WHEN HEALTH PROMOTION STAGNATES OR DECLINES: THE CASE FOR CONTINUOUS STRENGTHENING OF HEALTH PROMOTION SYSTEMS [current concerns 2-016]

 

7 October 2025 / current concerns 2-016

 

[This article may be freely published provide the credit/authorship is retained. We’ll appreciate receiving a reference/link to the publication] 

 

WHEN HEALTH PROMOTION STAGNATES OR DECLINES: THE CASE FOR CONTINUOUS STRENGTHENING OF HEALTH PROMOTION SYSTEMS

-          by Dr. Uzodinma Adirieje, FAHOA

 +2348034725905 (WhatsApp) / EMAIL: druzoadirieje2015@gmail.com

 CEO/Programmes Director, Afrihealth Optonet Association (AHOA) – CSOs Network and Think-tank

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INTRODUCTION

Health promotion—the science and art of enabling people to increase control over their health—has been widely acknowledged as a cornerstone of modern public health. It goes beyond curative care to emphasize prevention, empowerment, and supportive environments. However, despite global recognition of its importance, health promotion efforts often stagnate or even decline in certain contexts. This reality poses significant risks to societies struggling with growing burdens of noncommunicable diseases (NCDs), infectious outbreaks, climate-related health impacts, and systemic health inequities. Understanding the reasons for such stagnation, its consequences, and strategies for revitalization is therefore critical for health systems and communities.

 

WHY DOES HEALTH PROMOTION STAGNATE OR DECLINE?

 

1. Weak Policy Commitment

Health promotion requires political will, intersectoral collaboration, and long-term investment. In many countries, particularly in low- and middle-income settings, governments prioritize curative health services that deliver visible, short-term results over preventive strategies whose benefits are less immediate. This imbalance sidelines health promotion programs and reduces their sustainability.

 

2. Inadequate Funding and Resource Constraints

A major driver of stagnation is chronic underfunding. Health promotion is often seen as a “soft” investment compared to the more tangible infrastructure of hospitals, drugs, and equipment. Limited budgets result in insufficient training of health educators, weak communication campaigns, and inadequate community outreach. Over time, this lack of investment erodes momentum and diminishes impact.

 

3. Fragmented Implementation and Institutional Weakness

Even when policies exist, poor coordination among ministries, agencies, and community stakeholders hinders effectiveness. For example, promoting healthy diets requires collaboration between health, agriculture, education, and trade sectors—yet siloed approaches lead to duplication, confusion, or outright neglect. Similarly, weak governance structures, corruption, or poor monitoring systems can stall progress.

 

4. Competing Health Priorities and Emergencies

During health crises such as pandemics or humanitarian emergencies, resources and attention are often diverted away from long-term health promotion. For instance, the COVID-19 pandemic shifted focus toward testing, treatment, and vaccination, leaving preventive and educational campaigns underfunded and disrupted. In fragile health systems, such diversions can permanently derail ongoing health promotion initiatives.

 

5. Cultural and Social Resistance

Health promotion often requires behavior change, which can encounter resistance from entrenched social norms, cultural practices, or economic realities. When communities perceive health messages as incompatible with their way of life—or when interventions fail to be culturally sensitive—programs lose credibility and effectiveness, leading to disillusionment and eventual decline.

 

6. Commercial and Structural Determinants of Health

The global influence of industries producing tobacco, alcohol, sugary beverages, and processed foods undermines health promotion. Aggressive marketing campaigns often counteract health messages, especially in vulnerable populations. Without strong regulatory frameworks, commercial interests overpower health education and erode public trust in health promotion campaigns.

 

CONSEQUENCES OF STAGNATION OR DECLINE

 

When health promotion efforts stagnate or decline, societies experience both immediate and long-term consequences.

 

a. Increased Burden of Preventable Diseases: Without sustained campaigns on vaccination, nutrition, hygiene, and lifestyle choices, preventable diseases rise, straining health systems and increasing mortality.

 

b. Exacerbation of Inequalities: Vulnerable populations—such as rural communities, low-income households, and marginalized groups—lose access to the knowledge and resources needed to protect their health, widening social and economic inequities.

