The Ottawa Charter for
Health Promotion
First International Conference on Health Promotion, Ottawa, 21
November 1986
cited from
http://www.who.int/healthpromotion/conferences/previous/ottawa/en/
The Ottawa Charter for
Health Promotion
First International Conference on Health Promotion, Ottawa, 21 November
1986
The first International Conference on Health Promotion, meeting in
Ottawa this 21st day of November 1986, hereby presents this CHARTER for
action to achieve Health for All by the year 2000 and beyond.
This conference was primarily a response to growing expectations for a
new public health movement around the world. Discussions focused on the
needs in industrialized countries, but took into account similar
concerns in all other regions. It built on the progress made through
the Declaration on Primary Health Care at Alma-Ata, the World Health
Organization's Targets for Health for All document, and the recent
debate at the World Health Assembly on intersectoral action for health.
Health Promotion
Health promotion is the process of enabling people to increase control
over, and to improve, their health. To reach a state of complete
physical, mental and social well-being, an individual or group must be
able to identify and to realize aspirations, to satisfy needs, and to
change or cope with the environment. Health is, therefore, seen as a
resource for everyday life, not the objective of living. Health is a
positive concept emphasizing social and personal resources, as well as
physical capacities. Therefore, health promotion is not just the
responsibility of the health sector, but goes beyond healthy
life-styles to well-being.
Prerequisites for Health
The fundamental conditions and resources for health are:
peace,
shelter,
education,
food,
income,
a stable eco-system,
sustainable resources,
social justice, and equity.
Improvement in health requires a secure foundation in these basic
prerequisites.
Advocate
Good health is a major resource for social, economic and personal
development and an important dimension of quality of life. Political,
economic, social, cultural, environmental, behavioural and biological
factors can all favour health or be harmful to it. Health promotion
action aims at making these conditions favourable through advocacy for
health.
Enable
Health promotion focuses on achieving equity in health. Health
promotion action aims at reducing differences in current health status
and ensuring equal opportunities and resources to enable all people to
achieve their fullest health potential. This includes a secure
foundation in a supportive environment, access to information, life
skills and opportunities for making healthy choices. People cannot
achieve their fullest health potential unless they are able to take
control of those things which determine their health. This must apply
equally to women and men.
Mediate
The prerequisites and prospects for health cannot be ensured by the
health sector alone. More importantly, health promotion demands
coordinated action by all concerned: by governments, by health and
other social and economic sectors, by nongovernmental and voluntary
organization, by local authorities, by industry and by the media.
People in all walks of life are involved as individuals, families and
communities. Professional and social groups and health personnel have a
major responsibility to mediate between differing interests in society
for the pursuit of health.
Health promotion strategies and programmes should be adapted to the
local needs and possibilities of individual countries and regions to
take into account differing social, cultural and economic systems.
+Health Promotion Action Means:
Build Healthy Public Policy
Health promotion goes beyond health care. It puts health on the agenda
of policy makers in all sectors and at all levels, directing them to be
aware of the health consequences of their decisions and to accept their
responsibilities for health.
Health promotion policy combines diverse but complementary approaches
including legislation, fiscal measures, taxation and organizational
change. It is coordinated action that leads to health, income and
social policies that foster greater equity. Joint action contributes to
ensuring safer and healthier goods and services, healthier public
services, and cleaner, more enjoyable environments.
Health promotion policy requires the identification of obstacles to the
adoption of healthy public policies in non-health sectors, and ways of
removing them. The aim must be to make the healthier choice the easier
choice for policy makers as well.
Create Supportive Environments
Our societies are complex and interrelated. Health cannot be separated
from other goals. The inextricable links between people and their
environment constitutes the basis for a socioecological approach to
health. The overall guiding principle for the world, nations, regions
and communities alike, is the need to encourage reciprocal maintenance
- to take care of each other, our communities and our natural
environment. The conservation of natural resources throughout the world
should be emphasized as a global responsibility.
Changing patterns of life, work and leisure have a significant impact
on health. Work and leisure should be a source of health for people.
The way society organizes work should help create a healthy society.
