Final orientation for new graduates on the highest attainable standard of health


Purpose
The purpose of this paper is to discuss the importance of taking responsibility for our own self-care as fundamental to achieving optimum healthcare at all levels: family, community and country. However, for self-care to work at its best, the support of the government and the national medical and public health workforce are required in addition to increased facilities that ensure the development and long-term maintenance of a person’s health status. Moreover, inter-disciplinary government policy, strategy and resource support should be placed as a central part of the national healthcare development system.


Design/methodology/approach
It is a commentary piece of work from own long experience in working with the World Health Organization.


Findings
The value of self-care and individual responsibility in achieving one’s own good health ultimately results in improved national and global health standards.


Originality/value
This commentary explores the ideas and concepts on ways and means of leading people to think and act toward achieving their own optimum health in order to lead a socially and economically productive life and ultimately achieve “the highest attainable standard of health,” a WHO objective.



Introduction
Everyone, whether rich or poor, would like to be in good health. Governments, too, desire a healthy society as sickness and illness are a financial burden on national economies. When considering the means of achieving good health, both people and governments alike think of developed healthcare facilities and healthcare staff; it is expected that the presence of hospitals, health centers, medical clinics, doctors, nurses and health workers would assure the health of the community. This is true to a large extent. These facilities and qualified persons do provide medical treatment and care to cure sickness and can render rehabilitative and restorative care for disabled persons. Health staff can also provide advice, guidance and support to all who seek it.
It is, therefore, expected that in an attempt to ensure the good health of the nation, governments place a primary emphasis on the development of medical infrastructure, as well as the production of more doctors, nurses and other medical personnel. However, the result of this practice is that the global health budget continues to expand, sometimes exponentially.
The situation becomes more critical when people are more educated, as their knowledge leads to demands for better quality healthcare facilities and services. At the same time, the number of sick or ill and disabled people continues to increase unabatedly. As a consequence, among other things, there are more old people, with chronic non-communicable diseases, who need increasingly expensive long-term and specialized care. As a result, the cost of medical treatment and healthcare is skyrocketing.
Rapid advancement in medical and public health science and technology through extensive efforts in research and development have also contributed to the rapid increase of healthcare costs. New technology for medical interventions as well as for the production of new medical products is commercially promoted very widely through various channels of communication to win people's perceptions and decisions on their choice of healthcare, leading people to demand higher quality, more efficient and effective care: the care that is always more expensive.
Longer life spans due to improved medical treatment and care are increasingly leading to lengthier periods of morbidity, sickness and disability requiring long-term care creating a burden on the national health and social care systems. Furthermore, our planet is full of health risks which are also increasing and accelerating the rate of sickness in the community. The key question in this situation is how we may be able to stride forward to reach the goal of good health for all people in real terms.
First, it is necessary to agree on what health means and what we expect in the context of good health for all.
The highest standard of health is defined in the constitution of the WHO as "a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity" [1]. To many people, this definition of health seems to be too ideal.
However, for many "thinkers," this WHO definition is viewed as an aspirational health goal for academics and health experts to create "an ideal perspective" of health for the future. However, it is important to note that the world cannot have only one standard of health for the whole world or for all countries in the world. Each country will need to work out its frame of reference for the highest attainable standard of health. Ideally, a country-specific standard of health should be individually defined and used as the basis for the development and implementation of its national health policy, strategy and program. Such a standard should also be regularly reviewed and changed appropriately according to the changing levels of development of the country concerned.
In this way, the WHO definition of health may be used as a source of inspiration, motivation and encouragement and a means of achieving the highest attainable standard of health for all in spite of the prevailing disease or infirmity [2].
Nevertheless, whilst charting the course toward reaching "The Highest Attainable Standard of Health," one must accept the current reality that there is no one entirely without disease or infirmity, sickness or illnesses [3] as humans beings have to undergo a natural path of life and experience sickness, illness or pathological deterioration of the body.
