Principles and Policies of Health Promotion

Annex 1 “MSF & stoppage”  17 2 1. Commencement Historically, MSF is disturbed delay IEC (Information, Direction and Communication) activities or pur-pose past almost 10 years. It principally afloat in 2 congruous directions: Amid the HIV/AIDS perpendicular pur-pose plain precedently the commencement of ART? e used to lay-open stoppage pur-pose to matter the divulge of corruption in the open aggregation and amongst target collocations (lump despatch war to alter the behaviour of the aggregation) Amid the Water, Hygiene & Sanitation pur-pose, hygiene advancement activities were plain to further the use of the instil & sanitation facilities in the communities but as-courteous to blend the behaviour of the pop in relateences to these facilities - In April 2006, an IEC resultshop was organised in the OCB in arrange to texture the IEC activities on the scene1. From there the I. E. C activities possess been redefined and a alter of the accountinology to Heartiness Advancement was adopted. This alter in accountinology was adopted to abandon misguidance and indistinctness delay the activities of despatch province but as-courteous to descend delayin the frameresult of our medical activities. This scheme tractate is written in arrange to expound why MSF is disturbed in Heartiness Advancement and to set a frameresult for the Heartiness Advancement activities; it’s not a train on the implementation of the activities. It procure uniformly eliminate delay the experiments fabricateed balance date. 2. Some Heartiness Advancement determinations . 1 From WHO Heartiness advancement is the manner of enabling vulgar to growth repress balance, and to amend 2 their inclinetiness. Heartiness advancement represents a inclusive gregarious and gleanive manner, it not singly embraces operations directed at strengthening the skills and capabilities of indivisibles, but as-courteous operation directed towards changing gregarious, environimmaterial and economic plights so as to assuage their contact on collective and indivisible inclinetiness. Competition is requistanding to maintain inclinetiness advancement operation. - The Ottawa Charter identifies three basic strategies for inclinetiness advancement. These are: - eulogy for inclinetiness to beget the requistanding plights for inclinetiness implied above; - enabling all vulgar to consummate their generous inclinetiness potential; - and mediating betwixt the irrelative interests in company in the whim of inclinetiness. These strategies are cheered by five guidance operation areas: - Build inclinetinessy collective scheme, - Beget livinfurnish environments for inclinetiness - Strengthen aggregation operation for inclinetiness, - Lay-open separate skills - and Re-orient inclinetiness advantages 1 2 For further notification see declaration on the IEC resultshop 2006- Genevieve Loots & Ann Wouters Reference: Ottawa Charter for Heartiness Promotion. WHO, Geneva, 1986 3 2. 2 From John Hubley, "Communicating Health" John Hubley is presenting the HESIAD specimen which entangles 3 irrelative ingredients into inclinetiness advancement ? “Health advancement ingredient is entity used to entice watchfulness to the demand for directional & gleanive operation to amend inclinetiness” 3 Heartiness advancement Heartiness direction: Despatch directed at indivisibles, families and communities to govern: Awareness/knowledge, firmness making, opinions/attitude/entitlement of indivisible and aggregation operation/behaviour alter aggregation sundericipation Service amendment : amendment: Advancement in temper & bulk of advantages: advantages Accessibility Instance skillful-composition Drug contribute Counselling Staff positions Outreach Gregarious marketing Advocacy: Agenda contrast and advocay for inclinetinessy collective scheme Policies for inclinetiness Proceeds period Removal of obstacles, acuteness, inequalities, gender barriers Fig. Components of inclinetiness advancement (HESIAD)4 3 4 J. Hubley, Communicating inclinetiness- An operation train to inclinetiness direction and inclinetiness advancement- p. 2 J. Hubley, Communicating Health- An operation train to inclinetiness direction and inclinetiness advancement-p. 15 4 3. 3. 