Title: NATIONAL PUBLIC HEALTH PRIORITIES AND EDUCATIONAL NEEDS
1NATIONAL 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
2Public Health is
- The science and art
- of preventing disease,
- prolonging life and
- promoting health through organized efforts of
society - Acheson Report, 1988
3Public Health 1 cauld be defined as
- multidisciplinary
- population-based
- action oriented
- community targeted
- democracy-based
4Public 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
-
5Public Health 2
- Second definition emphasize
- Priority of state regulation
- Concept from the top level
- Small priority in private health services
6FROM CORE PH FUNCTIONS TO CORE TEACHING CURRICULUM
- Core PH Functions
- Core System Competencies
- Core Individual
- Competencies
- Core Teaching
- Curriculum
7ESSENTIAL PH FUNCTIONS/SERVICES
- Terminology
- Essential/core PH functions/services
- are fundamental
- in defining PH and meeting PH goals
- Essential Core
- Functions Services
8COMPETENCIES
- Competency
- The ability to perform an integrative task
- Knowledge, skills and abilities of organisation
or system members
9Competency Based Educational Planning
Knowledge
Attitude
Skills
10COMPETENCIES
- Terminology
- Competencies being fundamental
- in defining PH and
meeting - PH goals
- Essential Core
- Functions Services
11CORE PH FUNCTIONS
- United States
- England
- Canada
- Australia
- WHO
- WHO Western Pacific Region
- Pan American PH Organisation
- Serbia
12Core 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
13CORE PUBLIC HEALH FUNCTIONS Public Health
Function Steering Committee, USA, 1994
14ESSENTIAL 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
15CORE PH FUNCTIONSEngland, 2002
- Health surveylance, monitoring and analysis
(outbreaks, epidemics, risks) - Establishing, designing, managing health
promotion programs. - Enabling and empowering communities, , citizens
to promote health and reduce inequalities. - Creating , sustaining cross-governmental and
inter-sectorial partnership to improve health,
reduce inequalities. - Ensuring compliance with regulations and lows to
protect and promote health - Developing and maintening a well educated
multidisciplinary public health workforce - Ensuring effective performance of NHS services in
inproving health, preventing disease, reducing
inequalities - Research, development, evaluation and innovation
- Quality assurance for public health functions
16CORE PH FUNCTIONSWHO, 2002
- Prevention, surveylance and control of
communicable and non-communicable disease - Monitoring the health situation
- Health promotion
- Occupational health
- Protecting environmental
- Public health legislation and regulation
- Public health management
- Specific public health services
- Personal health care for vulnerable and risk
populations
17CORE PH FUNCTIONSWHO Western Pacific Region,
2002
- Health situation monitoring and analysis
- Epidemiological surveylance/ disease prevention
and control - Development of policies and planning of PH
- Strategic management of health systems and
services for population health gains - Regulation and enforcement to protect PH
- Human resources development and planning in PH
- Health promotion, social participation and
empowerment - Ensuring the quality of personal and
population-based health services - Research, development of innovative PH solutions
18CORE PH FUNCTIONSPan American PH Organisation,
PAHO, 2002
- Monitoring, evaluation, analysis of health status
- PH surveylance, research, control of risks and
threats to PH - Health promotion
- Social participation in health
- Development of policies, institutional capacity
for regulations and enforcement in PH definition - Strenghtening institutional capacity for planning
and management in PH - Valuation and promotion of equitytyable access to
health services - Human resource development and training in PH
- Quality assurance in personal and population
based services - Research in PH
- Reduction of impact of emergencies on the health
19CORE PH FUNCTIONS Advisory Committee on
Population Health, ACPH, Canada, 2001
- Population health assessment
- Health surveillance
- Health promotion
- Disease and injury prevention
- Health protection
20CORE PH FUNCTIONSAustralia 2002
- Assess, anlyze and communicate population health
needs, expectations - Prevent and control communicable and
non-communicable disease, injuries through risk
factor reduction, education, screening,
imunisation - Promote healthy lifestyles and behaviours through
action with individuals families, communities
and wider society - Promote, develop and support heakthy public
policy including legislation, regulation and
fiscal measures - 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 - Strenghten communitoes and build social capital
through consultation, participation and
empowerment - Promote, develop, support and initiate actions
which ensure safe and healthy environment - Promote, develop and support growth and
development through all life stages - Promote, develop and support actions to improve
the health status of Aboriginal and Torres Strait
Islander people and other vulnerable groups
21CORE PH FUNCTIONS Serbia, 2003
- Health Promotion
- Disease prevention
- Health protection
- Surveylance
- Population health assessment
- Intersectorial collaboration
22Six 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
23Core 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
24Core 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
25Core 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
26Core 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
27Core 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
28Core 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
29FIVE LONG RECOGNIZED CLASSICAL CORE AREAS OF PH
1. Biostatistics 2. Epidemiology 3. Social and
behavioral sciences 4. Environmental sciences 5.
Health services management
30CORE 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
31RELEVANT 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
32RELEVANT 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
33RELEVANT 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
34RELEVANT 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
-
35Core 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
36EIGHT 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
37EIGHT 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
38CONCLUSIONS
- 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)