[replace with]
[replace with]  THE
[replace with] JAKARTA DECLARATION ON LEADING HEALTH PROMOTION INTO THE 21ST
[replace with] CENTURY
[replace with] Fourth International Conference on Health Promotion,
[replace with] Jakarta 21 - 25 July 1997
[replace with] WHO/HPR/HEP/4ICHP/BR/97.4
[replace with]
[replace with] Preamble
[replace with] The Fourth International Conference on Health Promotion: New
[replace with] Players for a New Era - Leading Health Promotion into the 21st
[replace with] Century, meeting in Jakarta from 21 to 25 July 1997, has come at
[replace with] a critical moment in the development of international strategies
[replace with] for health. It is almost 20 years since the World Health
[replace with] Organizations Member States made an ambitious commitment to a
[replace with] global strategy for Health for All and the principles of primary
[replace with] health care through the
[replace with]
[replace with] Declaration of Alma-Ata. It is 11 years since the First
[replace with] International Conference on Health Promotion was held in Ottawa,
[replace with] Canada. That Conference resulted in proclamation of the
[replace with] Ottawa
[replace with] Charter for Health Promotion, which has been a source of
[replace with] guidance and inspiration for health promotion since that time.
[replace with] Subsequent international conferences and meetings have further
[replace with] clarified the relevance and meaning of key strategies in health
[replace with] promotion, including healthy public policy (Adelaide,
[replace with] Australia, 1988), and supportive environments for health (Sundsvall,
[replace with] Sweden, 1991).
[replace with] The
[replace with] Fourth International Conference on Health Promotion is the first
[replace with] to be held in a developing country, and the first to involve the
[replace with]
[replace with] private sector in supporting health promotion. It has
[replace with] provided an opportunity to reflect on what has been learned
[replace with] about effective health promotion, to re-examine the determinants
[replace with] of health, and to identify the directions and strategies that
[replace with] must be adopted to address the challenges of promoting health in
[replace with] the 21st century.
[replace with] The
[replace with] participants in the Jakarta Conference hereby present this
[replace with] Declaration on action for health promotion into the next
[replace with] century.
[replace with]
[replace with] Health promotion is a key investment
[replace with] Health is a basic human right and is essential for social and
[replace with] economic development. Increasingly, health promotion is being
[replace with] recognized as an essential element of health development. It is
[replace with] a process of enabling people to increase control over, and to
[replace with] improve, their health. Health promotion, through investment and
[replace with] action, has a marked impact on the determinants of health so as
[replace with] to create the greatest health gain for people, to contribute
[replace with] significantly to the reduction of inequities in health, to
[replace with] further human rights, and to build social capital. The ultimate
[replace with] goal is to increase health expectancy, and to narrow the gap in
[replace with] health expectancy between countries and groups.
[replace with] The
[replace with] Jakarta Declaration on Health Promotion offers a vision and
[replace with] focus for health promotion into the next century. It reflects
[replace with] the firm commitment of participants in the Fourth International
[replace with] Conference on Health Promotion to draw upon the widest possible
[replace with] range of resources to tackle health determinants in the 21st
[replace with] century.
[replace with]
[replace with] Determinants of health: new challenges
[replace with] The prerequisites for health are peace, shelter, education,
[replace with] social security, social relations, food, income, the empowerment
[replace with] of women, a stable eco-system, sustainable resource use, social
[replace with] justice, respect for human rights, and equity. Above all,
[replace with] poverty is the greatest threat to health.
[replace with]
[replace with] Demographic trends such as urbanization, an increase in the
[replace with] number of
[replace with]
[replace with] older people and the high prevalence of chronic diseases
[replace with] pose new problems in all countries. Other social, behavioural
[replace with] and biological changes such as increased
[replace with]
[replace with] sedentary behaviour, resistance to antibiotics and other
[replace with] commonly available drugs, increased drug abuse, and civil and
[replace with] domestic violence threaten the health and well-being of hundreds
[replace with] of millions of people.
[replace with] New
[replace with] and re-emerging infectious diseases, and the greater recognition
[replace with] of mental health problems, require an urgent response. It is
[replace with] vital that approaches to health promotion evolve to meet changes
[replace with] in the determinants of health.
[replace with]
[replace with] Transnational factors also have a significant impact on health.
[replace with] These include the integration of the global economy, financial
[replace with] markets and trade, wide access to media and communications
[replace with] technology, and environmental degradation as a result of the
[replace with] irresponsible use of resources.
[replace with]
[replace with] These changes shape peoples values, their lifestyles throughout
[replace with] the lifespan, and living conditions across the world. Some have
[replace with] great potential for health, such as the development of
[replace with] communications technology, while others, such as international
[replace with] trade in tobacco, have a major negative impact.
[replace with]
[replace with] Health promotion makes a difference
[replace with] Research and case studies from around the world provide
[replace with] convincing evidence that health promotion is effective. Health
[replace with] promotion strategies can develop and change lifestyles, and have
[replace with] an impact on the social, economic and environmental conditions
[replace with] that determine health. Health promotion is a practical approach
[replace with] to achieving greater equity in health.