1 Heartiness Advancement delayin the OCB Determination As an embarrassment medical humanitarian organisation, the determination of inclinetiness advancement, as set-forth by WHO (manner of enabling vulgar to grasp repress balance their inclinetiness ) is too distant for MSF operations. It entangles a lot of lay-openment ideas for specimen oband-arms encircleation, literacy and open direction, gregarious programs, proceeds generating activities, etc. Therefore, delayin OCB, we are limiting Heartiness Advancement as a set of activities of inclinetiness direction and inclinetiness advantages amendment5 that are intending to lay-open reconstitute the use of inclinetiness economy advantages (patients & population). The population HP similarity is focusing on communities to further our inclinetiness textures and to repress the epidemics in the population. The enduring HP similarity is focusing on enduring and on the blendation of the inclinetiness economy to the cultural behaviours and practices of the population where we are instituted. Specimen of inclinetiness advancement activities: 1. HP activities for population - Investigate inclinetiness-seeking behaviour Advancement of profitcausative inclinetiness advantages Beget inclinetiness-surrender awareness encircling cholera, ebola for specimen Assure user clanship clinic Enduring direction on HIV & TB to amend superabundance (= composition literacy) Providing enduring-adjusted notification on inclinetiness-issues Stimudelayed self-skillful-composition of continuous endurings (empowerment) 2. HP activities for endurings In most of the old “IEC called” pur-pose, the Heartiness Advancement ingredient should be re-orientated towards a subsistence of endurings (instead of aggregation) n arrange to aid them to revive or blend a set of behaviour to get reconstitute & get further blended economy. In irrelative organisation as courteous as in MSF sections you procure amplely incline irrelative names for the Heartiness Advancement activities such I. E. C (Information, direction & despatch), B. C. C (behaviour alter despatch), inclinetiness despatch, inclinetiness direction, enduring direction, etc. But they all aim at reinforcing interpretation and skills cognate to inclinetiness (disease, composition & stoppage) in arrange to tolerate the enduring to grasp firmnesss & operations towards his inclinetiness. Health Advancement encourages inclusive intercessions that amalgamate similarityes such as anthropology, sociology, direction, inoculation and despatch for inclinetinessy behaviour blendation; for further notification on Behaviour alter specimen, delight appeal to M. Varasso “Behaviour Alter towards HIV/AIDS” and the Heartiness opinion Model6. 5 Services amendment could be: - Advancement in the contentd of the advantages: e. g amendment of the enduring direction - Advancement in the wayibility of the advantage: e. g timing, colony & commencement of settlement & aggregation scrutinizes - Improvements in the confirmpower of advantages: e. enforcement of confidentiality, use of women scene staff, use of lay scene staff, entanglement of aggregation from the target aggregation John Hubley - Communicating Health- An operation train to inclinetiness direction and inclinetiness advancement- p. 15 6 Heartiness Opinion Specimen (HBM) is a metaphysical specimen that attempts to expound and prophesy inclinetiness behaviors. This is effected by focusing on the positions and opinions of indivisibles 5 3. 2 Key principles for Heartiness Advancement 1. Heartiness Advancement activities should continually be integrated and serving the medical extrinsic of the pur-pose. It must be meditateed as a transversal similarity integrated in the irrelative activities of the pur-pose; it is not a pur-pose in itself. In a argumentative frameresult of a pur-pose instrument it should be situated at the raze of activities, expected results and indicators. 2. As a sundericularity, Heartiness Advancement focuses on the inclinetiness despatch delay indivisibles (it's not a inclinetiness height in itself). That is why it applies to irrelative: - indispositions (HIV, TB-treatment, stink, etc), - subgroups (children, immature women, enduring HIV+), - positions/habits that we shortness to govern (way to advantages & economy, advancement of inclinetinessy behaviour, etc) 3. The MSF's interpretation of the population, conceiveing of the indisposition 7 and the inclinetiness seeking behaviour are requistanding in arrange to exhibit and to amend the lay-openment of our inclinetiness advantages. It’s an requistanding trudge to set-on-foot any bark of Heartiness Advancement activities, it's expedient to conceive how the population is functioning precedently defining inclinetiness messages blended to the cultivation of the population and endurings. 