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June, 2016

Volume 6, Issue 1


Importance of a global strategy for the International Network of Health Promoting Hospitals and Health Services (HPH) Clin Health Promot 2016; 6:3-4
A good strategy bridges the gap between the situation today and the future goals and vision

Raffaele Zoratti, Ida RK Bukholm, Jerneja Farkas-Lainscak, Susan Frampton, Bozena Walewska-Zielecka, Manel Santiñà, Jürgen Pelikan, Hanne Tønnesen

About the authors:

Governance Board of the International Network for Health promoting Hospitals and Health Services 2014-2016.

Why a global HPH strategy?

Having a strategy serves the purpose of focusing. Having a strategy helps to select a few, tangible and specific areas that should be improved in order to reach the concrete goals or guiding vision. The Global HPH strategies, past and new, are not just a nice pieces of paper or a collection of fancy buzz-words, but rather a strong and relevant tool with clear actions and clear measurable elements that outline the key practical steps towards fulfilling the overall goal of HPH.

The overall HPH goal is better health gain by improving the quality of health care, the relationship between hospitals and health services, the community and the environment, and the condition for and satisfaction of patients, relatives, and staff (1).

According to the HPH constitution, HPH “shall works towards incorporating the concepts, values, strategies and standards or indicators of health promotion into the organizational structure and culture of hospitals and health services” (2).

In general, implementation is easier said than done and a major challenge in real life. For this reason, it might well be difficult to know exactly what to do to, how to do it, who should do it, when and where to do it and so on, in order to achieve successful integration. In the health care setting, systematic implementation is crucial to reaching out to all patients and staff in order for them to individually benefit from effective health promotion, which of course in turn benefits both the organization and society as a whole.

Consequences of insufficient implementation

If only a minority of our patients and staff receives health promotion programs, then these would often tend to be the strongest, and those that already are characterized by more health and less needs for health promotion to begin with.

Those with the highest level of needs, however, hold the greatest potential for better health gain, but simultaneously they are all too often more silent and not as visible – especially when it comes to patients with very unhealthy lifestyle and poor socio-economic conditions. These groups rarely have a strong patient organization backing them and they are very rarely the ones to loudly require health promotion activities themselves in order to get a better health gain.

For that reason, it is truly paramount to implement systematic identification of needs for health promotion to all patients and staff according to e.g. the HPH DATA Model (3) - followed by systematic delivery of related health promotion activities to those in need. By such a simple need-triggers-action method, those with the highest need and most potential for improvement get the most services (4). In this way, the hospitals and health services of HPH can reach out to the otherwise un-reachable, socio-economically challenged groups and truly harvest the many great effects of patient-centered health promotion.


It is curious to note that the origins of the word “strategy” actually relate to war and its leadership, as the art of planning and directing overall military operations and battle movements (or the plan itself). Today, we hear it over and over in organisational contexts, regarding: A plan of action designed to achieve a long-term or overall aim (5)

Many more detailed definitions have been developed, as one might imagine, but usually the gist of it is similar to the above. If the mission is the aim of your daily activities and the vision is what you want to obtain in the future, then the strategy should be the practical steps that would take you closer to the vision.

How is the global HPH strategy developed?

Over time the global HPH strategy has supported different elements of the implementation towards the ambitious goal of better health gain. The elements have always been related to the mission and objectives of the HPH Constitution, the obligations outlined in the National/Regional HPH Network agreement with the International HPH, and the Letter of Intent that all HPH members have signed.

The global strategy is presented and recommended by the Governance Board and approved by the General Assembly. It usually runs for three years, and the fulfillment is evaluated closely and through the mandatory progress reports every second year, which are completed by all National/Regional HPH Networks and HPH Task Forces.

The first HPH strategy was developed for 2009-10 after a very long process (6). It followed the HPH Constitution from 2008 and the priorities given by the General Assembly, which then tasked the Governance Board with the developmental phase, in order to detail specific success criteria, activities, goals and monitoring.

The Governance Board spent many working hours to develop those – and already for the following HPH Strategy, it was decided to involve an international expert in development of organizations and change management, Mr. Tune Hein, who has since then offered in-kind support of the strategic work of the HPH Network.

The structure and content of the global HPH strategy over time

The HPH strategy has common areas of priority for both Governance Board, National/Regional HPH Networks and HPH Task Forces; however, the activities are different. Most often, the Governance Board has the International focus, while the National/Regional HPH Networks have a more local focus and the HPH Task Forces have a thematic focus.

The strategy is related as well as limited to a specific time period, because the relevance and needs for focusing on specific subjects change over time:




Quantitative Growth; Partnerships & Alliances; Standards & Indicators (in cluding qualitative growth) (6)

Growth & Member Care; Visibility & Publication: Partners & Affiliated Members; Qualitative Growth, Overall Implementation of HPH Strategy (7)

WHO-HPH Standards & Indicators; Teaching & Training; Communication & Advocacy; Advancement of Clinical Health Promotion Research; Overall Implementation of HPH Strategy (8)

New areas of priorities in the upcoming global HPH strategy?


WHO-HPH standards; capacity & Awareness; Development and Sustainability

The new strategy has many new sub-elements, including:

  • updated WHO Standards with the newest evidence and coverage of other health services than hospitals;

  • local HPH day to increase awareness

  • clarification of the responsibility and role of the national/regional coordinators;

  • stakeholder analyses

  • HPH member benefits


For the first time, the strategy also directly outlines the level of individual hospital and health services members, who are not yet part of an established National/Regional Network. In this way the new global HPH strategy includes all HPH members and levels and supports the overarching goal of a better health gain for patients, staff and community as well as the environment.


(1) HPH Constitution (
(2) World Health Organization; Groene O (ed) Manual for implementation of health promotion in hospitals 2010
(3) Tønnesen H, Svane JK, Lenzi L, et al: Handling Clinical Health Promotion in the HPH DATA Model. Clin. Health Promot. 2012; 2:5-11
(4) Tønnesen H, Christensen ME, Groene O, et al: An evaluation of a model for the systematic documentation of hospital based health promotion activities: results from a multicentre study. BMC Health Services Research 2007; 7:145
(6) HPH Strategy 2009-10 (
(7) HPH Global Strategy 2011-2013 (
(8) HPH Global Strategy 2013-2015 (

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