Four cornerstones of Maori health promotion
Discuss about the Maori Health Promotion and WHO-style Health Promotion.
Maori health promotion is the way of empowering the Maori to increase the control over the health and determinants of health for strengthening their identity as a Maori and promoting equal health throughout the community (Ratima, 2010). There are some parallel concept between the Maori concept of health promotion and western model of health promotion. Both share the concept of health and mental wellbeing. But there are two concepts of Maori health that is not defined clearly in the WHO concept of health promotion. Wh?nau (family) and wairua (spirituality) (Ratima, 2010). Hence there are four cornerstones of Maori health promotion which is somewhat a bit different from the WHO model of health promotion. The importance of the extended families in Maori community, is now widely accepted as an indicator of health. In relation to this, the Wh?nau Ora programme was first rolled out in 2010 (Health Promotion Forum of New Zealand, 2013). Spirituality is an important element of humanity. It involves connectedness with others, nature, self and embraces philosophical and secular as well as religious and cultural practices Puchalski et al., (2013). Although an increasing body of evidence is still required to understand the effectiveness of this facet of health promotion. Again there had been growing evidence for the effectiveness of Wairua (spirituality), in the health status of Maori. According to Maori concept, spirituality goes to the core of being human, which is more than a religious framework and is also related to health related physiological processes.
Health promotion is the process of enabling people to increase control over, and to improve their health (Ottawa Charter for Health Promotion. WHO, Geneva,1986).
According to World health organization, health promotion is a socio-political process and the actions does not only means the strengthening of the skills and the capabilities of the individuals but also the action focused towards modifying the environmental, social and the economic conditions for alleviating their impact on the health of an individual. Health promotion is mainly done to increase people’s authority over the determinants of health. According to the Ottawa charter health promotion mainly involves building of the public policy, creation of supportive and conducing environment for people, developing personal skills and reorienting the health services. Very less evidence supports the inclusion of spirituality in health promotion, as per the WHO guidelines.
Importance of family in Maori community
Public health: According to “Acheson Report”, London, 1988, public health can be defined as “The science and art of promoting health, preventing disease, and prolonging life through the organized efforts of society”.
Health promotion: Health promotion is the process of enabling people to increase control over, and to improve their health (Ottawa Charter for Health Promotion. WHO, Geneva, 1986).
Health education: Health education can be defined as the constructed opportunities for leaning to improve the health literacy. It also improves the improvement of the knowledge and the development of the life skills conducive to community of individual health.
It is to be mentioned that health education does not necessarily mean only the communication of the information, but also fostering empowerment, motivation and confidence required to improve public health (Baum, 2016). It is the health education that enables public to understand the health care needs and any sort of health inequalities they are faced with. It is the health literacy that enables the policy makers to adopt the health promotion strategies. Previously health education was specifically used to embrace a wider range of actions like advocacy and social mobilization, which is now covered under the term “health promotion”.
It is important to understand that although all these terms are interrelated, but there are subtle differences between the terms. Public health is a socio- political concept that is aimed to improve the quality of life of the individuals, by health promotion and the disease prevention strategies (Whittaker et al., 2012). The concept of the new definitions of public health involves in assessing the living conditions and the lifestyles determining the health status and determining the requirements for mobilizing the resources and making good investments in the making of the programs, policies and the services. It should be noted that health promotion is the intervention that is normally taken up to improve the public health. Public health is the cause and health promotion is the effect.
Lifestyle
Life style can be defined as the way an individual lives, based upon the personal choices and the behaviors that are determined by the relationship between personal characteristics of an individual, socioeconomic and ecological living conditions and the social interaction (Lappalainen et al., 2013).
Life style of an individual highly impacts the health of an individual. In most of the cases the chronic diseases are associated to poor and sedentary life styles. It is the life skills developed from the childhood and health literacy that enables or encourage a person to follow a particular life style.
Life skills
Life skills are abilities for adaptive and positive behavior that enable individuals to deal effectively with the demands and challenges of everyday life (Life skills education in schools. WHO, Geneva, 1993).
