Global Programme on Health

Promotion Effectiveness
dewirokhmah@unej.ac.id
081215400530
 The Outine
1) Global Programme on Health Promotion
Effectiveness; an Introduction
2) The Global Programme on Health Promotion
Effectiveness: A Case Study of Global
Partnership Functioning
3) Health Promotion and SDGs
4) Implementation of Health Promotion in
Indonesia
 Introduction
Health promotion is a vital component of public health practice. During last two
decades, health promotion has been consolidated and institutionalized. Public
health practitioners, policy-makers, academicians and researchers recognize the
role of health promotion in improving public health.

In 2009, health promotion was re-defined as, “Health Promotion is the art and
science of helping people discover the synergies between their core passions and
optimal health, enhancing their motivation to strive for optimal health, and
supporting them in changing their lifestyle to move toward a state of optimal
health.

Optimal health is a dynamic balance of physical, emotional, social, spiritual, and

intellectual health. Lifestyle change can be facilitated through a combination of
learning experiences that enhance awareness, increase motivation, and build skills
and, most important, through the creation of opportunities that open access to
environments that make positive health practices the easiest choice.
 Definition
The Global Programme on Health Promotion Effectiveness is
coordinated by the International Union for Health
Promotion and Education (IUHPE) in collaboration with the
World Health Organization and numerous other partners
and supporters. It is a unique worldwide programme which
aims to raise standards of health-promoting policy-making
and practice worldwide by :
1) Reviewing evidence of effectiveness in terms of health,
social, economic and political impact;
2) Translating evidence to policy makers, teachers,
practitioners, researchers;
3) Stimulating debate on the nature of evidence of
effectiveness.
 The Objection
The GPHPE is a worldwide partnership looking at health promotion
effectiveness around the globe. The multi-partner initiative is
coordinated by the International Union for Health Promotion and
Education (IUHPE) in collaboration with the World Health
Organization (WHO) and partners from national agencies and
organizations in Kenya, Switzerland, England, The Netherlands,
Canada, the United States and India, among others (GPHPE, 2005).

The main aim of the GPHPE is to “raise the standards of health

promoting policy making and practice world-wide by: reviewing and
building evidence in terms of health, social, economic and political
impact; translating evidence to policy makers, teachers,
practitioners, researchers; and stimulating debate on the nature of
effectiveness” (GPHPE, 2005).
Health promotion represents a comprehensive social
and political process, it not only embraces actions
directed at strengthening the skills and capabilities of
individuals, but also action directed towards changing
social, environmental and economic conditions so as to
alleviate their impact on public and individual health.

Health promotion is the process of enabling people to

increase control over the determinants of health and
thereby improve their health. (WHO, 1998)
Determinants of Health, interventions
and outcomes
Health promotion is
defined as processes
that facilitate people
to enhance and Health promotion is the
improve control over process of enabling people
their health (WHO, to increase control over, and
1986) to improve, their health. It is
a positive concept
emphasising personal,
social, political and
institutional resources, as
well as physical capacities.”
(WHO, 1990)
 Health Promotion
Health promotion enables
people to increase control
over their own health. It
covers a wide range of social
and environmental
interventions that are
designed to benefit and
protect individual people’s
health and quality of life by
addressing and preventing
the root causes of ill health,
not just focusing on
treatment and cure.
3 key elements of
health promotion:-
• Good governance for
health
• Increased
opportunities for
‘Health literacy’
• Implementation of
Healthy Settings
Global Declarations on Health Promotion…

Alma Ata on Primary Health Care (1978)

Ottawa Charter (1986)

Jakarta Declaration (1997)

Bangkok Charter (2005)

Nairobi Declaration (2009)

Helsinki Statement (2013)

Shanghai Declarations (2016)
 Health Promotion (Ottawa Charter 1986)

