Health promotion in Colombia and its scope within the complex political context in the country (1990-2019)

Abstract

This paper examines the scope of health promotion within the Colombian political sce-nario in the light of the guidelines set forth in the Ottawa Charter of 1986. It also addres-ses the political nature of the health promotion strategy in the context of public health, healthy public policies, and the concepts of politics, power, and political power. All of this takes into account the prerequisites or conditions for health defined in the Ottawa Charter, which are peace, education, shelter, food, income, a stable ecosystem, social justice, and equity, as well as five action means, namely, the formulation of healthy public policies, the creation of supportive environments, the strengthening of community action, the development of personal skills, and the reorientation of health services. At the national level, we present the regulation of decentralization, the 1991 Constitu-tion, the 1993 health sector reform and its associated transitions, changes in the economic model, war, violence, drug trafficking, poverty, inequity, and territorial inequalities as forces that have influenced the political aspect of health promotion in Colombia since its adoption in 1992. On the international level, the impact of globalization, the neolibe-ral tendency, the recommendations of the World Health Organization (WHO), and the conceptual and operational changes of the concepts of Health Promotion and Primary Health Care are described.