Lesson 16 · What are the opportunities for improving young people's health?
Health promotion in Australia II: the Ottawa Charter and partnerships with communities
Lesson 15 established that Australia acts on the conditions that produce health, not only on the people living in them. This lesson gives you the tool it uses to do that. The Ottawa Charter is the single most examinable framework in this course, and it is also the one most often reproduced as a memorised list of five phrases with nothing underneath. The difference between those two outcomes is whether you can say what each action area actually changes — and who has to be at the table for it to work.
A council is worried that teenagers in its area do almost no physical activity. It has $200,000 and a year. It builds an outdoor gym in the main park: good equipment, professionally installed, free to use, opened by the mayor with a photograph in the local paper.
Eighteen months later it is almost unused. The equipment is fine. The park is fine. Nothing is broken.
Write down at least four reasons it might be empty — and make yourself get to four, because the first two are easy and the useful ones come later. Then answer the question that matters: what should the council have done before it spent the money?
- Name and explain the five action areas of the Ottawa Charter, and say what each one changes.
- Classify a real Australian strategy into its action area, and recognise when one strategy spans several.
- Explain the three strategies — enable, mediate, advocate — and how they differ from the action areas.
- Explain why reorienting health services is the action area most often misunderstood.
- Justify why partnership with a community changes what a strategy achieves, using the difference between consultation and control.
- Evaluate a health promotion initiative by asking which action areas it uses and which it leaves empty.
- Ottawa Charter for Health Promotion — the 1986 World Health Organization charter setting out five action areas and three strategies for health promotion.
- Build healthy public policy — using legislation, regulation, taxation and organisational policy to make the healthy option the default.
- Create supportive environments — shaping the physical, social and economic settings where people live, work, learn and play.
- Strengthen community action — supporting communities to set their own health priorities and act on them.
- Develop personal skills — building the knowledge and capabilities people need to exercise control over their health.
- Reorient health services — shifting the health system's focus and funding from treating illness towards preventing it.
- Enable — giving people the resources and opportunity to reach their health potential.
- Mediate — bringing competing interests together and reconciling them in the interests of health.
- Advocate — speaking and acting publicly to make health a political and social priority.
- Partnership — working with a community as a decision-making participant rather than as the recipient of a programme.
- Community consultation — asking a community for its views before a decision is made by someone else.
- Community control — the community governing the organisation and setting its priorities itself.
The Ottawa Charter was adopted in 1986 and remains the framework Australian health promotion is written around. Its five action areas are not five kinds of campaign. They are five different levels at which you can intervene, and the reason the framework endures is that a strategy using only one of them is usually the one that fails.
| Action area | What it changes | Australian example |
|---|---|---|
| Build healthy public policy | The rules and the prices — what is permitted, what is required, what things cost. Works on everyone at once, whether or not they have heard of it | Tobacco excise and plain packaging; mandatory bicycle helmets; compulsory folate fortification of bread flour; alcohol licensing restrictions |
| Create supportive environments | The settings people are in — physical, social and economic — so the healthy action is convenient, safe and normal | Shaded, fenced playgrounds; safe cycleways and footpaths; canteen nutrition policies in NSW schools; smoke-free outdoor dining areas |
| Strengthen community action | Who decides — the community sets its own priorities and holds the resources to act on them | Aboriginal Community Controlled Health Organisations; local youth advisory groups; community-run sporting and social clubs |
| Develop personal skills | What individuals know and can do — health literacy, refusal skills, help-seeking, cooking, first aid | PDHPE and Health and Movement Science in schools; first aid training; resources teaching young people how to access mental health services |
| Reorient health services | What the health system spends its time and money on — moving effort from treating illness towards preventing it, and making services acceptable to the people who need them most | Bulk-billed preventive health checks; headspace centres designed around how young people actually seek help; cultural safety training for health staff |
Reorient health services is the one students get wrong, and it is worth being precise. It does not mean building more hospitals, and it does not mean a hospital running an education programme. It means changing what the health system is for and how it operates: funding prevention, moving services out of clinical settings and into the community, and redesigning them so that the people with the greatest need can actually use them. A youth mental health service with no appointment needed, no referral, no cost and a waiting room that does not look like a hospital is reorienting a service. A hospital with a bigger emergency department is not.
Quick check: Which of the following is an example of reorienting health services?
