Health Setting Approach

SETTING APPROACH
HLTH PROTECTION Settings – places where people
Legal and Institutional live, learn, work and play.
Approach VILLAGE/SETT

SCHOOL

HOSPITAL

TOWN DISTRICT PROVINCE

HOTEL

CHURCH

HLTH PROMOTION WORKPLACE

APPROACH
Community Dev. Programme
and Training
 Sea Breeze Terry Walk My Suva picnic park

SUVA CITY Tobacco Free Initiative

Civic Centre Phy. Activity

Monthly walk
Achieving sustainable and healthy environments for all:
Environment and Health Process

1. improved indoor and outdoor air quality

2. ensuring universal, equitable and sustainable access to safe drinking water, sanitation and
hygiene
3. minimizing the adverse effects of chemicals on human health and the environment
4. preventing and eliminating the adverse environmental and health effects, costs and
inequalities related to waste management and contaminated sites
5. strengthening adaptive capacity and resilience to health risks related to climate change
and supporting measures to mitigate climate change
6. supporting the efforts of European cities and regions to become healthier and more
inclusive, safe, resilient and sustainable
7. building the environmental sustainability of health systems.
Providing oral health
care – clinical and
preventive
An example of activity – Health Screening in the
workplace
 St Mary’s Primary School.

1. School Canteen

• When I attended the first HPS Workshop,

I realized the immediate health threat for
the school was in our School Canteen. It
was run by the Management at that
time. Upon my return I met the Manager
and asked him to allow the teachers run
the School Canteen. The first thing we
did was removing all the junk and
replaced it with healthy snacks like fruit,
fruit juices and healthy parcels. It was
amazing to note that we were making
profit from the sales and children would
be asking for more fruits when there is
not enough.
• ‘(Head Teacher) .
 NADI SANGAM SCHOOL
2. No burning
Nadi Sangam is one of the few big Primary
Schools in Fiji with an enrolment of 1000+
children. It is situated in Nadi Township. A
notable feature that would strike visitors is the
general neatness of the school. Colourful
recycled bottle chain links along the drive and
walkways. The absence of waste paper around
the school compound is a delight to note as
there is always a high probability to find pieces
of paper in schools.
The school has a ‘zero burning policy’. The
incinerator had been dismantled and the
concrete base turned into a lettuce plot. Pieces
of paper are used in their liquid compost.
The school has integrated its Environment
Program with HPS well.
 QALITU DISTRICT SCHOOL
3. Sports
Qalitu used the School Health Team’s report to
identify obese and overweight students. A Physical
Activity program was developed to take the
children’s through. This session attracted more
children.
The programme was linked to their Canteen where
all junk food had been removed. The school
negotiated with its supplier to accept roast peas
with very low salt content. The gardening
programme was boosted by gardening tools secured
from ‘HPS Seed Funds.’
Money raised from the Canteen and garden produce
allowed the HPS programme to sponsor their school
Athletics Inter-house and zone meet. One of the
overweight students finally made it to the Northern
Athletics meet.
This is a display of HPS being part of the normal
school activities in Fiji schools.
 
 BURETA DISTRICT SCHOOL

4. Gardening
 RABULU PRIMARY 5. Gardening and Fruit Day
Even though the school is right along the Kings
Highway in the Western side of Fiji’s main island
between Rakiraki and Tavua Townships it is a rural
school.
The School beautification programme which is a HPS
activity has contributed to the general school
neatness of the school. The erection of the HPS
billboard was part of this program.
The school has successfully enforced fruits day and
discouraged sweet drinks and junk from school. This
HPS initiative has eventually reached the parents;
and is surprised to find children asking for fruits
sweets to be brought from town. Fruit intake by
children has increased. The school is close to the ‘Fiji
Waters’ bottling plant. This is reflected in the quality
of water brought in by children (mostly bottles of Fiji
Water).
School gardening has encouraged children to make
own backyard gardens and parents are very
supportive. Rabulu has successfully sent out HPS
message to parents through children.

 
 St. Agnes Primary Schools.
‘The school organized a school fair last
term. An observation was made by teachers
and there was not a single fizzy drink bottle
or high salt crispy snack wrapping was seen
during the clean up. This was an outcome of
our HPS programme where students have
learnt to stay away from junk food.’
 
( Head Teacher)
 

6. Stay away from junk food

7. Tooth brushing drills in schools – Nehru Primary School
 What is a health Promoting School?

- promotes healthy choices and creates an environment supporting these choices by:

1. All students have access in the curriculum to health knowledge and skills

• Taught as a formal curriculum

• Health promotion should not be the responsibility of the health teacher alone
 What is a health Promoting School?
2. School environment
• a safe, pleasant and healthy environment for those who work and learn in school
- lower rates of absenteeism, injury and accidents are likely

• Includes relationship between staff and students

- students are healthier and better prepared for learning
- teachers can perform their functions and act as role models for students and their
families
- give consistent messages

• school policy management

- good relationships to support physical and social health established within the
school, parents and the community
- local and regional health services, PTA, local council, etc
- families involvement - encourage participation in the development of children
health skills and knowledge at home and school

• strong link between schools, local business, community services, families and groups -
enhancing resources to the school
 Advantages of a Health Promoting School

3. addresses significance of the physical environment

(buildings, sanitation, fresh water, play areas) in contributing to the health of the
children

4. support a positive learning environment and healthy relationships and emotional

well-being of students

5. links health services with the school to address specific health concerns which
affect school children(e.g worm infestations, sight and hearing problems, ECC, etc
 How to become a health promoting school? - 6 action areas

Policy Indicators
1. create conditions for good health and policies on;
influence school’s actions and resource - Food
allocation in areas that promote health - smoking
- alcohol
- drugs
2. behavior management policy - discourages - medication
corporal punishment - first aid
- safety
- HIV/AIDS
3. environmental sustainability e.g waste - information, and responsibility for
minimization and recycling health education/health promotion at
school

4. minimum classroom hours per week for

health education

5. Nutrition guidelines for boarding students

6. Equal access for girls and boys to sports,

computers and other resources
 CONCLUSIONS – IN ORAL HEALTH

1. Children in supportive schools, had better oral health than children in non-supportive
schools in deprived areas.

2. The more comprehensive the curriculum, the greater the probability that 12 year-old
children will be caries-free and have less dental trauma.

