Breastfeeding Promotion Strategies

Discuss about the Spectrum Of Health Promotion Interventions.

Back in 1948, the World Health Organization offered a biopsychosocial view of health when they defined it as “the complete physical, mental and social wellbeing and not just the absence of infirmity or disease” (WHO, n.d). This definition changed the focus from physical conditions to viewing the human being in a holistic view. This led to the consideration of not only physical determinants of health but also psychological, social and environmental. It is in definition that health promotion is built upon. Promotion of health is defined as “the process of enabling people to increase control over, and to improve, their health” (WHO, 1998). This is guided by the Ottawa Charter (1986) and the Jakarta Declaration (1997) which agree on advocacy, enabling and mediation as the three strategies for health promotion. Healthy public policy, health supportive environments, community action, personal skills development and reorientation of health services are the action areas identified under these strategies that guide the health promotion interventions (WHO, 1998).

Identify a range of strategies that could be used to address each of the following five issues

Issue 1: Encouraging breast feeding among socially disadvantaged mothers
Issue 2: Falls prevention among people living in aged care facilities
Issue 3: Promoting fruit and vegetable consumption among preschool-aged children

Issue 4: Prevention of road fatalities
Issue 5: Prevention of malaria

Issue	Screening, individual risk assessment, immunization	Health education and skill development	Social marketing Health information	Community Action	Settings/ supportive environments
Breast feeding	Promotion of skin to skin contact between the mother and the newborn which is important in initiating breastfeeding. Proper nutrition for the lactating mother so as to ensure there is sufficient supply of breast milk for the baby. Provision of rooming in and early maternal contact. This helps to initiate early contact and initiation of breastfeeding (Palda, Guise, & Wathen, 2004)	Training of breastfeeding to new lactating mothers so that they understand the correct procedure and issues revolving breastfeeding (Haroon, Das, Salam, Imdad, & Bhutta, 2013). Training of healthcare providers on breastfeeding technique and issues revolving around it. This helps them to give factual information to the patients. Training of community counselors that help in providing support for the women.	Use of mass media to spread information on breast feeding leading to creation of awareness. Provision of hospital discharge packs that contain breastfeeding information. Dissemination of published evidence based articles that provide current data on breastfeeding.	Peer social support groups are comprised of community members who have been trained on breastfeeding. Telephone based support for lactating mothers. This helps to reach a wide range of people. Hold advocacy campaigns that support pregnant and lactating mothers. This also helps in creating awareness and increasing community participation.	Provision of breastfeeding facilities in workplaces, public and commercial settings. This has positive impact on both the intention and duration of breastfeeding.  Limiting the marketing of infant formula which helps in the reduction of its usage. Promotion of partner support on employed mothers. This has shown positive feedback on the intention of women on breastfeeding (Tsai, 2014).
Falls prevention	Use of falls risk assessment before admission so as to identify persons who are more prone to falls. Management of psychoactive medication as they alter ones perception and have other physical effects on the body. Promotion of healthy nutrition and physical activity to the elderly. An example is the supplementation of calcium and vitamin D that helps increase bone strength.	Residents are to be trained on the importance of physical activity and healthy nutrition in increasing bone mass and density. Training of healthcare providers on falls prevention  Training the elderly on the use of walking aids. These help in providing support for the elderly.	Use of mass media to create awareness on risk factors for falls among the elderly and self management skills. Dissemination of brochures and posters with information on risk factors for falls and how to avoid them Dissemination of evidenced data on falls prevention to healthcare providers and the public.	Community health volunteers trained in exercises for bone strengthening Conducting home visits where occupational and physical exercises are done. Educating the community on the need of eye checkups for the elderly	Conducting home visiting programs that help to identify and rectify hazards around the house. One thing that is assessed is lighting as poor lighting is highly associated with falls. Provision of safe footwear that have a firm grip to the floor and prevent sliding (Lee, Lee, & Khang, 2013) Making the resident’s personal items easily accessible.
Fruit and vegetable consumption	Individual dietary counseling. This helps one to understand the client’s dietary intake. This guides the process of nutritional behavioral change. Screening of nutrition related diseases on risk groups. This helps in the identification of nutrients deficiencies and guides the management process and interventions Assessment of biomarkers in patients that inform us on nutrition level. An example of biomarker is the cholesterol level that informs us of conditions that may be precipitated by its level.	Holding seminars for health professions on fruit and vegetable consumption and their importance Educating patients on appropriate dietary intake. This helps them to understand their importance and brings about dietary change. Training the healthcare providers on fruit and vegetable intake and its importance	Nutritional labeling in all foods and on food menus in restaurants. This enables one to choose their meals wisely. Advertisements that encourage fruit and vegetable intake Proper labeling of foods with dietary information. This helps one to know the nutritional content of foods (VicHealth, n.d)	Advocating members of the community to start community gardens for vegetables like kales, spinach etc. This encourages people to consume fruit and vegetables as they are easily available and accessible. Holding advocacy campaigns for vegetable and fruit intake in the community. Home visits for risk groups like children, diabetics, elderly on fruit and vegetable intake. This will include a dietary assessment and counseling to guide them to better manage their conditions with healthy eating.	Inclusion of nutrition as part of school curriculum Reducing tax imposed on fruit and vegetables. Imposing tax on junk foods so as to discourage people from buying and consuming them. Encouraging vegetable and fruits to be included in school diets. Children spend a lot of time in school as compared to home. (Schmitz, Recine, da Silva, Amorim, Bernardon, & Rodrigues, 2008).
Road fatalities	Assessment of illnesses/ conditions that deter one from driving like epilepsy before one is given a license. Screening of alcohol intake in drivers. Evaluation of black spot and identification of factors that make them accident prone	Offering of refresher driving lessons for road law offenders. Retraining of driving school instructors. This ensures that they up to date with the trends in car manufacturing, road engineering and rules and regulations. This helps them train their students effectively. Education of drivers on traffic laws and the consequences. This helps them understand the rules and drive safely safeguarding their own lives and that of others.	Use of mass media and social media to spread information on road safety and black spots. Dissemination of information to the public on effects of alcohol and drug intake on driving. Provision of posters and posters with traffic laws.	Community advocacy against drug and alcohol abuse that is one of the major causes for accidents.  Advocating for use of helmets in motorcycles (WHO, 2015).  Community involvement in speaking out against reckless driving in public transport.	Provision of clear road signs and labeling so as to ensure that they are visible to drivers even at night. Evaluation of driving schools so as to ensure that only competent drivers are awarded with licenses. Enforcing traffic laws and regulations (Gupta, Menon, Devkar, & Thomson, 2015)
Malaria	Taking of malaria vaccine before visiting prone areas. This helps prevent them from infection. Regular screening activities in malaria endemic areas. This helps in the management of malaria infection. Intermittent prevention of malaria in pregnant women as they are a vulnerable population (CDC, n.d).	Educate the patients on malaria and its risk factors. Training the professionals on current trends in the management of malaria. Training of community of health volunteers on causes, risk factors and  prevention strategies for malaria .	Giving out of posters and pamphlets with information on malaria. Promotion of television and radio shows that educate on malaria. Dissemination of evidence based data that informs us current trends of malaria treatment and prevention.	Draining of stagnant water and clearing of bushes as they are breeding sites for mosquitoes. Community action on encouraging health seeking behaviors when infected so as to control it. Holding campaigns that inform the community on malaria and its prevention and management (NHS, 2015)	Provision of mosquito nets to malaria endemic areas. Encouraging house and compound spraying for vector control. Encourage better engineering for dams and irrigation schemes that facilitates circulation of water which prevents them from being breeding sites (World Health Organization, n.d)