Spirituality in Maori culture
Life skills can be referred to as personal, cognitive, interpersonal and the physical skills that enables an individual to control their ways of living, adapt themselves to the changing environment (Lappalainen et al., 2013). Some of the important life skills required are creative thinking, critical thinking and the decision making skills that allows a person to cope up with the pace of this modern life, such as dealing with stresses, frustrations and health (Tol et al., 2013).
Life skills like conscientiousness, persistence and control are important in early life, it influences the life style of a human being and also are of relevant use in future. According to studies, five life skills such as – conscientiousness, determination, emotional stability, optimism and control has been found to be associated with a successful life style in the future leading to social and economic success (Steptoe & Wardle, 2017).
Community driven health is the recent variant of the community based health care. Community driven health services can be defined as those services where the communities have direct influence over the key project decisions and the management of the investment funds (Whittaker et al., 2013). It is the people of the community that drives the health initiatives. Community driven approaches would encourage the community members to recognize, actively develop and mobilize their own resources (Minkler, 2012). Some of the community driven initiatives involves- A) Enhancing the sustainability by empowering the public to follow the sustainable development measures such as maintaining cleanliness. B) Preventing the spread of communicable diseases by actively taking part in the screening programs. C) Empowering the people belonging to low socioeconomic status to strengthen the governance and build the social capital. D) Expansion of the resources available to the poor by credit, social funds, occupational training and capacity building.
Community based health care on the other hand is an umbrella term to include the community driven approaches. It involves all types of care including home support, nursing, general practitioners, health literacy programs, occupational therapy and other rehabilitation services. There is an urgent need of community based care for the betterment of the public health (Garland et al., 2013).
References
Health Promotion Forum of New Zealand, (2013). M?ORI HEALTH PROMOTION: FIVE IMPORTANT FACETS FOR BUILDING THE DISCIPLINE. Access date: 30.7.2018. retrieved from : https://hauora.co.nz/maori-health-promotion-five-important-facets-for-building-the-discipline/
Steptoe, A., & Wardle, J. (2017). Life skills, wealth, health, and wellbeing in later life. Proceedings of the National Academy of Sciences of the United States of America, 114(17), 4354–4359. https://doi.org/10.1073/pnas.1616011114.
Baum, F. (2016). The new public health (No. Ed. 4). Oxford University Press.
Whittaker, R., Merry, S., Dorey, E., & Maddison, R. (2012). A development and evaluation process for mHealth interventions: examples from New Zealand. Journal of health communication, 17(sup1), 11-21.
Garland, A. F., Haine-Schlagel, R., Brookman-Frazee, L., Baker-Ericzen, M., Trask, E., & Fawley-King, K. (2013). Improving community-bsed mental health care for children: Translating knowledge into action. Administration and Policy in Mental Health and Mental Health Services Research, 40(1), 6-22.
Puchalski, C. M., Blatt, B., Kogan, M., & Butler, A. (2014). Spirituality and health: the development of a field. Academic Medicine, 89(1), 10-16.
Tol, A., Tavassoli, E., Shariferad, G. R., & Shojaeezadeh, D. (2013). Health-promoting lifestyle and quality of life among undergraduate students at school of health, Isfahan university of medical sciences. Journal of education and health promotion, 2.
Lappalainen, R., Sairanen, E., Järvelä, E., Rantala, S., Korpela, R., Puttonen, S., … & Kaipainen, K. (2014). The effectiveness and applicability of different lifestyle interventions for enhancing wellbeing: the study design for a randomized controlled trial for persons with metabolic syndrome risk factors and psychological distress. BMC public health, 14(1), 310.
Minkler, M. (Ed.). (2012). Community organizing and community building for health and welfare. Rutgers University Press.
WHO (1986). The Ottawa Charter for Health Promotion .Access date: 30.7.2018. Retrieved from: https://www.who.int/healthpromotion/conferences/previous/ottawa/en/
Ratima, M. (2010, May). M?ori health promotion–a comprehensive definition and strategic considerations. In Prepared for the Health Promotion Forum of New Zealand by Taumata Associates May.