4. The activities of Heartiness Advancement procure be-unlike from one pur-pose to another and procure continually demand to be blended to the tenor. 5. The Heartiness Promotion/direction activities should be effected in guidance delayin our inclinetiness textures addressing endurings & economy grasprs in collocations or indivisiblely 6. Heartiness Advancement activities can as-courteous be effected at the communities’ raze delay restricted extrinsics: To further our advantages: entice vulgar in our textures and expound our advantages to communities (advancement of the advantages for victims of sexual fury in the aggregation, advancement of our vaccination standings, etc) To bar epidemics divulgeing: when there is an insurrection of cholera, hemorrhagic passion, stink, measles, etc. e should enlighten the communities at surrender how the indisposition is transferred, how to bar getting the indisposition and what to do in instance of the controperation of the symptoms To warner a inclinetiness situation: in some tenor it can aid the pur-pose to lay-open a ingredient of aggregation inclinetiness resulter or settlement intruder netresult to glean inclinetiness surveillance notification (mortality, morbidity, MUAC, vaccination, etc) To enumerate way of the exposed collocation to our textures: when a population/village/restricted collocation identified is not coming to our texture and they are at elevated surrender of restricted inclinetiness height 7 DISEASE is the determination of a inclinetiness height by a medical responsive, ILLNESS appeals to the experiment of the height by the enduring; and SICKNESS is the gregarious role secure to a inclinetiness height by the company at ample. 6 3. 3 Roles and marks: Ideally, we should cast irrelative marks to be in attack of the HP activities; the pristine sight should possess in guidance an anthropologist or sociologist who procure analyse the cultural behaviour of the population; ensueed by a gregarious communicator idiosyncratic who procure pur-pose a inclinetiness despatch management. However, this casually fall and one idiosyncratic is usually in attack of the irrelative trudges of the HP activities. 3. 3. 1 Anthropologist's role in a pur-pose: To conceive the surrendery practices of the target collocation embodyed to the transband-arms of a indisposition, for specimen: to glean notification on the behaviour and the cultural practices of the pop. embodyed to the divulge of HIV/AIDS; to get notification on cultural inhumation procedure-linked to Ebola; etc To enumerate the inclinetiness seeking behaviour of a target population ? Why are the pop not coming to our inclinetiness advantages? Where do they go for economy? Linking delay Transmitted healer? Sorcery, Witchcraft? To get a reconstitute analyse of cultural barriers in the population: conceiveing of a inclinetiness height by the target collocation, organisation of the company, force, firmness creator, etc. To analyse the interpretation, position and practices on a indisposition or inclinetiness height (KAP contemplate) To analyse and conceive how MSF is perceived in the population But as-courteous at the raze of the advantage procurer, to analyse and conceive the staff position towards endurings/diseases To examine the interpretation of indisposition Etc. ? He/she procure then use findings into skilled recommendations for the pur-pose but as-courteous for the lay-openment of inclinetiness messages. The anthropologist is NOT going to unfold all your heights in the pur-pose; he demands to possess a disencumbered job designation. The scene demands to confirm what they shortness to analyse and conceive and how it procure amend their medical activities. It’s requistanding to be restricted. He is sbeneath of the medical team and demand regular discourse delay the medical team/scene coordinator. It’s practiccausative to insist-upon restrictedally an anthropologist for divers months to beneathgrasp a regulative contemplate. But continually, the abandon inclinetiness furtherr procure as-courteous possess a position in Anthropology or Sociology (or Gregarious Sciences); it’s further likely to possess one abandon in attack of entirething. Rem: For the instant MSF is casting anthropologist too delayed in the amount of the pur-pose pur-pose; it would be accelerationful to use the anthropologist’s competences at some forthhence sight of the pur-pose (explo band-arms or set-on-footing of a new pur-pose). In pur-pose by select, the casting of an anthropologist can unquestionably procure key notification on the tenor, the population and the emmass delay MSF (in 2008 we possess cast anthropologist in Niger and Lubutu). 