2 T he International Network of Health Pro- Pro-moting Hospitals and Health Services (HPH)
2.6 Phase 5: Restructuring, globalizing & extending the international network (2006-)
Table 14: Milestones of HPH development in phase 5
Phase 5: Restructuring, globalizing & extending the international network (2006-2011)
2006- Introduction of a General assembly & a Governance Board for the International Network 2008- Association “International Network of Health Promoting Hospitals & Health Services (HPH)”
2008- Extension of scope to other health care organizations and internationalization of network 2008- Task Force Smoke-Free-Health Services
2009- Task Force Alcohol and Alcohol Interventions 2010- Task Force HPH and Environment
Phase 5: Restructuring, globalizing & extending the international network (2006-2011)
2010 Memorandum of Understanding of International HPH Network with WHO-EURO
2011 Journal: Clinical Health Promotion. Research and best practice for patients, staff & community
Phase 5, which is still ongoing, is characterized by an increasing formalization and profes-sionalization of HPH.
On the level of the international HPH network, phase 5 is characterized by significant de-velopments, which are partly caused by a temporary shift in WHO-Euro’s policy towards the network. While HPH, as well as other networks initiated by WHO-Euro (e.g. the European Network of Health Promoting Schools), had received strong symbolic and partly also material support until 2005 (including, in the case of HPH, running the network secretariat between 2001 and 2005), WHO-Euro now expected the networks to become independent and to exist on their own.
For HPH, support from WHO had so far been an important argument in the dissemina-tion of the concept. As a reacdissemina-tion to the risk of losing this support, efforts were started to re-establish HPH as an international association, and to seek an agreement with WHO-Euro on areas of cooperation. For the first time in HPH, an interim steering committee of the network was established in 2004 to support the preparations of these important steps, and a first for-mal election of steering committee members was held in 2006. A Constitution was developed, which finally allowed establishing HPH as an international association according to Swiss law in 2008.
With the HPH Constitution, the aims and contents of HPH networking saw a further spec-ification. According to the Constitution, the mission of the international HPH network is to
“work towards incorporating the concepts, values, strategies and standards or indicators of health promotion into the organizational structure and culture of the hospital / health service. The goal is better health gain by improving the quality of health care, the relationship between hospitals / health services, the community and the environment, and the conditions for and satisfaction of patients, relatives and staff. […] The International HPH Network shall pro-mote and assist the dissemination of the concept of health promotion in hospitals and health services […] and support implementation within countries and regions, internationally, through technical support to members and the initiation of new national / regional networks.”
(HPH Network 2008)
As strategies to reach these aims, the Constitution describes the following:
To provide leadership on matters critical to health promotion in hospitals and health services and engaging in partnership where joint action is needed
To shape the research agenda and stimulate the generation, translation and dissemina-tion of valuable knowledge
To set norms and standards and promote and monitor their implementation
To articulate ethical and evidence-based policy options
To provide technical support, catalyze change and build sustainable institutional capac-ity
To monitor the development of health promotion in hospitals and health services.Building up on the HPH Constitution, a Memorandum of Understanding was signed be-tween WHO-Euro and the international HPH network as an agreement on specific contents of cooperation. In addition to the documents mentioned beforehand, the MoU formulates as additional goals that
HPH network members know and discuss WHO policies and strategies;
HPH documents, strategies and action plans reflect WHO policies and strategies;
Resulting outcomes, tools and materials are in line with WHO policies and strategies;
Both parties inform each other of relevant policies and strategies.(HPH Network 2009)
The newly developed HPH Constitution also provided, at least in principle, the option for other types of health services than hospitals to join the HPH Network. And it clearly specified the rights and duties of the different agencies that were now active in HPH – from the inter-national level with its statutory bodies to the network secretariat and the conference secretariat, as well as the network task forces (of which several new ones were founded during phase 5) down to the national and regional networks of HPH which the Constitution describes as cor-porate members of the international network. The Constitution and a related agreement that has to be renewed every 3 years describes clearly, and for the first time in the history of HPH, the rights and duties of the national / regional networks in the international HPH network.
Another important international development during phase 5 are several attempts to strengthening the research agenda for HPH as a reaction to critique on limited evidence on the HPH approach which was published in the international literature (see e.g. Whitehead 2004). One of these attempts was the PRICES-HPH evaluation project (which provided the empirical data for this dissertation project; compare project description in the introduction) that took place during this period. The other was the launch of an official scientific journal of the HPH network, “Clinical Health Promotion”, which was issued in 2011 for the first time.
On the level of national / regional HPH networks, the initiation of new national / regional HPH networks increased again during phase 5, as compared to phase 4, but, with an average foundation of 2 new networks per year, remains still clearly below the level of phases 2 and 3.
As is shown in Table 15 below, of the 11 networks founded between 2006 and 2011, only 2 were European, while 4 were Asian, 3 were located in Northern America and one in Australia.
These figures given, Europe is clearly no longer spearheading the growth of HPH, at least not in terms of new national / regional networks.
Table 15: National / regional HPH networks founded in phase 5 of network development
Network Year of foundation
Foundation related to EPHP
Direct Indirect None
1. Taiwan 2006
2. Spain – Catalonia 2007
3. Italy-Calabria 2007
4. USA-Connecticut 2008
Network Year of foundation
Foundation related to EPHP
Direct Indirect None
5. Canada-Ontario 2008
6.
USA-Pennsylvania 2009
7. Australia-Victoria 2010
8. Korea 2011
9. Singapore 2011
10. Thailand 2011
11. Slovenia
Phase 5 also led to an increasing formalization of cooperation between the international and the national / regional HPH networks, as the roles, rights and duties of the national / regional networks were, for the first time, specified in an official network document, i.e. the HPH Constitution and a related agreement between the international and the national / re-gional HPH networks. Accordingly, the national / rere-gional networks are responsible for put-ting the HPH mission into practice by supporput-ting strategic thinking and planning, the imple-mentation of health promotion, the development of communication systems and training and education. The networks are expected to develop a strategy and action plans for implementa-tion, to recruit new member hospitals and health services and to collect the international membership fee from their members. In addition, a periodic progress report should be sub-mitted to the Governance Board of the International HPH network10.
All in all, phase 5 can be described as a period of increasing formalization during which HPH took more and more signs of a formal organization (a purpose; statutory bodies and thus a certain network hierarchy; and membership regulations that provide clear inclusion and exclusion criteria).
10 This requirement came to life only in 2011.