Health promotion has been widely described as a new and promising paradigm for health services. The emphasis in a comprehensive approach to care and prevention, the comittment to quality of life as a main goal and the assumption of community participation as a fundamental tool for services planning and monitoring are its main foundations. Despite the expressive production on health promotion, little have been discussed, however, on the necessary philosophical shifts this approach introduces in the way health practices are to be planned and evaluated. The objective of the present essay is to identify these changes and their consequences for health practices in general and evaluation procedures in particular. Philosophical Hermeneutics, Heidegger's ontology and Gadamer's approach to the Aristotelian concept of practical wisdom conform its interpretive framework. The main argument is that evaluation shall have its focus on the meaning of health practices for human development, beyond (and by means of) their technical objectives. Theoretical and practical implications of this philosophical perspective for evaluation procedures are also pointed out.
Health promotion; Assessment; Health care; Philosophy