Student No:Provisional Grade:25%
Assessor:Agreed Grade:25%



Question 1

Mark:___10___ out of 35
I’m afraid the answer to this question was mainly out of focus. You included all expected elements in the description of three basic strategies and the five key themes defined in the Ottawa Charter for Health Promotion as expected. However you were asked to “Illustrate your reflection with one example that links the three basic strategies with one of the five key themes of your choice” and you didn’t. Instead you produced a brief recall on how each theme might be applied to generic situations or broad examples. The part of this question where students were expected to go deep and think how to utilise theoretical at a times vague concepts of the Charter was not fulfilled..


Question 2

Mark:_5_____ out of 35

The answer to this question is both suboptimal and questionable from top to bottom. It quite scared by the opinions and a prioris that you use. Obviously you cannot reference these as they are full of prejudice and victimising of patients. Could you please read it again and try to see my dismay? Try to read a bit before writing, right?

Question 3 Mark:__10____ out of 30

This is not a better answer. The writing is questionable but the problem is that there is little serious reading and research behind. It is merely descriptive and so vague that at times i could see quite a few of your writing applicable to almost anything in health research or health care. Imagine the scenario of a person who knows absolutely nothing about HNA and only has what you wrote to learn the basics. Do you think such person would have some kind of an idea of what is HNA after reading your coursework? I suspect he/she wouldn’t.

Overall feedback

Reviewing your reference list gives me some clues of what might have gone wrong: you don’t seem to have used the seminal recommended reading and instead your reading consists on different documents addressing very different issues. There is not core reading behind hence the obvious lack of foundation knowledge where to build upon.

Table of Contents

PART A.. 3

Model of Salutogenesis. 3

Implication on specific health condition. 7


1.Ottawa charter. 9

Example. 10

  1. Health literacy. 11

Areas of difficulties in health literacy. 12

Examples and illustration. 14

  1. Health need assessment (HNA) 15

Stages. 16

Use for health promotion programs. 17

References. 18



Model of Salutogenesis

Health promotion models support the process of improving healthcare service quality and facilitate patients with better medicinal and procedural healthcare services. The model of Salutogenesis is one of health promotion models that aim to improve healthcare services by utilizing internal factors of the industry (Conner, 2001).

Salutogenesis is a terminology coined by Aaron Antonovsky. He was an America Israeli professor of medical sociology. The term emphasis on the factors that support health and well-being of people rather than to cure and treat illnesses. The term Salutogenesis is a combination of Latin terminologies “Salus” and “genesis” that mean health and origin respectively. Salutogenesis focus on the resilience and stress and their respective role in maintaining health of people. The concept of author is to find out how people manage stress and in what ways it contributes to maintenance of health and well-being of people. “Pathogenesis” is a contrasting term that means suffering. This term is in contradiction with Salutogenesis and focus on identifying causes of illnesses and their respective cure plans. The model of Salutogenesis works on total disease and complete health i.e. dis-ease to ease (Green, 2000).

Salutogenesis is a concept that is based on finding and examination of factors that are responsible for the development and sustenance of health even if there are risky factors prone to the individual’s body. It is interesting to know that people can stay healthy even when they are under the influence of risk associated actors (SUE HEWARD1, 2007). Therefore, it is important to know that which factors contribute to the formation of healthy body than to prevent it from illnesses. The model of Salutogenesis focus on the process of factor balancing that persists the health and those who protect the health. The persistent factors are stressors and the protective factors are generalized resistance resources that are studied and analysed within the framework of life experience. The concept of Salutogenesis is to combat the stress and enhance the role of health maintaining factors (Morgan, 2014).

Generalized resistance resources (GRRs) are the characteristics in individuals, environment, group, family or society that helps against stressors and maintain the health of a person. These factors combat stressors and help people to fight against them and maintain a steady health system of body. GRR can be financial condition, social support, emotional sufficiency and ego, personal confidence, etc. all these factors contribute to the health of a person and support his health maintenance plan. For example, if a person is to fall sick from high temperature in summers, financial strength will combat the issue when the individual buys air conditioner to keep a comfortable room temperature (Tanahill, 2009). The wide variety of these GRRs are defined by Aaron as physical, emotional, biochemical, psychological, cognitive, arti factual material, attitudinal, group, interpersonal relationship, socialisation, macro social culture factors, etc. these factors entail variety of elements that can serve as a stress fighter and maintain the health of a person. These elements are further classified as specific resistance resources (SRRs) that are main role players in reducing the impact of stressors on human health. However, if resources are missing to avail SRRs, the generalized resistance deficit occurs and the process of fighting stress becomes slow or ceased. For example, in the aforementioned example, the absence of financial capacity to buy air conditioner would be the generalized resistance deficit (Rangburger, 2003).