Alongside the five action areas the Charter names three strategies. Students routinely merge the two lists, so hold the distinction clearly: the action areas are where you act; the strategies are how you act. Any action area can be pursued through any of the three.
| Strategy | What it means | Example |
|---|---|---|
| Enable | Giving people the resources, skills and opportunity to achieve their health potential, and reducing the differences that stop them | Funding free transport to a health service in a town with no bus route, so that access is real rather than theoretical |
| Mediate | Bringing conflicting interests together and reconciling them in the interests of health, since health promotion almost always crosses sectors with different priorities | Negotiating between a council wanting revenue from a venue, residents wanting quiet, and health authorities wanting reduced alcohol harm |
| Advocate | Speaking and acting publicly to make health a political and social priority, and to change the conditions that damage it | A public health organisation campaigning for restrictions on gambling advertising during sport |
Mediate is the strategy that explains why health promotion is slow. Almost every structural measure has someone who loses by it — an industry, a revenue stream, a group that values something other than health. The Charter names mediation as a core strategy precisely because it treats that conflict as normal and as something to be worked through, rather than as evidence that the measure is wrong. An answer that recognises this is more sophisticated than one that treats opposition as unreasonable.
Match each Australian measure to its Ottawa Charter action area.
- Healthy public policy
- Supportive environments
- Community action
- Personal skills
- Compulsory folate fortification of bread-making flour
- Building shaded, fenced playgrounds and safe cycleways
- An Aboriginal Community Controlled Health Organisation setting its own priorities
- Teaching young people how to recognise and access mental health support
The outdoor gym is a real pattern and it recurs in every council area in Australia. Read it through the Charter and the diagnosis is immediate: the council used exactly one action area, and it was not the one that was binding.
Building the gym created a supportive environment. That is a genuine action area and a genuine contribution. But consider what it did not do.
- No community action. Nobody asked the teenagers what they wanted, where they would use it, or whether they would use outdoor gym equipment at all. The council decided, then delivered. Young people had no role in setting the priority, so they have no stake in the result.
- No personal skills. A row of resistance equipment is not self-explanatory. Someone who has never used a gym does not know what to do with it, and will not risk looking foolish in a public park in order to find out. A skills element — a few supervised sessions, a coach for a term — costs a fraction of the equipment.
- No healthy public policy. Nothing changed about the rules, the lighting hours, or whether the park is a place teenagers are welcome. In many towns the same council that installs the gym also has signage and security arrangements that treat groups of teenagers as a problem to be moved on.
- No reorientation of services and no mediation. Nobody connected the gym to a school, a club, a youth service or anybody whose job it was to keep it alive after the opening photograph.
And the environment itself may not have been supportive in the way that counts. Is the park reachable without a car? Is it lit? Is it overlooked? Do young women feel safe there at the times they would use it? An environment is only supportive for the people who can safely be in it, which is why "we built the facility" is not the same claim as "we created a supportive environment".
The general rule worth carrying into the exam
When you are asked to evaluate a health promotion initiative, run it against all five action areas and name the empty ones. That single move — identifying what was not done — is worth more marks than describing at greater length what was done, because it demonstrates the framework is being used analytically rather than recited. It is also the answer to Card 01's second question: what the council should have done first is ask, which is community action, and it is free.
True or false: Building a facility is by itself sufficient evidence that a supportive environment has been created.
"Strengthen community action" is the action area that most distinguishes health promotion from health education, and it is the one most often claimed without being done. Lesson 14 introduced the distinction this turns on, and it is worth restating because it decides marks: consultation asks a community what it thinks; control lets it decide.
| Level | What happens | Who holds the decision |
|---|---|---|
| Informing | The community is told what will happen | The agency |
| Consulting | The community is asked for its views, which may or may not be acted on | The agency |
| Partnership | The community shares decisions and resources with the agency | Shared |
| Control | The community governs the organisation and sets its own priorities | The community |
Three reasons this changes outcomes, and all three are defensible in an exam answer.
Relevance. A community knows its own barriers. An agency designing from outside will solve the problem it can see, which is frequently not the binding one — the gym instead of the transport, the pamphlet instead of the opening hours.
Trust and reach. Lesson 14 established that community organisations reach people that formal services do not, because young people who avoid institutions will still talk to someone they know. A programme delivered through a trusted local organisation reaches a different population from the same programme delivered by a government department, even when the content is identical.
Durability. Externally designed programmes end when the funding round ends. Programmes a community owns continue, because the community has a stake in continuing them and the capability to run them stays local.
