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Title: NATIONAL PUBLIC HEALTH PRIORITIES AND EDUCATIONAL NEEDS


1
NATIONAL PUBLIC HEALTH PRIORITIES AND EDUCATIONAL
NEEDS
  • Linas Å umskas MD, PhD
  • Assoc. Professor
  • Faculty of Public Health
  • of Kaunas University of Medicine
  • Kyiv, July 1, 2004

2
Public Health is
  • The science and art
  • of preventing disease,
  • prolonging life and
  • promoting health through organized efforts of
    society
  • Acheson Report, 1988

3
Public Health 1 cauld be defined as
  • multidisciplinary
  • population-based
  • action oriented
  • community targeted
  • democracy-based

4
Public Health 2 cauld be defined as
  • Those activities of government
  • agencies or community groups not
  • normally done by the private sector
  • that improve the health status of
  • the community or of individuals in
  • the community.
  • BJ Cassens,1992
  • Preventive Medicine and Public Health

5
Public Health 2
  • Second definition emphasize
  • Priority of state regulation
  • Concept from the top level
  • Small priority in private health services

6
FROM CORE PH FUNCTIONS TO CORE TEACHING CURRICULUM
  • Core PH Functions
  • Core System Competencies
  • Core Individual
  • Competencies
  • Core Teaching
  • Curriculum

7
ESSENTIAL PH FUNCTIONS/SERVICES
  • Terminology
  • Essential/core PH functions/services
  • are fundamental
  • in defining PH and meeting PH goals
  • Essential Core
  • Functions Services

8
COMPETENCIES
  • Competency
  • The ability to perform an integrative task
  • Knowledge, skills and abilities of organisation
    or system members

9
Competency Based Educational Planning
  • Competency TASK

Knowledge
Attitude
Skills
10
COMPETENCIES
  • Terminology
  • Competencies being fundamental
  • in defining PH and
    meeting
  • PH goals
  • Essential Core
  • Functions Services

11
CORE PH FUNCTIONS
  • United States
  • England
  • Canada
  • Australia
  • WHO
  • WHO Western Pacific Region
  • Pan American PH Organisation
  • Serbia

12
Core Functions of PH (Institute of Medicine,
USA, 1988)
  • Assessment/monitoring of the health of
    communities and populations
  • Policy development in collaboration with
    community and government leaders
  • Assurance appropriate and cost-effective health
    promotion and disease prevention services

13
CORE PUBLIC HEALH FUNCTIONS Public Health
Function Steering Committee, USA, 1994

14
ESSENTIAL PUBLIC HEALTH FUNCTIONS (PH Functions
Steering Committee, USA, 1994)
  • Assessment
  • Monitor health status to identify community
    health problems
  • Diagnose, investigate health problems, health
    hazards in the community
  • Policy development
  • Inform, educate, empower people about health
    issues
  • Mobilize community partnerships to identify and
    solve health problems
  • Develop policies and plans that support
    individual and community health efforts
  • Asurance
  • Enforce laws, regulations that protect health,
    ensure safety
  • Link people to needed personal health services
    and assure the provision of health care
  • Assure a competent public health and personal
    health care workforce
  • Evaluate effectiveness, accessibility, quality of
    personal and population-based health services
  • Serving All Functions
  • Research for new insights, innovative solutions
    to health problems

15
CORE PH FUNCTIONSEngland, 2002
  1. Health surveylance, monitoring and analysis
    (outbreaks, epidemics, risks)
  2. Establishing, designing, managing health
    promotion programs.
  3. Enabling and empowering communities, , citizens
    to promote health and reduce inequalities.
  4. Creating , sustaining cross-governmental and
    inter-sectorial partnership to improve health,
    reduce inequalities.
  5. Ensuring compliance with regulations and lows to
    protect and promote health
  6. Developing and maintening a well educated
    multidisciplinary public health workforce
  7. Ensuring effective performance of NHS services in
    inproving health, preventing disease, reducing
    inequalities
  8. Research, development, evaluation and innovation
  9. Quality assurance for public health functions

16
CORE PH FUNCTIONSWHO, 2002
  1. Prevention, surveylance and control of
    communicable and non-communicable disease
  2. Monitoring the health situation
  3. Health promotion
  4. Occupational health
  5. Protecting environmental
  6. Public health legislation and regulation
  7. Public health management
  8. Specific public health services
  9. Personal health care for vulnerable and risk
    populations