• Strategies for Health • So, health promotion focuses

Promotion: on:
– Enabling individuals to take
control over the determinants
– Build Healthy Public of health;
Policy; – Empowering individuals and
populations to make informed
– Create Supportive decisions about their health;
Environments; – Providing supportive social,
– Strengthen Community economic and physical
environments through diverse
Actions; but complementary strategies;
– Develop Personal Skills; – Equipping systems and sectors
to address the social
– Reorient Health determinants of health; and
Services; – Working in collaboration with a
wide range of sectors.
Health Promotion Objectives
• To promote equity
• To ensure social justice
• To advocate for improved population health outcomes
• To work in partnership
• To ensure intersectoral collaboration
• To promote community engagement
• To support empowerment
• To promote sustainability
• To embrace evidence based practice
• To value contextual knowledge
• To celebrate and value cultural knowledge
• To improve health literacy through system level changes
 Health Promotion Helps in a Way:
1. Large numbers of people affected are addressed for
healthy choices with adequate awareness;

2. Poor health outcomes in different measures are

minimized;

3. Risk factors of both communicable diseases and NCDs

are timely addressed & communicated;

4. Additional health care costs due to limited health literacy

are minimized;

5. Health information demands are complemented; &

6. Contributing effectively to minimize health equity gaps.

 Sustainable Development
Health promotion interventions have
been proven to be effective in
addressing many social, economic
and environmental determinants of
health.
…It is the development
that meets the needs
and aspirations of the
current generation
without compromising
the ability to meet
those of future
generations…
(Brundtland Report, entitled “Our
Common Future," and published by
the United Nations in 1987)
Health: Ensure healthy lives & promote well-being for all at all ages
Targets:
• Reduce the global maternal mortality ratio to less than 70 per 100,000
live Births;

• End preventable deaths of newborns and children under 5 years of age;

• End the epidemics of AIDS, tuberculosis, malaria and neglected tropical

diseases and combat hepatitis, water-borne diseases and other
communicable diseases;

• Reduce by one third premature mortality from non-communicable

diseases through prevention and treatment and promote mental health
and wellbeing;

• Strengthen the prevention and treatment of substance abuse, including

narcotic drug abuse and harmful use of alcohol;

• Halve the number of global deaths and injuries from road traffic
accidents;

• Ensure universal access to sexual and reproductive health-care services, 17

including for family planning, information and education;
Health: Ensure healthy lives & promote well-being for all at all ages
Targets:
• Achieve universal health coverage, including financial risk protection, access
to quality essential health-care services and access to safe, effective, quality
and affordable essential medicines and vaccines for all;

• Substantially reduce the number of deaths and illnesses from hazardous

chemicals and air, water and soil pollution and contamination;

• Strengthen the implementation of the World Health Organization Framework

Convention on Tobacco Control in all countries, as appropriate

• Support the research and development of vaccines and medicines for the
communicable and non-communicable diseases that primarily affect
developing countries;

• Substantially increase health financing and the recruitment, development,

training and retention of the health workforce in developing countries, LDCs,
and small island developing States;

• Strengthen the capacity of all countries, in particular developing countries,

for early warning, risk reduction and management of national and global
health risks 18
 Shanghai Declaration on promoting health in the 2030 Agenda for
Sustainable Development, particularly emphasizes to:
• apply mechanisms as available through full use of public policies;

• strengthen legislation, regulation, and taxation of unhealthy commodities;

• implement fiscal policies as a powerful tool to enable new investments in health;

• introduce UHC as an efficient way to achieve both health and financial protection;

• ensure transparency and accountability by broadening engagement of civil society;

• strengthen global governance to better address cross border health issues;

• respect importance and value of traditional medicine in improved health outcomes;

• prioritize city policies making full use of social innovation & interactive technologies;

• support cities to promote equity and social inclusion, priorities for strong community engagement;

• re-orient health and social services to optimize fair access of people & communities;

• recognize health literacy as a critical determinant of health and strengthen in all population settings;

• increase citizens’ control of their own health and its determinants, through harnessing the potential
of digital technology; and