 

c. Reduced Community Engagement and Trust: Health promotion thrives on participation and empowerment. When programs fade, communities may feel neglected, leading to distrust in health systems and poor uptake of future initiatives.

 

d. Economic Costs: Preventable diseases increase healthcare expenditure, reduce workforce productivity, and constrain national development. The cost of inaction in health promotion often surpasses the investment required to sustain it.

 

REVITALIZING HEALTH PROMOTION

 

The decline or stagnation of health promotion is not inevitable. Several strategies can re-energize efforts:

 

1. Strengthening Political and Policy Commitment

Governments must elevate health promotion within national health agendas, framing it as a critical investment in sustainable development. Policies should integrate health promotion across sectors such as education, transport, agriculture, and urban planning. Legislative measures, such as tobacco control laws or sugar taxes, can reinforce healthier environments.

 

2.  Sustainable Financing

Dedicated funding streams—whether from government budgets, international aid, or innovative financing mechanisms—are crucial. Embedding health promotion into universal health coverage (UHC) packages ensures it is not sidelined during resource allocation.

 

3. Building Strong Institutions and Partnerships

Robust health promotion requires cross-sectoral collaboration and multi-level governance. Partnerships between government, civil society, academia, and the private sector can mobilize resources, amplify reach, and enhance accountability. Empowering local governments and communities ensures interventions are context-specific and sustainable.

 

4. Harnessing Technology and Media

Digital tools and social media platforms provide cost-effective avenues for health education and behavior change campaigns. Mobile health (mHealth) applications can support chronic disease management, vaccination reminders, and lifestyle interventions, especially in younger, tech-savvy populations.

 

5. Community Participation and Empowerment

Sustainable health promotion cannot be imposed; it must be co-created with communities. Culturally appropriate approaches that respect local practices, values, and beliefs foster ownership and increase uptake. Training community health workers, peer educators, and local leaders strengthens trust and ensures continuity.

 

6. Regulating Harmful Commercial Practices

Governments should implement policies to reduce the influence of industries that promote unhealthy products. Bans on misleading advertising, plain packaging for tobacco, and taxation of sugary beverages are proven tools. Aligning health promotion with the broader agenda of addressing social determinants of health strengthens resilience against corporate interference.

 

CONCLUSION

 

Health promotion is a linchpin for building healthier societies, preventing disease, and achieving equity in health outcomes. Yet, when it stagnates or declines, the ripple effects are profound—ranging from rising disease burdens to weakened community trust. The reasons for stagnation are complex, spanning political, financial, institutional, social, and commercial domains. However, revitalization is possible through strong policy commitment, sustainable funding, cross-sectoral collaboration, community empowerment, and regulation of harmful commercial influences. Ultimately, societies cannot afford to neglect health promotion. As the global community faces interlinked challenges of NCDs, pandemics, climate change, and inequality, health promotion must remain dynamic, resilient, and central to public health practice. Its decline is not just a setback for health systems but a reversal of social progress. Ensuring its continuity is therefore both a moral and developmental imperative.

 

 

Dr. Uzodinma Adirieje is an environmental health researcher with Afrihealth Optonet Association (AHOA), focused on linking ecosystem health and human well-being in Nigeria. He is a global health practitioner, development expert, and civil society leader whose work sits at the critical nexus of biodiversity, health, and climate change. He serves as the Chief Executive Officer of AHOA, a pan-African civil society network advancing sustainable development through advocacy, policy dialogue, and grassroots interventions. With over two decades of experience, Dr. Adirieje has championed the understanding that biodiversity is essential for human health - supporting food security, disease regulation, clean water, and resilient livelihoods. His leadership promotes integrated approaches that address environmental degradation, climate change, and poverty simultaneously. Through AHOA, he leads multi-country initiatives on climate change, ecosystem restoration, renewable energy, universal health coverage, and climate-smart agriculture, while advocating for stronger governance and inclusive community participation. At national, regional, and global levels, Dr. Adirieje engages with governments, international organizations, and civil society to drive policies linking health and environment. His work underscores that safeguarding biodiversity is not only an ecological necessity but also a cornerstone of global health and sustainable development in Africa and the Global South.