ECOSOC Annual Ministerial Review
Regional Ministerial Meeting for
Asia and the Pacific
Promoting Health Literacy,
Promoting Multisectoral Actions
Dr Fiona Adshead
Director, Chronic Diseases and Health Promotion
World Health Organization
29-30 April 2009
Beijing, China
Health literacy: a whole of society approach
 Health literacy involves:
– People using information at key decision points,
delivered through different media,
– An enabling environment promoting healthy choices,
– Cross-sectoral, whole-of-society action,
– Empowering people to make healthy choices.
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ECOSOC Annual Ministerial Review
Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009
GOVERNMENT leadership
Government – civil society – private sector – media
ENABLING
ENVIRONMENT
HEALTH LITERACY
Empowerment
Access to
information,
knowledge
reinforcement,
and opportunity
to act
BEHAVIOUR CHANGE
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ECOSOC Annual Ministerial Review
Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009
HEALTH
OUTCOME
Feedback and policy change
MULTISTAKEHOLDER, CROSS-SECTORAL APPROACH
Multisectoral action:
enabling breastfeeding in the workplace
 Enabling workplace conditions for breastfeeding are important for the
health of mother and child.
 The ILO Maternity Protection Convention 183 (2000) provides for 14
weeks paid maternity leave and paid breastfeeding breaks.
 The Philippines example of multisectoral action:
– Key stakeholders involved:
•
•
•
•
•
Department of Labour and Employment and DoH
Trade Union Congress of the Philippines (TUCP)
Employers Confederation of the Philippines (ECOP)
NGOs
WHO support
– Benefits
• health benefits for mother and child, lower cost of infant feeding, improved bonding,
• lower absenteeism and higher productivity, enhancement of employer–employee relationship.
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ECOSOC Annual Ministerial Review
Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009
Counseling (health literacy) empowers
mothers to practice exclusive breastfeeding
Exclusive breastfeeding (%)
100
80
60
40
Control
20
Counselled
0
Age:
Brazil '98
Mexico '99
Bangladesh '98
3 months
(Albernaz)
3 months
(Morrow)
5 months
(Haider)
Bangladesh '96
2 weeks after
diarrhoea (Haider)
All differences between intervention and control groups are significant at p<0.001. Source: CAH/WHO .
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ECOSOC Annual Ministerial Review
Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009
Reducing salt consumption:
a health literacy approach
 Government role:
– Leadership across society,
– Creating enabling environments,
– Building capacity in consumers,
– Working in partnership with industry and NGOs,
– Measuring outcomes and ensuring it works.
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ECOSOC Annual Ministerial Review
Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009
The UK health literacy journey on salt
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ECOSOC Annual Ministerial Review
Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009
The Value of Partnerships
Project Neptune
REGIONAL NETWORKS
• European Salt Action Network
• PAHO Observatory on Chronic
Noncommunicable Disease
Policies
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ECOSOC Annual Ministerial Review
Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009
Successful Intervention programs
Salt intake in Finland 1977-2007
15
24h urine, men
24h urine, women
13
NaCl
g/d 11
9
7
5
1977 1979 1981 1982 1987 1991 1992 1994 1997 1998 2002 2007
Source: National Public Health Institute, Helsinki, Finland
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ECOSOC Annual Ministerial Review
Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009
Health literacy and self care:
co-producing health in chronic disease
Health Literacy
Self care:
Empowered
Citizen
Health
Promotion
The Self Care Circle
Self care
Patient and citizen
involvement
Chronic disease
self-management
© Harry Cayton
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ECOSOC Annual Ministerial Review
Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009
• A great example of
partnership between
public and health service.
• $100 spent on self care =
$150 worth of benefits
delivered in return.
• A sense of control over
one's destiny =
PRICELESS.
Health literacy:
at the centre of public health delivery
 Improving people's health literacy capability needs to be
coupled with a cross-sectoral, multistakeholder
approach, creating enabling environments.
 Examples of breastfeeding and reduction in salt
consumption shows that it can work.
 The lessons learned can be applied to broader public
health delivery including achievement of the MDGs.
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ECOSOC Annual Ministerial Review
Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 2009