Health promotion generates living and working conditions that are safe,
stimulating, satisfying and enjoyable.
Systematic assessment of the health impact of a rapidly changing
environment - particularly in areas of technology, work, energy
production and urbanization - is essential and must be followed by
action to ensure positive benefit to the health of the public. The
protection of the natural and built environments and the conservation
of natural resources must be addressed in any health promotion strategy.
Strengthen Community Actions
Health promotion works through concrete and effective community action
in setting priorities, making decisions, planning strategies and
implementing them to achieve better health. At the heart of this
process is the empowerment of communities - their ownership and control
of their own endeavours and destinies.
Community development draws on existing human and material resources in
the community to enhance self-help and social support, and to develop
flexible systems for strengthening public participation in and
direction of health matters. This requires full and continuous access
to information, learning opportunities for health, as well as funding
support.
Develop Personal Skills
Health promotion supports personal and social development through
providing information, education for health, and enhancing life skills.
By so doing, it increases the options available to people to exercise
more control over their own health and over their environments, and to
make choices conducive to health.
Enabling people to learn, throughout life, to prepare themselves for
all of its stages and to cope with chronic illness and injuries is
essential. This has to be facilitated in school, home, work and
community settings. Action is required through educational,
professional, commercial and voluntary bodies, and within the
institutions themselves.
Reorient Health Services
The responsibility for health promotion in health services is shared
among individuals, community groups, health professionals, health
service institutions and governments.
They must work together towards a health care system which contributes
to the pursuit of health. The role of the health sector must move
increasingly in a health promotion direction, beyond its responsibility
for providing clinical and curative services. Health services need to
embrace an expanded mandate which is sensitive and respects cultural
needs. This mandate should support the needs of individuals and
communities for a healthier life, and open channels between the health
sector and broader social, political, economic and physical
environmental components.
Reorienting health services also requires stronger attention to health
research as well as changes in professional education and training.
This must lead to a change of attitude and organization of health
services which refocuses on the total needs of the individual as a
whole person.
Moving into the Future
Health is created and lived by people within the settings of their
everyday life; where they learn, work, play and love. Health is created
by caring for oneself and others, by being able to take decisions and
have control over one's life circumstances, and by ensuring that the
society one lives in creates conditions that allow the attainment of
health by all its members.
Caring, holism and ecology are essential issues in developing
strategies for health promotion. Therefore, those involved should take
as a guiding principle that, in each phase of planning, implementation
and evaluation of health promotion activities, women and men should
become equal partners.
+Commitment to Health Promotion
The participants in this Conference pledge:
to move into the arena of healthy public policy, and
to advocate a clear political commitment to health and equity in all
sectors;
to counteract the pressures towards harmful
products, resource depletion, unhealthy living conditions and
environments, and bad nutrition; and to focus attention on public
health issues such as pollution, occupational hazards, housing and
settlements;
to respond to the health gap within and between
societies, and to tackle the inequities in health produced by the rules
and practices of these societies;
to acknowledge people as the main health resource;
to support and enable them to keep themselves, their families and
friends healthy through financial and other means, and to accept the
community as the essential voice in matters of its health, living
conditions and well-being;
to reorient health services and their resources
towards the promotion of health; and to share power with other sectors,
other disciplines and, most importantly, with people themselves;
to recognize health and its maintenance as a major
social investment and challenge; and to address the overall ecological
issue of our ways of living.
The Conference urges all concerned to join them in their commitment to
a strong public health alliance.
+Call for International Action
The Conference calls on the World Health Organization and other
international organizations to advocate the promotion of health in all
appropriate forums and to support countries in setting up strategies
and programmes for health promotion.
The Conference is firmly convinced that if people in all walks of life,
nongovernmental and voluntary organizations, governments, the World
Health Organization and all other bodies concerned join forces in
introducing strategies for health promotion, in line with the moral and
social values that form the basis of this CHARTER, Health For All by
the year 2000 will become a reality.
CHARTER ADOPTED AT AN INTERNATIONAL CONFERENCE ON HEALTH PROMOTION* The
move towards a new public health, November 17-21, 1986 Ottawa, Ontario,
Canada.