[replace with] The
[replace with] five strategies set out in the Ottawa Charter for Health
[replace with] Promotion are essential for success:
[replace with]
[replace with] -
[replace with]
[replace with] build healthy public policy
[replace with] -
[replace with]
[replace with] create supportive environments
[replace with] -
[replace with]
[replace with] strengthen community action
[replace with] -
[replace with]
[replace with] develop personal skills
[replace with] -
[replace with]
[replace with] reorient health services.
[replace with]
[replace with]
[replace with] There is now clear evidence that:
[replace with]
[replace with] -
[replace with]
[replace with] comprehensive approaches to health development are the
[replace with] most effective. Those that use combinations of
[replace with] the five strategies are more effective than single- track
[replace with] approaches.
[replace with] -
[replace with]
[replace with] particular settings offer practical opportunities for the
[replace with] implementation of comprehensive strategies. These include
[replace with] mega-cities, islands,
[replace with]
[replace with] cities, municipalities, local communities, markets,
[replace with]
[replace with] schools, the
[replace with]
[replace with] workplace, and health care facilities.
[replace with] -
[replace with]
[replace with] participation is essential to sustain efforts. People
[replace with] have to be at the centre of health promotion action and
[replace with] decision-making processes for them to be effective.
[replace with]
[replace with] -
[replace with]
[replace with] health learning fosters participation. Access to
[replace with] education and information is essential to achieving effective
[replace with] participation and the empowerment of people and communities.
[replace with]
[replace with]
[replace with]
[replace with] These strategies are core elements of health promotion and are
[replace with] relevant for all countries.
[replace with]
[replace with] New responses are needed
[replace with] To address emerging threats to health, new forms of action are
[replace with] needed. The challenge for the coming years will be to unlock the
[replace with] potential for health promotion inherent in many sectors of
[replace with] society, among local communities, and within families.
[replace with]
[replace with]
[replace with] There is a clear need to break through traditional boundaries
[replace with] within government sectors, between governmental and
[replace with] nongovernmental organizations, and between the public and
[replace with] private sectors. Cooperation is essential; this requires the
[replace with] creation of new partnerships for health, on an equal footing,
[replace with] between the different sectors at all levels of governance in
[replace with] societies.
[replace with]
[replace with] Priorities for health promotion in the 21st Century
[replace with]
[replace with] 1. Promote social responsibility for health
[replace with]
[replace with]
[replace with] Decision-makers must be firmly committed to social
[replace with] responsibility. Both the public and private sectors should
[replace with] promote health by pursuing policies and practices that:
[replace with]
[replace with]
[replace with] -
[replace with]
[replace with] avoid harming the
[replace with] health of individuals
[replace with] -
[replace with]
[replace with] protect the
[replace with] environment and ensure sustainable use of resources
[replace with]
[replace with] -
[replace with]
[replace with] restrict
[replace with] production of and trade in inherently harmful goods and
[replace with] substances such as tobacco and armaments, as well as
[replace with] discourage unhealthy marketing practices
[replace with] -
[replace with]
[replace with] safeguard both the
[replace with] citizen in the marketplace and the individual in the
[replace with] workplace
[replace with] -
[replace with]
[replace with] include
[replace with] equity-focused health impact assessments as an integral part
[replace with] of policy development.
[replace with]
[replace with]
[replace with] 2.
[replace with] Increase investments for health development
[replace with]
[replace with]
[replace with] In many countries, current investment in health is inadequate
[replace with] and often ineffective. Increasing investment for health
[replace with] development requires a truly multisectoral approach including,
[replace with] for example, additional resources for education and housing as
[replace with] well as for the health sector. Greater investment for health
[replace with] and reorientation of existing investments, both within and
[replace with] among countries, has the potential to achieve significant
[replace with] advances in human development, health and quality of life.
[replace with]
[replace with]
[replace with] Investments for health should reflect the needs of particular
[replace with] groups such as women, children, older people, and indigenous,
[replace with] poor and marginalized populations.
[replace with]
[replace with] 3.
[replace with] Consolidate and expand partnerships for health
[replace with]
[replace with]
[replace with] Health promotion requires partnerships for health and social
[replace with] development between the different sectors at all levels of
[replace with] governance and society. Existing partnerships need to be
[replace with] strengthened and the potential for new partnerships must be
[replace with] explored.
[replace with]
[replace with] Partnerships offer mutual benefit for health through the
[replace with] sharing of expertise, skills and resources. Each partnership
[replace with] must be transparent and accountable and be based on agreed
[replace with] ethical principles, mutual understanding and respect. WHO
[replace with] guidelines should be adhered to.
[replace with]
[replace with] 4.
[replace with] Increase community capacity and empower the individual
[replace with]
[replace with]
[replace with] Health promotion is carried out by and with people, not on or
[replace with] to people. It improves both the ability of individuals to take
[replace with] action, and the capacity of groups, organizations or
[replace with] communities to influence the determinants of health.
