Social conditions

The Importance of the societal context in health promotion and prevention

Health promotion and prevention activities always take place in a political context. Health promotion and prevention, in a larger sense, are therefore also political activities. Depending on the societal context and the political framework, health promotion is sometimes understood to be a social and political responsibility or is, on the other hand, seen as the individual affair of each member of society. Health promotion and prevention are shaped by contextual conditions but also leave their own mark on them and thus contribute to sustainable health promoting conditions. Depending on how the societal context is perceived, assessed or influenced, it plays a crucial role in health promotion and prevention.

The concept of Best Practice developed by Health Promotion Switzerland defines the framework for professional actions and decisions. Societal, socio-economic and cultural contexts as well as value and knowledge dimensions are important factors. Best practice requires good knowledge and careful analysis of the important contextual factors and is deemed to be a prerequisite for successful intervention.

The importance of contextual factors

A contextual analysis is indispensable for identifying the contextual factors that will be important in the planning of a project. The analysis aims at recognizing and assessing all important contextual factors in order to take them into account when implementing a project. The identification of these factors will help in the recognition and control of the forces that may influence a project. Particular interests and potential sources of conflict are more easily identified. Dealing with contextual factors means:

  • active project piloting
  • realistic context assessment
  • identification and use of windows of opportunity

Describing contextual factors and knowing how they influence interventions also provides valuable experience and insight for other interventions. However, caution is required when transferring knowledge and experiences from one particular project to another context, i.e. when making generalizations. Contexts vary considerably and a comparative contextual analysis is recommended in order to identify similarities and differences - and to factor them in when transferring experiences.

Identification of contextual factors

The Context Check grid provided by the Best Practice concept is a necessary aid for a systematic analysis of all relevant contextual factors. Systematic scanning questions concerning factors on the local, regional and national level are provided. For the analysis of political factors, the following questions are important:

  • What degree of acceptance does the theme have with political or other groups? Is there opposition to the theme and, if so, why?
  • Who (individuals, groups, organizations) can be expected to provide practical support?
  • Are the interests of the political powers known? Are you familiar with the opponents’ arguments?
  • Which alliances are needed for tackling which themes and questions?

Leadership questions regarding health promotion and prevention need to be asked, e.g.: Is anybody already advocating a particular theme? Who can be approached and won over as a promoter in terms of power, expertise and finance? How can leadership be established and strengthened?

Thinking systematically about the important factors heightens awareness for contextual conditions: feasibility assessment is realistic - resistance, conflicts and new chances are detected and networking opportunities and multiplication of good ideas are not overlooked.

Bibliographical references

  • Broesskamp-Stone, Ursel (2009). Gute, viel versprechende, beste Praxis? Der Best-Practice-Rahmen für Gesundheitsförderung und Prävention. In: Kolip, Petra; Müller, Veronika (Hg.) Qualität von Gesundheitsförderung und Prävention. Handbuch Gesundheitswissenschaften, S. 115-136. Bern: Huber.
  • Health Promotion Switzerland (Ed.) (2010). Best Practice. A normative framework for optimal health promotion and disease prevention. Berne: Health Promotion Switzerland

Why you would disregard these aspects

  • You are strongly focused on professional background and give less importance to contextual factors.
  • You are less interested in political and economic frameworks and are therefore not really giving it much thought.

What you have to gain

  • Thinking about the political, socio-economic and cultural context will help you to make better use of existing framework conditions in achieving your aims.
  • You recognize opposition and barriers early on or even manage to avoid them.
  • You assess more realistically your project’s feasibility.

What you can actually do

  • Use the different aspects of the Context-Check developed by Health Promotion Switzerland for their concept of Best Practice as support in a systematic assessment of your context.
  • Make a careful analysis of the political landscape in which your project takes place and identify the key persons that are relevant for the success of your project.

Questions for critical reflection

  • Which societal and political factors are particularly important for your project?
  • In your actual context, which factors promise to help your projects and which ones may become obstacles?
  • Which factors can you possibly exploit in favour of your project?