The sense of coherence is another element of health promotion model. Salutogenesis believes that predictions and expectations are derived from realistic world and there is an increased likelihood that they will turn out just as we expect them to be. The sense of coherence is a way to treat the model on patient so that his general adjustment towards healthcare services is assessed. Therefore, the sense of coherence has three components:

Comprehensibility: It is a belief that things will occur in a systematic manner and will continue to form a pattern which can be reasonably predicted in the future as well.

Manageability: As the term reflects, the sense of coherence believes that there is a good chance that surrounding people, environment, skills, abilities, support and help will turn out as good as they may seem to help the change to occur. Manageability believes that things would be under control and manageable easily in the future too.

Meaningfulness: It is a belief that things are interesting and can become satisfaction source. There is a worth of everything that happen and have a purpose to receive care about everything.

The sense of coherence is a theoretical formulation that insists on the role of stress in functioning of human health. Stress factors that supports regular functioning of body are not included in determination of what stress could cause harm to the sense of coherence. The validity of stress elements are assessed when the sense of coherence is checked to be affected by non-absolute factors or not.

The model of Salutogenesis elaborates that the influence of General Resistance Resources (GRRs) is enhanced when the sense of coherence is supported through life experiences. A research explains that an individual foes through more life experiences causing control and balancing when he has sufficient influence of GRRs. The capacity of GRRs enhances the experience of life and supports the person’s effort to maintain a healthy body function.

Stress is the main feature of the model of Salutogenesis. The model insists that there should be a coherent approach of stress fighting elements in every individual’s life so that he can combat the stress and maintains his health. If a person has a weak sense of coherence, the efficiency of GRRs is reduced and SRRs increase their performance. Sense of self identity and self-sufficiency is increased when a person is in good health. In healthcare industry, the model of Salutogenesis works on the pattern of assessing influence of stress causing factors in the patient’s life and evaluates the impact of SRRs. The assessment of SRRs also reveals that how much GRRs are available to patient which can be used to enhance the influence of medicinal prescription by doctors. For example, doctor might assess that the patient does not have sufficient income to buy high brand food items and thus consume food from unhygienic stall that makes him fall for sick. Therefore, he will recommend the patient to use his available financial resources to get raw ingredients and cook food for himself at home and prevent against diseases and illnesses.

Implication on specific health condition

Stress, anxiety and depression can affect a person’s physical, emotional, social and psychological health. A depression person can face various emotional, psychological and physical problems which can badly influence his relationships and social stature. Therefore, clinical depression needs to be treated with appropriate mechanism and medicines in order to alleviate it and re instate healthy mental condition of the patient. Therefore, Salutogenesis emphasize on factors that support stress fighting factors and strengthen emotional strength of a person. In order to do this, there should be availability of GRRs that can support the depressed person and help him get rid of it. GRRs are then compared to SRRs and their role in determining the health of a person. For a stress free person, GRRs should be more than SRRs in order to speed up the treatment process and increase sense of coherence in the patient.

Family, friends, spouse, children, financial strength and social interactions can be useful GRRs to alleviate depression and return the person towards normal life activities. A loving family, supportive friend, understanding spouse, children and established financial condition can help a person to get rid of stress. However, it is also interesting to know that sometimes one or few of these GRRs can serve the same purpose as similar to all of them. For example, a loving spouse and financial strength can alleviate depression of a person. Wife can counsel emotional insecurity of depressed husband and take him on vacations to change the environment so that he can forget the stress and be normal again. Moreover, even if there is no emotional support from friends, family or spouse, financial capacity can get relaxation means to a depressed individual. Substance use is one of the classic example that how people spend on drugs and alcohol to get rid of depression temporarily. In certain cases where the financial capacity is low but the spouse and family loves, the patient can achieve similar results. Therefore, it is needed to assess that the patient has high performing GRRs which can decrease the influence of SRRs. However, if specific resistance resources (SRRs) are present, there is a high chance that the person will not be able to get rid of depression easily or sooner. Being an individual, everyone needs support from emotional and materialistic resources to get relief from depression (Steve Booth-Butterfield, 2004). As similar to the psychological theory presented by Abraham Maslow, a person needs to have sufficient physiological and emotional motivators to perform something well. Therefore, Salutogenesis model is easier to understand that there is a need to have GRRs more than SRRs in order to treat depression of a person.




