Table of Contents

Introduction------------------------------------------------------------------------------- 1

Background-------------------------------------------------------------------------------- 1-5

Methodology------------------------------------------------------------------------------- 6

Study Area--------------------------------------------------------------------------------- 6

Sources of Information------------------------------------------------------------------- 6

Tools---------------------------------------------------------------------------------------- 6

Techniques--------------------------------------------------------------------------------- 6

Literature Review--------------------------------------------------------------------------7-9

Discussion and Conclusion---------------------------------------------------------------10-11

References-----------------------------------------------------------------------------------12
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Introduction

Health promotion is the process of enabling people to increase control over, and to improve, their

health. It moves beyond a focus on individual behavior towards a wide range of social and

environmental interventions.(World Health Organization, n.d.) Health promotion is an essential

component of public health that helps communities, governments, and individuals deal with

health issues. This is achieved through fostering supportive settings, constructing sound public

policies, and enhancing individual and community capacity. It encompasses a broad spectrum of

social and environmental interventions intended to address and prevent the underlying causes of

illness in order to improve and safeguard the health and quality of life of specific individuals. A

fundamental human right is health. According to Nepal's 2072 constitution, all citizens are

entitled to receive basic healthcare services from the government, and they all have equal access

to these services. The word "health promotion" is relatively new compared to "health education."

Green defines it as "any combination of educational programs and associated institutional,

financial, and environmental supports for individuals', groups', or communities' behavior

conducive to health" (Green & Kreuter, 2005). The branch of public health that plays a quiet role

in addressing these issues is health promotion.

Background

The idea of "health promotion" acknowledges the impact of both internal and external variables

on illness. Henry E. Sigerist originally used it in 1945 when he outlined the four main goals of

medicine: promoting health, preventing disease, healing the ill, and rehabilitation. Health

promotion has a more comprehensive strategy by incorporating multiple participants and

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emphasizing multispectral methods, whereas health education concentrates on giving health

information and knowledge to individuals and communities. The conventional "biomedical

concept" of health was questioned and replaced with the "Health Field concept," which was

composed of four "health fields": lifestyle, environment, healthcare organization, and human

biology. The Lalonde report was published by the Government of Canada in 1974. In addition to

outlining 23 potential courses of action, the report included five strategies for promoting health,

research, efficient healthcare, and regulatory systems. A significant boost to health promotion

came in 1978 with the Alma Ata declaration, which recognized its significance for long-term

social and economic advancement, improved living standards, and international peace.

Nepal's health environment is distinguished by a combination of achievements and problems.

Nepal is a landlocked nation in South Asia that shares borders with China to the north and India

to the south, east, and west. It is distinguished by a variety of geographical features, such as the

Terai plains and the Himalayan Mountain range. Nepal's healthcare system combines public and

private services. It might be difficult to get healthcare services, particularly in rural and hilly

places. With the signing at the Alma Ata Declaration for Health Promotion, Nepal has also made

significant contributions in health promotion through a range of national level programs.

In some areas, communicable diseases like diarrhea, respiratory infections, and vector-borne

illnesses still make up a sizable portion of the disease burden. The growth of non-communicable

diseases (NCDs) is ascribed to aging populations, urbanization, and changing lifestyles.

Initiatives in the healthcare field have prioritized maternal and child health. Initiatives have been

undertaken to enhance prenatal, institutional, and postnatal care. Malaria, TB, and waterborne

illnesses are among the infectious diseases that Nepal needs to contend with. Measures have

been implemented to manage and stop the spread of these illnesses. Malnutrition is still a
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problem, especially for women and children. A healthy diet is more easily accessible and

nutritional inadequacies are being addressed. There is a chance of being infected with waterborne

illnesses in places with limited access to sanitary facilities and clean water. Initiatives have been

put in place to upgrade the infrastructure related to water and sanitation. To address issues

related to public health, the Nepali government has put in place a number of health-related

policies and initiatives. Among these are the Essential Health Care Package and the Nepal Health

Sector Program. Healthcare is greatly aided by traditional medicine, particularly in rural places

where access to contemporary medical facilities may be restricted. The health industry has a

number of difficulties, such as differences in access to care between urban and rural areas, a

scarcity of medical experts, and infrastructure constraints, especially in isolated places. There

have been initiatives over time to improve health education, fortify the health system, as well as

promote health care practices.