The most developed Australian expression of this is the Aboriginal Community Controlled health sector, and the Closing the Gap framework agreed with Aboriginal and Torres Strait Islander representatives — a partnership whose explicit premise is that programmes designed for communities without them had not worked, and that shared decision-making is not a courtesy but the mechanism.
Fill the gaps. Type one word in each box.
The Ottawa Charter sets out five action areas and three strategies: enable, and advocate. The action area concerned with shifting the health system from treatment towards prevention is to health services. Where a community governs the organisation and sets its own priorities, the arrangement is called community .
The Ottawa Charter appears in HSC questions more often than any other framework in this module. Three failure modes account for most of the marks lost.
- Listing without applying. Naming the five action areas earns almost nothing on its own. The marks are in what each one does in the specific situation the question gives you. If your answer would read the same for any health issue, it is a list.
- Forcing all five. Not every initiative uses every action area, and pretending otherwise produces invented examples. It is stronger to say that an initiative used three and to name the two it left empty, because that is an evaluation. Card 06 is the model.
- Confusing the action areas with the strategies. Enable, mediate and advocate are not action areas. Writing "the campaign used the action area of advocacy" signals the framework has been half-learned, and it is easy to avoid once the two lists are separated.
The strongest answers do one more thing: they connect the Charter back to Lesson 15. The five action areas are the socio-ecological approach made operational. Three of the five — policy, environments, community action — act on conditions rather than on individuals. One, personal skills, is the behavioural approach retained in its proper place as a component rather than the whole. And reorienting health services is the biomedical system being asked to look upstream. The Charter is not a separate topic from Lesson 15; it is the same argument with instructions attached.
Text description
- Two parts, one above the other.
- Above, a box labelled health promotion, with the five action areas of the Ottawa Charter beneath it: build healthy public policy, create supportive environments, strengthen community action, develop personal skills, and reorient health services.
- Each is annotated with the question it answers: what are the rules, what are the settings, who decides, what do people know, and what is the health system for.
- Below, a four-rung ladder of community involvement rising from informing at the bottom, through consulting and partnership, to control at the top, with the decision-holder marked at each rung as the agency, the agency, shared, and the community.
Activities · put the method to work
Choose a real Australian health promotion initiative aimed at young people. Good candidates include headspace, the Life Education programme, a state road safety campaign for young drivers, a school-based mental health programme, or a local council youth activity programme.
Describe it accurately in four or five sentences, from its own material and from one independent source. Record both.
Work through all five action areas. For each one, give the specific evidence that the initiative uses it, or write "not used". Do not force a fit — an empty row is a finding.
Place it on the ladder from Card 07. Were young people informed, consulted, partners, or in control? Quote the evidence you are using, because organisations describe themselves generously.
Write one recommendation that would fill the most important empty action area, and name who would have to act and what it would cost, at least roughly.
Finish with the judgement: does the initiative's biggest weakness lie in an empty action area, or in the rung it occupies on the ladder? Those are different diagnoses and they lead to different recommendations, so say which one you are making.
Odd one out. Three of these are Ottawa Charter action areas. Which one is not?
Return to Card 01. The council still has $200,000 and a year, and it has asked you to design the programme instead. It has one condition: you may not spend more than half the budget on physical infrastructure.
Start with community action. Describe exactly how you would find out what young people in this area want, who you would ask, and how you would avoid hearing only from the ones already involved in organised sport.
Design across at least four action areas, with a rough cost for each component, adding to $200,000.
Name the mediation you will need. Who will object, on what grounds, and what would you offer them? At least one objection should be one you think is reasonable.
Say how it survives you. What is still running in three years when the funding and the staff have gone, and what makes that true?
The last step is the real test. Most health promotion programmes for young people end when their funding round ends, and a design that has no answer to step 4 has reproduced the problem it was written to solve — which is why Card 07 put durability alongside relevance and trust rather than after them.
Explain how the action areas of the Ottawa Charter are used to promote the health of young people in Australia.
Explain requires the relationship, not the list. The structure that earns marks here is one action area per paragraph, each with a named Australian example aimed at young people, and a sentence on what that action area changes that the others do not.
Plan: one-sentence statement of what the Charter is; five short paragraphs, each area with a youth-specific example and its distinctive contribution; close on why the areas are used together.