3. Commitment towards health and safety at school was the best predictor of the
probability of children having dental trauma.

SIMONE TETU MOYSÉS, SAMUEL JORGE MOYSÉS, RICHARD G. WATT1 and AUBREY SHEIHAM1 HEALTH PROMOTION INTERNATIONAL Vol. 18, No. 3 ©
Oxford University Press 2003.
Healthy Settings
Healthy Settings
Emerging Corona virus and call for proper sanitation and hygiene
 Healthy
EARLY EASY
Lifestyle

EXCITING &
ENJOYABLE EVERYWHERE
Patients, personnel, visitors and the population in the hospital environment are
affected by the health promoting/disease producing character of the hospital
setting;
- ecological effects of the hospital functions (e.g. ecological management of
dangerous waste and resource consumption) 
- architecture: both functionality and aesthetic design can affect the health of
patients, staff and visitors.
- smoke-free hospital: to reduce the smoke pollution for non-smokers and
offer assistance for those who want to quit smoking.
Agents causing foodborne disease include viruses, bacteria, parasites, toxins, pesticides,
industrial chemicals, metals and, more recently, prions.

Foodborne diarrhoeal disease is one of the most common illnesses worldwide.

A common feature of most food markets is the wide array of foodstuffs from fruits and
vegetables to grains and tubers, and from meats, poultry and fish to eggs and dairy
products, as well as processed and semi-processed foods.

Often sold fresh at reasonable prices. Usually offer street-vended foods - ready-to-eat foods
that are accessible and affordable

- essential settings for maintaining the health and nutritional status of urban populations,
Guiding Principles for a Healthy Food Market
1. Ensure the market provides safe and nutritious food to the community
- food markets have the essential function of providing consumers with safe and
nutritious food.
- founded on a scientific understanding of linkages between adverse health effects and
chemical and biological agents in food.

2. Seek to improve food safety from production to consumption

- encompasses all levels of the farm-to-table continuum.
- food may be unsafe before it enters the market
- safe food may become unsafe after it leaves the food market
- hazards in food can arise at many different points in the food-chain
- coordinated efforts are essential for assuring the safety of the food supply.
- improper handling of food by consumers in the home is a major cause of foodborne
illness.
- 3 main reasons for improper food handling are
- lack of knowledge concerning foodborne diseases, their causes, symptoms and
implications
- lack of perception of the extent of the threat or risk
- lack of knowledge about how to change behaviour.
3. Foster partnerships among food suppliers, government and consumers
- views and concerns can be integrated, resources can be shared and problems can be
more easily resolved.
- Multisectoral team should involve persons from vendor’s associations, government, and
consumer organizations as well as academia. Representatives from agriculture, fisheries
and animal husbandry may be involved to address problems that could arise during
production.
- Municipal authorities - to ensure essential services and support are provided
- Government agency responsible for food safety and public health officials, especially
those responsible for community health care, are essential advisers.
WHO defines Healthy Ageing “as the process of developing and maintaining
the functional ability that enables wellbeing in older age”. 

Physiologic changes that occur with aging:

1. Eye
- tissue around the eyes atrophies, which can cause changes in the eyelids
- also decreased tear production as well as decreased drainage
- changes in the lens and iris can lead to changes in vision
- there are changes in the ability to adjust to light
- thus compromise daily function

2. Hearing loss
- associated with age is known as presbycusis - a gradual loss of hearing as a result
of the loss of hair cells in the organ of Corti and of cochlear neurons.
- tympanic membrane becomes thicker and degenerative changes in the ossicles.
3. Thermo-regulation
- decrease in lean muscle mass results in a reduction in the ability to produce and
conserve heat.
- decrease in the vascular response to temperature changes - lead to increased risk of
hyperthermia or hypothermia.

4. Skin
- ages as a result of sun (actinic) damage and the influence of hormonal changes
- loss of hydration, which leads to drier skin, resulting in wrinkles.
- loss of elasticity and thinning of the skin leads to easier bruising and abrasions
- thinning and graying of the hair occurs

5. Gastrointestinal system
- decrease in the production of gastric acid, but gastric motility is not altered
- Changes in the small intestine cause decreased motility and reduce
absorption of nutrients.
6. Cardiovascular system
- response of the heart to exertion becomes impaired with aging and a longer period of
recovery is observed
- Both systolic and diastolic blood pressure increase as a result of changes in the arteries,
including loss of compliance and elasticity of the vessels, and thickening of the arterial
walls
- Uncontrolled hypertension can lead to cerebrovascular accidents, and persistent
elevations in blood pressure lead to a chronically decreased blood supply to the brain and
increased risk for vascular dementia.
- An irregular heartbeat can lead to the development of blood clots, which can cause
strokes or compromise the blood supply (ischemia) to other parts of the body

7. Respiratory system
- Loss of elasticity in the alveoli decreases the amount of surface area for gas exchange.
- external factors, such as smoking and environmental exposures, can lead to chronic
pulmonary diseases, and other lung cancers.
Healthy settings practiced around the world