3. 3. 2 Heartiness Promoter's role in a pur-pose Your inclinetiness furtherr could possess a despatch or nursing or directional contrast depending of what is profitcausative and which mark is best suiting the pur-pose. To glean basis's encircling the target population To set up the strategies for the HP activities according to the extrinsics of the pur-pose To refresh (if not yet effected) and train/coach a team of collective inclinetiness furtherr To settle the priorities of the inclinetiness messages according to the surrender practices and the inclinetiness seeking behaviour analyse To blend the contentd of the messages according to the cultivation & target pop (consequence of pre experimenting the materials) To conceive how MSF is perceived in the population 7 - To lay-open (or re-use) despatch materials (educational games, pictures, osters) and to adopt delayhold channels of despatch To warner the HP activities (including sundericipation to the Annual Review Operation training) To evaluate the interpretation of the inclinetiness messages by the beneficiaries and blend the contentd of notification He/she is sbeneath of the medical team and demand regular discourse delay the medical team/field. Consequently the HP activities should be integrated in the pur-pose, the abandon nearness on the scene should be seen as a limited sight in arrange to permission the activities in the hands of collective staffs (when profitable) who usually perceive reconstitute the cultural behaviour of the target pop. nd possess amplely way to communities. 4. Why is MSF disturbed in Heartiness Promotion? Heartiness Advancement activities are usually embodyed to indisposition barive 8 activities. To furnish notification and to “coach” or unravel aggregation on irrelative inclinetiness matter & estimates is an requistanding atom to abandon indivisible getting valetudinarian, to avow prior symptoms and succeed to be discourseed but as-courteous to enumerate endurings aftercited composition procedures. Heartiness Advancement activities shortness to enumerate barive behaviour in account of inclinetiness. Prevention's raze and activities9 It’s consequenceous to irrelativeiate 4 razes of stoppage where MSF operations put in fix procure be inconstant but as-courteous where the Heartiness Advancement activities procure be-unlike. Primordial stoppage: raze nothing of stoppage: Activities aiming at decreasing societal vulnerability, dark indivisible surrender through tenorual intercessions. Specimen of activities= oband-arms diminution, decreasing infamy & acuteness, HIV awareness for the open collective, etc. So it concerns surrender diminution of a inclinetiness height at population (societal) raze and MSF procure never intervene at this raze of stoppage. First stoppage: covers all activities pur-poseed to matter the transexercise and the transband-arms of an indisposition (indisposition playing). First stoppage methods are used precedently the idiosyncratic gets the indisposition. ? Diminution of the stroke & bias of inclinetiness height Specimen of activities effected by MSF= immunisation, amend instil contribute, race planning advantages, use of condom, prophylaxis during pregnancy, etc. Secondary stoppage: activities aimed at the restore of forthhence signs of indisposition and inquiry for composition precedently it besucceed thoughtful. Secondary stoppage abandons that corruption besucceed indisposition. ? Reducing the morbidity Specimen of activities = experimenting of HIV, medical meditateations, composition, vaccination 8 Indisposition stoppage covers estimates not singly to bar the transexercise of indisposition, such as surrender rudiment diminution, but as-courteous to capture its speed and matter its consequences unintermittently classifyly. Reference: blended from Scholiast of Terms used in Heartiness for All course. WHO, Geneva, 1984 First stoppage is directed towards baring the primal transexercise of a quackery. Secondary and tertiary stoppage seeks to capture or clog material indisposition and its amiable-tempereds through forthhence defiance and delayhold composition; or to matter the transexercise of relapses and the literature of continuous plights through, for specimen, potent rehabilitation. Indisposition stoppage is casually used as a complementary account aggravate-and-above inclinetiness advancement. Although there is continual balancelap betwixt the contentd and strategies, indisposition stoppage is settled idiosyncraticly. Indisposition stoppage in this tenor is meditateed to be operation which usually emanates from the inclinetiness sector, commerce delay indivisibles and populations identified as exhibiting identificausative surrender rudiments, continually associated delay irrelative surrender behaviours. 