  1. Ottawa charter

The Ottawa charter for health promotion states that there are three basic strategies that are needed to practice in order to give equal healthcare promotion services access to all human beings. The charter emphasizes on building healthy public policy, creation of supportive environment, strengthen community actions, development of personal skills, reorient health services and moving into the future as some of basic actions to support healthcare promotion activities among the public.

The Ottawa charter demands for the role of government, state authorities, directly responsible healthcare officials, communities, agencies, civil societies and general public to spread awareness about the importance of healthcare facilities and maintain the awareness level of people (Heller R, 2008). The promotion of healthcare services, according to Ottawa charter, is only possible when there is a cumulative as well as individual role of public that forms the “need” of health promotion and up gradation process. In this way, the general effort to improve healthcare services is formed and communities get access to better healthcare services. The Ottawa charter works on basic strategies of advocacy, mediation and enabling that have a power to enhance performance of all healthcare related activities and support the process of improving services of the healthcare sector (Caldwell, 2005).






According to Ottawa charter, the three basic strategies for human health promotion:

Advocate: Advocate strategy believes that social, cultural, economic, political, technological and environmental factors can support or harm activities of health promotion. Advocacy strategy works on making all these factors favourable for health promotion and reduces their adversity on human beings striving to achieve healthcare facilities (Taylor, 2011).

For example, in the above illustration, the general socio-economic, cultural and environmental conditions are included in the advocacy strategy. These factors can turn out as supportive or hindrances in promoting healthcare services for public.

Enable: The enable strategy works on making all healthcare facilities accessible to general public. The aim of this strategy is to provide necessary and contemporary healthcare facilities to all human beings without discriminating them on any basis.

In the above illustration, social and community networks can work for facilitating healthcare promotional facilities to all human beings. Aligned efforts with community policies and state permission can increase the access options for healthcare promotional activities for all human beings (Lietz, 2010).

Mediates: Healthcare promotional activities are needed support of government, agencies, institutions, fund raisers and community helpers to bring advancement in healthcare promotional activities. For this purpose, it is important to have a proper system of food supply, sanitation and hygiene, pollution free environment and other essential living rudiments that support health maintenance process of people (Sharma, 2012).

In the above illustration, the ring of agriculture and food production, education, work environment, living and working condition, unemployment, water and sanitation, healthcare services and housing facilities. These elements are necessary to create a healthy environment for human beings that support them to lead a healthy life style.

Thus, five basic themes of food, shelter, water, environment and employment are directly linked to basic strategies to maintain facility of health promotion to everyone.

  1. Health literacy

Health literacy is the degree to which people can attain, learn, access or interpret health related information as well as healthcare services in their lives ref?. At some point of life, everyone needs to have sufficient health literacy that would work for the healthcare decision and process outcome. Research has found that lack of health literacy is one of the premium causes of immature, early and unexpected deaths ref?. Rise in mortality rate is due to insufficient attention of people for being literate about healthcare issues (Booth-Butterfield, 2004).

Health literacy is a contemporary concept in healthcare awareness and promotion. It was first coined in 1990s and later became an essential part of various areas of healthcare research ref. The preference of healthcare literacy is to educate people about healthcare services, information and processes so that they can understand the decision made by doctors as well as participate in making an informed consent ref. The health literacy term is actually composed of three main elements i.e. clinical understanding, prevention awareness and understanding of healthcare services ref?. For example, reading healthcare pamphlets and printed texts on the box of medicine is a part of healthcare literacy through which patients and their families can decide about medical process or to raise queries to clarify doubts (McFarland, 2013).

However, it is not always easy to get literate about healthcare information and services secular writting. There is an obvious barrier of being uneducated about medical terminologies that need specialised study. Along with that, there are some other difficulties in the process of being healthcare literate. The following discussion briefly reviews those hindrances and their possible solutions.

Areas of difficulties in health literacy

The first and foremost difficulty in health literacy is the lack of basic education rate in countries. In developed? countries, the literacy rate is higher due to which expectancy rate of health literacy? is also high. However, in developing countries where literacy rate is already low, it is difficult to spread awareness about healthcare literacy. To be literate about healthcare services and information, it is mandatory to have sufficient knowledge about healthcare services (WHO, 2012). Countries need to establish a feasible rate of health literacy? that can provide knowledge to people about basic and advanced health care information and services. The lack of basic literacy is the foremost hindrance in spreading healthcare literacy and gaining positive outcomes from the process.