Healthy public policy: minimum purchase ages for alcohol, tobacco and vapes, graduated licensing for young drivers, and mandatory helmet laws — measures that change the environment for every young person whether or not they have heard of them. Supportive environments: canteen nutrition policies, safe cycleways and lit parks, and smoke-free school grounds. Community action: youth advisory groups and Aboriginal Community Controlled organisations setting their own priorities. Personal skills: PDHPE and Health and Movement Science, first aid training, and help-seeking education. Reorienting health services: headspace, designed around how young people actually seek help — no referral, no cost, and not resembling a clinic.
No single area is sufficient. Policy changes the rules but not whether a young person knows how to act within them; personal skills raise capability but cannot remove a cost or a distance; and a facility that nobody helped design is frequently unused. Used together, each covers what the others cannot reach.
The Ottawa Charter, adopted by the World Health Organization in 1986, sets out five action areas for health promotion, and Australian strategies aimed at young people draw on all five. Building healthy public policy changes the rules and prices that apply to every young person regardless of their knowledge or intentions: minimum purchase ages for alcohol, tobacco and vaping products, graduated licensing schemes that restrict passengers and night driving for provisional drivers, and compulsory bicycle helmet laws. These act on the whole population at once, which is their distinctive contribution, and they reach young people who have never encountered a health message. Creating supportive environments shapes the settings young people are actually in, making the healthy option convenient, safe and normal: nutrition policies governing school canteens, smoke-free school grounds, lit and overlooked parks, and safe cycleways that make active travel realistic rather than theoretical. Strengthening community action shifts who decides, and it is the area most often claimed and least often done: youth advisory groups with a genuine budget, and Aboriginal Community Controlled Health Organisations, which are governed by the communities they serve and set their own priorities. Its contribution is relevance and durability, because a community identifies the barrier that actually binds and continues the work after external funding ends. Developing personal skills builds what individuals know and can do, through PDHPE and Health and Movement Science in schools, first aid training, and resources teaching young people how to recognise a mental health problem and how to access help. Reorienting health services changes what the health system is for and how it operates, and headspace is the clearest Australian example: youth mental health services delivered without referral, without cost and in settings deliberately unlike a clinic, because the barrier for young people was never only the availability of treatment but the acceptability of the way it was offered. These areas are used in combination rather than separately because each covers what the others cannot. Policy changes the rules but not whether a young person knows how to act within them; personal skills raise capability but cannot remove a cost, a distance or an unsafe route; and a facility built without the involvement of the young people it is for is frequently left unused however well it is equipped. The most effective Australian initiatives for young people therefore combine several action areas and, critically, involve young people in the decisions rather than only in the consultation — which is the difference between a programme designed for a community and one designed with it.
A council builds an outdoor gym in a public park to increase physical activity among local teenagers. Eighteen months later it is almost unused. Evaluate the initiative using the Ottawa Charter, and recommend how it should have been designed.
Evaluate requires a judgement supported by criteria. The Charter supplies the criteria, so the structure is: what the initiative did well, what it left out, and a judgement with a recommendation. Starting with a fair account of the strength is not politeness — an evaluation that finds only fault reads as a complaint.
Plan: credit the supportive environment genuinely; work the four empty areas in order of importance; interrogate whether the environment was even supportive; then judge and recommend.
Community action is the critical omission: no young person was involved in deciding what was needed or where, so the council solved the problem it could see rather than the one that binds. Personal skills is the next: unfamiliar equipment in a public place is not self-explanatory, and few teenagers will risk looking incompetent in order to learn. Healthy public policy was untouched, including whether the park is a place teenagers are actually welcome. And nothing reoriented any service or connected the gym to a school, club or youth worker with a continuing role.
Even the supportive environment claim deserves scrutiny. An environment is supportive only for those who can safely and practically be in it: whether the park is reachable without a car, whether it is lit, whether it is overlooked, and whether young women would feel safe there at the times they would use it. "We built the facility" is not the same claim as "we created a supportive environment".