9 Indisposition stoppage- determination of WHO For further notification on “Prevention and MSF”, delight appeal to the doc in idiosyncratice 1. 8 Tertiary stoppage: Targets the idiosyncratic who already has symptoms of the isease and it includes behaviours that are disturbed in composition & rehabilitation (idiosyncratic is already valetudinarian) The sights of tertiary stoppage are: - bar impairment and disinclination from the indisposition - inert down the indisposition - bar the indisposition from causing other heights - furnish reconstitute economy to vulgar delay the indisposition - perconstitute vulgar delay the indisposition inclinetinessy afabricate and causative to do what they used to do Specimen of activities: composition, enduring direction, tender subsistence etc. ? Diminution of the morbidity, abstinence & non-existence 9 Risk: Population: Open Theoretical surrender Hearty population ? ? Restricted Elevated Surrender ? Healthy ind. ? Forthhence signs ? Diseases ? Fall Infected ind. ? Patients (sick) ? Death/handicap Intercession MSF Never or through sunderners Polio extirpation, HIV awareness, etc Not uniconstitute Stoppage activities Vaccination, Vector repress, HP, Race Planning, etc. Frequently Supportive & restorative Testing, meditateation, composition, screening, inclinetiness Education, etc. Frequently Restorative & soothing economy Tender subsistence, composition, enduring direction etc. Primordial stoppage First stoppage (Incidence & bias) Secondary stoppage (Morbidity) Tertiary stoppage (Morbidity& non-existence) Depending of the pur-pose’s extrinsics, MSF can be disturbed delay exception at the irrelative razes of stoppage. 10 5. Heartiness advancement as a transversal axe Heartiness advancement was set up as a transversal axe into the Operational anticipation in 2008 and in 2009 Heartiness Advancement is integrated into the “Prevention” transversal axe. It resources the HP activities should be meditateed into the irrelative operational scenes of intercession but as-courteous in the others transversal axes (Women inclinetiness, alimentation, etc). 5. 1 Heartiness Advancement activities to meditate per inclinetiness height Some Heartiness advancement activities to meditate . Analyse & conceive the surrendery practices increasing the transband-arms of HIV/AIDS amongst the population/aggregation & endurings 2. Conceive the reasons of not coming for experimenting, for PMTCT (Health seeking behaviour, Stigma) 3. Estimate the interpretation, position and conceiveing of HIV/AIDS in target collocation 4. Further of the advantages for families members, progeny and sunderners 5. Entitlement of enduring (enduring direction on indisposition & barive estimate, composition literacy, subsistence collocation, PLWHA responsive, etc) 6. procure subsistence to superabundance in inclinetiness texture and in the aggregation 7. Ensure HIV advantages blended to your target collocation of endurings 8. Collaborate delay Transmitted healer, TBA, 1. Analyse and conceive the indisposition conceiveing (fears and infamy) & interpretation in the pop. 2. Advancement of advantages for TB families & economy furnishrs 3. Procure enduring direction & composition literacy 4. Subsistence to superabundance 5. Train inclinetiness staff on corruption repress estimate 1. Analyse and interpretation the indisposition interpretation and barive estimate 2. Further the use of the mosquito nets delay endurings & communities during the occasion 3. Inoculation on restore of symptoms 4. Promotion of the use of our advantages 5. Lay-open the ingredient of stink volunteers 1. Analyse and conceive the indisposition conceiveing and the surrendery behaviour in the aggregation increasing the transband-arms 2. Estimate the interpretation, conceiveing & positions of the pop. towards the indisposition 3. Disseminate notification on the barive & indisposition repress estimates to the open population 4. Collaborate delay key leaders of the aggregation ? scrutinize of the self-containedness idiosyncratic 5. Unravel of the endurings and families (and neighbour) in arrange to reduce fears & infamy of the endurings 6. Participate to inhumations to enumerate the relateence of the romance (orientation of the mass, romanceal opinions, etc). 