• Ensure that consumer environments support healthy choices through pricing policies, transparent
information and clear labelling.
 Contributing to social and economic development: sustainable action across sectors to improve
health and health equity (follow-up of the 8th Global Conference on Health Promotion)- 68 WHA
Role of the Government:
• identify and prioritize health issues;
• build knowledge and generate an
evidence base for policy development and
strategic planning;
• assess the effectiveness of action across
sectors and the cost of inaction versus
investment;
• initiate regular and continuous dialogue
with other sectors and with the whole of
society, and create structures for this
dialogue if needed;
• understand the priorities and decision-
making methods of other sectors;
• advocate for health protection and for
social determinants of health to be
addressed in public discourse and public
policies; and
• promote synergy and negotiate trade-offs
between sectors and among potential
institutional
Role of the WHO:
• compile and promote evidence-based
practices for action across sectors;
• promote action on universal health
coverage and the social determinants of
health;
• support policies for global health
protection and health promotion;
• provide guidance and technical assistance
for the implementation of policies across
sectors on various levels of governance;
• provide a platform to advance
multisectoral action to implementation of
the WHO Global NCD Action Plan 2013–
2020 on the Prevention and Control of
Noncommunicable Diseases; and
• work with and provide leadership for
other United Nations organizations and
intergovernmental organizations to
consider health objectives when
implementing and monitoring major
strategic initiatives.
Health promotion strategic actions for South-East Asia: WHO SEARO

• Establish and sustain infrastructure & supports in countries to

coordinate and manage health promotion activities across sectors;

• Strengthen & institutionalize national capacity for health promotion;

• Introduce public legislation, policies, and regulations that promote,

support and project health of all citizens;

• Encourage Member States to create & sustain a political & economic

environment conducive to initiating & maintaining partnership,
alliances or networks for health with multisectoral partners;

• Establish evidence-based information to systematically monitor

health promotion policies, programmes, infrastructures, investment
& interventions; and

• Encourage social mobilization and advocacy for integration of health

promotion across sectors and settings.
REPUB
LIK
INDON
ESIA

Implementation of Health Promotion

Program in Indonesia
REPUB
LIK
Promosi Kesehatan dan SDGs
INDON
ESIA

Kesehatan
Masyarakat

Akses,
Fokus kualitas, dan
Promosi Pengendalian
Kesehatan faktor risiko
efisiensi
Promosi Kesehatan SDGs
berperan strategis pelayanan
dalam upaya kesehatan
pencapaian SDGs
• Kebijakan publik
berwawasan
kesehatan
• Penciptaan Pencegahan
lingkungan yang
mendukung
• Pelibatan dan
peran serta aktif
masyarakat
• Peningkatan
kapasitas
Sumber: Health Affairs (2016) - The MDG To SDG Transition: Implications For Health Care
individu dan Systems
23
REPUB
Promosi Kesehatan Dalam RPJMN
2015-2019
LIK
INDON
ESIA

Sasaran  Meningkatnya upaya peningkatan promosi kesehatan dan pemberdayaan

RPJMN masyarakat, serta meningkatnya pembiayaan kegiatan promotif dan preventif
2015-2019  Meningkatnya upaya peningkatan perilaku hidup bersih dan sehat

Arah Kebijakan 9
Meningkatkan Promosi Kesehatan dan Pemberdayaan Masyarakat

a. peningkatan advokasi kebijakan pembangunan berwawasan kesehatan;

b. pengembangan regulasi dalam rangka promosi kesehatan;
c. penguatan gerakan masyarakat dalam promosi kesehatan dan pemberdayaan
masyarakat melalui kemitraan antara lembaga pemerintah dengan swasta, dan
masyarakat madani;
d. peningkatan pemberdayaan masyarakat melalui pendidikan kesehatan
masyarakat, komunikasi, informasi dan edukasi (KIE) serta upaya kesehatan
berbasis masyarakat (UKBM) termasuk pengembangan rumah sehat;
e. peningkatan SDM promosi kesehatan; dan
f. pengembangan metode dan teknologi promosi kesehatan. 24
REPUB
LIK
Gerakan Masyarakat Hidup Sehat
INDON
ESIA

