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Health Promotion International, Vol 13, 99-120, Copyright © 1998 by Oxford University Press
P Gillies
This paper assesses the impact of alliances or partnerships for health
promotion in northern and southern nations, as described in published
papers and through contemporary accounts of best practice. The balance of
evidence from published literature and case study accounts is clear.
Alliance or partnership initiatives to promote health across sectors,
across professional and lay boundaries and between public, private and
non-government agencies, do work. They work in tackling the broader
determinants of health and well-being in populations in a sustainable
manner, as well as in promoting individual health-related behaviour change.
The greater the level of local community involvement in setting agendas for
action and in the practice of health promotion, the larger the impact.
Volunteer activities, peer programmes and civic activities ensure the
maximum benefit from community approaches. In addition, durable structures
which facilitate planning and decision-making, such as local committees and
councils, are key factors in successful alliances or partnerships for
health promotion. Such mechanisms also support the sharing of power,
responsibility and authority for change, the maintenance of order and of
programmatic relevance, and allow local people one means of reflection and
for dissent. At a national, regional, district, village and local community
or neighbourhood level, this review found that the existence and
implementation of policies for health promotion activities were also
crucial to sustainability. The evidence from the review suggests the need
for new 'social' indicators to measure the effects of health promotion.
Indicators for success which focus only upon benefits for individuals
cannot capture adequately the extent of the impact of the many and varied
collective, collaborative health promotion initiatives, alliances or
partnerships currently underway around the world. These have been shown to
affect families, communities, institutions and aspects of the organisation
of social and civic life. This paper posits the notion of social capital as
one important new framework for organising our thinking about the broader
determinants of health and how to influence them through community based
approaches to reduce inequalities in health and well-being.Key
words: alliances; health promotion; partnerships
ARTICLES
Effectiveness of alliances and partnerships for health promotion
Health Education Authority, Hamilton House, Mabledon Place, London WC1 9TX, UK
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