Here are some types of health promotion programs that could be implemented in Nepal:

a) Immunization Programs:

Ensuring widespread vaccination coverage against preventable diseases

b) Maternal and Child Health Programs:

Promoting prenatal care, safe deliveries, and postnatal care to improve maternal and child health

c) Nutrition Programs:

Initiatives to address malnutrition and promote balanced diets, especially among children and

pregnant women.

d) Infectious Disease Control Programs:

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Targeting diseases such as malaria, tuberculosis, and HIV/AIDS through prevention, education,

and treatment efforts

e) Water and Sanitation Programs:

Promoting clean water access and proper sanitation practices to prevent waterborne diseases.

f) Non-Communicable Disease Prevention Programs:

Raising awareness about lifestyle factors contributing to non-communicable diseases (NCDs)

such as cardiovascular diseases and diabetes

g) School Health Programs:

Implementing health education in schools, including topics like hygiene, nutrition, and

reproductive health.

h) Community Health Workers:

Training and deploying community health workers to provide basic healthcare services and

health education at the community level

i) Mental Health Awareness Programs:

Reducing stigma surrounding mental health issues and promoting mental well-being.

j) Family Planning and Reproductive Health Programs:

Providing education and access to family planning methods to empower individuals and families

to make informed decisions about their reproductive health

k) Tobacco and Substance Abuse Prevention Programs:

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Implementing campaigns to reduce tobacco and substance abuse, including education on the

associated health risks

l) Health Technology Initiatives:

Using technology, such as mobile applications, for health education, tracking health indicators,

and facilitating tele-health services

m) Elderly Health Programs:

Addressing the unique health needs of the elderly population, including preventive care and

support services

n) Disaster Preparedness and Response Programs:

Educating communities on health risks during disasters and implementing strategies for effective

health responses.
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Methodology

 Study Area

No area

 Sources of Information

Secondary: Reports, books, Research article

 Tools

Internet

 Techniques

Desk/ document review

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Literature Review

Various literatures were reviewed throughout the study, the literature review helped in

understanding the context of the title selected, previous works and findings. Literature review

was mainly conducted via PubMed and Google Scholar websites for various national as well as

international literatures.

The process of empowering people to enhance and improve their health is known as health

promotion. Although it is still a relatively new idea in Nepal, health promotion has become

recognized throughout the world as a distinct field under public health. Research in the area of

health promotion has certain difficulties. Making health a top priority for policy makers in all

government ministries is necessary for health promotion. The purpose of this research was to

identify the main health promotion policies and strategies in Nepal as well as the many practices

and activities that they implement. The evaluation of national health policies that were released

during various time periods served as the foundation for this investigation. (Nepal Journals

Online, n.d. 2023)

“Policies and Practices of Health Promotion in Nepal” (2018), authored by Karki, examined the

current state of health promotion policies and practices in Nepal. It highlighted the growing

recognition of health promotion as a crucial aspect of public health but acknowledged its

relatively recent emergence in the Nepalese context. Karki. highlighted the need for

strengthening research in health promotion to inform policy and practice and focused on the inter

sectoral collaboration to address health promotion and prioritized the need for capacity building

to develop skilled personnel and infrastructure for effective program implementation.

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A 2012 study published in the journal "Health Renaissance" described the development of a

health promotion intervention in rural Nepal. The intervention was designed to be

multidisciplinary, Theory-based and Evidence-based. The intervention began with a community-

based needs assessment and consultation with local stakeholders that made use of existing

resources, such as government and non-governmental organization (NGO) programs. The study

found that the intervention was successful in improving health outcomes in the community. The

intervention was also likely to be sustainable because it is based on existing resources and

community.

In 1986, the World Health Organization (WHO) collaborated with Canada to introduce the

"Ottawa Charter for Health Promotion," to organize an international conference on health

promotion due to the growing global demands in public health. Health promotion is the process

of giving people the power to take charge of and make improvements to their health, according

to the Ottawa Charter. An individual or group must be able to recognize and fulfil needs, adapt to

changes in the environment, and reach a state of total physical, mental, and social well-being. As

a result, people view health as a resource for daily living rather than the goal of existence. Peace,

shelter, education, food, money, a stable ecosystem, sustainable resources, social justice, and

equity are the essential resources and conditions for health. Therefore, health promotion extends

beyond leading a healthy lifestyle to overall wellbeing and is not solely the domain of the health