The second area of difficulty is the lack of interest of people. It is a common practice that patients usually avoid being in unnecessary detail about healthcare procedure which may be essential to know as a patient are you talking about something you read? Or something that you think?. Patient education and awareness is not a common practice which leads to low health literacy rate. Patient and their families prefer to rely on the decision made by doctors without being into quest of logic or rationale behind it about who are you talking about?. Unfortunately, sometimes this situation ends up in death of patient and families blame doctors and institution for being negligent about the treatment process oh dear… you are just giving your personal [and rather unfortunate opinions here]. Therefore, it is important for people to get literate about healthcare so that they can understand the decision (Nutbeam, 2015).

Another area of difficulty in people is the absence of opportunities to access information about healthcare processes and decisions. The Internet is one of the biggest sources of information which is easily accessible and affordable for everyone. The healthcare service and information are available on internet but there is a lack of public access to it. People do not rely on information available on internet considering it unauthentic and misguiding. Unfortunately, there is no trend of reading health related books or to quest about general medication and treatment processes as to why they are necessary and which outcome is expected from them. The lack of access options decrease health literacy rate and complexes the process of patient awareness (Ilona Kickbusch, 2015).

Examples and illustration

The following illustration is about an informed consent form that is given to family or spouse of patient. The form entails basic information about Cesarean Section (Bultz, 2007). The consent is achieved so that if any unfortunate incident happens, the hospital can avoid legal and professional complexities. Well… consent not only has a legal protection aim. Actually, it is designed to give information

The form has all necessary consent statements which are to be understood by the signee person before handing it back to the hospital. Therefore, in this case, it is essential to be literate about the form and the terminologies so that proper consent can be given. If the signee person is not health literate, he or she? can make wrong consent? which can be fatal or risky for patient’s life. It is essential for the patient to give authority of signature to only that individual whom she trusts for being health literate.

Health literacy is essential to decrease consent led mortality rate. It should be a part of every education system where people are given basic know how about healthcare information and services access and its usefulness in real life.

  1. Health Needs Assessment (HNA)

Health Need Assessment is a systematic process of reviewing a health issues being faced by particular population that should result in mutual agreement of problem solvers and resource allocation shouldn’t be another reference here?. The health need assessment is a part of improving healthcare services for people that are in need of up graded health care system (WHO, 2004).

Reduction of inequality in healthcare is an essential part of health need assessment. The process of health need assessment is specifically aimed to develop a plan for improving healthcare services and maintain an upgraded health care facility for everyone (JOBSC, 2015). Development of creative and innovative interventions is a part of health need assessment plan. It is an optimal way to enhance inter-sectorial partnerships by resource allocation and service planning. Health need assessment strengthen the role of communities in decision making process of healthcare service infrastructure. These programs improve intercommunity partnerships and mutual collaborations (SRH, 2010). Furthermore, the process of health need assessment improves communication between commodities? and general public which is essential to collect information about health needs. The health needs assessment process also works for professional development of skills and abilities of people associated with healthcare process.



The first stage of the HNA process is to determine the target population. It is important to identify the population specifically before beginning the process of need assessment. This stage also entails informing stakeholders about the health need assessment process and prepares them to get engaged in it. Identification of need of resources is also an essential part of this stage. The assessor/s? must specify clearly that which and how much resources will be needed to carry out the process.

The second stage is to collect qualitative as well as quantitative data from the target population to know about the health needs. The data collection process must result in filtered information that indicates health need of specific area. The stage also includes existing healthcare service review as to which extent need is being met by the current administration (Bilic, 2005). The assessment of evidence effectiveness is also a part of this stage in which collected evidence for existing service is assessed thoroughly.

The third stage is to identify priorities for change and determine the size and severity of potential impact being made on population and health stakeholders. The stage also checks the current availability of effective and acceptable interventions for health needs and gathers the data about each one of them. The last part of this stage is to form local partnerships and intercommunity arrangements through which the identified health need will be met (Wagstaff, 2002).

The last stage is to implement the health need provision policy and launch the program of change or up gradation. The stage also includes evaluation and monitoring of launched program and measure the impact of launched change.


Use for health promotion programs

In health promotion programs, HNAs provide information about the actual lacking and need of population. It is easier to identify that the population is suffering from scarcity of health need and whether it is being met by existing framework or not. Health promotion programs also gather data from HNA programs and assess that what could be the impact of planned change on specific population.