* Co-sponsored by the Canadian Public Health Association, Health and
Welfare Canada, and the World Health Organization.
+Health Promotion Emblem
A brief explanation of the logo used by WHO since the First
International Conference on Health Promotion held in Ottawa, Canada, in
1986. Select an element of the logo for the specific explanation of
that part or simply read on for the complete explanation.
This logo was created for the First International Conference on Health
Promotion held in Ottawa, Canada, in 1986. At that conference, the
Ottawa Charter for Health Promotion was launched. Since then, WHO kept
this symbol as the Health Promotion logo (HP logo), as it stands for
the approach to health promotion as outlined in the Ottawa Charter.
The logo represents a circle with 3 wings. It incorporates five key
action areas in Health Promotion (build healthy public policy, create
supportive environments for health, strengthen community action for
health, develop personal skills, and re-orient health services) and
three basic HP strategies (to enable, mediate, and advocate).
The main graphic elements of the HP logo are:
one outside circle,
one round spot within the circle, and
three wings that originate from this inner spot, one
of which is breaking the outside circle.
a) The outside circle, originally in red colour, is representing the
goal of "Building Healthy Public Policies", therefore symbolising the
need for policies to "hold things together". This circle is
encompassing the three wings, symbolising the need to address all five
key action areas of health promotion identified in the Ottawa Charter
in an integrated and complementary manner.
b) The round spot within the circle stands for the three basic
strategies for health promotion, "enabling, mediating, and advocacy ",
which are needed and applied to all health promotion action areas .
(Complete definitions of these terms can be found in the Health
Promotion Glossary, WHO/HPR/HEP/98.1)
c) The three wings represent (and contain the words of) the five key
action areas for health promotion that were identified in the Ottawa
Charter for Health Promotion in 1986 and were reconfirmed in the
Jakarta Declaration on Leading Health Promotion into the 21st Century
in 1997.
More specifically:
the upper wing that is breaking the circle
represents that action is needed to "strengthen community action" and
to "develop personal skills". This wing is breaking the circle to
symbolise that society and communities as well as individuals are
constantly changing and, therefore, the policy sphere has to constantly
react and develop to reflect these changes: a "Healthy Public Policy"
is needed;
the middle wing on the right side represents that
action is needed to "create supportive environments for health"
the bottom wing represents that action is needed to
"reorient health services" towards preventing diseases and promoting
health.
Overall, the logo visualises the idea that Health Promotion is a
comprehensive, multi-strategy approach. HP applies diverse strategies
and methods in an integrated manner - one of the preconditions "for
Health Promotion to be effective" (Jakarta Declaration 1997). Health
Promotion addresses the key action areas identified in the Ottawa
Charter in an integrated and coherent way.
The term Health Promotion (HP) was, and still today is sometimes,
narrowly used as equivalent for Health Education (HE). But HE is one of
several key components and action areas of HP as illustrated by the HP
logo(see the key action area of "develop personal skills").
The HP logo and approach were reinforced at the second and third
conferences on Health Promotion that took place in Sundsvall and in
Adelaide.
In the light of the venue of the Fourth International Conference on
Health Promotion, that was held in Jakarta, Indonesia, in July 1997,
the design of the Ottawa logo was slightly modified to reflect culture
and atmosphere of the host country of the conference, making sure that
the shape and elements of the original logo were preserved, together
with its inner meaning.
The Jakarta Conference logo is a more open and slightly more abstract
version of the original HP logo from Ottawa. The three wings, that are
now in brick-red colour, still represent the key HP action areas. The
outside circle and the inner spot of the Ottawa logo are merged into a
unique blue spot from where the three wings originate. This still
symbolises that HP addresses its action areas with an integrated
multi-strategic approach. Overall, the design of the HP logo adapted
for the Conference in Jakarta is more open and lively; all the wings
are now reaching out of the circle. This, visualizes the fact that the
field of HP has grown and developed, and that today and in the future
HP is outreaching to new players and partners, at all levels of
society, from local to global level.
http://www.who.int/healthpromotion/conferences/previous/ottawa/en/