In 1986, the Ottawa Charter defined health promotion as "the process of enabling people to increase control over, and to improve, their health", providing the opportunity for the overall population's social, physical, and mental well-being (WHO, n.d.). This global conference states health pre-requisites include "peace, shelter, education, food, income, a stable eco-system, sustainable resources, social justice and equity." These factors and determinants can build the foundation for improving and maintaining overall health.
The Importance of Government
The document of the first global conference indicates the importance of government in interventions for health promotion, and it shows government's role can effectively implement various interventions or actions. For instance, it can coordinate with different health and non-health professional sectors, mediate with varying levels of populations or other groups with conflicts of interests, reorient the health services over the country, and call for cross-country intervention to set the framework (WHO, n.d.).
The research on the government's role in health promotion claims that government is important in funding health-related research (Whitsel, 2017). This can help the government establish and develop the healthcare services system and public health strategies, which can better treat and prevent both infectious and non-communicable diseases (NCD) in the population, and improve their health and well-being. Based on the financial relationship between the government and the health system, governments can improve the health care facilities in the health agencies. That can improve the efficiency, accuracy, accessibility and availability of healthcare services (Scholz et al., 2015) and prevent healthcare-related infections (Chaitkin et al., 2022). Whitsel (2017) also states the importance of governments in public communications and campaigns. For instance, governments can cooperate with the ministry of health to build guidance for healthy dietary and physical activities for children and adults, for increased awareness of the cognition of healthy lifestyles in public, to engage the population in reducing risk factors of diseases and maintaining their health status. Moreover, governments can play a role in the legislation to influence the policy decision-making to reduce the exposure of risk factors for the general population, especially more vulnerable groups.
Health Promotion for Healthy Food Accessibility in Africa
Food is a pre-requisite for achieving universal health and well-being for the population. African countries are experiencing the process of transforming their nutrient system due to changes in their food systems (Booth et al., 2021). Based on climate change, fast urbanization and globalization, countries like Ethiopia, Kenya and Ghana are changing the traditional food system, with a high intake of local and short-distance agricultural foods, to a capitalized market economy dominated by supermarkets, with increased intake of high sugary, high-sodium, high saturated fat and high-trans fats foods (Minten et al., 2018) (Healthy Food Africa, n.d.). This high proportion of unhealthy dietary food accessibility can increase the risk of obesity, micronutrient deficiencies and under-nutrient, leading to a rise in NCDs, like type-2 diabetes.
In this case, Ghana's government trained health professionals in human resources (Food and Agriculture Organization of the United Nations. , n.d.), who cooperated with the Food and Agriculture Organization of the United States (FAO) to organize the FAO's Effective Nutrition in Action (ENACT) course, for training government staff. This intervention introduced the healthy dietary guide and increased awareness of its importance, helping governmental teams build the food intake guidance most suitable for their population. Hence, this food guidance applies more effectively and efficiently to the local population. In addition, this training benefited Ghana's future nutritionists and professional health services providers. This helped disseminate knowledge to future generations, with a better understanding of practices to access healthy food. Thus, these led to reducing NCD risk and improving the population's overall health and well-being.
Another health intervention, Healthy Food Africa, which was formed by multiple cross-country interventions, was funded by the European Union (Healthy Food Africa, n.d.). Because this intervention was placed in 10 different places in Kenya, Uganda, Ethiopia, Benin, Ghana, and Zambia, the governments of these places needed to coordinate with the program leaders and staffs, and organize communities, farmers, decision-makers, and entrepreneurs to implement the intervention (RUAF Urban Agriculture and Food Systems, n.d.). With the government's help, the intervention connected the local merchants and consumers to expand the range of accessible food choices and strengthen the local agricultural food supplements in food markets. That benefited in building the sustainable producing system for foods, increasing healthy food accessibility to the population, then promoting social and health equity.
Overall, the government is one of the essential players in promoting health for the population. In two given interventions, one is organized by the government, and another is building partnerships with local governments. That shows governments' significant influence on healthy food accessibility, through structuring the food system, coordinating with different sectors on healthy food research, training the health professionals in human resources, and more pathways. With the inclusion of governments in interventions, health promotion programs can effectively reach the ultimate goal of improving communities' food accessibility, thereby promoting healthier communities.
Yicheng Cao (Cynthia):
Cynthia is the 4th year Health Science student in Bachelor of Arts from Simon Fraser University. Her interests focus on socioeconomic inequity and gender inequity from her learning at the university. She expects her future career to be focused on implementing interventions or programs that can promote health equity and gender equality.