INSTRUKSI PRESIDEN NO. 1 TAHUN 2017

TENTANG GERAKAN MASYARAKAT HIDUP
SEHAT 25
REPUB
Pendekatan Lintas Sektor Dalam
Germas
LIK
INDON
ESIA
AKTIVITAS FISIK
Kemenpora, Kemenhub, Kemen
PU dan PR, Kemendikbud,
Kemenaker, Kemenkes, Kemen
BUMN, Kemenristek Dikti,
Kemenpar, Kemenag, K/L lain
PANGAN SEHAT DAN yang terkait, Pemda, Sektor
BERGIZI Non Pemerintah terkait
Kementan, Kemenkes,
KKP, Kemendag, LINGKUNGAN SEHAT
Kemenperin, BPOM, K/L Kemenkes, Kemen LHK,
lain yang terkait, Pemda, Kemen PU dan PR,
Sektor Non Pemerintah Kemendikbud, Kemenag,
Gerakan
terkait Kemenpar, Kemensos,
Masyarakat
Hidup K/L lain yang terkait,
DETEKSI DINI Sehat Pemda, Sektor Non
Kemenaker, Pemerintah terkait
Kemenkes, Kemen PP
dan PA, BPJS
A EDUKASI HIDUP SEHAT
Kesehatan, Kemen PAN dan RB,
Kemenhan/ TNI, Kemenag,
POLRI, K/L lain yang Kemendikbud,
terkait, Pemda, Sektor Kemenkominfo,
Non Pemerintah PERILAKU SEHAT Kemenkes, BKKBN, BNN,
terkait Kemendikbud, Kemenag, Kemendes PDTT, Kemen
Kemenristek Dikti, PU dan PR, K/L lain
Kemenkeu, Kemenkes, yang terkait, Pemda,
Kemenaker, Kemendag, Sektor Non Pemerintah
K/L lain yang terkait, terkait
Pemda, Sektor Non
Pemerintah terkait 26
REPUB
LIK
4. Strategi dan Implementasi
INDON
ESIA

Prinsip SDGs
Universal
Integratif
No One Left Behind
Dasar Hukum
 Perpres
 Permen
Text Here  Regulasi
daerah

Instrumen
 Kelembagaan
 Pengarusutamaan
SDGs Pedoman Teknis
 Roadmap dan
Rencana Aksi  Metadata SDGs
 Monitoring dan Indonesia
Evaluasi  Penyusunan Rencana
 Inovasi Data Aksi
27
 Strategi Komunikasi
REPUB
LIK
Perpres SDGs
INDON
ESIA

28
 Pengarusutamaan SDGs Dalam Agenda
REPUB
LIK
INDON
ESIA
Pembangunan
TARGET
TARGET
PILAR/GOAL RPJMN HIGHLIGHT PRIORITAS NASIONAL
GLOBAL
2015-2019
SOSIAL 47 25 • Pengentasan Kemiskinan
(1, 2, 3, 4, 5) • Kesejahteraan Penduduk
• Peningkatan Kedaulatan Pangan
• Implementasi Program Indonesia Pintar dan Program Indonesia
Sehat
• Perlindungan Anak, Perempuan, dan Kelompok Marjinal
EKONOMI 54 30 • Kedaulatan Energi
(7, 8, 9, 10, 17) • Percepatan Pertumbuhan Ekonomi Nasional
• Peningkatan Daya Saing Tenaga Kerja
• Pembangunan Konektivitas Nasional
• Pemerataan Pembangunan Wilayah
• Implementasi Politik Luar Negeri Yang Independen dan Aktif

LINGKUNGAN 56 31 • Ketahanan Air Bersih

(6, 11, 12, 13, • Pembangunan Perumahan dan Area Permukiman
• Perubahan Iklim dan Informasi Iklim dan Bencana RAN
14, 15)
Pengurangan Emisi GRK
• Pembangunan Maritim dan Ekonomi Kelautan
• Pelestariaan Sumber Daya Alam, Lingkungan, dan Pengurangan
Risiko Bencana
• Rencana Aksi dan Strategi untuk Keanekaragaman Hayati
Indonesia
PEMBANGUNA 12 8 • Peningkatan Kualitas Perlindungan Bagi Masyarakat
N HUKUM • Penegakan Hukum Yang Adil
• Membangun Transparansi dan Akuntabilitas Pemerintah
DAN TATA
29
KELOLA (16)
REPUB
LIK
Kemitraan Pemangku Kepentingan
INDON
ESIA

1. Penetapan Target, Platform SDGs 1. Peningkatan

Kebijakan &
Kapasitas
Prinsip Kemitraan Program
2. Evaluasi
2. Pengembangan
3. Policy
Data & Indikator
Paper/Policy
3. Diseminasi,
Membangu Brief, input
Komunikasi &
n PEMERINTAH untuk
Advokasi AKADEMISI &penyusunan
Kepercayaa 4. Dukungan & kebijakan
n Regulasi & PAKAR
Kemitraan PARLEMEN 4. Pengembangan
Anggaran
Yang Data dan
5. Monev &
Setara Pelaporan Implement Indikator
asi SDGs
Partisipasi
1. Advokasi Pelaku FILANTROPI 1. Diseminasi dan
OMS &
Usaha & Advokasi
2. Fasilitasi MEDIA 2. Fasilitasi
Akuntabel Program BISNIS Program
(Komunikasi, 3. Advokasi,
Peningkatan Awareness, dan
Saling Kapasitas, Peningkatan
Menguntu Dukungan Kapasitas
ngkan Sumberdaya) 4. Monitoring