17
CORE PH FUNCTIONSWHO Western Pacific Region,
2002
  1. Health situation monitoring and analysis
  2. Epidemiological surveylance/ disease prevention
    and control
  3. Development of policies and planning of PH
  4. Strategic management of health systems and
    services for population health gains
  5. Regulation and enforcement to protect PH
  6. Human resources development and planning in PH
  7. Health promotion, social participation and
    empowerment
  8. Ensuring the quality of personal and
    population-based health services
  9. Research, development of innovative PH solutions

18
CORE PH FUNCTIONSPan American PH Organisation,
PAHO, 2002
  1. Monitoring, evaluation, analysis of health status
  2. PH surveylance, research, control of risks and
    threats to PH
  3. Health promotion
  4. Social participation in health
  5. Development of policies, institutional capacity
    for regulations and enforcement in PH definition
  6. Strenghtening institutional capacity for planning
    and management in PH
  7. Valuation and promotion of equitytyable access to
    health services
  8. Human resource development and training in PH
  9. Quality assurance in personal and population
    based services
  10. Research in PH
  11. Reduction of impact of emergencies on the health

19
CORE PH FUNCTIONS Advisory Committee on
Population Health, ACPH, Canada, 2001
  • Population health assessment
  • Health surveillance
  • Health promotion
  • Disease and injury prevention
  • Health protection

20
CORE PH FUNCTIONSAustralia 2002
  1. Assess, anlyze and communicate population health
    needs, expectations
  2. Prevent and control communicable and
    non-communicable disease, injuries through risk
    factor reduction, education, screening,
    imunisation
  3. Promote healthy lifestyles and behaviours through
    action with individuals families, communities
    and wider society
  4. Promote, develop and support heakthy public
    policy including legislation, regulation and
    fiscal measures
  5. Plan, found manage and evaluate health gain and
    capacity building programs designed to achieve
    measurable improvemnets in health status and to
    strenghten skills, competencies, systems and
    infrastructure
  6. Strenghten communitoes and build social capital
    through consultation, participation and
    empowerment
  7. Promote, develop, support and initiate actions
    which ensure safe and healthy environment
  8. Promote, develop and support growth and
    development through all life stages
  9. Promote, develop and support actions to improve
    the health status of Aboriginal and Torres Strait
    Islander people and other vulnerable groups

21
CORE PH FUNCTIONS Serbia, 2003
  • Health Promotion
  • Disease prevention
  • Health protection
  • Surveylance
  • Population health assessment
  • Intersectorial collaboration

22
Six Core Competencies of PH Professionals(PH
Faculty/Agency Forum, USA)
  • Analytical skills
  • Communication skills
  • Policy/program development skills
  • Cultural skills
  • Basic Public Health Science Skills
  • Management, financial planning skills

23
Core Competencies of PH Professionals(PH
Faculty/Agency Forum, USA)
  • Analytical skills
  • Define PH program
  • Determine apropriate use of data, statistical
    methods for problem identifivcation and solution
  • Select and define variables relevant to PH
    problems
  • Evaluate the data, their quality and gaps
  • Understand how data illuminate ethical, political
    economical sides of PH issues
  • Make relevant inferences from data

24
Core Competencies of PH Professionals(PH
Faculty/Agency Forum, USA)
  • Communication skills
  • Communicate effectively writing and orally
  • Present accurately demographic, statistical,
    program, scientific information for professionals
    and lay audience
  • Solicit inputs from individuals and organisations
  • Advocate for PH programs and resources
  • Leadand participate in groups to address specific
    issues
  • Use media to communicate important public health
    information
  • Make relevant inferences from data

25
Core Competencies of PH Professionals(PH
Faculty/Agency Forum, USA)
  • Policy Development/Program Planning Skills
  • Collect and sumarize data relevant to the issue
  • State policy options
  • Agriculture health, fiscal, administrative,
    legal, social and political implementations of
    each policy option
  • Write a clear and concise policy statements
  • Develop the plan to implement the policy (goals,
    outcomes, process objectives and implementation
    steps)
  • Translate policy into organisational plans,
    structures, programs
  • Identify PH laws, regulations, policies related
    to specific programs
  • Develop mechanisms to monitor, evaluate programs
    for their effectiveness and quality

