Background
This Health Promotion Strategic Plan for NCDs in Jamaica 2020-2025 works towards fulfilment of the first programme priority in the 2013 National Strategic & Action Plan for NCDs: risk factor reduction through health promotion. It will fulfil the Ministry of Health and Wellness’ (MoHW) Vision 2030 commitment to develop a comprehensive plan for healthy lifestyles promotion.
The MoHW’s 10-year strategic plan, Vision 2030, emphasizes the importance of addressing social determinants of health (SDH) and health inequities. The health promotion strategic plan for NCDs utilizes theoretical approaches that align it with Vision 2030 to address SDH and promote healthy behaviours in “the conditions in which people are born, grow, live, work and age.”1 In addition, these approaches, the Social Ecological Model and the Life Course Concept, reflect the current direction of MoHW health promotion to reduce risk factors for NCDs. The Social Ecological Model and the Life Course Concept are briefly described below.
The Social Ecological Model
The Social Ecological Model (SEM) serves as a guide and is closely related to the WHO “Healthy Settings” approach that was laid out in the 1986 Ottawa Charter and the 1993 Caribbean Charter for Health Promotion. SEM also corresponds with the three pillars of health promotion featured at the WHO 2016 Global Conference on Health: good governance, healthy cities and health literacy.2
SEM “is a theory-based framework for understanding the multifaceted and interactive effects of personal and environmental factors that determine behaviours, and for identifying behavioural and organizational leverage points and intermediaries for health promotion within organizations. There are five nested, hierarchical levels of the SEM: Individual, interpersonal, community, organizational, and policy/enabling environment.3
The levels in SEM correspond with the Healthy Settings approach’s components to create supportive environments through flexibility, community participation, partnership, empowerment and equity. SEM encourages a combination of interventions at all levels (e.g. individual, community, etc.) resulting in an effective approach to public health prevention and control. SEM will guide MoHW health promotion to reach Jamaicans at all levels with an appropriate methodology.