1. Consider overlap (250 words – 10 marks)

Comments on any overlap and/or connections across the spectrum of interventions that you have noted when researching this task. Briefly reflect on any variation across different health issues. (250 words)

For effective promotion strategies, a strategy cannot be applied on its own. They are all connected one way or another. For instance in health promotion strategies for vegetable and fruit intake, the dietary and nutrition assessment sets motion to all the other interventions as it provides a basis for training and education of the patient, healthcare providers and community (Eleftheriou, 2013). It is also through this assessment and evidence based data in publications that guide the policies that provide supportive environment for the health promotion strategy.

The education of the patients, healthcare providers and the community helps in the creation of awareness. This helps the community to create initiatives such as campaigns, walks and screening activities. These activities are supported by the community and government bringing the overall desired outcome (Laverack, 2007).

Activities that require community action are somewhat similar across a range of diseases and conditions. Advocacy campaigns, walks, health talks and medical camps are carried out in order to create awareness for both acute and chronic conditions like tuberculosis, cancer, HIV/AIDS and diabetes (Eleftheriou, 2013). They also depend on community health volunteers (CHVs) who are trained on a range of conditions and they offer advice and rally the members of the community to participate in activities. (Kuule, et al., 2017)

Falls Prevention Strategies

Biological assessments like screening are condition specific as different conditions are assessed differently. The tools used to assess malaria are not the same tools used to assess conditions like cancer, diabetes etc. This is where there are major disparities in health promotion strategies across a spectrum of health conditions (World Health Organization, 2001).

