School of Public Health, Queensland University of Technology, Queensland, Australia.
Glob Health Promot. 2013 Jun;20(2):22-9. doi: 10.1177/1757975913490427.
The Ottawa Charter is undeniably of pivotal importance in the history of ideas associated with the establishment of health promotion. There is much to applaud in a charter which responds to the need to take action on the social and economic determinants of health and which seeks to empower communities to be at the centre of this. Such accolades tend to position the Ottawa Charter as 'beyond critique'; a taken-for-granted 'given' in the history of health promotion. In contrast, we argue it is imperative to critically reflect on its 'manufacture' and assess the possibility that certain voices have been privileged, and others marginalized.
This paper re-examines the 1986 Ottawa Conference including its background papers from a postcolonial standpoint. We use critical discourse analysis as a tool to identify the enactment of power within the production of the Ottawa health promotion discourse. This exercise draws attention to both the power to ensure the dominant presence of privileged voices at the conference as well as the discursive strategies deployed to 'naturalize' the social order of inequality.
Our analysis shows that the discourse informing the development of the Ottawa Charter strongly reflected Western/colonizer centric worldviews, and actively silenced the possibility of countervailing Indigenous and developing country voices.
The Ottawa Charter espouses principles of participation, empowerment and social justice. We question then whether the genesis of the Ottawa Charter lives up to its own principles of practice. We conclude that reflexive practice is crucial to health promotion, which ought to include a preparedness for health promotion to more critically acknowledge its own history.
《渥太华宪章》无疑是与健康促进相关的理念史上的一个重要里程碑。在这样一份宪章中，我们看到了很多值得称赞的地方，它回应了在社会和经济决定因素方面采取行动的需求，并寻求使社区成为这一行动的核心。这些赞誉往往使《渥太华宪章》处于“无可非议”的地位；成为健康促进史上的一个理所当然的“既定事实”。相比之下，我们认为，批判性地反思其“产生过程”并评估某些声音是否被赋予特权，而其他声音则被边缘化，这一点至关重要。
本文从后殖民主义的角度重新审视了 1986 年的渥太华会议及其背景文件。我们使用批判话语分析作为一种工具，以确定在渥太华健康促进话语的产生过程中权力的实施。这一做法使人们注意到在会议上确保特权声音占据主导地位的权力，以及用来“自然化”不平等的社会秩序的话语策略。
我们的分析表明，为制定《渥太华宪章》提供信息的论述强烈反映了以西方/殖民者为中心的世界观，并积极压制了与之相悖的土著和发展中国家的声音。
《渥太华宪章》拥护参与、赋权和社会正义的原则。那么，我们不禁要问，《渥太华宪章》的诞生是否符合其自身的实践原则。我们的结论是，反思性实践对于健康促进至关重要，健康促进应该准备好更批判性地承认其自身的历史。