industry. The Charter called for mediation for multisectoral action as well as advocacy for health

initiatives to bring about favorable political, economic, social, cultural, environmental,

behavioral, and biological determinants for health and to empower individuals to take charge of

the variables influencing their health. According to the Charter, an action pertaining to health

promotion is one that: a) develops healthy public policy by combining various but
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complementary techniques, such as legislation, fiscal measures, taxation, and organizational

transformation, to produce policies that foster equity; and b) creates surroundings that are

supportive, c) encourage community action by giving communities the ownership and control

over their own goals and fates; d) build personal skills through health education, information

sharing, and life skill improvement; and e) shift the focus of health services from only providing

clinical and curative care to health promotion. (Kumar & Preetha, 2012)

The article, titled "Ecological Perspective on Health Promotion Programs: A Contextual

Approach to Improving Health Outcomes", discusses the need for health promotion programs to

consider the social and environmental factors that affect people's health. The authors McLeroy

Kenneth and Bibeau Daniel (1988) argued that traditional health promotion programs have

focused too much on individual behavior and not enough on the social and environmental

context in which people live. They call for a more ecological approach to health promotion that

takes into account all of the factors that influence people's health.
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Discussion and Conclusion

Health promotion, as defined by the World Health Organization (WHO), extends beyond

individual behavior modification to encompass broader social and environmental interventions

aimed at improving overall well-being. In Nepal, the constitution guarantees basic healthcare

services to all citizens, highlighting the government's commitment to promoting health as a

fundamental human right.

The historical background outlined in the text traces the concept of health promotion back to

Henry E. Siegrist’s four main goals of medicine in 1945. Over time, the focus shifted from the

traditional biomedical model to a more holistic approach, encompassing various factors such as

lifestyle, environment, healthcare organization, and human biology. International initiatives like

the Lalonde report and the Alma Ata declaration further reinforced the importance of health

promotion in achieving long-term social and economic development.

Nepal faces unique challenges in its healthcare system, characterized by a combination of

achievements and ongoing issues. While progress has been made in areas such as maternal and

child health, communicable diseases, and infrastructure development, challenges persist,

particularly in rural and hilly regions. Non-communicable diseases (NCDs) are on the rise due to

factors like urbanization and changing lifestyles, necessitating targeted interventions.

The provided list of health promotion programs offers a glimpse into the diverse strategies that

can be implemented in Nepal. From immunization and maternal health to water sanitation and

mental health awareness, these programs address a wide range of health concerns tailored to the

country's specific needs.

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Conclusion:

Health promotion plays a crucial role in improving health outcomes by focusing on preventive

measures and empowering individuals and communities to take control of their health. In

conclusion, by adopting a comprehensive approach that addresses social, environmental, and

behavioral determinants of health, Nepal can effectively tackle its healthcare challenges and

improve the well-being of its population. While progress has been made, ongoing efforts are

needed to strengthen healthcare infrastructure, enhance access to services, and address emerging

health threats such as non-communicable diseases. Extensive research programs on health and

health related programs can be implemented rigorously for making effective health policy. By

implementing targeted health promotion programs and leveraging international frameworks and

collaborations, Nepal can continue to make strides towards achieving its healthcare goals and

ensuring the right to health for all its citizens.

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References

World Health Organization (WHO). (n.d.). Retrieved January 30, 2023, from https://www.who.int/

Nepal Journals Online. (n.d.). Retrieved November 18, 2023, from https://www.nepjol.info/

Mahato. (2022) “Reflections on Health Promotion Fieldwork in Nepal: Trials and Tribulations.” Journal

of Health Promotion 10: 5–12. https://doi.org/10.3126/jhp.v10i1.50978

Karki,(2018) Policies and Practices of Health Promotion in Nepal.”

https://www.researchgate.net/publication/342857907_Policies_and_Practices_of_Health_Promot

ion_in_Nepal

Kumar, S., & Preetha, G. (2012). Health Promotion: An Effective Tool for Global Health. Indian

Journal of Community Medicine: Official Publication of Indian Association of Preventive &

Social Medicine, 37(1), 5–12. https://doi.org/10.4103/0970-0218.94009

Teijlingen, E.V. (2012) “Making the Best Use of All Resources: Developing a Health Promotion

Intervention in Rural Nepal.” Health Renaissance 10: 229–35.

https://doi.org/10.3126/hren.v10i3.7141.
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