Assessed against the Ottawa Charter, the council's initiative used one action area competently and left four empty, which accounts for its failure. Creating supportive environments was genuinely addressed: the equipment is free, publicly accessible and permanent, and removing the cost barrier to physical activity is a real contribution that no campaign could substitute for. The omissions, however, are decisive. The most important is strengthening community action. No young person appears to have been involved in deciding what was needed, where it should go, or whether outdoor gym equipment was wanted at all; the council consulted nobody and therefore solved the problem it could see rather than the one that was binding, which might have been transport, cost, safety after dark, or simply having somewhere to be with friends. Because young people had no role in setting the priority, they also have no stake in the outcome. The second omission is developing personal skills: a row of resistance equipment is not self-explanatory to someone who has never used a gym, and few teenagers will risk appearing incompetent in a public park in order to learn, so a small investment in supervised sessions or a coach for a term would have cost a fraction of the equipment and made it usable. Third, no healthy public policy was built — nothing changed about lighting hours, signage, or whether groups of teenagers are treated as welcome in that park rather than as a problem to be moved on, and in many council areas those two policies actively contradict each other. Fourth, no service was reoriented and no mediation occurred: the gym was connected to no school, club or youth service with a continuing responsibility for it, so nothing sustained it once the opening had been photographed. Even the supportive environment claim warrants scrutiny, since an environment is supportive only for those who can safely and practically be in it: whether the park is reachable without a car, whether it is lit and overlooked, and whether young women would feel safe using it at the times they would want to. My judgement is therefore that the initiative was not poorly executed but poorly designed, and that its failure was predictable from the Charter before any money was spent, because a single action area was carrying the entire strategy. The recommendation follows directly. The council should have begun with community action, which is also the cheapest step: working with young people from the outset, including those not already involved in organised sport, to identify what would actually increase their activity. It should then have designed across at least four action areas — the facility, a skills component to make it usable, a policy component ensuring young people are welcome in the space, and a partnership with a school, club or youth service that gives somebody a continuing role once the funding ends. Spending less on equipment and more on the people around it would almost certainly have produced a better result from the same $200,000, and would have satisfied the Charter's central premise that health promotion is done with communities rather than delivered to them.
Multiple choice · 5 questions
MC 1. The Ottawa Charter was adopted by the World Health Organization in:
- A. 1978
- B. 1986
- C. 1997
- D. 2005
MC 2. Compulsory folate fortification of bread-making flour is an example of:
- A. developing personal skills
- B. reorienting health services
- C. building healthy public policy
- D. strengthening community action
MC 3. Which of the following is a strategy of the Ottawa Charter rather than an action area?
- A. Mediate
- B. Create supportive environments
- C. Develop personal skills
- D. Reorient health services
MC 4. A youth health service is redesigned so that it requires no referral, charges nothing and operates from a shopfront rather than a clinic. This best demonstrates:
- A. developing personal skills
- B. building healthy public policy
- C. strengthening community action
- D. reorienting health services
MC 5. A council surveys young people about a proposed skate park, then makes the final decision itself. On the ladder of community involvement this is:
- A. consultation, because the decision remains with the agency
- B. partnership, because young people were asked
- C. community control, because the community's views were collected
- D. informing, because the council told young people about the proposal
Short answer · exam style
SA 1. Remember Band 3 Name the five action areas of the Ottawa Charter and give one Australian example of each. (5 marks)
SA 2. Understand Band 5 Explain how the Ottawa Charter action areas are used to promote the health of young people in Australia. (5 marks)
SA 3. Evaluate Band 6 A council builds an outdoor gym to increase teenage physical activity and it is barely used. Evaluate the initiative using the Ottawa Charter and recommend a better design. (6 marks)
📖 Comprehensive answers (click to reveal)
Multiple choice: 1 → B. 2 → C. 3 → A. 4 → D. 5 → A.
Activity 1 guidance: The instruction not to force a fit is the part that decides whether this activity teaches anything. Almost every initiative genuinely uses two or three action areas, and the temptation is to write a sentence for all five so the table looks complete — which produces invented evidence and trains exactly the habit that loses marks. An empty row is a finding, and naming it is the evaluation. On step 3, expect a gap between how an organisation describes its youth involvement and what the evidence supports: most describe themselves as working in partnership with young people, while the documented practice is usually consultation, because young people are asked for views but hold no budget and no vote. headspace is the most instructive case, since its youth reference groups sit genuinely higher on the ladder than most, and comparing it with a council programme shows the ladder discriminating rather than flattering everyone. On the final judgement, the distinction matters: an empty action area is fixed by adding a component, while a low rung on the ladder is fixed only by giving away decision-making power, which is harder, cheaper and much rarer.