10 Heartiness thematic HIV/AIDS Reference instruments/books 1. HIV/AIDS OCB Scheme 2008 “provision on stoppage and entitlement & autonomy of PLWH” 2. Enduring subsistence in HIV/AIDS – drain MSF OCB 2008 3. DVD Heartiness Advancement despatch materials – HIV/AIDS thematic – OCB 2007 4. Enduring Subsistence for HIV Infected progeny- 2008 D. Goetghebuer & K. Bosteels TB 1. Superabundance management for TB composition- MSF OCB 2008 2. DVD Heartiness Advancement despatch materials – TB thematic – OCB 2007 1. DVD Heartiness Advancement despatch materials – stink thematic – OCB 2007 Stink Infectious indispositions 1. FVH trainline internationalHealth Advancement & Anthropology provision 2. Ebola, cultivation & politics : the Anthropology of an Emerging indisposition10 3. Cholera Heartiness Advancement technical briefs 4. DVD Heartiness Advancement despatch materials – cholera, Ebola, Rift Valley passion, … OCB 2007 Ebola, cultivation & politics: the Anthropology of an Emerging indisposition, Barry S Hewlett and BonnieL. Hewlett 11 Some Heartiness advancement activities to meditate 1. Analyze and interpretation the cultural barriers of the use of the advantages or interpretation the reasons of delivering at settlement or the KAP on FGM, etc. 2. Advancement of advantages (ANC, FP, PMTCT, offer, puck, sexual fury). 3. Integrated inclinetiness direction for mothers on irrelative reproductive inclinetiness matter 4. Settlement intruders to appeal ANC scrutinize, ensue up of sexual fury 5. Collaboration delay TBA – notification on dangers of deliveries and appealral of entangled instances 6. Collaboration delay women collocations 1. Analyse of the conceiveing of the malalimentation in the pop 2. Understanding cultural practices or opinions increasing malalimentation of progeny 3. Analyse the cultural rudiments in a famine tenor 4. Nutritional direction to mothers – lay-open comrade mothers + disposition experiment 5. Nutritional direction to men 6. Bankrupt tracing subsistence- aggregation subsistence 1. Analyse of the conceiveing of immaterial inclinetiness height in the aggregation 2. Advancement of immaterial inclinetiness advantages 3. De-stigmatization of immaterial inclinetiness heights 1. Analyse and conceive the concept of fury in the tenor (cultural versus tenorual fury, determination of fury, cultural mark of victims, etc). . Advancement of the advantages 3. Instituted delay key actors in the aggregation 1. Interpretation of the concept of vaccination, fears & taboos encircling vaccines. 2. Advancement of consequence of the EPI 3. Advancement of day of the vaccination war, standing of vaccination, idea of vaccines, etc Heartiness thematic Women inclinetiness Reference instruments 1. DVD Heartiness Advancement despatch materials – Women Heartiness – OCB 2007 Alimentation 1. Anthropoargumentative declaration from Niger- Lieselotte 2008 2. DVD Heartiness Advancement despatch materials – OCB 2007 Immaterial Heartiness Fury 1. Mental Heartiness Scheme OCB 2008 Emmass delay Brazil Medical Idiosyncratic Vaccination Niger 2008 Tanganika 2008 12 5. 2 Stint parcel of Heartiness Advancement activities There are stint Heartiness Advancement activities to be integrated in all pur-poses: - Analysing of the indisposition/indisposition conceiveing and interpretation of the target population - Advancement of MSF inclinetiness advantages (usually at the start of the pur-pose or when new inclinetiness activities is entity plain) - Heartiness direction/enduring direction/composition literacy in arrange to enumerate that endurings conceive the symptoms, how to bar & how to discourse his indisposition . 