In addition, the increasing gap between rich and poor is making it more difficult to improve peoples' health. Getting health services is becoming expensive, and in countries like nepal where almost 32 per cent of the people are living under the poverty line, its very hard for them to access health facilities as all the health expenses are paid from one's own pocket. Hence, it is the responsibility of every sector to put healthy public policy into practice, strengthening structures and processes, applying knowledge-based practice, building a competent health promotion work-force and empowering communities (iuhpe 2007). The population Growth Rate In India essay, research Paper. The population Growth Rate in India. For many years concern has been voiced over the seemingly unchecked rate of population growth in India, but the most recent indications are that some success is being achieved in slowing the rate of population growth. The progress which has been achieved to date is still only of a modest nature and should not serve as premature cause for complacency.
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The economic condition of the world is changing and it is widening the gap between the poor and the rich at national or international level. Meanwhile, it is very difficult to maintain the health of people as the environment is changing due to immense emission of carbon-dioxide and other harmful gases by different sources, degradation of land and water, and increasing human jones population. Similarly, there are people who are undernourished and others that are overnourished, leading them to obesity and chronic diseases. New diseases are emerging and older diseases are still continuing, which is challenging the health of the entire world population. These new diseases also act as a passage for other diseases, decreasing the human immune system and resulting to a decline in life expectancy (McMichael butler 2007). Discussion, health promotion focuses on political, economical, social, cultural, environmental, behavioral and biological conditions. Therefore, health promotion should be integrated with different disciplines and co-ordination/collaboration from government, public, private, community, universities, national and international sectors is required. This helps to map capacities at national and international level (Mittelmark. Such mapping can help database to reduce poverty and inequalities around the globe. Another important agenda is to promote sustainable environmental and social conditions, as these are determinants of health (McMichael butler 2007). With increasing globalization and change in lifestyle, people are facing more challenges to survive in this world.
This is also the case in Nepal, where the human poverty index (in 2007).1 (mohp 2009). Due to a lack plan of knowledge and awareness regarding healthy practices, community people are more vulnerable to acquiring diseases, and there is also a lack of properly trained health personnel who can provide appropriate information. Health promotion focuses on community participation and empowerment, but in Nepal there is less community participation and inadequate awareness programs. Furthermore, political instability has caused health promotion programs to be delayed, and these programs are either inadequate or neglected by the government. Also, there is a lack of inter-sectoral co-ordination between different organizations and inadequate supervision, monitoring and evaluation of health promotion programs (who 2008). Moreover, increasing population, urbanization, environmental pollution and new health problems pose further barriers for promoting health. Global challenges in health Promotion, according to who (2005 the world is changing and different problems are occurring around the world with increasing globalization, poverty, violence, mental health, inequity between societies, harmful products, new diseases and current health problems. Other challenges in health promotion are: role of the state or government, participatory public policy, building partnership, leadership and sustainable health promotion infrastructures, unemployment and sustainable funding.
Indeed, it has succeeded to spread the relevant messages for improving the health of the population reviews for many years (who 2008). Essential health care services like reproductive health, child health, communicable diseases, non-communicable diseases and other health issues were planned and iec and bcc (focus on personal preventive and curative care) were implemented in a participative manner through community mobilization (who 2008). Health promotion programs according to demograhic health Survey, nepal (2001) include: family planning, antenetal care, safe motherhood, institutional delivery, postnatal care, complete immunzation, breast-feeding, iodinized salt use, feeding vitamin a, ors treatment diarrhoea, ari treatment and prevention from hiv. Furthermore, for ensuring the health of the population, different International Non-governmental Organizations (ingos non-governmental Organizations (NGOs local social groups and other agencies are actively participating in different levels of health care. Their support has provided a major contribution for improving the condition of Nepal. Some of them with their priority areas are mentioned in Table. Barriers for health Promotion in Nepal. The major barriers to promote the health of the population in Nepal result from the lack of infrastructure, limited resources, inequity, socio-economic differences and poverty. According to maslows theory, human beings cannot perform well until the basic requirements are fulfilled (Benson.
It aims to improve the health condition of those whose needs are not often met. There it addresses disparities in healthcare, assuring gender sensitivity and equitable community access to quality healthcare services. It targets to reach its goal by reducing mortality and morbidity rates and by increasing health service facilities (mohp mohp 2009). In 2002, the national health Education, Information and Communication Center (nheicc) came directly under the mohp as the focal point for health promotion. It promotes health of the population by providing heic activities at national, regional, district and community level. It designs, plans, implements, monitors and evaluates health promotion activities. Further, it develops and disseminates appropriate heic messages to the target population through different channels of media including health institutions, community groups, schools, dramas and street shows.
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Due to geographic, topological and socio-cultural factors, nepal has been deprived of economical development. Furthermore, the health of the population is in very poor condition. Both communicable and non-communicable diseases are the major cause of mortality and morbidity. Acute preventable childhood diseases, complications of child birth, nutritional disorders, malaria, kalazar, tuberculosis, leprosy, stds, rabies, and vector borne diseases are increasingly high (mohp 2009). Additionally, other health problems like mental health, oral health, hearing impairment, blindness, hiv/aids, cardiovascular diseases, diabetes, hypertension, malignancies and elderly problems are also affecting the country (who 2008).