Previously, when world leaders were not satisfied with the population's "health gain," all countries decided to double their efforts to further improve the level of health of their populations and further narrow the health gap among groups of populations, between and within countries. Previously, all involved countries collectively set a social goal of "Health for All" at their 30th WHA in 1977 [4], calling for the attainment of "the level of health that can permit all people in the world to lead a socially and economically productive life." This is another level of the "attainable standard of health," which needs to be realized and incorporated into health policy by individual countries within their own specific, context and capacity. "Health for All" also implies that people must be adequately satisfied with their life within their own status, situation and capacity. Crucially, the "Health for All" concept accepts that in reality, there will be no one free from suffering due to sickness, illnesses and disability. However, through the right approach in public health, people can still reach the level of the highest attainable standard of health or ideally, the level of health that can permit them to lead a socially and economically productive life. This can be achieved through the core principles of the "Primary Health Care Approach" [5]. The principle of equity and social justice in health must be applied equally with strong and unwavering determination, regardless of social and economic status, and political beliefs. Naturally, health development must also be on the agenda of other development sectors, such as agriculture, environment, industry and Final orientation for new graduates education because health development is really a multi-sectorial affair and all levels of a communityindividual, family, community, and countryshould realize that individual health is the basic component of community and population health.
Most important in this process is the active participation and involvement of all people of all walks of life in health development activities whose aim should be toward achieving self-reliance as a long-term health goal whereby individuals are able to decide and efficiently manage their own health affairs at their own initiative and then extend this to family and community care levels too.
Even though health is universally accepted as a fundamental right of every human being, resulting in the demand for good health as part of a government's policies and social infrastructure, the fact is that individuals own and possess their own health. This makes good health an individual responsibility. With this acceptance of responsibility, people will appreciate the value of being in good health, strive for it and protect it as long as they live.
However, it is true that not everyone has the appropriate information, knowledge or proper tools at their disposal to act in this manner. Thus, it is an undisputable role of the government, health personnel and other concerned institutions or persons to help develop the most suitable set of such information and knowledge for use by people in pursuing their self-care; the care that can be expanded and that will lead to effective family and community healthcare, that can significantly contribute to the healthy population of the country.
Community health workers and community health volunteers, and those, among others, who are working from the grassroots, have a critical responsibility and role in the process of educating and empowering people in the community in order to attain proficiency or literacy and capacity in health development and management, especially at primary care level, at their own initiative.
One important impediment in achieving this goal is that the number of sick people continues to increase and the cost of medical treatment and care continues to skyrocket unabatedly. This is in spite of the significant increase in people's knowledge and awareness of the need to be in good health and increased practices of health promotional and protective measures. And yet, the efforts to prevent sickness are inadequate and healthcare facilities are still very much overwhelmed with the burden of the sick or ill and disabled people.
By following the principle that prevention is cheaper and better than cure, increased investment in health development from a human and financial perspective is required in order to build up an effective public healthcare infrastructure including interventions and measures to achieve good health for all people through a proactive health strategy; the strategy that directs special attention to health risks and health determinants in the development process. This process requires well-coordinated and synchronized multi-sectorial and multi-disciplinary actions including strong public health leadership at all levels.
Health for all people will be realized only when all people of all walks of life are working tirelessly for health; and this can be achieved once individual responsibility for achieving this goal is acknowledged. People should not depend on the government or health personnel to make them healthy but should take the initiative themselves.
In the current situation, taking advantage of the rapid advancement in information and communication technology (ICT) is critically essential. All the same, people must protect themselves from the misuses of ICT advancement such as the irresponsible commercial promotion of spurious health information or health products that ultimately leads to the exploitation of people.

Conclusion
Above all, it is worth bearing in mind that the human body is a wonderful thing; it is naturally created and has naturally acquired the capacity to resist sickness or illness if it is properly protected and maintained. Most importantly, human beings must not do or inflict any harm to their own body such as smoking tobacco, drinking alcohol, abuse of drugs and exposing oneself indiscriminately to environmental pollutions. Furthermore, at times of poor health, seeking excessive medical intervention is unnecessary. Effective self-care, individually and collectively, is a pre-requisite for good health of all people, and for the highest attainable standard of health.