[replace with]
[replace with]
[replace with] Improving the capacity of communities for health promotion
[replace with] requires practical education, leadership training, and access
[replace with] to resources. Empowering individuals demands more consistent,
[replace with] reliable access to the decision-making process and the skills
[replace with] and knowledge essential to effect change.
[replace with]
[replace with] Both traditional communication and the new information media
[replace with] support this process. Social, cultural and spiritual resources
[replace with] need to be harnessed in innovative ways.
[replace with]
[replace with] 5.
[replace with] Secure an infrastructure for health promotion
[replace with]
[replace with]
[replace with] To secure an infrastructure for health promotion, new
[replace with] mechanisms for funding it locally, nationally and globally
[replace with] must be found. Incentives should be developed to influence the
[replace with] actions of governments, nongovernmental organizations,
[replace with] educational institutions and the private sector to make sure
[replace with] that resource mobilization for health promotion is maximized.
[replace with]
[replace with]
[replace with] "Settings for health" represent the organizational base of the
[replace with] infrastructure required for health promotion. New health
[replace with] challenges mean that new and diverse networks need to be
[replace with] created to achieve intersectoral collaboration. Such networks
[replace with] should provide mutual assistance within and among countries
[replace with] and facilitate exchange of information on which strategies
[replace with] have proved effective and in which settings. Training in and
[replace with] practice of local leadership skills should be encouraged in
[replace with] order to support health promotion activities. Documentation of
[replace with] experiences in health promotion through research and project
[replace with] reporting should be enhanced to improve planning,
[replace with] implementation and evaluation.
[replace with]
[replace with] All countries should develop the appropriate political, legal,
[replace with] educational, social and economic environments required to
[replace with] support health promotion.
[replace with]
[replace with]
[replace with] Call for action
[replace with] The participants in this Conference are committed to sharing the
[replace with] key messages of the Jakarta Declaration with their governments,
[replace with] institutions and communities, putting the actions proposed into
[replace with] practice, and reporting back to the Fifth International
[replace with] Conference on Health Promotion.
[replace with] In
[replace with] order to speed progress towards global health promotion, the
[replace with] participants endorse the formation of a global health promotion
[replace with] alliance. The goal of this alliance is to advance the priorities
[replace with] for action in health promotion set out in this Declaration.
[replace with]
[replace with]
[replace with] Priorities for the alliance include:
[replace with]
[replace with] -
[replace with]
[replace with] raising awareness of the changing determinants of health
[replace with]
[replace with] -
[replace with]
[replace with] supporting the development of collaboration and networks for
[replace with] health development
[replace with] -
[replace with]
[replace with] mobilizing resources for health promotion
[replace with] -
[replace with]
[replace with] accumulating knowledge on best practice
[replace with] -
[replace with]
[replace with] enabling shared learning
[replace with] -
[replace with]
[replace with] promoting solidarity in action
[replace with] -
[replace with]
[replace with] fostering transparency and public accountability in health
[replace with] promotion
[replace with]
[replace with]
[replace with] National governments are called on to take the initiative in
[replace with] fostering and sponsoring networks for health promotion both
[replace with] within and among their countries.
[replace with] The
[replace with] participants call on WHO to take the lead
[replace with] in building such a global health promotion alliance and enabling
[replace with] its Member States to implement the outcomes of the Conference. A
[replace with] key part of this role is for WHO to engage governments,
[replace with] nongovernmental organizations, development banks, organizations
[replace with] of the United Nations system, interregional bodies, bilateral
[replace with] agencies, the labour movement and cooperatives, as well as the
[replace with] private sector, in advancing the priorities for action in health
[replace with] promotion.
[replace with]
[replace with] Note: please refer to the
[replace with] WHO
[replace with] Resolution on Health Promotion ( filed as A51.12 in the WHA
[replace with] Journal) which has been adopted at the 51st World Health
[replace with] Assembly last May 1998.
&nb[replace with]p;
[replace with]
[replace with] All
[replace with] rights of this document are reserved by the World Health
[replace with] Organization. The document may nevertheless be freely reviewed,
[replace with] abstracted, reproduced or translated into any other language,
[replace with] but not for sale in conjunction with commercial purposes. The
[replace with] World Health Organization, the Division of Health Promotion,
[replace with] Education and Communication, Health Education and Health
[replace with] Promotion Unit would appreciate receiving one copy of any
[replace with] translation.
[replace with]
[replace with] The
[replace with] designations employed and the presentation of the material in
[replace with] this document do not imply the expression of any opinion
[replace with] whatsoever on the part of the Secretariat of the World Health
[replace with] Organization concerning the legal status of any country,
[replace with] territory, city or area or of its authorities, or concerning the
[replace with] delimitation of its frontiers or boundaries.
[replace with]
&nb[replace with]p; |
[replace with] 
©
[replace with] Copyright SDNP