwhile on the second components in demographics are sample age, 30.9% (29) have come from age of 19 – 59 years old group. For the level of education, 69.2% stated are from secondary level and the last components in demographic data are sample income 77.8% (n:28) stated monthly income more than Rm 3001 per month. For assessment of level KAP. From the data analysed all components of knowledge stated 94.33%. Meanwhile, in attitude components show 96.26% and practice show 93%. An average percentage is 94.5% which from this study showed HCAP members have good knowledge, attitude, and practice in promoting healthcare.

Characterization of digital communication models in organizations of the third sector

The changes established by the Ottawa Charter in he conceptualization of public health replaced risk prevention strategies with other promotion strategies focused on the development of competencies. Contributing to a better quality of life for people under favorable social, political and economic conditions enforcing the necessary means for greater control over health decisions with intersectoral participation made up of different organizations. The objective of the work is to recognize the communicative models in organizations linked to the health of the Third Sector of the city of Mar del Plata (Argentine Republic) at present. A quantitative, descriptive methodology is adopted on the study population, revealing strategies anchored in prevention, deterministic, vertical, based on the dissemination of content and scarcely oriented towards the collective construction of behavioral patterns that allow awareness of the factors Contributory to psycho-bio- social well-being.

Risky sexual behaviours among young people in sub-Saharan Africa: how can parents use the Ottawa Charter for Health Promotion for change?

ABSTRACTDespite progress made in the treatment of HIV and AIDS by making available the antiretroviral treatment in Africa, youth are still struggling with inadequate knowledge, a negative attitude towards AIDS and high-risk sexual behaviour. All of these are compounded by a lack of open communication between parents and youths which among others, which impedes on the control of the pandemic in this vulnerable group. Building on ‘Ottawa Charter for Health Promotion’ as one way of breaking all barriers in this communication, we suggest keys points in five different domains of this framework namely: building healthy public policies, creating a supportive environment, strengthening community action, developing personal skills, and reorienting the health services.

Sowing social inclusion for marginalised residents of a social housing development through a community garden.

In addition to food, physical activity, mental health and environmental benefits, community gardens (CGs) provide opportunities for social inclusion and increased social capital. These are particularly important to the socially isolated residents of social housing developments (SHDs). This scoping study explored the feasibility of a CG program for tenants of SHD in inner eastern Melbourne by assessing their interest in, and requirements for, inclusively designed CGs. In this phenomenological enquiry, focus group discussions, supported by photo-elicitation, were employed. Three focus groups (N=19) were conducted with self-selected participants who consented to participate. Two focus groups were conducted with English-speaking tenants while a third focus group was conducted with Mandarin-speaking tenants. There was a demand for CGs by the English-speaking participants driven by desire for networking, social connectedness and inclusion; for improved access to fresh produce, connection with nature, physical activity and mental well-being. Participants expressed interest in a garden located near their SHD with supportive physical and social environments including disability access, plot autonomy, fencing, socio-cultural events, training programs and management opportunities. However, the Mandarin-speaking tenants maintained that age, language difficulty and neighbourhood insecurity posed significant barriers to their participation. Guided by the Ottawa Charter for Health Promotion, social inclusion and community development theories, the study recommends that to establish socially inclusive CGs, a dynamic relationship of the design principles of a CG and the socio-ecological determinants of health should be established to address any barriers and successfully facilitate engagement. In addition, CG programs need to be guided by community development principles. Future research could employ community-based participatory research models in the implementation and evaluation of a CG program for socially isolated population groups.

