scholarly journals Effectiveness of health promotion and public health interventions: Lessons from Latin American Cases

1969 ◽  
Vol 41 (1) ◽  
pp. 85-97
Author(s):  
Ligia De Salazar
Author(s):  
Luiz Augusto Cassanha Galvao ◽  
Volney Câmara ◽  
Daniel Buss

The relationship between environment and health is part of the history of medicine and has always been important to any study of human health and to public-health interventions. In Latin America many health improvements are related to environmental interventions, such as the provision of better water and sanitation services. Latin America’s development, industrialization, and sweeping urbanization have brought many improvements to the well-being of its populations; they have also inaugurated new societies, with new patterns of consumption. The region’s basic environmental-health interventions have needed to be updated and upgraded to include disciplines such as toxicology, environmental epidemiology, environmental engineering, and many others. Multidisciplinary and inter-sector approaches are paramount to understanding new profiles of health and well-being, and to promoting effective public-health interventions. The new social, economic, labor, and consumption aspects of modern Latin American society have become more and more relevant to understanding the complex interactions in the region’s social, biological, and physical environment, which are essential to explaining some of the emerging and re-emerging public-health problems. Environmental health, as concept and as intervention, is simple and easily understood, but no longer sufficient to achieve the levels of health and well-being expected and required by these new realities. Many global changes such as climate change, biodiversity loss, and mass migrations has been identified as main cause of ill health and are at the center of the sustainable development challenges in general, and many are critical and specific public health. To face this development, other frameworks have emerged, such as planetary health and environmental and social determinants of health. Public health remains central to some, such as the improved environmental-health agenda, while others assign public health a relative position in a variety of overarching frameworks.


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Lauren Herlitz ◽  
Helen MacIntyre ◽  
Tom Osborn ◽  
Chris Bonell

Abstract Background The sustainability of school-based health interventions after external funds and/or other resources end has been relatively unexplored in comparison to health care. If effective interventions discontinue, new practices cannot reach wider student populations and investment in implementation is wasted. This review asked: What evidence exists about the sustainability of school-based public health interventions? Do schools sustain public health interventions once start-up funds end? What are the barriers and facilitators affecting the sustainability of public health interventions in schools in high-income countries? Methods Seven bibliographic databases and 15 websites were searched. References and citations of included studies were searched, and experts and authors were contacted to identify relevant studies. We included reports published from 1996 onwards. References were screened on title/abstract, and those included were screened on full report. We conducted data extraction and appraisal using an existing tool. Extracted data were qualitatively synthesised for common themes, using May’s General Theory of Implementation (2013) as a conceptual framework. Results Of the 9677 unique references identified through database searching and other search strategies, 24 studies of 18 interventions were included in the review. No interventions were sustained in their entirety; all had some components that were sustained by some schools or staff, bar one that was completely discontinued. No discernible relationship was found between evidence of effectiveness and sustainability. Key facilitators included commitment/support from senior leaders, staff observing a positive impact on students’ engagement and wellbeing, and staff confidence in delivering health promotion and belief in its value. Important contextual barriers emerged: the norm of prioritising educational outcomes under time and resource constraints, insufficient funding/resources, staff turnover and a lack of ongoing training. Adaptation of the intervention to existing routines and changing contexts appeared to be part of the sustainability process. Conclusions Existing evidence suggests that sustainability depends upon schools developing and retaining senior leaders and staff that are knowledgeable, skilled and motivated to continue delivering health promotion through ever-changing circumstances. Evidence of effectiveness did not appear to be an influential factor. However, methodologically stronger primary research, informed by theory, is needed. Trial registration The review was registered on PROSPERO: CRD42017076320, Sep. 2017.


2014 ◽  
Vol 13 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Sudesh Raj Sharma ◽  
Neetu Karki

Culture plays a key role in influencing health related behaviours. However, cultural issues are often neglected in public health interventions. The viewpoint attempts to highlight key prerequisites for developing culturally sensitive public health interventions in the context of Nepal. Qualitative research should be promoted to understand the critical link of cultural issues with health problems and tailor interventions accordingly. Making key elements of Behaviour Change Communication (source, message, and channel) process culturally appropriate can render positive effects for health interventions. On an operational level, involving an anthropologist can act as a bridge between community and health workers throughout the implementation process; community organization and empowerment strategies within interventions have proven to be beneficial and sustainable in terms of health promotion and disease prevention. Focusing on developing culturally competent health workforce can produce a synergistic effect in health promotion efforts. To conclude, culturally sensitive interventions should not only be evidence based but empowering and engaging community.DOI: http://dx.doi.org/10.3126/hprospect.v13i1.11104 Health Prospect Vol.13(1) 2014: 1-3


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