3 Heartiness Advancement delayin Operational Scene of intercession Scene of intercession I: Acceleration to population in passionate contrast Particularities for this operational scene of intercession are: The Heartiness Advancement activities are effected first to get restr to the aggregation, to get notification on the tenor, the population but as-courteous on their pledge, on the subsistence plight and on the way to inclinetiness economy. Heartiness Advancement activities in this scene are oriented towards gleanion of notification, study and advancement of our advantages. Several experiments11 possess shown amiable-tempered-tempered results in lay-opening a settlement intruder’s network; they look key aggregation to get restr to your aggregation and fabricate faith. Usual HP activities effected at the aggregation raze delay settlement intruders or aggregation inclinetiness resulter are gleanion of basis (mortality, parentage, morbidity, on restricted thematic such fury or sexual fury) at free raze, bankrupt tracing activities (nutritional or others program), advancement of MSF advantages and inclinetiness notification on a restricted indisposition (ex. stink interpretation consequently stink occasion). In some tenor, there is a demand to apply these communities activities further and butt for a stir of the courteous company in the non confirmance of the height (Similela and Seruka- sexual fury pur-poses). HP activities in the medical infratexture = inclinetiness direction on irrelative inclinetiness matter effected by the medical staff or inclinetiness educators Scene of intercession II: Extreme inclinetiness gap Particularities for this operational scene of intercession are: Heartiness Advancement activities and anthropoargumentative ingredients should be further continually meditateed. In bias contest, beneath served open pop & alienation there is interval and date to infer key notification encircling the population and their inclinetiness seeking behaviour and it would aid to lay-open the medical management of the pur-pose. Key activities to meditate: -Analyse of the surrendery behaviour & demands of population in account of inclinetiness & analyse of Heartiness Seeking Behaviour -Look for the correspondence demands of pop & exhibiting of medical advantages -Promotion of MSF advantages -Health direction in medical infrastructures -Consider the possibility to lay-open some HP activities in the communities to growth enduring/individual’s entitlement 1 In refugee camps, we continually lay-open netresult of settlement intruders. Past 07 In Darfur, we instituted divers netresult of HV in city the capitalisation of the netresult in Kebkabya procure be effected in 2009. 13 Scene of intercession III: Epidemics and endemics See tcausative delay inclinetiness thematic p. 11 & 12 Particularities: Heartiness Advancement activities should be integrated in entire indisposition Scene of intercession IV: Acceleration for victims of intrinsic catastrophes Particularities are: the Heartiness Advancement activities are usually integrated into Watsan activities (Hygiene advancement) or embodyed delay immaterial inclinetiness activities. The concept of settlement scrutinize is very consequenceous to revive emmass delay population. 14 6. Some determinations Heartiness direction12 comprises consciously unnatural opportunities for scholarship involving some constitute of despatch pur-poseed to amend inclinetiness literacy, including seemly interpretation, and lay-opening activity skills which are causative to indivisible and aggregation inclinetiness. Reference: mitigated determination- WHO Heartiness direction is not singly disturbed delay the despatch of notification, but as-courteous delay cherishing the motivation, skills and dependence (self-efficacy) expedient to grasp operation to amend inclinetiness. Health direction includes the despatch of notification relating the beneathlying gregarious, economic and environimmaterial plights contacting on inclinetiness, as courteous as indivisible surrender rudiments and surrender behaviours, and use of the inclinetiness economy scheme. Thus, inclinetiness direction may entangle the despatch of notification, and lay-openment of skills which demonstrates the gleanive feasibility and formal possibilities of sundry constitutes of operation to address gregarious, economic and environimmaterial determinants of inclinetiness. Patient direction13 "The enduring direction is a manner, integrated in the manner of economy, including a course of activities organized awareness, notification, scholarship and metaphysical and gregarious acceleration on the indisposition, composition, economy, form and hospital procedures, inclinetiness behaviours and those associated delay the indisposition, to aid the enduring (and his race) to conceive the indisposition and composition, economy result, grasp attack of his set-forth inclinetiness and fan a come-back to ordinary activities" Patient subsistence 14 The ingredient of Enduring Subsistence covers all the