Poverty, low literacy rates, low level of hygiene and sanitary facilities, limited safe drinking and water, tobacco use, excessive use of alcohol, less physical activity, obesity, poor nutrition and polluted environment are the major causes behind the poor status of health among the nepalese population (who. Other conditions include limited resources (man, money and material) and poor infrastructure, poorly managed organization and low co-ordination (mohp 2009). To combat these health problems, ministry of health and Population (mohp) of Nepal has been actively embedding health promotion goals and processes in national and multinational health policies, strategies and objectives. In 1991, a national health Policy was adopted to improve the health of the population and 14 policies were developed: preventive health services, promotive health services, curative health services, basic primary health services, ayurvedic and other traditional health services, organization and management, community participation, human. For promotive health services, the national health Policy assured for gender equality, enabling people to lead healthy lives, and creating access to quality health services that were affordable and consistent. It also focused on nutrition, breast-feeding, growth monitoring and deficiency of iodine, iron, and vitamin. The second Long-Term health Plan was developed for.
Other procedures may include decisional balance, social modeling, outcome expectation and social support. Social cognitive theories have been applied to bring changes in sedentary behavior, smoking, unhealthy diet, weight loss and fitness (Pinto floyd 2008, nutbeam harris 2004). Salutogenesis theory helps to maintain and develop health and quality of life and was introduced by Antonovsky in 1979 with the concept of Sense of Coherence (SOC). It explains why some people tend to live healthy even though they are going through stressful situations and others do not (Eriksson lindström 2008). Antonovsky states that people with a strong soc are motivated to cope in the situation (meaningfulness) with their best possible understanding (comprehensibility) and manage the resources that are available (manageability) (Antonovsky 1996).
Therefore, the strength of the soc is determined by general resistant resources which are available in ones surroundings. It includes lifestyle condition, social factors and cognitive behavior (Griffiths 2009). Studies have shown that this might be the framework for health promotion as the core principles of health promotion are also a central element for the salutogenic concept and are correlated to the well-being and quality of life (Lindström eriksson 2006, Eriksson lindström 2008). In explaining the process of Salutogenesis, the authors have mentioned health in river of Life with 4 different stages: cure or treatment of diseases, health protection/disease prevention, health education/health promotion and improving quality of life (wellbeing) (Eriksson lindröm 2008). Health promotion in Nepal, nepal is a landlocked country, situated between India and China. The country is divided into three regions geographically: mountains, the terai and hills. The estimated population of Nepal.3 million and it has a land area of 147,181 square kilometers (mohp 2009).
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After the contemplation stage, the patient/client takes an action to make some changes but does not perform successfully. In the action stage, the patient/client modifies the behavior by performing regularly for less than 6 months, and in the maintenance stage, the action is carried out for 6 months or more, avoiding relapse and maintaining the new and healthy habits. However, the person might undergo relapses in the changed habits and experience regression in any stage. Therefore, it is a cyclic process and might be repeated from the beginning. But in order to motivate, maintain or prepare for behavioral change, decisional balance construct (pros and cons of behavioral change self-efficacy and cognitive and behavioral process are used in the ttm (Pinto floyd 2008). Social Cognitive theories rely on the principle that behavior change is influenced by interaction of environmental, psychosocial and behavioral factors mini (Pinto floyd 2008). Individuals may perceive their behavior as good or bad depending on their cognitive power and their exposure to the environment, resulting them to continue the behavior, either positive or negative (Nutbeam harris 2004). Therefore, to make the healthy behavioral change, self-efficacy or self-confidence is a very important tool. It can be developed through personal strategies by setting realistic goals and making favorable environmental conditions which help one to learn and adopt behavior.
outcome of a behavior the social cognitive theory (interrelationship of a persons behavior, their environment, and thought processes) and the. Some other important theories for health promotion. Transtheoretical Model (TTM) is developed from different psychological and behavioral theories, for instance, social cognitive theory and learning theory (Pekmezi. 2010, kennedy gregoire 2009). In the transtheoretical model, a new behavior is adopted through 5 different stages of change: precontemplation, contemplation, preparation, action and maintenance. It has been applied in different health behaviors such as fitness, condom use for human immunodeficiency virus protection, use of sunscreens to prevent skin cancer, low-fat diet, medical compliance, mammography screening, stress management, exercise and substance abuse (Pekmezi. 2010, kennedy gregoire 2009, pinto floyd 2008). In the precontemplation stage, the patient/client is not thinking about modifying or changing his/her behavior. If the patient/client is thinking but has not yet taken any initiation towards changing the behavior, he/she is in contemplation stage.
It was reported in 1974, issued by the marc Lalonde "A new perspective on the health of Canadians" which focused on ecological approaches (Norman 2009). A decade later, in the first International Conference on health Promotion, the concept for health promotion was provided and the prerequisites for health, namely peace, shelter, education, food, income, a stable eco-system, sustainable resources, social justice and equity, were identified (who 1986). The conference also identified advocacy, enabling and mediating as basic strategies for health promotion and presented five priority action areas to achieve positive health (see table 1). From this point forward, health promotion emerged and was illustrated in Global Conferences in health Promotion by who, which are regarded parts as milestones for health promotion. At present, we can find many definitions for health promotion. These include: "any planned combination of educational, political, environmental, regulatory, or organizational mechanisms that support actions and conditions of living conducive to the health of individuals, groups, and communities" (Reicherter greene 2005 "motivating someone to improve their well-being and actualize their health potential" (Pender 1996. Health promotion theory, health promotion can be classified into five different approaches: medical, behavioral changes, educational, client-centered and societal change (Irvine 2007).
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"The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition who). With the objective of health promotion, people in the world can achieve reviews their best possible health. In this paper we have described some milestones of health promotion, its theory and challenges. Moreover, we have also briefly presented information about health promotion in Nepal, its supporters and barriers. Health promotion is defined as "the process of enabling people to increase control over the determinants of health and thereby improve their health" (who 2005a). This definition acts as a landmark for defining health promotion, from layman to the health professionals. The first concept of health promotion emerged when health was seen beyond the biological perspective.