ECOSOC Annual Ministerial Review Regional Ministerial Meeting for

Asia and the Pacific

Promoting Health Literacy,Promoting Multisectoral Actions

Dr Fiona AdsheadDirector, Chronic Diseases and Health Promotion

World Health Organization

29-30 April 2009Beijing, China

ECOSOC Annual Ministerial Review

Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 20092 |

Health literacy: a whole of society approachHealth 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.

ECOSOC Annual Ministerial Review

Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 20093 |

MULTISTAKEHOLDER, CROSS-SECTORAL APPROACHMULTISTAKEHOLDER, CROSS-SECTORAL APPROACHGovernment – civil society – private sector – media

BEHAVIOUR CHANGEBEHAVIOUR CHANGE

ENABLING ENABLING ENVIRONMENTENVIRONMENT

HEALTH LITERACYHEALTH LITERACY

EmpowermentEmpowerment

HEALTHHEALTHOUTCOMEOUTCOME

Access to information, knowledge reinforcement, and opportunity to act

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GOVERNMENT leadershipGOVERNMENT leadership

ECOSOC Annual Ministerial Review

Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 20094 |

Multisectoral action: enabling breastfeeding in the workplace 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.

ECOSOC Annual Ministerial Review

Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 20095 |

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Brazil '98 Mexico '99 Bangladesh '98 Bangladesh '96

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Control

Counselled

Counseling (health literacy) empowers mothers to practice exclusive breastfeeding

All differences between intervention and control groups are significant at p<0.001. Source: CAH/WHO .

Age: 5 months (Haider)

3 months (Albernaz)

3 months (Morrow)

2 weeks after diarrhoea (Haider)

ECOSOC Annual Ministerial Review

Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 20096 |

Reducing salt consumption: a health literacy approach

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.

ECOSOC Annual Ministerial Review

Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 20097 |

The UK health literacy journey on saltThe UK health literacy journey on salt

ECOSOC Annual Ministerial Review

Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 20098 |

The Value of Partnerships The Value of Partnerships

Project Neptune

REGIONAL NETWORKS

• European Salt Action Network

• PAHO Observatory on Chronic Noncommunicable Disease Policies

ECOSOC Annual Ministerial Review

Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 20099 |

Successful Intervention programsSuccessful Intervention programs

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1977 1979 1981 1982 1987 1991 1992 1994 1997 1998 2002 2007

24h urine, men

24h urine, women

NaClg/d

Salt intake in Finland 1977-2007

Source: National Public Health Institute, Helsinki, Finland

ECOSOC Annual Ministerial Review

Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 200910 |

Empowered Citizen

Health Literacy

Health Promotion

Self care

Chronic disease self-management

Patient and citizen involvement

The Self Care Circle

© Harry Cayton

Health literacy and self care: co-producing health in chronic disease

Health literacy and self care: co-producing health in chronic disease

Self care:

• 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.

ECOSOC Annual Ministerial Review

Regional Ministerial Meeting for Asia and the Pacific | 29-30 April 200911 |

Health literacy:at the centre of public health delivery

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.