Addressing NCDs through health promotion at community level

Discussion and interviews on maternal and child health promotion, Ladakh, India. Photo: © Mira Gardi/MMS

The discussion started by highlighting how in low income countries, where access to health care is often limited, prevention of diseases is essential at the community level. To promote prevention, however, significant changes in politics and in the equity system are necessary. Furthermore, for too long we have been focusing our attention on strengthening the healthcare system and as a result it is difficult for people to implement soft aspects of health care, such as health promotion.

One of the participants underlined that health promotion is well-developed in the field of mother and child health, from her experience, and that we should focus on how to transfer this expertise to other fields. The same participant also raised the issue of how health promotion is often tackled by NGOs and not integrated into the health system, so that once health workers leave at the end of a project, health promotion becomes neglected.

Education of community health workers is essential

The discussion then moved to the topic of education, that currently seems to be too static and not evolving. Not enough training on health promotion is offered to community health workers, making it difficult to transpose knowledge on health promotion in developing countries.

The key aspect with which all participants agreed is the necessity of working inter-sectorially, promoting transparency in all governmental departments and cross-cutting funding. One of the participants stressed that the main obstacle to this is the lack of willingness of the different sectors to cooperate, and not, as one may believe, the lack of funding.

Towards the end of the discussion, several participants mentioned how community leaders have a vital role to play in conducting health promotion, as they often are reference figures for the community itself. Churches have been considered as the main mediators between health workers and the community to promote behavioural change, as religious institutions often benefit from the trust of members of the community.

All in all, the discussion has been rich in content and participants have shared their experience working in developing countries, especially in the NGO sector. It emerged that conducting health promotion involves numerous challenges, above all the necessity of political decisions fostering health promotion instead of only healthcare, although such change may take time and needs the contribution of the civil society sector.