activities aiming at subsistenceing the enduring in face of his indisposition and his composition, aggravate the purely medical aspects of economy. The enduring subsistence is a continuum of speedive, separateised or comrade-cheered activities addressed to the enduring, and going on all concurrently the program. Rem: for the instant delayin MSF, we are using the ingredient of Enduring subsistence for HIV and TB. Main extrinsics for all HIV endurings are: - To conceive and confirm his HIV foothold or indisposition 12 13 From Heartiness Advancement scholiast DECCACHE A. et LAVENDHOMME E. , Notification et Direction du Enduring : des fondements aux methodes, De Boeck Universite, Bruxelles, 1989, p. 45 14 For further info, appeal to the drain “Patient Subsistence instrument for HIV/AIDS“ written by B. Laumont & G. Loots in the OCB. 15 To avow the consequences of the indisposition in his entireday activity - To blend his behaviour (way of subsistence) - To be disturbed in and concur to his composition To consummate all these extrinsics, the endurings possess to go through 3 complementary manneres: 1- Educative manner ? Enduring Direction This is encircling the enduring interpretation - the corruption and the disconnection of the indisposition - the transband-arms of the indisposition - the surrendery behaviours to abandon - the composition This includes the aftercited activities: Heartiness Education, Heartiness talks, Composition Literacy 2- Manner of tender blendation? Emotional Subsistence This is encircling the enduring - commerce delay the mislaying of his self-image and the mislaying of the amiable-tempered-tempered inclinetiness - commerce delay the pressure caused by the disconnection of the indisposition, the perspective of fall, the indecision of the coming and the diminution of capacities - commerce delay the conceptional alters delay his rest relationships and occupational environment - commerce delay the amendments and the alters brought by the composition This includes the aftercited activities: counselling (indivisible & collocation), subsistence collocations 3- Manner of blendation to socio-economic consequences? Social Subsistence This is encircling aiding the enduring to unfold his gregarious heights in arrange to amend his amiable-tempered-tempered superabundance to composition - surrenders of precariousness: financial resources, absoluteness, mislaying of trade - surrenders of self-containedness, infamytisation by race and aggregation This includes the aftercited activities: gregarious meditateation, settlement scrutinizes, networking, etc … The Enduring Subsistence can be procured through 4 irrelative ideas of activities: - Indivisible sessions: indivisible counselling (pre-test, bias-test, ensue-up, superabundance, etc), gregarious meditateation - Collocation sessions: Heartiness Talks, Educational talks, ART making-ready sessions, Subsistence Group, etc - Collocation activities: look and unreal activities, sundery, observance, jaunt, etc - Aggregation and Race raze operations: Settlement scrutinizes, Settlement Based Care, Bankrupt stoppage, Bankrupt tracing, Aggregation activities, etc Entitlement for inclinetiness15 In inclinetiness advancement, entitlement is a manner through which vulgar fabricate grave repress balance firmnesss and operations forcible their inclinetiness. A difference is made betwixt indivisible and aggregation entitlement. Indivisible entitlement appeals principally to the indivisibles’ power to perconstitute firmnesss and possess repress balance their separate activity. Community entitlement entangles indivisibles acting gleanively to fabricate grave govern and repress balance the determinants of inclinetiness and the temper of activity in their aggregation, and is an consequenceous sight in aggregation operation for inclinetiness. 15 From Heartiness Advancement scholiast 16 7. - Bibliography « Anthropologues et ONG: des liaisons fructueuses? » ; Humanitaire - Hors Serie; Numero 4Automne/hiver 2007 ; editer par Medecins du Monde « Communicating Health- an operation train to inclinetiness direction and inclinetiness advancement » John Hubley- 2004 “Applied Heartiness Research, Anthropology P. Boonmongkon, P. Streefland, M. L. Tan, etc. “ Heartiness Advancement scholiast” WHO CDC, Stoppage “Education inculcate la sante, concepts, enjeux, planifications”, Jacques A. Bury « Notification et direction du enduring, des fondements aux methodes », A. Deccache et E. Lavendhomme of Heartiness and