Comparing and contrasting Social Change and Empowerment as Approaches to Public Health Promotion

What is Public Health?

Public Health is concerned with the science of preventing diseases (Hobson, 1975), prolonging life, promoting health and social wellbeing of specific communities (King, 1966). Several resources are available with the capacity to control and prevent the spread and occurrence of infectious and non-communicable diseases in the populace. The World Health Organisation (1997) recognizes five approaches to Public Health promotion. These approaches are Educational, Social Change, Empowerment, Behaviour Change, and Medical approaches. The list is by no means exhaustive of the several approaches employed in Public Health promotion. For the purposes of this paper, only the Empowerment and Social Change approaches will be discussed.

Social Change as an approach to Public Health Promotion

Social Change approach seeks to empower individuals and groups with the skills they need to advocate on their own behalf, improve lives and provide communities with access to resources (Christopher et al, 1996). Friis (2007) opines that Societal or Social Change approach aims to bring about changes to the physical, social and economic environment which enables people to enjoy better health. Social Change approach focuses on changing society and not only on changing the behaviour of individuals. The World Health Organization (1984) stated that the role of the Empowerment approach is to first and foremost help people identify their own needs and concerns and gain the necessary skills and confidence to act upon them. Thus it can be deduced that empowerment stems from the innate ability to improve self esteem and self-awareness and ultimately to decision making. Social Change and Empowerment approaches have similarities by way of goals. Social Change targets communities and groups of people (Friis, 2007) while the Empowerment approach places emphasis on individual and community empowerment. Community empowerment is an agent of social change related to community development aimed at creating active, participating communities which are able to change the world around them through a programme of action.

Methods in Empowerment Approach

Methods in Empowerment Approach involve promoting public involvement and participation in decision making on health related issues (Tom, Vittorio, and Miranda, 1999). This type of approach is self centered and encourages health advocacy. Conversely, the Social Change Approach according to Friis (2007) is centered on lobbying, legislation, fiscal measures, and the creation of supportive and physical environment in the creation of better health. The process of evaluation is deemed to be difficult when implementing the Empowerment Approach because empowerment takes a long time to happen. Difficulty in quantifying and specifying results makes this approach of intervention complicated to implement. Whereas the Social Change Approach is easier to document, it nevertheless places emphasis on collective action to redress inequalities in health and enhances access to health care.

These sophisticated approaches to Public health cannot achieve much unless Public Health legislation is put in place and fiscal controls adopted to ensure adequate implementation of health programmes.



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