Promover a saúde no novo paradigma

O movimento internacional em torno da promoção da saúde teve início na década de 80 do século XX. A I Conferência Internacional sobre Promoção da Saúde, em novembro de 1986, em Ottawa, Canadá, sinaliza o marco histórico para a mudança de paradigma. As discussões baseadas na Declaração de Alma-Ata para os Cuidados Primários em Saúde, no documento da OMS sobre Saúde Para Todos, assim como no debate ocorrido na Assembleia Mundial da Saúde originaram a ‘Carta de Ottawa’(1). De acordo com o documento: “Promoção da saúde é o nome dado ao processo de capacitação da comunidade para atuar na melhoria de sua qualidade de vida e saúde, incluindo uma maior participação no controle deste processo”(1).&#x0D; Promover a saúde é hoje uma obrigação nos diversos sistemas de saúde, articulada a ações que visam dar resposta à diversidade de necessidades sociais não dissociadas das potencialidades humanas. No novo paradigma de intervenção do setor da saúde a abordagem extravasa as considerações nacionais, apelando à participação de atores e de parcerias e à articulação entre a investigação e a prática clínica. Neste pacto, todos terão um papel a desempenhar na disseminação de práticas de referência – os cidadãos, os profissionais de saúde, os educadores, os trabalhadores dos vários setores, autarquias e o Governo(2). As mudanças que se avizinham nos próximos anos implicarão desafios para todos os setores da sociedade (desde a educação, ao meio ambiente, à economia, à qualidade dos serviços e às competências dos profissionais), em que as políticas assumirão um papel importante pela sua exigência na promoção de saúde(3). &#x0D; A investigação que tem sido feita, neste âmbito, destaca que as necessidades regionais específicas, identificadas durante o processo de construção da política, reforçam a riqueza de desenvolver, de forma inovadora, democrática e participativa, ações que possam dar sentido à promoção da saúde. É o exemplo do estudo que anuncia a sustentabilidade das políticas públicas de promoção de saúde, destacando a formação de redes colaborativas, além de consistência política e legislativa que permita a continuidade das intervenções(4). Já outros estudos, oriundos de processos de revisão na área política, enunciam a sua importância pelo seu contributo na produção e difusão do conhecimento na área, subsidiando diretrizes e mecanismos de pesquisa, formação e educação permanente sobre a temática.&#x0D; É o caso do estudo que destaca a necessidade da constituição de novos arranjos de advocacy e boa governança mediante a criação de espaços de articulação intergovernamental e intersectorial, caminho que tende para a ascensão e participação regional no processo de formulação de uma política. Encontros de trabalho coletivo parecem dar conta de uma aprendizagem inter-regional, intersectorial e intergeracional, pela existência de validação dos pares e parceiros, além das contribuições deste processo para o fortalecimento da agenda estratégica da Saúde Coletiva(5). &#x0D; Neste processo de transição as iniciativas dos cidadãos e da sociedade em geral serão fundamentais na redução das doenças crónicas, no incremento da qualidade e no acesso a evidências científicas, sem, no entanto, perder o reforço do papel do Estado na garantia das condições de vida à população, “para não se correr o risco de se afirmar uma política que, principalmente, culpabiliza e responsa¬biliza o indivíduo pela sua não saúde”(6).&#x0D; Esta edição da RBPS apresenta resultados de estudos de interesse diversificado no campo da promoção da saúde, geradores de reflexões nos leitores interessados pelos temas. Integra onze artigos em português, selecionados entre aqueles que foram apresentados no 6º Congresso Ibero-Americano em Investigação Qualitativa (www.ciaiq.org), que teve lugar em Salamanca em Julho de 2017. Para a sua seleção foi considerada a avaliação dos artigos pela comissão científica do CIAIQ. Foram ainda sujeitos a ampliação e a verificação pelos editores convidados. A seleção considerou ainda os objetivos editoriais da RBPS. Pretende-se com esta edição contribuir para o desenvolvimento científico, teórico e metodológico em Saúde como ciência e profissão.&#x0D; Mais uma vez exprime, inequivocamente, que a promoção de saúde é um campo vasto de estudo, cuja pluralidade explica a diversidade dos problemas, questões de investigação e opções metodológicas. Destaca-se a natureza qualitativa comum aos artigos que constam desta edição, uma abordagem cada vez mais presente na investigação na área da saúde, uma vez que contactar com as diferentes perspetivas e significações dos fenómenos do processo saúde-doença contribui efetivamente para a promoção da saúde, promovendo uma maior adesão em ações de saúde implementadas individual e coletivamente, através de respostas ajustadas a recetores e prestadores de serviços de saúde(7).&#x0D; A discussão dos estudos que se seguem contribui para fortalecer a comunidade científica, que se identifica tanto pela elucidação das práticas, como pelo fundamento teórico, abrindo o leque de abordagens no terreno da ação.

New frontiers in community initiatives to increase vegetable consumption.

Public health concerns about insufficient consumption of vegetables across all demographics in Australia have led to 20years of behaviour change interventions ranging from social marketing to interactive small group programs, with modest results. To maximise health promotion intervention outcomes, practitioners need up-to-date information that helps them navigate the complexity of food systems and eating behaviours. This scoping review of Australian and international research, including peer-reviewed and grey literature, provides a picture of health promotion nutrition interventions, as well as other initiatives that may promote increased vegetable consumption. Search terms related to nutrition and vegetable consumption, type of intervention or initiative, for example, campaign; and consumer values and behaviour. A wide range of data sources were used including scholarly papers, market research reports and publicly available websites of community organisations (eg, OOOOBY). A broad food systems typology was developed to provide a framework for the review. The review finds an emerging group of community-driven initiatives within local food systems that appear to have positive impacts on vegetable consumption. These initiatives sit within a multi-faceted approach to health and well-being that is consistent with the tenets of the Ottawa Charter for Health Promotion, including community engagement, social justice and sustainability goals. More research into the impact of these new frontiers is needed, but our preliminary findings point to the potential for health promotion practitioners to collaborate on local/community food system initiatives that are not motivated primarily by health goals, but have the potential to deliver multiple health and environmental outcomes. SO WHAT?: This review demonstrated community-driven initiatives around local food systems show the most promise in promoting vegetable consumption and addressing the determinants of health. Health promotion efforts to encourage food security and healthy eating could be strengthened through collaborations within these new frontiers.

THE ROLE OF PUSKESMAS IN THE IMPLEMENTATION OF PHBS AT SLB ALPA KUMARA WARDANA II

Puskesmas as a health service facility, organized public health effort and individuals in the first level. As a first-rate health facility, puskesmas are responsible for health in their working area. School is one of the institutions that become the responsibility of puskesmas. Health efforts in schools are realized through the development of health promotion. The development of school health promotion is implemented through a health program, UKS. UKS targets are all schools which means not only public schools but also specials schools (SLB) are included. Children with special needs is one of the human resources whose quality must be improved. Such quality improvement can be done through basic behavioral cultivation, including health behavior. PHBS in school is an absolute necessity. This can be said because the various diseases that often attack school-age children associated with PHBS. SLB Alpa Kumara Wardana II is one of the target schools of Puskesmas Pucang Sewu so that the implementation of PHBS from the school is also the responsibility of Puskesmas Pucang Sewu. This study aims to analyze the role of puskesmas in the implementation of PHBS in schools at SLB based on Ottawa Charter. The method used in this research is qualitative with the determination of informants using purposive sampling technique. The results obtained from this research is the role of puskesmas in the implementation of PHBS in schools at SLB Alpa Kumara Wardana II is still less than optimal in the implementation of PHBS in schools. Implementation of PHBS in SLB is still need to improved application from the aspect of build healthy public policy, create supportive environtment, reorient health services, strengthen community action, and develop personal skills.