Team impetus and commitment is also enhanced by using HNA program results. Health care promotion program seeks information about the health needs of that area and provides necessary information to the health promoting team. The response of the public and the potential difficulty evaluation are some of main outcomes through which healthcare promotion program can seek benefits (Bowleg, 2012). Moreover, HNA also form coalitions and partnerships that serve administrative benefits to health promotion programs. Formed partnerships and established coalitions save time of promotion program managers and support them in speedy launch of strategies.

Another use is the data which is collected in HNA programs. It is an economical option for a health promotion program to obtain data from HNA program and begin working on devised strategy as soon as possible. The availability of required data saves time, cost and effort of health promotion program and serves as a catalyst to promotional programs. In this way, health promotion programs seek efficiency and maintain a steady momentum for program implementation (Hunting, 2014).




Bilic, B., 2005. The theory of planned behaviors and health behaviors. Hellenic journal of psychology , Volume 2, pp. 243-259.

Booth-Butterfield, R. B., 2004. The message changes belief and the rest is theory: the “1% or less” milk campaign and reasoned action.. Prev Med., 39(3), pp. 581-588.

Bowleg, L., 2012. The Problem With the Phrase Women and Minorities: Intersectionality—an Important Theoretical Framework for Public Health. AJPH, 102(7).

Bultz, A., 2007. evlaution of qualitative research. Journal of public healthcare, Volume 21, pp. 195-197.

Caldwell, K. T. G., 2005. Developing a framework for critiquing health research.. Journal of Health, Social and environmental issues , 6(1), pp. 45-54.

Conner, M., 2001. Efficacy of the Theory of Planned Behaviour: A meta-analytic review. British journal of social psychology , 40(4), pp. 471-499.

Green, J., 2000. The role of theory in evidence-based health promotion practice. Health Educ Res, 15(2), pp. 125-129.

Heller R,. J. E. R., 2008. Critical appraisal for public health: a new checklist.. Public Health. , 122(1), pp. 92-98.

Hunting, G., 2014. Intersectionality-informed Qualitative Research: A Primer, s.l.: The Institute for Intersectionality Research & Policy.

Ilona Kickbusch, F. A. &.T., 2015. Health Literacy, s.l.: WHO.

JOBSC, 2015. What matters to women: a systematic scoping review to identify the processes and outcomes of antenatal care provision that are important to healthy pregnant women. An International Journal of Obstetrics and Gynaecology, 123(4).

Lietz, C. A., 2010. Evaluating Qualitative Research for Social Work Practitioners. Advances in Social Work , 11(2), pp. 1-202.

McFarland, D. M., 2013. Associations of demographic variables and the Health Belief Model constructs with Pap smear screening among urban women in Botswana. International Journal of Women’s Health, Volume 5, p. 709–716.

Morgan, A., 2014. Revisiting the Asset Model: a clarification of ideas and terms. Sage journals , 21(2), pp. 1-9.

Nutbeam, D., 2015. Defining, measuring and improving health literacy , s.l.: University of South ampton.

Rangburger, B., 2003. Health Promotion theories, s.l.: Jones and Barlett.

Sharma, M. J. M., 2012. A Systematic Review of Physical Activity Interventions in Hispanic Adults. Journal of Environmental and Public Health.

SRH, 2010. Fair society and healthy living, s.l.: Strategic review of health inequalities.

Steve Booth-Butterfield, a. B. R., 2004. The message changes belief and the rest is theory: the ‘‘1% or less’’ milk campaign and reasoned action. Preventive Medicine , Volume 39, pp. 581-588.

SUE HEWARD1, C. H. K., 2007. Organizational change—key to capacity building and effective health promotion. Health Promotion International, 22(2), pp. 170-178.

Tanahill, A., 2009. Health promotion: the Tannahill model revisited. Public health, 123(5), pp. 396-399.

Taylor, G., 2011. Developing a framework for critiquing health research: An early evaluation. Nurse education today, 31(8), pp. 1-7.

Wagstaff, A., 2002. Poverty and health sector inequalities.. Bull World Health Organ., 80(2), pp. 97-105.

WHO, 2004. Global burden of disease , s.l.: WHO.

WHO, 2012. Health education: theoretical concepts, effective strategies and core competencies, s.l.: WHO.






"Are you looking for this answer? We can Help click Order Now"