Promote health in the new paradigm

Abstract

The international movement for health promotion began in the 1980s. The I International Conference on Health Promotion, November 1986, in Ottawa, Canada, signals the historical milestone for the paradigm shift. Discussions based on the Alma-Ata Declaration on Primary Health Care in the WHO document on Health for All, as well as on the debate at the World Health Assembly, originated the “The Ottawa Charter for Health Promotion”(1). According to the document: "Health promotion is the process of enabling people to increase control over, and to improve, their health."1 Promoting health is now an obligation in the various health systems, articulated to actions that aim to respond to the diversity of social needs not dissociated from human potentialities. In the new paradigm of intervention of the health sector the approach goes beyond national considerations, appealing to the participation of actors and partnerships and the articulation between research and clinical practice. In this pact, everyone will have a role to play in disseminating reference practices - citizens, health professionals, educators, workers in the various sectors, municipalities and the Government(2). Changes in the coming years will pose challenges for all sectors of society (from education, the environment, the economy, the quality of services and skills of professionals), where policies will play an important role for their demands on health promotion(3). The research that has been done in this context highlights that the specific regional needs identified during the policy-building process reinforce the wealth of developing, in an innovative, democratic and participatory way, actions that can give meaning to health promotion. It is the example of the study that announces the sustainability of public health promotion policies, highlighting the formation of collaborative networks, as well as political and legislative consistency that allows the continuity of interventions(4). Other studies, based on review processes in the political area, state their importance for their contribution in the production and diffusion of knowledge in the area, subsidising guidelines and mechanisms for research, training and permanent education on the subject. This is the case of the study that highlights the need to create new advocacy arrangements and good governance through the creation of spaces for intergovernmental and intersectoral articulation, a path that tends to increase and for regional participation in the process of policy formulation. Collective work meetings seem to account for interregional, intersectoral and intergenerational learning, by the existence of validation of peers and partners, as well as the contributions of this process to the strengthening of the strategic agenda of Collective Health(5). In this transition process, the initiatives of citizens and society in general will be fundamental in reducing chronic diseases, increasing quality and access to scientific evidence, without, however, losing the reinforcement of the State's role in guaranteeing living conditions to the population, "so as not to run the risk of asserting a policy that, in particular, blames and makes the individual responsible for his / her non-health"(6). This edition of RBPS presents results of studies of diversified interest in the field of health promotion, generators of reflections in readers interested on the themes. It integrates eleven articles in Portuguese, selected among those presented at the 6º Congresso Ibero-Americano em Investigação Qualitativa (www.ciaiq.org), which took place in Salamanca in July 2017. For their selection was considered the evaluation of the articles by the scientific committee of CIAIQ. They were also subject to enlargement and verification by the invited editors. The selection also considered the editorial objectives of RBPS. It is intended with this edition to contribute to the scientific, theoretical and methodological development in Health as science and profession. It once again expresses unequivocally that health promotion is a vast field of study, the plurality of which explains the diversity of problems, research issues and methodological options. The qualitative nature common to the articles in this issue is an increasingly present approach in research in the health area, since contacting the different perspectives and meanings of the phenomena of the health-disease process contributes effectively to the promotion of health, promoting a greater adhesion in health actions implemented individually and collectively, through adjusted responses to recipients and health service providers(7). The discussion of the following studies contributes to the strengthening of the scientific community, which is identified both by the elucidation of the practices and by the theoretical foundation, opening the range of approaches in the field of action.