Activity 2 guidance: The budget constraint is doing deliberate work — it forces the money towards people rather than equipment, which is where the evidence says it should have gone. Strong designs typically spend around a quarter on a facility that young people asked for, a substantial share on a coach, youth worker or club partnership for at least a year, something on lighting or access, and a real amount on the consultation itself, since doing that properly requires going to where young people are rather than issuing a survey. On step 1, the best answers recognise that consulting through schools and sporting clubs systematically misses the young people who are least active, which is the population the programme exists for; reaching them means approaching youth services, shopping centres, or existing informal groups. On step 3, the reasonable objection is the one students find hardest to write and the one that most demonstrates understanding of mediation: nearby residents objecting to noise and late-night gathering are not being unreasonable, and a design that acknowledges this and offers something concrete — agreed hours, a location further from housing, involving residents in the decision — is applying the Charter rather than reciting it. Step 4 is where most answers thin out: durability requires an organisation with a continuing reason to run the programme, which usually means an existing club, school or youth service, and a design whose answer to step 4 is "the council will review it" has not answered it.
SA 1 (5 marks): One mark per action area correctly named with a valid Australian example. Build healthy public policy — tobacco excise, plain packaging, minimum purchase ages, helmet laws, folate fortification [1]. Create supportive environments — school canteen nutrition policies, safe cycleways, lit parks, smoke-free outdoor areas [1]. Strengthen community action — Aboriginal Community Controlled Health Organisations, youth advisory groups, community sporting clubs [1]. Develop personal skills — PDHPE and Health and Movement Science, first aid training, help-seeking education [1]. Reorient health services — headspace, bulk-billed preventive health checks, cultural safety training [1]. An example placed under the wrong action area earns nothing, and the two most common misplacements are putting an education campaign under supportive environments and putting hospital expansion under reorienting health services.
SA 2 (5 marks): The Charter identified as the 1986 WHO framework of five action areas [1]. At least four action areas named with examples that are specific to young people — graduated licensing, school canteen policy, youth advisory groups, PDHPE, headspace — rather than general population examples [2]. What each named area uniquely changes, so that the areas are distinguished rather than merely listed [1]. The combination argument: no single area is sufficient, because policy does not build capability, capability does not remove cost or distance, and a facility nobody helped design goes unused [1]. Answers that reproduce the five phrases with general examples and no youth specificity typically sit at two to three marks however accurate they are.
SA 3 (6 marks): Credit given for the action area genuinely used, creating supportive environments, with the cost barrier identified as a real contribution [1]. Community action identified as the critical omission, with the consequence explained — the council solved the visible problem rather than the binding one, and young people have no stake [1]. Personal skills identified, with the reason unfamiliar equipment goes unused [1]. At least one further omission named from healthy public policy, reoriented services or mediation, with its consequence [1]. The supportive environment claim itself interrogated — access without a car, lighting, safety, whether young women would use it [1]. An explicit judgement plus a recommendation naming sequence, actors and the reallocation of money, ideally identifying the failure as one of design rather than execution [1]. An answer that lists the four omissions without ranking them, or that offers no recommendation, cannot reach the top band because neither weighing nor recommendation has occurred.
Five action areas, five questions. What are the rules? Build healthy public policy. What are the settings? Create supportive environments. Who decides? Strengthen community action. What do people know? Develop personal skills. What is the health system for? Reorient health services. Those five questions are faster to recall than the five official phrases and lead to the same content.
Three strategies, and they are not action areas. Enable gives people the resources and opportunity. Mediate reconciles competing interests, and is the reason health promotion is slow rather than evidence that it is going wrong. Advocate makes health a public and political priority. Putting these among the action areas is the commonest structural error in answers on this dot point.
Reorienting health services is not building more hospitals. It is changing what the system is for — funding prevention, moving services into the community, and redesigning them so the people with the greatest need can actually use them. headspace is the example worth knowing.
Evaluate by naming the empty areas. The outdoor gym used one action area out of five, and the one it used was not the binding constraint. Identifying what was not done earns more than describing what was, and it is the move that turns the Charter from a list into an instrument.
And the partnership principle underneath all of it: consultation asks, control decides. Relevance, trust and durability all improve as a community moves up that ladder, which is why the Aboriginal Community Controlled sector and the Closing the Gap partnership are the reference cases in Australian practice.
Finally, tie this back to Lesson 15: the five action areas are the socio-ecological approach made operational. Three of the five act on conditions, one keeps the behavioural approach in its proper place as a component, and one asks the biomedical system to look upstream.
Lessons 17 and 18 move to the other global framework now shaping Australian practice — the United Nations Sustainable Development Goals, and how they are being used to improve health.
Mark lesson as complete
Tick when you've finished the practice and review.