26
Core Competencies of PH Professionals(PH
Faculty/Agency Forum, USA)
  • Cultural skills
  • Understand forces for cultural diversity
  • Interact sensitively, effectively and
    professionally with persons from diverse
    cultural, socioeconomical, educational,
    professional backgrounds, with persons of all
    ages and preferences
  • Identify the role of cultural and behavioral
    factors in determining disease, in disease
    prevention, health promoting behaviour, and
    service organisation , delivery
  • Develop and adapt approaches to problems that
    take into account cultural diffrences

27
Core Competencies of PH Professionals(PH
Faculty/Agency Forum, USA)
  • Basic PH Science Skills
  • Define, assess and understand health status of
    population, determinants of health and illness,
    factors contributing to health promotion and
    disease prevention, factors influencing the use
    of health services
  • Understand research methods in all basic PH
    sciences
  • Apply the basic PH sciences (behavioral and
    social sciences, biostatistics, , epidemiology,
    environmental PH, prevention of chronic disease
    and injury)
  • Understand the historical development and
    structure of state, local and national public
    agencies

28
Core Competencies of PH Professionals(PH
Faculty/Agency Forum, USA)
  • Financial Planning and Management Skills
  • Develop and present budget
  • Mange programs with budgetary constrains
  • Develop strategies for determining budget
    priorities
  • Monitor program performance
  • Prepare proposals for funding from external
    sources
  • Apply basic human relation skills to the
    management of organizations, resolution of
    conflicts
  • Manage personnel
  • Understand the theory of the organizational
    structure and its relation to organizational
    practice

29
FIVE LONG RECOGNIZED CLASSICAL CORE AREAS OF PH
1. Biostatistics 2. Epidemiology 3. Social and
behavioral sciences 4. Environmental sciences 5.
Health services management
30
CORE CURRICULUM (ASPH, USA, Roemer M., 1999)
  • Basic tools of social analysis
  • Health and disease of population
  • Promotion of health and disease prevention
  • Health care systems and their management

31
RELEVANT FIELDS OF PH TEACHING (ASPHER
Criteria, 2001)
  • Tools for measurement of health of population
  • Main determinants of health in individuals and
    populations
  • 3. Intervention to change health
  • 4. Health policy, advocacy from national to
    global levels

32
RELEVANT FIELDS OF PH TEACHING (ASPHER
Criteria, 2001)
  • 1. Tools for measurement of health of population
  • describtive and etiological epidemiology,
  • epidemiological, statistics techniquesfor
    assesing interventions
  • istruments for measuring health, disease,
    quality of life
  • 2. Main determinants of health of individuals
    and populations
  • environmental and occupational factors
  • socio-economic factors
  • lifestyle, behavior
  • genetic factors

33
RELEVANT FIELDS OF PH TEACHING (ASPHER
Criteria, 2001)
  • 3. Intervention to change health
  • environmental monitoring of physical
    environmental
  • health promotion at population level
  • personal health promotion, behavioural change
  • provision of health services

34
RELEVANT FIELDS OF PH TEACHING (ASPHER
Criteria, 2001)
  • 4. Health policy, advocacy, from national to
    global levels
  • health policy structures
  • structures of public health services
  • health service finance and organisation
  • evaluation of policy and programmes

35
Core Areas and Scope of European Master in
European Public Health (EMEPH) Teaching
Program(ASPHER, 1999)
1. PH in Europe 2. Health policy and
management 3. Epidemiology and biostatistics 4.
Health promotion/health education and social
sciences 5. Environment and health
36
EIGHT FUTURE" AREAS IN PH TRAINING (Committee
on Educating PH Professionals for 21st century,
Institute of Medicine, USA, 2003)
1. Informatics 2. Genomics 3. Communication 4.
Cultural competence 5. Community based
participatory research 6. Global health 7. Policy
and law 8. Public health ethics
37
EIGHT FUTURE" AREAS IN PH TRAINING (Committee
on Educating PH Professionals for 21st century,
Institute of Medicine, USA, 2003)
  • Recommendations
  • Competencies be identified
  • Each area included into PH training
  • Continuing development of knowledge
  • Opportunity for specialisation be offered

38
CONCLUSIONS
  • Essental PH functions in the country be defined
  • 2. Core curriculum of SPH should be based on
  • a) core PH functions (country
    specific)
  • b) core competencies (country
    specific)
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