30
REPUB
LIK
Peraturan Presiden tentang SDGs
INDON
ESIA

 Perpres No. 59/2017 tentang

Pelaksanaan Pencapaian Tim Koordinasi Nasional
Tujuan Pembangunan
Berkelanjutan SDGs

Steering Committee
dipimpin Presiden RI
Koordinator
Pelaksana
dipimpin Men PPN/Ka.
Bappenas
Tim Pelaksana
dipimpin Deputi Bid. Tim
Kemaritiman dan SDA, Pakar
Bappenas
Sekretar
iat

Kelompok Kerja
Kelompok Kerja Kelompok Kerja Kelompok Kerja Pilar Pembangunan
Pilar Sosial Pilar Ekonomi Pilar Lingkungan Hukum dan Tata
Kelola

Anggota dari Tim Pelaksana dan Kelompok Kerja terdiri atas 4 partisipan
platform
(Pemerintah dan Parlemen, CSO, Filantropi dan Dunia Usaha dan Akademisi) 31
REPUB
LIK
Dokumen SDGs
INDON
ESIA

Rencana Aksi
• Dokumen
perencanaan
Nasional • Dokumen
tentang perencanaan
• Dokumen
langkah pencapaian
perencanaan
strategis SDGs tingkat
pencapaian
pencapaian daerah
SDGs tingkat
SDGs 2016-
Roadmap Rencana Aksi
nasional
2030
SDGs Daerah

32
REPUB
LIK
Persiapan dan Pelaksanaan SDGs
Peningkatan Forum
INDON
ESIA
Dasar Hukum Diseminasi
Kapasitas Internasional
• Perpres • Kepada 4 platform kemitraan di • Partisipasi dan peningkatan • Forum internsional
• Permen tingkat nasional kapasitas kepada beberapa tentang SDGs dan
• Kepada 4 platform kemitraan di universitas dan asosiasi (IPB, agenda terkait
tingkat daerah ITB, UGM, UI, Universitas
• VNR 2017
Ahmad Dahlan, Unair, Unpad,
• Fasilitasi provinsi dan kab/kota
Unpar, PPM, Unika
• Informasi dan diseminasi dalam Soegijopranoto, Uhamka, Binus,
forum internasional (Side Event Univ Pertamina, Konas IAKMI).
UNGA, ADB, IDB, Forum Bisnis
• Penyediaan informasi sebagai
Int., Knowledge Sharing Asia
narasumber pada kegiatan-
Pacific, Persiapan G20 Cina,
kegiatan CSOs (INFID, LBH
Sustainability Reporting Award).
APIK, Transparency
International Indonesia, Plan
International, & Yayasan
Penyusunan Sayangi Tunas Cilik).
Mapping target dan Rencana Aksi Koordinasi dan
indikator
• Mapping antara target dan • Penyusunan pedoman •Komunikasi
Koordinasi rutin dengan mitra
indikator global dan nasional rencana aksi pembangunan (UN Agencies, JICA,
• Penyelarasan SDGs dan • Exercise penyusunan GIZ, & DFAT)
RPJMN 2015-2019 rencana aksi • Koordinasi reguler dengan filantropi
• Metadata SDGs . dan dunia usaha
• Penyusunan strategi komunikasi

33
 Tantangan Pelaksanaan SDGs di
REPUB
LIK
INDON
ESIA
Indonesia
Sinergi prioritas
Memastikan Integrasi pemerintah
prinspip inklusif program dengan sektor
dan no one left antarpemangku non-pemerintah
behind kepentingan

Database yang Sinergi rencana Indonesia merupakan

komprehensif aksi yang ada negara kepulauan
dan terintegrasi dengan agenda dengan jumlah
pembangunan penduduk yang besar

34
REPUB
LIK
INDON
ESIA

Terima Kasih