Select and describe strategies in detail (150-200 words X 5 strategies = 750-1000 words – 25 marks)

Select ONE issue from Q1 and provide a detailed description of FIVE strategies that span the spectrum of interventions (i.e. choose one strategy from each column in the table you devised in Q1 above). Provide 150-200 words per example + a hyperlink to reference/more information for each one.

Breastfeeding is known for its outstanding benefits on not only the child but also the mother. It is known to reduce risk of breast and ovarian cancer, osteoporosis and cardiovascular diseases to the mother (NHS, 2017). Breast milk has immunoglobins that help in the growth and strengthening of the child’s immunity. Aside from this it s important in the growth and development of the child as it is equipped with proteins, carbohydrates and nutrients. Due to this, WHO and UNICEF recommend that breastfeeding should be initiated within the first one hour after birth and it should be exclusive for a period of six months (WHO, n.d). To implement this, a number of interventions have been put in place.

First we have the encouragement of skin to skin contact between the mother and the child after birth. Skin-to-skin contact is an exercise conducted after birth where the baby is laid on the mother’s bare chest for an hour or until the first feeding time and they are both covered with a warm blanket (UNICEF, n.d). It is important in that it encourages more interaction between the mother and the baby, brings about the motherly instinct as the mother is able to stroke, caress and even converse with the baby and helps the baby adapt to the environment outside the womb by helping regulate the heart rate and breathing (NIH, 2017). It helps in initiating breastfeeding and helps reduce infant stress (Hector, King, & Webb, 2004).

The other intervention is the training of mothers on breastfeeding. This can be conducted for lactating mothers or expecting mothers. It involves educating the women on the appropriate procedure for breastfeeding, challenging the myths in place and informing them on the benefits it has as compared to artificial feeding (Burgio, et al., 2016). The training can be a one-on-one session or a group session. This helps the women when deciding on feeding methods of the child. In a study carried out in Vietnam in 1994 revealed that the level of knowledge on breastfeeding had improved and there was an overall positive attitude and intention in the group that had prenatal education (King, Hector, & Webb, 2005). Mothers who have undergone this training do breastfeed their babies for longer than those who didn’t (Willumsen, 2013).

Fruit and Vegetable Consumption Promotion Strategies

Provision of discharge packs to mothers is another intervention that has proved to be effective in that it reflects the professional support to these mothers (Rosenberg, Eastham, Kasehagen, & Sandoval, 2008). The discharge packs contain information on physiology and process of breastfeeding, the importance of breastfeeding on both the mother and the baby and myths associated with breastfeeding. This is mostly used along with education and peer support groups so as to bring the desired effects. It serves as a remembrance for the training one received. It also helps in explaining and directing one on the procedure of breastfeeding (Hector, King, & Webb, 2004).  

The peer support group is one way of community involvement and is widely used in the advocacy for breastfeeding. This helps in encouraging expecting and lactating mothers to breastfeed (Phipps, 2006). They are informative and offer the emotional support that women need. Aside from that, they help tackle problems that may hinder breastfeeding. Women who serve as peer counselors are trained beforehand so as to ensure that the women are receiving factual information and appropriate care. One thing that makes this very efficient is that the peer counselors and the peer group are more accessible as compared to health institutions as they are found in the grass root of the community (Centers for Disease Control and Prevention, 2013).

One of the main challenges cited by women with regards to breastfeeding is the lack of facilities to breastfeed their children. Most women are faced to either quit their jobs or stop breastfeeding prematurely (Bettinelli, 2012). This has facilitated the provision of breastfeeding facilities at the workplace, public and commercial centers It is proven that full time working women express reduced rates of breastfeeding initiation and shorter breastfeeding duration (Centers for Disease Control and Prevention, 2013). Businesses and offices are setting aside space for breastfeeding and expression of milk. This helps in that women can breastfeed their child as compared to using teat and feeding bottles (Womenshealth, 2014). It also reduces the rate at which new mothers resign in order to provide the exclusive breastfeeding and care for the child. This helps the child, the mother and the organization as it doesn’t lose its manpower (Centers for Disease Control and Prevention, 2013).

Conclusion

Health promotion is comprised of a number of strategies and not just health education. It is composed of personal skills development, education, and creation of awareness using media, community action and provision of supportive environments. It is a practice that involves intersectoral collaboration and community action in order to make it effective.

Road Safety Promotion Strategies

References

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